Citation Nr: 21015817 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 14-08 418 DATE: March 18, 2021 REMANDED Entitlement to service connection for blindness is remanded. Entitlement to service connection for glaucoma is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for a traumatic brain injury (TBI) is remanded. Entitlement to service connection for rheumatoid arthritis is remanded. Entitlement to service connection fora right shoulder disability is remanded. Entitlement to service connection for a left shoulder disability is remanded. Entitlement to service connection for a left elbow disability is remanded. Entitlement to service connection for a right elbow disability is remanded. Entitlement to service connection for a right wrist disability is remanded. Entitlement to service connection for a left wrist disability is remanded. Entitlement to service connection for a disability of the right toes is remanded. Entitlement to service connection for a left leg disability is remanded. Entitlement to service connection for a jaw disability is remanded. Entitlement to service connection for a right hip disability is remanded. Entitlement to service connection for a left hip disability is remanded. Entitlement to service connection for a right knee disability is remanded. Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for a right ankle disability is remanded. Entitlement to service connection for a left ankle disability is remanded. Entitlement to service connection for bilateral pes planus is remanded. Entitlement to service connection for a left foot bunion is remanded. Entitlement to service connection for a right foot bunion is remanded. Entitlement to service connection for residuals of a rib fracture is remanded. Entitlement to service connection for a right-hand disability is remanded. Entitlement to service connection for a left-hand disability is remanded. Entitlement to service connection for tonsillitis is remanded. Entitlement to service connection for dizzy spells is remanded. Entitlement to service connection for chronic fatigue is remanded. Entitlement to service connection for pharyngitis is remanded. Entitlement to service connection for allergies/hay fever is remanded. Entitlement to service connection for a respiratory disorder is remanded. Entitlement to service connection for sleep apnea is remanded. Entitlement to service connection for a cardiac disability is remanded. Entitlement to service connection for an ulcer is remanded. Entitlement to service connection for gastritis is remanded. Entitlement to service connection for a gastrointestinal disability, manifested by gas and stomach problems is remanded. Entitlement to service connection for gastroesophageal reflux disease (GERD) is remanded. Entitlement to service connection for a kidney disability is remanded. Entitlement to service connection for a lipoma of the left chest is remanded. Entitlement to service connection for obesity is remanded. Entitlement to service connection for a left arm disability is remanded. Entitlement to service connection for a disability of the left fingers is remanded. Entitlement to service connection for a disability of the right fingers is remanded. Entitlement to service connection for a disability of the left toes is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from October 1975 to August 1976. 1. Entitlement to service connection for blindness is remanded. 2. Entitlement to service connection for glaucoma is remanded. 3. Entitlement to service connection for hypertension is remanded. 4. Entitlement to service connection for a TBI is remanded. 5. Entitlement to service connection for rheumatoid arthritis is remanded. 6. Entitlement to service connection fora right shoulder disability is remanded. 7. Entitlement to service connection for a left shoulder disability is remanded. 8. Entitlement to service connection for a left elbow disability is remanded. 9. Entitlement to service connection for a right elbow disability is remanded. 10. Entitlement to service connection for a right wrist disability is remanded. 11. Entitlement to service connection for a left wrist disability is remanded. 12. Entitlement to service connection for a disability of the right toes is remanded. 13. Entitlement to service connection for a left leg disability is remanded. 14. Entitlement to service connection for a jaw disability is remanded. 15. Entitlement to service connection for a right hip disability is remanded. 16. Entitlement to service connection for a left hip disability is remanded. 17. Entitlement to service connection for a right knee disability is remanded. 18. Entitlement to service connection for a left knee disability is remanded. 19. Entitlement to service connection for a right ankle disability is remanded. 20. Entitlement to service connection for a left ankle disability is remanded. 21. Entitlement to service connection for bilateral pes planus is remanded. 22. Entitlement to service connection for a left foot bunion is remanded. 23. Entitlement to service connection for a right foot bunion is remanded. 24. Entitlement to service connection for residuals of a rib fracture is remanded. 25. Entitlement to service connection for a right-hand disability is remanded. 26. Entitlement to service connection for a left-hand disability is remanded. 27. Entitlement to service connection for tonsillitis is remanded. 28. Entitlement to service connection for dizzy spells is remanded. 29. Entitlement to service connection for chronic fatigue is remanded. 30. Entitlement to service connection for pharyngitis is remanded. 31. Entitlement to service connection for allergies/hay fever is remanded. 32. Entitlement to service connection for a respiratory disorder is remanded. 33. Entitlement to service connection for sleep apnea is remanded. 