Citation Nr: 21023618 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 14-09 230A DATE: April 21, 2021 REMANDED Entitlement to service connection for a bilateral lower limb polyneuropathy disability is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1982 to September 1985 and January 1992 to February 1998. He died in February 2015. The Appellant, the Veteran’s surviving spouse, has been substituted for the Veteran. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an October 2012 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA). In October 2020, the Board remanded this matter for more development. The Board finds that there was not substantial compliance with its prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding that a remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with its remand instructions, and imposes upon VA a concomitant duty to ensure compliance with the terms of the remand); see also D’Aries v. Peake, 22 Vet. App. 97, 105 (2008) (holding that only substantial rather than strict compliance with the Board’s remand directives is required under Stegall). In a January 2021 rating decision, service connection for degenerative disc disease, lumbar spine, L4-5, L5-S-1 (lumbar herniated nucleus pulposus) and for left lower extremity radiculopathy was awarded effective July 18, 2008. Entitlement to service connection for a bilateral lower limb polyneuropathy disability is remanded. The Veteran contended that while he was on active duty in the Air Force that he was repeatedly soaked in aircraft hydraulic fluid from just above his waist to his feet. He reported that he had to wait 8-12 hours before he was released to go back to his barracks, to wash the fluid off his body. See January 2013 Notice of Disagreement. The Veteran’s service treatment records reflect that the Veteran frequently reported leg pain, numbness, tingling, and cramps, during service. See February 1995 and June 1995 Treatment Notes, September 1997 Report of Medical History. In October 1997, the Veteran underwent a neurological consultation. The Veteran reported that while he was stationed in Mississippi in March 1993, that he awoke with pain in his left leg and numbness and tingling. The Veteran was unable to remember any previous back or leg injuries. The Veteran reported that while his back and leg pain improved, the numbness and tingling remained. The Veteran did not report any right leg symptoms. The examiner opined that Veteran had lumbar disc disease, with left-sided radiculopathy, and would benefit from surgery. The Veteran was never afforded a VA examination that specifically addressed his lower limb disability; however, a September 2012 VA examination of the back reflected that the Veteran developed a “generalized polyneuropathy that is not related to [degenerative disc disease] of the lumbar spine.” In November 2020, and January 2021 VA secured VA medical opinions for the Veteran’s claimed lower limb polyneuropathy disability pursuant to the October 2020 Board remand. In the November 2020 opinion, the examiner opined that the Veteran’s claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. The examiner did not provide a rationale for her opinion beyond merely listing the Veteran’s medical history. In the January 2021 addendum opinion, the examiner again opined that the Veteran’s claimed lower limb polyneuropathy disability was less likely than not incurred in or was caused by service. In support of that opinion, the examiner described the Veteran’s medical history and provided an explanation as to the difference between radiculopathy and neuropathy. However, as to the rationale for the opinion, the examiner merely provided the conclusory statement that, “there is no objective medical evidence showing a link between the current diagnoses of peripheral polyneuropathy and the Veteran’s time in military service.” The Board finds that the November 2020 and January 2021 VA medical opinions are inadequate for adjudication purposes and therefore do not substantially complete the Board’s October 2020 remand directives. See Barr v. Nicholson, 21 Vet. App. 303 (2007) (holding that when the VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). The November 2020 and January 2021 medical opinions were inadequate because 1.) The examiner did not clarify whether the Veteran had a lower extremity nerve condition in addition to the now service-connected left lower extremity radiculopathy; 2.) The examiner did not adequately address the fact that the Veteran had frequently reported leg pain, numbness, tingling, and cramps, during service; and 3.) The examiner did not address the Veteran or his mother-in-law’s lay statements including that he was repeatedly soaked in aircraft hydraulic fluid from just above his waist to his feet for 8-12 hours during service. Thus, a remand is necessary to obtain an addendum opinion. The matter is REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician other than the clinician who provided the November 2020 and January 2021 medical opinions. The complete record, to include a copy of this remand, and the claims folder must be made available to and reviewed by the clinician. The examiner should first clarify whether the Veteran had a lower extremity condition in addition to the service-connected left lower extremity radiculopathy. Then, provide an opinion as to whether it is at least as likely as not (50 percent probability or more) that the diagnosed bilateral lower limb polyneuropathy had its onset in active service or is otherwise etiologically related to the Veteran’s active service. In rendering the opinion, the examiner must address the following: (a.) The Veteran frequently reported leg pain, numbness, tingling, and cramps, during service. (b.) The Veteran and his mother-in-law provided lay testimony stating that the Veteran was repeatedly soaked in aircraft hydraulic fluid from just above his waist to his feet for 8-12 hours during service. The clinician must explain why the above factors do or do not show that the Veteran’s diagnosed bilateral limb polyneuropathy had its onset in active service or is otherwise etiologically related to active service. 2. The Agency of Original Jurisdiction (AOJ) must review the opinion to ensure it is adequate and complies with the Board’s specific remand directives herein. If deficient in any manner, corrective action must be taken. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding that AOJ compliance with Board remand directives is not discretionary or optional). 3. Then, the claim must be readjudicated. If the benefit sought on appeal is not granted to the Appellant’s satisfaction, the Appellant must be provided a Supplemental Statement of the Case and be given an adequate opportunity to respond. Thereafter, the case should be returned to the Board for further appellate action. T. J. ANTHONY Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Quist 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.