Citation Nr: 21020935 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 17-34 961 DATE: April 8, 2021 REMANDED Entitlement to service connection for a right foot condition, to include gout, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from July 1976 to July 1998. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2017 legacy rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In February 2021, the Veteran testified before the undersigned Veterans Law Judge (VLJ) before a virtual videoconference hearing. A transcript of the hearing is of record. The Veteran contends that his current right foot gout had its onset during active duty service and has continued ever since. After review of the record, the Board finds that further development of the evidence is required prior to adjudicating the Veteran’s claim, in accordance with the VA’s duty to assist. In June 2017, the Veteran was afforded two VA examinations to assess the current nature and etiology of his claimed right foot condition. Upon review of each, the examiner diagnosed the Veteran with right foot gout, with an onset in 1994; however, provided an unfavorable opinion as to this condition being etiologically related to the Veteran’s active duty service, rationalizing that the Veteran’s discharge exam had no specification of which joints were swollen, with the Veteran currently reporting intermittent swelling and the current exam revealing minimal swelling. See C&P Exams, June 2017. Nevertheless, the Board finds this opinion to be inadequate for adjudicative purposes, as the examiner improperly relied on the lack of specific medical evidence corroborating complaints or treatments of a right foot condition in-service as a basis for providing the unfavorable opinion. Additionally, the examiner failed to consider and/or discuss the Veteran’s competent and credible lay statements regarding the onset of his symptoms in-service, to include the statement that his reported swollen or painful joints noted on his discharge examination included his right foot pain (see Hearing Transcript, pp.3), to which he has continuously experienced symptoms ever since. Lastly, the Board notes the examiner, herself, specifically noted the onset of the Veteran’s diagnosed right foot gout to be in 1994, which is during the Veteran’s active duty service, however, failed to consider and/or discuss her noted in-service onset in rendering her unfavorable opinion. Therefore, based on the above, the Board finds that the Veteran should be provided an addendum VA medical opinion that adequately addresses the Veteran’s claim, prior to re-adjudication of the claim. Accordingly, a remand is necessary to address the matters discussed above. The matters are REMANDED for the following action: 1. Request the Veteran to identify all medical providers (VA and private) from whom he has received treatment for his gout and obtain any outstanding records and associate them with the Veteran’s claims file. 2. After associating all newly acquired records with the claims file, send the claims file back to the June 2017 VA examiner to provide the Veteran with an addendum VA medical opinion to determine the nature and etiology of the Veteran’s gout. If the June 2017 VA examiner is not available, obtain the necessary addendum opinions from another appropriate clinician. The entire claims file, including a copy of this remand, must be made available to the examiner, and note review of the record in the examination report. Any indicated tests or studies should be performed, and all material relevant evidence should be discussed. All pertinent medical complaints, symptoms, and clinical findings must be reported in detail. The Veteran should be scheduled for another examination if deemed necessary by the person providing the addendum report to address the following: (a) Opine whether it is at least as likely as not (50 percent or greater probability) the Veteran’s gout had its onset during any period of active duty service, or is otherwise etiologically related to his active duty service, to include the in-service complaint of swollen or painful joints on the February 1998 discharge examination. Please note: the examiner must specifically discuss the Veteran’s reports of the complaint of swollen or painful joints found in the February 1998 discharge exam included his right foot pain, with symptoms that have continued ever since service; as well as, discuss the specific notation of the Veteran’s gout having a diagnosed onset of 1994, a period of active duty service, found in the June 2017 VA examinations. (b) Any opinion should include a detailed rationale. The examiner should consider the entire claims file and discuss the Veteran’s lay statements regarding the nature and onset of symptoms. The examiner is advised that the Veteran is competent to report symptoms, and that he is reports must be considered in formulating the requested opinion. (c) If the examiner(s) is unable to offer the requested opinion(s), it is essential that the examiner offer a rational for the conclusion that an opinion could not be provided without resorting to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. See Jones v. Shinseki, 23 Vet. App. 382. (2010). DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Hodges, 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.