Citation Nr: 21042258 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 06-30 974 DATE: July 12, 2021 REMANDED 1. Entitlement to service connection for an enlarged prostate is remanded. 2. Entitlement to service connection for erectile dysfunction (ED) is remanded. 3. Entitlement to service connection for a bilateral hip disability is remanded. 4. Entitlement to service connection for a left wrist disability is remanded. 5. Entitlement to service connection for sleep apnea is remanded. 6. Entitlement to service connection for cardiomyopathy is remanded. 7. Entitlement to service connection for sinusitis is remanded. 8. Entitlement to a total rating based on individual unemployability due to service-connected disability (TDIU) is remanded. REASONS FOR REMAND The Veteran who served on active duty in the Army from October 1979 to June 1984 and from January 1985 to August 1992. He died in September 2016. The appellant is his surviving spouse, and has been substituted as the claimant for the purpose of processing the Veteran's claims to completion, as acknowledged by the VA in a November 2019 letter. This matter is before the Board of Veterans' Appeals (Board) on appeal of Department of Veterans Affairs (VA) rating decisions. A March 2005 rating decision denied service connection for cardiomyopathy. An August 2005 rating decision denied service connection for sleep apnea. (These claims were denied again in a March 2006 rating decision, but the Veteran had continually pursued them since the initial rating decisions.) A June 2008 rating decision denied service connection for sinusitis. An April 2010 rating decision denied the remaining listed claims on appeal. In July 2012, the Board remanded the case to afford the Veteran the Board hearing he had requested. A videoconference hearing was held before the undersigned in February 2016. In June 2016 and December 2020, the Board in pertinent part remanded the case to the Regional Office (RO)/Agency of Original Jurisdiction (AOJ) for further development of the claims. 1. - 7. Entitlement to service connection for an enlarged prostate, ED, a bilateral hip disability, a left wrist disability, sleep apnea, cardiomyopathy, and sinusitis Unfortunately, there has not been substantial compliance with the Board's previous remand directives, and another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). It is not apparent that the AOJ undertook any search for service records, to include of the Houston RO and Army Reserve records repository. Further, the AOJ has also not made a Formal Finding of Unavailability, as specifically requested. In addition, in February 2021, the AOJ received advisory medical opinions (based on review of the record), which address the likelihood that the claimed disabilities are related to the Veteran's service. While most opinions are comprehensive, there are a few instances where an opinion is inadequate for failure to consider an evidentiary document relevant to a particular disability. Therefore, an addendum opinion must be sought in regard to the disability. Also, if any additional service records are located and associated with the claims file, all the opinions should be reconsidered considering the new evidence. 8. Entitlement to a TDIU Consideration of the TDIU claim, which is inextricably intertwined with the pending service connection claims being remanded, is deferred pending resolution of those claims. The matters are REMANDED for the following: 1. Arrange for an exhaustive search (to include by the Houston RO and the Army Reserve records repository) for service treatment records from the Veteran's first (October 1979 to June 1984) period of service. All efforts to obtain the records should be documented in the claims file. If the records are not located, the AOJ should make a Formal Finding of Unavailability of such records for the record. 2. Then, arrange for return of the claims file to the VA examiner who furnished the February 2021 opinion, for re-review and an addendum opinion regarding the nature and etiology of the claimed disabilities. [If he is unavailable or unable to provide the addendum opinions sought, send the claims file to another appropriate clinician for such opinion.] Upon review of the claims file to include any service records that may be located and associated with the record since the February 2021 opinion, the provider is asked to opine whether it is at least as likely as not (a 50 percent or higher probability) that the Veteran's claimed disabilities were related to an injury, disease, or event during service from October 1979 to June 1984 and from January 1985 to August 1992. The examiner is also asked to specifically consider/address the following: (a). Regarding enlarged prostate and ED, comment on the Veteran's March 2012 hearing testimony that he has had the disabilities since service (since his return from Saudi Arabia), in determining the likelihood that the disabilities are related to service. (b). Regarding the left wrist disability, comment on VA outpatient treatment records, to include those in March 2011, July 2011, September 2011, and December 2012, which show the Veteran was seen on various occasions with complaints of bilateral wrist pain and tendonitis and was issued wrist braces, in determining the likelihood that the disability is related to injury during service. (c). Regarding sleep apnea, comment on the Veteran's hearing testimony in January 2007, March 2012, and February 2016, in determining the likelihood that the sleep apnea is related to service. Specifically, he testified that he was evaluated in 1992 (it is not clear if it was during service or on VA examination) and given a breathing aid/machine (inhaler/CPAP, it is not clear which) for snoring and has had consistent sleep disturbance since then. (d). Regarding sinusitis, comment on the July 1984 service medical record (report of medical history) notation of hay fever, the December 2008 MRI finding of a right maxillary sinus mucus retention cyst, and the February 2016 hearing testimony that his disability started in service when the weather was cold and he was given "drops and some pills," in determining the likelihood that the disability was related to service. Explain the reasons for the opinions with reference, as appropriate, to pertinent evidence, to specifically include service treatment records. 3. Then review the record, arrange for any further development indicated, and readjudicate the claim for TDIU considering the determinations made on the other claims remanded. George R. Senyk Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Debbie Breitbeil, 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.