34. Entitlement to service connection for a cardiac disability is remanded. 35. Entitlement to service connection for an ulcer is remanded. 36. Entitlement to service connection for gastritis is remanded. 37. Entitlement to service connection for a gastrointestinal disability, manifested by gas and stomach problems is remanded. 38. Entitlement to service connection for GERD is remanded. 39. Entitlement to service connection for a kidney disability is remanded. 40. Entitlement to service connection for a lipoma of the left chest is remanded. 41. Entitlement to service connection for obesity is remanded. 42. Entitlement to service connection for a left arm disability is remanded. 43. Entitlement to service connection for a disability of the left fingers is remanded. 44. Entitlement to service connection for a disability of the right fingers is remanded. 45. Entitlement to service connection for a disability of the left toes is remanded. 46. Entitlement to a TDIU is remanded. Issues 1-46: While the Board sincerely regrets the delay, unfortunately, there is no basis for taking jurisdiction of the claims of entitlement to service connection for anorexia, back disability, sore throat, claustrophobia, and a psychiatric disability at this time and the remaining claims cannot be adjudicated until those claims are initially adjudicated. As discussed in the Board’s two prior remands, the Veteran has claimed service connection for anorexia, a back disability, a sore throat, claustrophobia, and a psychiatric disability. He has claimed that his disabilities currently on appeal are secondary or related to these disabilities and, therefore, intertwined. Specifically, an October 2016 Board remand directed the Regional Office (RO) to adjudicate these claims. The RO included these issues in a February 2017 Supplemental Statement of the Case (SSOC) but did not issue a rating decision or Statement of the Case (SOC). Under 38 C.F.R. §19.31(a), an SSOC may not be used to announce a decision on an issue not previously addressed in an SOC. See Mayfield v. Nicholson, 499 F.3d 1317, 1324 (Fed. Cir. 2007) (emphasizing an SSOC is appropriate for readjudicatory purposes, but NOT for original adjudication of decisions or issues. Also, finding 38 C.F.R. §19.31(a) confirms an SSOC may not announce decisions on issues not previously addressed in a preceding SOC). As such, the February 2017 SSOC was not a proper initial adjudication of the anorexia, back disability, sore throat, claustrophobia, and psychiatric disability claims. As the February 2017 SSOC was not a proper initial adjudication of these claims, the April 2020 Board remand specifically ordered that the anorexia, back disability, sore throat, claustrophobia, and psychiatric disability claims must be adjudicated in a Rating Decision. HOWEVER, THE RO HAS FAILED TO TAKE ANY ACTION ON THESE CLAIMS IN VIOLATION OF THE BOARD’S REMAND DIRECTIVES. As such, the Board must remand the case once again to comply with the April 2020 remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). Additionally, the Board notes that the TBI claim was remanded for a VA exam and opinion in the April 2020 remand. He was afforded a VA contract examination and opinion in November 2020. VA-LHI TBI examination, November 2020. However, the examiner provided conflicting answers indicating that the Veteran’s TBI residuals were directly related to service, but also that they pre-existed service and were not aggravated therein. He also failed to address the articles from the Veteran discussing the long-term effects of childhood TBIs or the Veteran’s contentions that his discharge for “immature personality” following his in-service head injury showed a worsening of his pre-existing TBI residuals. In light of these deficiencies, this claim must also be remanded for an addendum opinion. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The matters are REMANDED for the following actions: 1. Issue a RATING DECISION for the claims of entitlement to service connection for anorexia, a back disability, a sore throat, claustrophobia, and a psychiatric disability. (a.) NOTE THAT AN SSOC IS INSUFFICIENT BASED ON 38 C.F.R. § 19.31(a). 2. After completion of the above, send the Veteran’s claims file to an appropriate examiner to provide an addendum opinion regarding the nature and etiology of his TBI residuals. The Veteran may be recalled for examination if deemed necessary. The examiner must address the following: (a.) Did the Veteran’s TBI residuals clearly and unmistakably (undebatable) preexist his service? (b.) If the examiner finds TBI residuals did clearly and unmistakably preexist service, they must opine whether the TBI residuals were clearly and unmistakably not aggravated by service. (c.) If the examiner finds that the TBI residuals either did not clearly and unmistakably preexist service, or were not clearly and unmistakably aggravated by service, they must opine whether the Veteran’s TBI residuals are at least as likely as not related to an in-service injury, event, or disease, including the June 1976 head injury. The examiner should specifically discuss: (1) the Veteran’s normal entrance examination, (2) the June 1976 in-service head injury, (3) the Veteran’s argument that his August 1976 discharge for a personality disorder indicated that his childhood TBI was aggravated by the June 1976 in-service head injury, and (4) the articles submitted by the Veteran regarding the long-term effects of childhood TBI. The term “at least as likely as not” does not mean “within the realm of medical possibility.” Rather, it means that the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of the conclusion (e.g., etiology) as it is to find against the conclusion. YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Moore, 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.