Citation Nr: 21022607
Decision Date: 04/16/21	Archive Date: 04/16/21

DOCKET NO. 14-10 127
DATE: April 16, 2021

REMANDED

Entitlement to service connection for liver cyst as secondary to service-connected COPD is remanded.

Entitlement to service connection for pancreatic cyst as secondary to service-connected COPD is remanded.

Entitlement to service connection for renal cyst as secondary to service-connected COPD is remanded.

REASONS FOR REMAND

The Veteran served on active duty in the United States Navy from August 1960 until October 1963. 

In March 2015, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record.

This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.902 (c). 38 U.S.C. § 7107 (a)(2). 

This appeal has been before the Board previously, most recently, in September 2020. While there has been substantial compliance with the Board’s prior remand directives, for the reason described below, the Board cannot proceed to adjudication and another remand is now required. Stegall v. West, 11 Vet. App. 268, 271 (1998).  

1. Entitlement to service connection for liver cyst as secondary to service-connected COPD is remanded.

2. Entitlement to service connection for pancreatic cyst as secondary to service-connected COPD is remanded.

3. Entitlement to service connection for renal cyst as secondary to service-connected COPD is remanded.

The claims must be remanded to obtain medical opinions that consider medical literature recently submitted. The Veteran's representative also questioned the adequacy of the most recent medical opinions. The claims are remanded for medical opinions that consider the medical literature submitted by the. 

The matters are REMANDED for the following action:

1. Obtain an addendum medical opinion from an appropriate clinician to address whether the liver, pancreas and kidney cyst conditions are secondary to his service-connected COPD. The opinion provider should be provided copies of all pertinent documents. If the opinion provider determines an opinion cannot be offered without examination of the Veteran, one should be scheduled. 

The examiner must specifically answer the following for the liver, pancreas and kidney cyst disabilities: 

(a) Is it at least as likely as not (50 percent or greater probability) that the condition is proximately due to or caused by his service-connected COPD? 

(b) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s liver cyst condition is aggravated by (any increase in disability) his service-connected COPD? 

In answering the above, the opinion provider must consider, and discuss as appropriate, the article from the International Journal of COPD entitled Managing Comorbidities in COPD submitted by the Veteran in April 2021. 

If the opinion provider determines that a requested opinion cannot be provided without resort to speculation, they must explain why.

2. Confirm that the VA medical opinions provided comport with this remand. Specifically, verify that the standard for the aggravation prong of secondary service connection is any increase in disability, not the standard of beyond the natural progression as noted on the examination form itself. If the wrong standard is used, obtain an addendum opinion that applies the correct standard. 

 

M.E. Larkin

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	M.D. Collins, 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.