Citation Nr: 21040225 Decision Date: 07/02/21 Archive Date: 07/02/21 DOCKET NO. 17-28 519 DATE: July 2, 2021 REMANDED Entitlement to service connection for osteoarthritis of the right knee is remanded. Entitlement to service connection for sarcoidosis is remanded. Entitlement to service connection for lung damage/chronic bronchitis, to include as due to a qualifying chronic disability, is remanded. Entitlement to service connection for cirrhosis of the liver, to include as due to a qualifying chronic disability, is remanded. Entitlement to service connection for congestive heart failure (CHF), to include as secondary to a qualifying chronic disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1991 to August 1995. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2017 rating decision, which denied the Veteran's claims of entitlement to service connection for osteoarthritis of the right knee, sarcoidosis, lung damage/chronic bronchitis, CHF, and cirrhosis of the liver. A May 2018 videoconference hearing was held before a Veterans Law Judge who is no longer employed at the Board. In a May 2021 correspondence, the Veteran was given 30 days to inform the Board if he wished to have another hearing; as of this date, no response has been submitted and the Board thus construes the lack of response as a new hearing is not requested. In January 2019, the Board denied service connection for each claim on appeal. The Veteran appealed the January 2019 Board decision to the United States Court of Appeals for Veterans Claims (Court). In a Memorandum Decision, the Court set aside the entirety of the Board decision and remanded the matter for further proceedings. First, the Court found error in the Board's analysis of the right knee disability by not assessing the credibility of the Veteran's lay statements. Second, the Court stated that the Board did not indicate whether VA satisfied its duty to assist the Veteran in making efforts to obtain certain records, including VA treatment records from the Albuquerque VA Medical Center and Social Security Administration records. Third, and tied to the second defect, the Court found the RO determined that "relevant medical records" from the Albuquerque VAMC had been obtained; the Court noted relevance is not the qualifier with respect to VA records. Finally, the Court remanded the claims for lung damage and chronic bronchitis, cirrhosis of the liver, and CHF because the claims are inextricably intertwined with the claim for service connection for sarcoidosis. VA Treatment and SSA Records The Board notes that the earliest VA treatment record in the Veteran's file is June 2001. In line with the Court's remand, the RO should obtain records from the Albuquerque VAMC from January 1998 to June 2001. Additionally, SSA records should be obtained. See Golz v. Shinseki, 590 F.3d 1317, 1323 (Fed. Cir. 2010). Right Knee Osteoarthritis In addition, the Veteran should be provided a VA examination for his right knee disability. VA is obligated to provide an examination and obtain a medical opinion in an initial claim of service connection when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with active service, and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C. § 5103A(d) (2012); McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this case, the Veteran was diagnosed with osteoarthritis of the right knee and the Veteran reported that his right knee pain began in service as a result of traveling up and down stairs and ladders while aboard the U.S.S. Hewitt. As the Board does not have sufficient evidence on which to decide the claim, a VA examination and medical opinion is warranted. Sarcoidosis The Board finds that the Veteran should be provided a VA examination for his sarcoidosis. Here, the Veteran is diagnosed with sarcoidosis, which the Veteran contends is due to his exposure to oil fires while in service in the Middle East. As the Board does not currently have sufficient evidence upon which to decide the claim, the Board must remand for a VA examination and medical opinion. McLendon, supra. Furthermore, the issues of entitlement to service connection for lung damage/chronic bronchitis, cirrhosis of the liver, and CHF are inextricably intertwined with the Board's decision herein and the issues being remanded, and adjudication of the issues must be deferred pending the proposed development. See Harris v. Derwinski,1 Vet. App. 180, 183 (1991) (the adjudication of claims that are inextricably intertwined is based upon the recognition that claims related to each other should not be subject to piecemeal decision-making or appellate litigation). The matters are REMANDED for the following action: 1. Obtain a complete set of the Veteran's VA treatment records from Albuquerque VA Medical Center (VAMC) from 1998 to the present. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified, and this should be documented for the record. Required notice must be provided to the Veteran. 2. Contact the SSA and request copies of SSA's determination on the Veteran's claim for SSA disability benefits, as well as copies of the complete medical records considered in that determination. A copy of any response from SSA, including any records obtained and/or a negative reply, should be included in the claims file. 3. Ensure that all outstanding VA treatment records are associated with the claims file. 4. Only after directives #1, #2, and #3 above are fulfilled, but regardless if new evidence is received, provide the Veteran with a VA examination to help determine the likely etiology of the claimed right knee osteoarthritis. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. After a review of the claims file and examination of the Veteran, the examiner is asked to respond to the following: (a) Provide an opinion as to whether it at least as likely as not (50 percent or higher probability) the right knee osteoarthritis had its onset during service, manifested within one year of the Veteran's separation from service, or is otherwise related to it. In answering these questions, the examiner is asked to address the Veteran's testimony that he struggled with knee pain since he was discharged from service; the knee pain developed from running up and down the ladders of the ship, and such activity wore out his knee; and he sought treatment for his knee pain within 6 months of discharge from service. 5. Thereafter, provide the Veteran with a VA examination to help determine the likely etiology of the sarcoidosis. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. After a review of the claims file and examination of the Veteran, the examiner is asked to respond to the following: (a) Provide an opinion as to whether it at least as likely as not (50 percent or higher probability) the sarcoidosis had its onset during service, manifested within one year of the Veteran's separation from service, or is otherwise related to it. In doing so, address (i) the Veteran's testimony that his sarcoidosis is related to exposure to burning oil fields while in service in the Persian Gulf; (ii) the April 2017 "Gulf War" examination noting exposure to burning oil wells; and (iii) the MedlinePlus article submitted in May 2018, which can also be accessed online at medlineplus.gov/ency/article/000076.htm. 6. If and only if the Veteran's sarcoidosis is found to be related to service, provide the Veteran with a VA examination to help determine the likely etiology of the lung damage/chronic bronchitis. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. After a review of the claims file and examination of the Veteran, the examiner is asked to respond to the following: (a) Is the Veteran's lung damage/chronic bronchitis at least as likely as not proximately due to his sarcoidosis? (b) Is the Veteran's lung damage/chronic bronchitis at least as likely as not aggravated, i.e., worsened beyond its natural progression, by his sarcoidosis? *In doing so, address the April 2017 VA "Gulf War" examination. 7. If and only if the Veteran's sarcoidosis is found to be related to service, provide the Veteran with a VA examination to help determine the likely etiology of the cirrhosis of the liver. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. After a review of the claims file and examination of the Veteran, the examiner is asked to respond to the following: (a) Is the Veteran's cirrhosis of the liver at least as likely as not proximately due to his sarcoidosis? (b) Is the Veteran's cirrhosis of the liver at least as likely as not aggravated, i.e., worsened beyond its natural progression, by his sarcoidosis? *In doing so, address the April 2017 VA "Gulf War" examination. 8. If and only if the Veteran's sarcoidosis is found to be related to service, provide the Veteran with a VA examination to help determine the likely etiology of the CHF. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. After a review of the claims file and examination of the Veteran, the examiner is asked to respond to the following: (a) Is the Veteran's CHF at least as likely as not proximately due to his sarcoidosis? (b) Is the Veteran's CHF at least as likely as not aggravated, i.e., worsened beyond its natural progression, by his sarcoidosis? *In doing so, address the April 2017 VA "Gulf War" examination. (Continued on the next page) A complete rationale should be provided for all opinions. 9. Thereafter, readjudicate the remanded claims. Idongesit T. Umo Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Moldawer, 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.