Citation Nr: 21014344 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 16-35 686 DATE: March 11, 2021 REMANDED Whether the severance of service connection for peripheral arterial disease of the left lower extremity (previously claimed as leg condition) was proper, is remanded. Whether the severance of service connection for peripheral arterial disease of the right lower extremity (previously claimed as leg condition) was proper, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1946 to November 1966. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In January 2019, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In April 2019 and again in September 2020, the Board remanded the case for additional development and it now returns for further appellate review. 1. Whether the severance of service connection for peripheral arterial disease of the left lower extremity (previously claimed as leg condition) was proper. 2. Whether the severance of service connection for peripheral arterial disease of the right lower extremity (previously claimed as leg condition) was proper. The Veteran challenges the propriety of the May 2014 decision that severed service connection for left and right lower extremity arterial disease. He seeks restoration of service connection for these disabilities. As explained above, the Board previously remanded this matter multiple times, most recently in September 2020. Unfortunately, the Board must find that another remand is necessary so that VA ensures compliance with the Board’s previous remand instructions. Stegall v. West, 11 Vet. App. 268, 271 (1998). The April 2019 and September 2020 remand directives both instructed the RO to obtain a medical opinion regarding whether it was clear and unmistakable that the Veteran had a current bilateral lower extremity diagnosis that was related to service, to include the substantial amount of lower extremity symptoms and treatment he had in service. While the examination report obtained as the result of the April 2019 remand directive did not use the proper clear and unmistakable standard, the November 2020 opinion and December 2020 addendum opinion did include that standard. However, the Board also instructed the RO in both April 2019 and September 2020 to obtain a medical opinion that included a list of all extant diagnoses relating to the Veteran’s bilateral lower extremities. Regrettably, the November 2020 and December 2020 opinions do not include any significant discussion regarding the current disabilities in the Veteran’s legs. The December 2020 opinion, in particular, merely states that his peripheral arterial disease is clearly and unmistakably unrelated to his in-service lower extremity symptoms and treatment. Neither opinion includes any discussion regarding whether the Veteran has satisfied the diagnostic criteria for any other lower extremity disability. The Board therefore finds that there has not been substantial compliance with its September 2020 remand directives that an examiner “must provide a diagnosis for any and all conditions found extant.” The matters are REMANDED for the following action: 1. Obtain an opinion from a qualified medical professional regarding the Veteran’s current lower extremity diagnoses. The need for an additional in-person examination should be determined by the examiner. The examiner is asked to provide an opinion on the following: (Continued on the next page)   (a.) What is the Veteran’s current diagnosis(es) as it pertains to his bilateral lower extremities? The examiner must provide a diagnosis for any and all conditions found extant. If peripheral arterial disease is the only bilateral lower extremity disability, the examiner must make an affirmative statement indicating it is the only current bilateral lower extremity disability. (b.) Whether it is clear and unmistakable that a current diagnosis in his bilateral lower extremity is not related to the Veteran’s condition treated during service. The examiner is asked to accept that for the purposes of this question, “clear and unmistakable” means that no equally qualified medical professional reviewing the same information would reasonably be able to reach a different conclusion. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Whitelaw, 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.