Citation Nr: 21014583 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 14-07 947 DATE: March 15, 2021 REMANDED The claim of entitlement to service connection for a left elbow disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1983 to November 1991, and from February 2003 to February 2006. He also had reserve service between 1991 and 2010. This matter comes to the Board of Veterans’ Appeals (Board) on appeal of a rating decision by a U.S. Department of Veterans Affairs (VA) Regional Office (RO). In June 2017, the Veteran testified in a videoconference hearing before the Board. A transcript of the hearing has been included in the record and has been reviewed. In November 2017 and July 2020, the Board remanded this matter for additional medical inquiry. The case is again before the Board for appellate review. Another remand is necessary. Pursuant to the November 2017 remand, the Veteran underwent medical examination for two claims –a claim of entitlement to service connection for a neck disorder, and for a left arm disorder. The claim regarding a neck disorder was eventually granted. Pursuant to the July 2020 remand, the Veteran underwent medical examination addressing whether a left elbow disorder relates to the now service-connected neck disability. A remand is necessary for issuance of an addendum opinion because the opinions provided – dated in September and November 2020 – are not responsive to the July 2020 remand. In particular, they rely on the assumption that the Veteran does not have a left elbow disorder. Inasmuch as he has been diagnosed with such a disorder during the appeal period, the diagnosed disorder must be addressed. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007) (the requirement of a current disability is satisfied when the claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim). An addendum opinion should also address a new assertion by the Veteran – that his left elbow disorder is secondary to service-connected right elbow disability as well. The matters are REMANDED for the following action: Return the case to the November 2020 VA examiner, or to a suitable substitute, for issuance of an addendum medical opinion. After reviewing the electronic claims file, the examiner should answer the following questions: 1. Is it at least as likely as not (probability of 50 percent or more) that a left elbow disorder is due to or caused by service-connected disability to include neck and right elbow disabilities? 2. If the answer to (1) is negative, is it at least as likely as not that a left elbow disorder has been aggravated (i.e., permanently or temporarily worsened beyond the natural progress) by service-connected disability to include neck and right elbow disabilities? In answering these question(s), accept as true that the Veteran has a left elbow disorder. In a VA report dated in January 2017, a diagnosis of left lateral epicondylitis is noted. The Board must address this diagnosed disorder even if your evaluation indicates that the disorder has resolved since January 2017. The term “at least as likely as not” does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. In rendering the requested opinion, the examiner should note that the Veteran is competent to attest to matters of which he has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should indicate this in the examination report and provide a rationale for that determination. In remanding this case, the Board makes no credibility determination, expressed or implied, at this juncture. (Continued on the next page)   Please explain in detail any opinion provided and the supporting rationale. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Christopher McEntee, 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.