Citation Nr: 21042244 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 17-04 259 DATE: July 12, 2021 REMANDED Entitlement to service connection for peripheral neuropathy of the right lower extremity (RLE) is remanded. Entitlement to service connection for peripheral neuropathy of the left lower extremity (LLE) is remanded. Entitlement to service connection for peripheral neuropathy of the right upper extremity (RUE) is remanded. Entitlement to service connection for peripheral neuropathy of the left upper extremity (LUE) is remanded. Entitlement to service connection for diabetes mellitus, type II (DM) is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for a left foot disability is remanded. Entitlement to service connection for a right foot disability is remanded. Entitlement to service connection for osteoarthritis (painful joints) is remanded. Entitlement to service connection for muscle pain is remanded. Entitlement to service connection for cholelithiasis (gallstones) is remanded. Entitlement to service connection for duodenal ulcer disease is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from August 1971 to December 1972. These claims were previously remanded by the Board in June 2019. 1. Entitlement to service connection for peripheral neuropathy of the RLE is remanded. The Veteran was afforded a VA contract examination and opinion for his peripheral neuropathy of the RLE in January 2020. VA-VES Peripheral Nerves Conditions examination, January 2020. The examiner found that his peripheral neuropathies were not related to service because there was no documented in-service injury. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the RLE claim and it must be remanded for an addendum opinion. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). 2. Entitlement to service connection for peripheral neuropathy of the LLE is remanded. The Veteran was afforded a VA contract examination and opinion for his peripheral neuropathy of the LLE in January 2020. VA-VES Peripheral Nerves Conditions examination, January 2020. The examiner found that his peripheral neuropathies were not related to service because there was no documented in-service injury. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the LLE claim and it must be remanded for an addendum opinion. See Barr, supra. 3. Entitlement to service connection for peripheral neuropathy of the RUE is remanded. The Veteran was afforded a VA contract examination and opinion for his peripheral neuropathy of the RUE in January 2020. VA-VES Peripheral Nerves Conditions examination, January 2020. The examiner found that his peripheral neuropathies were not related to service because there was no documented in-service injury. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the RUE claim and it must be remanded for an addendum opinion. See Barr, supra. 4. Entitlement to service connection for peripheral neuropathy of the LUE is remanded. The Veteran was afforded a VA contract examination and opinion for his peripheral neuropathy of the LUE in January 2020. VA-VES Peripheral Nerves Conditions examination, January 2020. The examiner found that his peripheral neuropathies were not related to service because there was no documented in-service injury. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the LUE claim and it must be remanded for an addendum opinion. See Barr, supra. 5. Entitlement to service connection for DM is remanded. The Veteran was afforded a VA contract examination and opinion for his DM in January 2020. VA-VES DM examination, January 2020. The examiner found that his DM was not related to service because there was no documented in-service DM. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the DM claim and it must be remanded for an addendum opinion. See Barr, supra. 6. Entitlement to service connection for hypertension is remanded. The Veteran was afforded a VA contract examination and opinion for his hypertension in January 2020. VA-VES Hypertension examination, January 2020. The examiner found that his hypertension was not related to service because there was no documented in-service hypertension. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the hypertension claim, and it must be remanded for an addendum opinion. See Barr, supra. 7. Entitlement to service connection for a left foot disability is remanded. The Veteran was afforded a VA contract examination and opinion for his left foot in January 2020. VA-VES Foot Conditions examination, January 2020. The examiner found that his left foot condition was not related to service because there was no documented in-service injury. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the left foot claim and it must be remanded for an addendum opinion. See Barr, supra. 8. Entitlement to service connection for a right foot disability is remanded. The Veteran was afforded a VA contract examination and opinion for his right foot in January 2020. VA-VES Foot Conditions examination, January 2020. The examiner found that his right foot condition was not related to service because there was no documented in-service injury. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the right foot claim and it must be remanded for an addendum opinion. See Barr, supra. 9. Entitlement to service connection for osteoarthritis (painful joints) is remanded. The Veteran was afforded a VA contract examination and opinion for his osteoarthritis claim in January 2020. VA-VES Muscle Injuries examination, January 2020. The examiner found that his claimed painful joints were not related to service because there was no documented in-service injury. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the osteoarthritis (claimed as painful joints) claim and it must be remanded for an addendum opinion. See Barr, supra. 10. Entitlement to service connection for muscle pain is remanded. The Veteran was afforded a VA contract examination and opinion for his muscle pain claim in January 2020. VA-VES Muscle Injuries examination, January 2020. The examiner found that his claimed muscle pain was not related to service because there was no documented in-service injury. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the muscle pain claim and it must be remanded for an addendum opinion. See Barr, supra. 11. Entitlement to service connection for cholelithiasis (gallstones) is remanded. The Veteran was afforded a VA contract examination and opinion for his cholelithiasis claim in January 2020. VA-VES Gall Bladder and Pancreas Conditions examination, January 2020. The examiner found that his cholelithiasis was not related to service because there were no documented in-service complaints. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the cholelithiasis claim and it must be remanded for an addendum opinion. See Barr, supra. 12. Entitlement to service connection for duodenal ulcer disease is remanded. The Veteran was afforded a VA contract examination and opinion for his duodenal ulcer disease claim in January 2020. VA-VES Intestinal Conditions examination, January 2020. The examiner found that his duodenal ulcer disease was not related to service because there were no documented in-service complaints. He also concluded that the Veteran had "no known condition that can be directly related to or noted as aggravated beyond natural progression by hepatitis C." However, he provided no rationale for this conclusion. As such, it is not sufficient to decide the duodenal ulcer disease claim and it must be remanded for an addendum opinion. See Barr, supra. 13. Entitlement to a TDIU is remanded. The Veteran claims that he is unemployable due to the disabilities remanded herein. As such, a decision on the remanded service connection issues could significantly impact a decision on the issue of TDIU. The issues are inextricably intertwined, and a remand of the TDIU claim is required. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following actions: 1. Send the Veteran's claims file to an appropriate examiner(s) to provide addendum opinions regarding the nature and etiology of his claimed peripheral neuropathies of the bilateral upper and lower extremities, DM, hypertension, bilateral feet disabilities, osteoarthritis, muscle pain, cholelithiasis, and duodenal ulcer disease. The Veteran may be recalled for examination(s) if deemed necessary. For each of the claimed disabilities, the examiner must state whether it is at least as likely as not that the Veteran's current disability was caused or aggravated by his service-connected hepatitis C. THE EXAMINER MUST PROVIDE A COMPLETE RATIONALE FOR EACH OPINION. The term "at least as likely as not" does not mean "within the realm of medical possibility." Rather, it means that the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of the conclusion (e.g., etiology) as it is to find against the conclusion. 2. THE AOJ MUST REVIEW THE CLAIMS FILE AND ENSURE THAT THE FOREGOING DEVELOPMENT ACTION HAS BEEN COMPLETED IN FULL. IF ANY DEVELOPMENT IS INCOMPLETE, APPROPRIATE CORRECTIVE ACTION MUST BE IMPLEMENTED. IF ANY REPORT DOES NOT INCLUDE ADEQUATE RESPONSES TO THE SPECIFIC OPINIONS REQUESTED, IT MUST BE RETURNED TO THE PROVIDING EXAMINER FOR CORRECTIVE ACTION. YVETTE R. WHITE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Moore, 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.