Citation Nr: 21013418 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 14-33 764 DATE: March 9, 2021 REMANDED Entitlement to service connection for a right elbow disability, to include tendonitis, is remanded. Entitlement to service connection for a left elbow disability, to include tendonitis, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from October 1992 to October 2012. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In September 2018, the Board remanded this claim to afford the Veteran an addendum medical opinion. The case was again remanded in July 2020 due to non-compliance with the September 2018 remand directives. Unfortunately, the Board must again remand the claim for an adequate VA medical opinion. The Veteran contends that his bilateral elbow disabilities are related to repetitive use in service, including doing pull-ups. See September 2013 Notice of Disagreement. In the July 2020 remand, the Board requested an addendum medical opinion which addressed the Veteran’s lay statements regarding his in-service repetitive activities involving his elbow, specifically to include his pull-ups. A VA addendum medical opinion was obtained in September 2020. The examiner stated that longitudinal medical evidence, including the lay statements of the Veteran regarding the onset and progression of this current symptomatology had been reviewed and considered but based on the objective findings the previously July 2019 VA medical opinion remained unchanged. See September 2020 VA addendum medical opinion. The Board finds that the September 2020 VA addendum medical opinion is inadequate. The examiner failed to address the Veteran’s lay statements regarding the onset and progression of his bilateral elbow disabilities, only stating such had been reviewed. In other words, the examiner merely noted the lay statements were reviewed and did not address whether the repetitive elbow activities, such as pull-ups, were related to his currently diagnosed tendonitis. Dalton v. Nicholson, 21 Vet. App. 23 (2007). Lastly, a Supplemental Statement of the Case (SSOC) was issued in August 2019. Subsequently, additional VA medical records and the additional September 2020 VA addendum medical opinion were associated with the claims file. However, it is unclear if an additional SSOC was issued by the RO. In this regard, an October 2020 SSOC Notice Response is contained in the file. However, any updated SSOC is not associated with the claims file. Accordingly, a remand is required for the issuance of an appropriate SSOC that considers the most recent examinations, VA treatment records, and any other relevant evidence since the last SSOC. 38 C.F.R. § 19.30. As such, the Board remands the claims for a new VA medical opinion from a different examiner to determine the nature and etiology of the Veteran’s bilateral elbow disability and the issuance of a Supplement Statement of the Case (SSOC). The matters are REMANDED for the following actions: 1. Ensure that all outstanding VA treatment records are associated with the claims file. 2. Thereafter, obtain a medical opinion from an appropriately qualified examiner, who has not previously provided an opinion in this matter, to determine the etiology of the Veteran’s currently diagnosed bilateral elbow disability. The claims file and a copy of this remand must be made available to the examiner for review, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated. The need for another examination is at the discretion of the assigned examiner. After a review of the claims file, the examiner is asked to respond to the following: If a diagnosis cannot be provided but the Veteran’s right and/or left elbow disabilities manifest in pain and symptoms that cause functional impairment of earning capacity, then the examiner should consider them a “disability” for the purpose of providing the requested opinion(s) below. (b.) Is the current bilateral elbow disability, to include tendonitis, at least as likely as not related to service, including his repetitive use or activities involving his elbows, such as pull-ups? In providing the requested opinion, consider the Veteran’s description of his in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran’s reported injury and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran’s reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran’s reports generally inconsistent with medical knowledge or implausible? The examiner should provide a complete rationale for each opinion. 3. Thereafter, readjudicate the remanded claims, to include consideration of the additional VA examination reports and treatment records. If the benefits sought on appeal are not granted in full, issue the Veteran and his representative a Supplemental Statement of the Case (SSOC) and provide the Veteran an opportunity to respond. S. Merrick Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Moldawer, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.