Citation Nr: 21040816 Decision Date: 07/07/21 Archive Date: 07/07/21 DOCKET NO. 15-26 972 DATE: July 7, 2021 REMANDED Entitlement to service connection for poor circulation of the bilateral legs, to include as secondary to service-connected left ankle disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1980 to September 1983. The Board most recently remanded the claim in February 2021 for further development. The Veteran seeks service connection for a disability characterized by poor circulation of the bilateral legs, to include as secondary to his service-connected left ankle disability. In March 2021, an examiner opined that the Veteran's poor circulation condition was less likely than not incurred in service because the first mention of any circulatory issues wasn't until 2012, 30 years after the Veteran's service period ended. The examiner additionally opined that the Veteran's poor circulation condition is less likely than not proximately due to or aggravated by service-connected left ankle disability because it is not known to cause or aggravate circulatory issues. The Board cannot make a fully informed decision on the issue of service connection for poor circulation condition because the VA medical opinion obtained by the AOJ in March 2021 is inadequate. For both direct and secondary claims, the examiner provided improper conclusory opinions. Remand is needed to obtain adequate opinions. A supplemental VA opinion is needed to provide more responsive explanations that specifically considers his lay statements concerning the onset and progression of his symptoms. The matters are REMANDED for the following actions: 1. Obtain an addendum opinion from an appropriate clinician to determine the nature and likely etiology of the Veteran's poor circulation condition. Copies of all pertinent records must be made available to the examiner for review. If the examiner determines that an opinion cannot be provided without an examination, (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) one should be scheduled. After reviewing the claims file, the examiner is asked to answer the following questions: (a) Is it at least as likely as not (50 percent probability) that any currently diagnosed poor circulation condition was incurred in or is otherwise related to service? (b) If (a) is answered no, is it at least as likely as not (probability of at least 50 percent) that any currently diagnosed poor circulation condition is proximately due to (caused by) the Veteran's service-connected left ankle disability? (c) If (b) is answered no, is it at least as likely as not (probability of at least 50 percent) that any currently diagnosed poor circulation condition has been aggravated by the Veteran's service OR service-connected left ankle disability? The examiner is informed that aggravation here is defined as any increase in disability. If aggravation is present, the clinician should indicate, to the extent possible, the approximate level of disability (baseline) before the onset of the aggravation. The examiner is also advised that the Veteran is competent to provide evidence of symptomatology readily apparent to him, regardless of whether the symptoms are noted in the service medical records or on the date of examination. The examiner must provide reasons for each opinion given. If the examiner is unable to provide an opinion without resort to speculation, he or she should explain why this is so and what, if any, additional evidence would be necessary before an opinion could be rendered. Saudiee Brown Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S.E. Bresler, 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.