Citation Nr: 21025947 Decision Date: 04/29/21 Archive Date: 04/29/21 DOCKET NO. 16-29 403 DATE: April 29, 2021 REMANDED Entitlement to service connection for chronic tonsillitis is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from November 1989 to May 1992. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in December 2018, at which time the Board remanded the claims for further development. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives, accordingly another remand is required. See Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Entitlement to service connection for chronic tonsillitis is remanded. The Veteran is seeking service connection for chronic tonsillitis. He contends his tonsillitis is chronic and related to his in-service treatment for tonsillitis. This matter was remanded by the Board in December 2018 for additional development, including a new VA examination considering the Veteran’s lay statements and medical evidence of record. The Board’s directives further stated that all disabilities regarding the pharynx should be identified and an opinion should be provided as to whether the diagnosed disability is related to the Veteran’s military service. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives. The Veteran underwent a VA examination in December 2019. The VA examiner provided inconsistent statements regarding a current disability. The VA examiner stated the Veteran has not been diagnosed with a sinus, nose, throat, larynx, or pharynx disability, but later checked the box “Yes” for “other nose, throat, larynx or pharynx conditions, pertinent physical findings or scars due to noise, throat, larynx, or pharynx conditions” but did not provide any further details. The VA examiner noted the Veteran underwent an October 2017 sleep endoscopy which showed partial anterior/posterior collapse, complete circumferential collapse, and partial lateral wall collapse of the hypopharynx. The VA examiner concluded there is no diagnosis for the Veteran’s claimed condition of chronic tonsillitis because there are no findings, signs, or symptoms to support a diagnosis. The Board notes the VA examination is inadequate. It is unclear to the Board whether the Veteran has a diagnosis of any pharynx disability, as the VA examiner gave inconclusive responses. Further, the Board finds the opinion regarding the Veteran’s tonsillitis to be unclear and insufficient, in addition to not complying with the Board’s prior directives. Thus, this matter must be remanded to obtain an adequate examination. The matter is REMANDED for the following action: Schedule the Veteran for a VA examination to assess the nature and etiology of any currently diagnosed pharynx disability, to include chronic tonsillitis. The examiner must elicit a full history from the Veteran and discuss the Veteran’s lay statements offered by the Veteran regarding symptoms in-service with worsening since. a) After review of the evidence of record, including a copy of this remand, the examiner must identify all disabilities of the pharynx at any time during the pendency of this appeal. b) For each identified disorder, indicate whether it is at least as likely as not that the condition began in service, was caused by service, or is otherwise related to service. The examiner is asked to evaluate and discuss the Veteran’s tonsil infection in-service, his VA treatment records regarding swollen tonsils, and his 2017 sleep endoscopy and the results. The examiner is to address these records in their opinion. A complete rationale should be provided for all opinions or conclusions expressed. If the reviewer cannot provide any of the requested opinions without resort to speculation, that conclusion also should be explained. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Mouzakis, 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.