Citation Nr: 21031806 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 16-40 784A DATE: May 24, 2021 REMANDED Entitlement to service connection for a left hip disability is remanded. Entitlement to service connection for a left ankle is remanded. Entitlement to service connection for gout is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from June 1978 to September 1980. This matter comes before the Board of Veterans' Appeals (Board) on appeal from September 2013 and December 2015 rating decisions issued by the Department of Veterans Affairs (VA) Regional Office. In June 2020, the Veteran testified at a Board hearing before a Veterans Law Judge. A transcript of the hearing is associated with the file. In March 2021, the Board wrote the Veteran and his representative to inform them that the Veterans Law Judge who conducted the hearing in June 2020 was no longer employed by the Board. He was offered the opportunity to testify at another Board hearing and was informed that if he did not respond within 30 days the Board would proceed on the assumption that he did not desire another hearing. No response was thereafter received within 30 days, and he has not otherwise indicated that a new hearing is desired. This case was previously before the Board in October 2020, at which time the issues currently before the Board were remanded for additional development. The case has now been returned to the Board for further appellate action. Although the Board sincerely regrets the delay, additional development is required to comply with the previous remand instructions. Stegall v. West, 11 Vet. App. 268 (1998). Service Connection Left Hip Disability, Left Ankle Disability, & Gout In the October 2020 remand, the Board directed that VA medical opinions be obtained to determine the nature and etiology of his left hip disability, left ankle disability, and gout. The Board found the opinions must specifically speak to the factor of aggravation, with supporting rationale. A review of the record shows that the directed addendum VA medical opinions were obtained in January 2021. For the claimed disabilities, the VA examiner opined that the Veteran's left hip disability, left ankle disability, and gout were less likely as not aggravated by his service-connected bilateral knee disability. The Board finds that these opinions do not substantially comply with the Board's remand directives. Stegall, 11 Vet. App. 268 (holding that a remand by the Board confers the right to compliance with remand orders); see also Dyment v. West, 13 Vet. App. 141 (1999). In this regard, while the Board asked the examiner to explain whether or not the Veteran's left hip disability, left ankle disability, and gout were worsened beyond the natural progress by a bilateral knee condition, the examiner simply provided medical definitions of the terms gout, strain, and degenerative joint disease. The VA examiner did not fully explain how such definitions provided an explanation for the negative opinions. Therefore, the Board finds the January 2021 VA examiner's rationales amount to conclusory statements that do not allow for a fully informed decision. Stefl v. Nicholson, 21, Vet. App. 120, 124 (2007). As such, a further medical opinion complying with the directives of the Board. See also Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (if VA provides an examination, the examination must be adequate). The matters are REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. After the foregoing development has been completed, obtain an addendum opinion from an appropriate clinician to determine the nature and etiology of any currently present left hip disability, left ankle disability, and gout. Following a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that any currently diagnosed left hip disability, left ankle disability, and gout were aggravated (i.e., permanently or temporarily worsened beyond natural progression) by the Veteran's service-connected bilateral knee disability. In so doing, the Board notes that secondary service connection does not require permanent worsening of the secondary condition; rather, any incremental increase in disability is sufficient, regardless of its permanence. See Ward v. Wilkie, 31 Vet. App. 233 (2019). The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner(s) selected to offer the requested opinions. A complete medical rationale for all opinions expressed must be provided. 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issues on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. Richard Kettler Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. Umez-Eronini, 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.