Citation Nr: 21022345 Decision Date: 04/15/21 Archive Date: 04/15/21 DOCKET NO. 13-25 935 DATE: April 15, 2021 REMANDED The issue of entitlement to service connection for an inguinal hernia is remanded for additional development. REASONS FOR REMAND The Veteran served on active duty from January 1964 to February 1968. His awards include the Vietnamese Service Medal, the Vietnamese Campaign Medal, National Defense Service Medal, and the Rifle Marksmanship Badge. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2011 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In July 2016, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing is of record. In August 2017 and November 2018, the Board remanded the current issue for further evidentiary development. Entitlement to service connection for an inguinal hernia. A remand by the Board confers on the claimant, as a matter of law, the right to compliance with the remand orders. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Failure of the Board to ensure compliance with remand instructions constitutes error and warrants the vacating of a subsequent Board decision. Id. The Board remanded this appeal in December 2020 so that the Agency of Original Jurisdiction (AOJ) could obtain a VA medical opinion, and then readjudicate the Veteran’s claim for service connection for an inguinal hernia. In January 2021, the AOJ issued a supplemental statement of the case (SSOC) continuing to deny the claim. Pursuant to the December 2020 remand, an addendum opinion was obtained in January 2021. In rendering a negative nexus opinion, the examiner reasoned that there was no etiological relationship between urethral discharge, tinea cruris (dermatophyte infection involving the crural fold), and inguinal hernia. As for the Veteran’s military duties, the examiner reasoned that there was no objective documentation of inguinal hernia or chronic abdominal wall injury in-service or within one year of separation service. For these reasons, the examiner determined that his repaired hernia was not related to military activities. However, the examiner ignored the Veteran’s assertions that although he was not diagnosed with an inguinal hernia until 1979, he may have had related issues prior to his diagnosis but did not have money to see a doctor until 1979. The examiner then referenced a recitation of medical literature regarding risk factors but did not discuss how they applied to the Veteran. If VA provides an examination that examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). By issuing an SSOC without obtaining an adequate VA medical opinion, the AOJ did not substantially comply with the Board’s December 2020 remand order. See D’Aries v. Peake, 22 Vet. App. 97, 105 (2008) (holding that only “substantial” rather than strict or exact compliance with the Board’s remand directives is required under Stegall); accord Dyment v. West, 13 Vet. App. 141, 146-47 (1999). Thus, the claim of entitlement to service connection for an inguinal hernia must again be remanded for necessary further development followed by re-adjudication of the claim by the AOJ. The matter is REMANDED for the following actions: Obtain an addendum opinion from an appropriate clinician to determine the nature and the etiology of the Veteran’s inguinal hernia. The contents of the entire electronic claims file, to include a complete copy of this REMAND, must be made available to the designated clinician. The clinician should opine on the following: For the inguinal hernia, is it at least as likely as not that the condition is causally related to service? Please explain why or why not. In rendering his or her opinion, the clinician must consider the Veteran’s contentions that although his service records are silent for any complaints or a diagnosis of an inguinal hernia in service or within one year of separation, and that he was not diagnosed with an inguinal hernia until 1979, he had related issues prior to his diagnosis but did not have money to see a doctor until 1979. The clinician must also consider the March 1965 report of urethral discharge of two days duration, with non-reactive follow up venereal disease research laboratory (VDRL) tests in April 1965 and June 1965, a March 1966 impression of tinea cruris of the groin lasting one week, the Veteran’s conceded exposure to herbicides, and the Veteran’s in-service trauma that included jumping from helicopters, crawling through tunnels, sliding down stairs on a submarine, and carrying his rucksack. The rationale for any opinions expressed must be set forth. If the examiner cannot provide an above opinion without resorting to speculation, he/she should explain why an opinion cannot be provided (e.g. lack of sufficient information/evidence, the limits of medical knowledge, etc.) S.C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Bilstein, 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.