Citation Nr: 21039915 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 03-03 102A DATE: July 1, 2021 REMANDED Entitlement to service connection for polycystic kidney disease, to include as secondary to a service-connected disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1983 to January 1987. He died in December 2019. The Appellant is his surviving spouse. In September 2020, the RO concluded that the Appellant was an appropriate substitute claimant for the Veteran in this appeal. This appeal has a long and complicated procedural history. The Board previously remanded the claim to the RO for further development in August 2014, August 2015, and January 2018. Having reviewed the record evidence, and although the Board is reluctant to contribute to "the hamster-wheel reputation of Veterans law" by remanding this claim again, additional development is required before the underlying claim can be adjudicated on the merits. Cf. Coburn v. Nicholson, 19 Vet. App. 427, 434 (2006) (Lance, J., dissenting) (finding that repeated remands "perpetuate the hamster-wheel reputation of Veterans law"). The Board notes that, in response to its prior remands, January and March 2021 VA examiners provided well-reasoned opinions that the Veteran's polycystic kidney disease is a genetic disease that he had since birth and is not related to active service or any incident of service, to include as due to service-connected hypertension. A January 2019 opinion from a private physician indicated that the Veteran's service-connected testicular cancer exacerbated his polycystic kidney disease, however, but provided no rationale to support this opinion. Although no rationale was provided to support this opinion, it raises the possibility of an etiological link between service-connected testicular cancer and polycystic kidney disease. Thus, the Board finds that remand is required to obtain an addendum VA medical opinion concerning the contended etiological relationship between the Veteran's testicular cancer and polycystic kidney disease. The matters are REMANDED for the following action: 1. Forward the Veteran's claims file and a copy of this REMAND to the January 2021 VA examiner or another appropriate clinician for an addendum opinion concerning the contended etiological relationship between the Veteran's service-connected testicular cancer and his polycystic kidney disease. Because the Veteran is deceased, he should not be asked to report for examination. Based on a review of the claims file, the clinician is asked to state whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's service-connected testicular cancer caused or aggravated his polycystic kidney disease. A rationale must be provided for the requested opinion. If any requested opinion cannot be provided without resorting to speculation, then the clinician must explain why this is so. The examiner is asked to address the clinical significance, if any, of the January 2019 private opinion which concluded that testicular cancer exacerbated the Veteran's polycystic kidney disease in his or her own opinion. 2. Readjudicate the appeal. MICHAEL T. OSBORNE Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Howell, 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.