Citation Nr: 21025379 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 14-99 781A DATE: April 28, 2021 REMANDED Entitlement to service connection for anemia is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1981 to February 2001. This matter comes before the Board of Veterans’ Appeals (“Board”) from a December 2013 rating decision of the Department of Veterans Affairs (“VA”) Regional Office (“RO”). The Board remanded this matter in November 2020 for affording the Veteran a medical examination and obtaining a medical opinion on the nature and etiology of the claimed anemia. The Board also notes that other issues that were remanded by the Board in November 2020 were granted by the RO and are no longer on appeal. The RO afforded the Veteran a VA medical examination and obtained a medical opinion in January 2021. However, the Board finds the opinion inadequate for deciding the issue on appeal. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). Hence, the Board finds that further remand is necessary in this matter. Entitlement to service connection for anemia is remanded. Initially, the Board notes that the appeal period starts from January 2013, when the Veteran filed an informal claim for entitlement of service connection for anemia. Pursuant to the November 2020 Board’s remand, the Veteran was afforded a VA examination in January 2021. The examiner noted the clinical findings of Hemoglobin (HGB) value as 15.6 (gm/100ml), per January 2021 testing. The examiner did not diagnose the Veteran with anemia and opined that the 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. As a rationale, the examiner stated that after reviewing medical records and performing physical exam, there is no pathology or diagnosis to render an opinion. The Board finds the above January 2021 opinion inadequate because in finding no diagnosis of anemia, the examiner only relied on January 2021 laboratory testing, whereas the Board notes that the VA treatment records, clearly indicate that that Veteran had anemia during the appeal period. Specifically, July 2014 and April 2015 VA treatment records noted anemia and iron deficiency, and medication the Veteran was taking to treat this condition. The requirement that a current disability be present is satisfied when a claimant has a disability at any time during the pendency of a claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Furthermore, the examiner did not discuss the Veteran’s claimed in-service exposure to radiation, and HGB (hemoglobin) and HCT (hematocrit) values noted during service, when it was specifically directed, in the November 2020 Board’s remand, to address them. Consequently, a remand is warranted to obtain an addendum medical opinion on the nature and etiology of the claimed anemia. The matter is REMANDED for the following action: 1. Forward the claims file and a copy of this remand to the examiner who rendered the January 2021 medical opinion, or to an appropriate clinician if the January 2021 examiner is unavailable, to obtain an addendum opinion on the nature and etiology of the claimed anemia. In-person examination of the Veteran is left to the discretion of the clinician providing the addendum opinion. If the clinician deems such examination is necessary, then an examination should be scheduled. 2. The examiner is asked to provide an opinion as to whether it is at least as likely as not that the Veteran’s claimed anemia had its onset during his period of active service, or related to an in-service injury, event, or disease, including the claimed in-service exposure to radiation. In providing the above opinion the examiner is advised to address the HCT and HGB values and indication of anemia; and the Veteran’s claimed exposure to radiation as noted in documents associated with the claims file, with entries dated: (i) 09/24/2019, titled “CAPRI,” page number 68, 221, and 941-42, which contain notation of anemia in VA treatment records from April 2015, July 2014, and August 2007 respectively; (ii) 03/09/2004, titled “STR – Medical,” page number 33, which contains the report of dizziness and hazard exposure including radiation exposure during service; (iii) 03/09/2004, a different document titled “STR – Medical,” page number 23, 39, and 43, which contain reported values of HGB and HCT in October 1991, November 1991, and October 1993 service treatment records, indicating gradual decrease in these values; (iv) 03/09/2004, another document titled “STR – Medical,” page number 14, 21, and 23, which contain the reported values of HGB and HCT noted in March 1996, October 1997, and November 2000 service treatment records respectively, indicating gradual decrease in these values; (v) 12/15/2006 titled “VA 21-4138 Statement In Support of Claim,” where the Veteran asserted that he was exposed to ionizing radiation during his service. A complete rationale for the opinions rendered must be provided. If the examiner is unable to provide an opinion without resorting to mere speculation, then the examiner must state this and provide any information needed to make an opinion, if possible 3. Thereafter, readjudicate the claim on appeal. If the benefit sought remains denied, issue the Veteran and his representative a supplemental statement of the case and provide a reasonable opportunity to respond before returning the matter to the Board for further appellate review. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Tariq, Nadeem, 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.