Citation Nr: 21022212 Decision Date: 04/15/21 Archive Date: 04/15/21 DOCKET NO. 12-20 982A DATE: April 15, 2021 REMANDED Entitlement to service connection for nephritic syndrome membranoproliferative glomerulonephritis, also claimed as a renal condition, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1990 to February 1994. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a May 2014 Board hearing before a different Veterans Law Judge (VLJ). The Veteran was provided an opportunity for another hearing in February 2021 because the VLJ who conducted the hearing in May 2014 is no longer at the Board. The Veteran was told that if the Board did not receive a response within 30 days from the date of the February 2021 letter, it would be assumed that he did not want another hearing. The Board did not receive a response from the Veteran or his representative. As such, this option is deemed waived. In a March 2017 decision, the Board denied the Veteran’s claim for entitlement to service connection for nephritic syndrome membranoproliferative glomerulonephritis, also claimed as a renal condition. In response to the March 2017 decision denying the claim, the Veteran appealed this decision to the United States Court of Appeals for Veterans Claims (CAVC). In March 2018, the Court granted a Joint Motion for Remand (JMR) filed by the parties, which requested a vacatur and remand of the March 2017 decision addressing the claim. The Board then remanded the issue in August 2018 and May 2020 in accordance with the JMR. The Board finds that the December 2020 addendum opinion regarding the Veteran’s renal condition was not fully responsive to the directives specified in the May 2020 Board remand. Stegall v. West, 11 Vet. App. 268 (1998). The remand directed the examiner to consider and address the Veteran’s reports of (1) in-service fevers and whether they are related to his current renal disability, (2) lay statements of record regarding the Veteran’s physical appearance; (3) August 2011 and August 2014 private physicians’ opinions; (4) the June 1995 general examination, and (5) the Veteran’s claims of exposure to toxins in service. However, the December 2020 opinion does not mention nor address the reports of in-service fevers, the private physicians’ opinions, or the 1995 general examination. The examiner also provided a medical nexus opinion using the wrong legal standard, as all that is required to decide in favor of the Veteran is at least a 50 percent probability, not a greater than 50 percent probability. As such, the Board finds that a new opinion should be provided on remand to address the deficiencies noted above and fulfills the prior remand directives. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s renal condition is at least as likely as not (i.e., a 50 percent or greater probability) related to his service. The clinician must consider the entire claims file, and address the following evidence: (a) Reports of in-service fevers. (b) The detailed lay statements associated with the claims file attesting to the Veteran’s swollen face, hands, and feet after separation from service. (c) The August 2011 private physician’s opinion. (d) The August 2014 private physician’s opinion. (e) The June 1995 general examination. (f) The Veteran’s claimed in-service exposure to toxins such as chlorine, bleach, iodine tablets, pesticides, dead bodies, body parts, dead animals, burning fecal matter, and drinking and showering in bleached water. A cogent rationale must be provided for each opinion proffered, to include reference to any supporting medical literature. The examiner is reminded that the absence of in-service treatment is not fatal to a Veteran’s claim. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Ariasaif, 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.