Citation Nr: 21031920 Decision Date: 05/25/21 Archive Date: 05/25/21 DOCKET NO. 14-41 209 DATE: May 25, 2021 REMANDED Entitlement to service connection for right knee disorder, status post-total replacement (TKR), is remanded. Entitlement to service connection for low back disorder, including degenerative disc disease (DDD), is remanded. Entitlement to service connection for hypertension, to include as secondary to chronic kidney disease, is remanded. Entitlement to service connection for chronic kidney disease is remanded. Entitlement to service connection for skin disorder, including eczema, and including as due to chronic kidney disease, is remanded. REASONS FOR REMAND As a member of the U.S. Army Reserve (USAR), the Veteran had active duty for training (ACDUTRA) from August 1964 to January 1965. Additional records obtained in April 2021 disclose subsequent brief periods of "ANACDUTRA" (abbreviation for annual active duty for training). This appeal comes before the Board from a May 2013 rating decision. The Board remanded the case for additional development in July 2018 and May 2020, to include obtaining examinations and medical opinions. See 07/30/2018 BVA Decision. While the matter was pending on remand, the Veteran died in December 2020. This triggered a death dismissal of the appeal by the Board in February 2021. Subsequently, the appellant, who is the Veteran's surviving spouse, filed an application to be the substitute claimant in this appeal. This was accepted by the RO who recognized the appellant as the substitute claimant in March 2021. The Board finds that the evidence confirms that the appellant is the surviving spouse and has met the criteria for the substitute claimant. ] 1. Entitlement to service connection for right knee disorder status post TKA is remanded. Medical opinions were obtained in September 2020 addressing the etiology of the right knee disorder, to include a detailed discussion of favorable evidence submitted (an April 2018 opinion from Dr. G) as requested by the prior remand directives. Unfortunately, another remand is necessary. Specifically, in April 2021 additional service department records were obtained, comprising 51 pages of military personnel records (also referred to as service personnel records or "SPRs"). These include records that were not previously available for review, hence the VA medical opinions obtained to date did not include review of these service personnel records. Significantly these records now show multiple periods of ANACDUTRA in addition to the period of ACTDUTRA from August 27, 1964 to January 23, 1965 recognized in the DD-214 which showed MOS of auto repair helper, automobile mechanic. Of note, these additional ANACDUTRA periods shown include 15 days beginning August 8, 1965; 15 days beginning July 16, 1966; 15 days beginning July 1, 1967; and 15 days beginning June 15, 1968. His principle duties during these ANACUTRA periods were shown to be "Sr. Security Gd." See 51 pg. Military Personnel Records received 4/30/21 at pg. 21. In light of the above, an addendum opinion must be obtained addressing the right knee disorder that includes review and consideration of these additional SPRs and these additional periods of active duty for training now shown. 2. Entitlement to service connection for low back disorder is remanded. 3. Entitlement to service connection for hypertension, to include as secondary to chronic kidney disease, is remanded. 4. Entitlement to service connection for chronic kidney disease is remanded. 5. Entitlement to service connection for skin disorder, including eczema, and including as due to chronic kidney disease is remanded. For the same reason as discussed above when addressing the right knee disorder, an addendum opinion must be obtained which addresses the etiology of the low back disorder, hypertension, chronic kidney, and skin disorders which includes review and consideration of these additional SPRs and these additional periods of active duty for training now shown. Additionally, the examiner's August 2020 opinion regarding the skin disorder requires a clarification as to the starting date of his eczema. In the opinion the examiner pointed to the eczema having been diagnosed in 1973 post service, and elsewhere the opinion points to the eczema starting in July 1969 per a STR showing the Veteran was recommended to be excused from ANACDUTRA due to eczema. Thus, on remand, the examiner should clarify the starting date of the Veteran's eczema in providing the opinion as to its causation/aggravation. The matters are REMANDED for the following action: To the extent possible, the AOJ shall refer the claims file to the VA examiner (initials D.C) who provided the September 2020 VA examinations and opinions regarding all the appealed issues of service connection for a right knee disorder, a back disorder, a chronic kidney disease, hypertension as secondary to a chronic kidney disease and a skin disease (eczema) claimed as secondary to a chronic kidney disease. If this physician is no longer available, please forward this file to the appropriate medical professional(s) to provide an addendum opinion. The examiner(s) should review the claims file to include the opinions provided in the September 2020 VA examination reports and consider the additional service personnel records received in April 2021, which show multiple periods of ANACDUTRA in addition to the period of ACTDUTRA from August 27, 1964 to January 23, 1965 recognized in the DD-214; to include ANACDUTRA periods of 15 days beginning August 8, 1965; 15 days beginning July 16, 1966; 15 days beginning July 1, 1967; 15 days beginning June 15, 1968, with principle duties during these ANACDUTRA periods shown to be "Sr. Security Gd." After reviewing the file including these additional SPRs, the examiner should review the September 2020 opinions addressing the etiologies of the claimed right knee disorder, back disorder, kidney disorder, hypertension as secondary to a chronic kidney disease, and a skin disease (eczema) claimed as secondary to a chronic kidney disease. The examiner should also review the prior remand directives of May 2020 outlining the requested opinions addressing these disorders to assist in providing an addendum. The examiner should state whether the evidence in the SPRs now showing additional ANACDUTRA periods warrants a change in any of the September 2020 etiology opinions addressing the claimed right knee disorder, back disorder, kidney disorder, hypertension as secondary to a chronic kidney disease, and a skin disease (eczema) claimed as secondary to a chronic kidney disease. If a change in any opinion is warranted, the examiner should provide an addendum opinion describing the changed opinion(s) and state the reasons for the changed opinion with adequate rationale. In addressing the etiology of the claimed skin disorder of eczema both claimed as directly due to service and as secondary to chronic kidney disease, the examiner should clarify whether the eczema was first diagnosed in July 1969 when he was recommended to be excused from ANACDUTRA due to eczema or later after service in 1973. All opinions should be accompanied by adequate rationale. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Eckart 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.