Citation Nr: 21042506 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 15-07 120 DATE: July 13, 2021 REMANDED Entitlement to service connection for disability manifested by difficulty walking and abnormal gait is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from May 1997 to May 2001. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2014 rating decision letter issued by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was most recently remanded by the Board in March 2021 in order to obtain a relevant VA examination concerning the Veteran's claim on appeal. As discussed below, the Board finds that remand is again required in order to obtain an adequate medical examination and/or opinion. See Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for disability manifested by difficulty walking and abnormal gait is remanded. The matter last appeared before the Board in March 2021 at which time the issue was remanded to obtain an examination in which the examiner addressed whether the Veteran has a disability manifested by difficulty walking and abnormal gait. The examiner was further asked to specifically identify any objectively demonstrated symptoms that are not attributable to a known clinical diagnosis and whether such constitute a medically unexplained chronic multi-symptom illness. At the outset the Board notes that after the March 2021 Board remand, the Veteran was solely provided a Parkinson's Disease Examination in April 2021 and the record does not reflect that attempts were made to schedule the Veteran for any other type of examination in relation to his claimed difficulty walking and abnormal gait disability. As noted below, the Parkinson's Disease examination reflects an inadequate opinion. As such, remand is warranted to obtain an appropriate examination and opinion. The April 2021 Parkinson's Disease examination reveals that the examiner failed to provide an opinion and stated that as no diagnosis is offered, no opinion is warranted. The examiner noted that although the Veteran has resting tremor and some gait abnormality, he also has action tremor and was told that his gait was abnormal due to his hips and to see neurology, but also due to symptoms that are not completely consistent with Parkinson's, no diagnosis is offered. The examiner remarked that at this point, they did not feel that they can answer completely. The examiner noted that the Veteran feels that he may have Parkinson's and he has mentioned this to his primary care manager who said they would arrange for referral to neurology for symptoms and without known etiology they examiner cannot really say if more or less likely due to potential Southwest Asia exposure. In this case, the April 2021 examiner solely relied on the Veteran's account of his symptoms rather than additionally formulating an opinion and as such completely disregarded the request for an opinion. Lay testimony is competent as to features or symptoms, but not etiology, of an injury or illness. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). It is a medical examiner's responsibility to provide a well-supported opinion so that the Board may carry out its duty to weigh the evidence of record. See NievesRodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Here, the April 2021 examiner completely failed to do so and instead discussed a referral to neurology, as relayed by the Veteran. Further, the examiner failed to specifically identify any objectively demonstrate symptoms that are not attributable to a known clinical diagnosis and whether such constitute a medically unexplained chronic multi symptom illness, and instead states they cannot do so without known etiology. Yet, such was the intent and purpose of the examination. In light of the above, the Board finds that the April 2021 VA examination report does not substantially comply with prior Board remand directives, and an additional remand is warranted to obtain development as directed by the March 2021 Board remand. See Stegall, 11 Vet. App. 268. The matter is REMANDED for the following action: 1. Obtain any updated treatment records and associate those records with the claims file. 2. Schedule the Veteran for an examination by an appropriate VA examiner with expertise in neurology and/or movement disorders to determine the nature and etiology of any current disability manifested by difficulty walking and abnormal gait. The examiner should identify any objective evidence of the Veteran's claimed disability manifested by difficulty walking and abnormal gait; render a diagnosis with respect to each claimed symptom which is due to a known clinical diagnosis; and, provide an opinion with respect to each currently diagnosed disorder as to whether it is at least as likely as not that the disorder is etiologically related to the Veteran's military service, to include service in the Southwest Asia theatre of operations. The examiner should also specifically identify any objectively demonstrated symptoms that are not attributable to a known clinical diagnosis and whether such constitute a medically unexplained chronic multi symptom illness. The examiner should further indicate whether such disabilities existed for 6 months or more or whether they exhibit intermittent worsening over a 6-month period. A detailed rationale for any opinion proffered should be provided. D. C. JOHNSON Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Q. Alli, 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.