Citation Nr: 21022553 Decision Date: 04/16/21 Archive Date: 04/16/21 DOCKET NO. 17-58 583 DATE: April 16, 2021 REMANDED Entitlement to service connection for a right ankle disability, to include as secondary to radiation exposure and Gulf War environmental exposure, is remanded. Entitlement to service connection for a left ankle disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure, is remanded. Entitlement to service connection for a low back disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure, is remanded. Entitlement to service connection for a right knee disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure, is remanded. Entitlement to service connection for a left knee disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure, is remanded. Entitlement to service connection for a right hip disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure is remanded. Entitlement to service connection for a left hip disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from June 1992 to June 1998. For his meritorious service, the Veteran was awarded (among other decorations) the National Defense Service Medal, and the Armed Forces Expeditionary Medal. These matters are before the Board of Veterans’ Appeals (Board) on appeal of a June 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In November 2019, the Veteran provided testimony at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is in the Veteran’s file. In March 2020, the Board remanded the claims for additional development. 1. Entitlement to service connection for a right ankle disability, to include as secondary to radiation exposure and Gulf War environmental exposure, is denied. 2. Entitlement to service connection for a left ankle disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure, is denied. 3. Entitlement to service connection for a low back disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure, is denied. 4. Entitlement to service connection for a right knee disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure is remanded. 5. Entitlement to service connection for a left knee disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure, is remanded. 6. Entitlement to service connection for a right hip disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure is remanded. 7. Entitlement to service connection for a left hip disability, to include as secondary to radiation exposure, claimed right ankle disability, and Gulf War environmental exposure, is remanded. The Veteran contends that his bilateral ankle disability, bilateral hip disability, bilateral knee disability and low back disability are related to his active service, and/or secondary to claimed right ankle disability, and Gulf War environmental exposure. In November 2019, the Veteran testified that he was exposed to radiation during service as a surface ship nuclear propulsion plant operator aboard the U.S.S. Enterprise. The matter was subsequently remanded by the Board in March 2020 for further development to determine if he had such exposure, however, it does not appear as if the development was taken by the RO. Moreover, the Board finds that VA examinations and opinions obtained in July 2020 are inadequate for adjudicating the claims on appeal. With respect to the bilateral ankle and low back claims, the examiner determined that the Veteran did not have current disabilities of the ankles and back; however, the examiner did not reconcile prior bilateral ankle and low back disabilities diagnoses that were made by a VA examiner in July 2017. With respect to the bilateral knee and bilateral hip disability claims, the examiner provided negative nexus opinions but did not provide adequate rationales for the opinions. Also, the examinations were conducted without development of the radiation exposure allegation made by the Veteran, which could affect the outcome of the claims. Thus, further remand is required to make sure that the ionizing radiation exposure has been developed and appropriate VA medical opinions are obtained. See 38 C.F.R. § 3.311. The matters are REMANDED for the following action: 1. The AOJ is to complete any required development under 38 C.F.R. § 3.311, and if necessary, sending the Veteran’s case to the Under Secretary of Health for a dose estimate and to the Under Secretary of Benefits for an appropriate medical opinion regarding any ionizing radiation exposure he had while in service. 2. After completing the above development, obtain an opinion as to whether the Veteran’s bilateral ankle, low back, bilateral knee disability and bilateral hip disability are related to his active service, to include radiation exposure and secondary to the Veteran’s claimed right ankle disability. Whether an examination is needed prior to rendering an opinion is left to the discretion of the examiner. The examiner should respond to the following: (a) The examiner should clarify whether the Veteran has current diagnoses of right and left ankle disabilities and a low back disability. If no current diagnosis is found, the examiner should reconcile such a finding with the July 2017 VA medical opinion which shows current diagnoses of the right and left ankle disabilities and a low back disability. (b) For each diagnosed disability of the right and left knee, right and left hip, right and left ankle and low back, the examiner should opine as to whether it is related to in-service injury, event, or disease, to include ionizing radiation while serving as a surface ship nuclear propulsion plant operator, reactor control. (c) If the examiner finds that the Veteran’s right ankle is the only disability that is related to service, the examiner should state whether the Veteran’s bilateral hip disability, bilateral knee disability, left ankle disability, and low back disability are proximately due to, caused by, or aggravated by his claimed right ankle disability. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Henriquez, 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.