Citation Nr: 21042555
Decision Date: 07/13/21	Archive Date: 07/13/21

DOCKET NO. 17-00 541
DATE: July 13, 2021

REMANDED

Entitlement to service connection for bilateral carpel tunnel syndrome is remanded.

REASONS FOR REMAND

The Veteran served on active duty from July 1967 to July 1971.  

The Board previously remanded the issue on appeal for further development in January 2019. However, after reviewing the evidence of record the Board finds that the RO has not substantially complied with its remand directives and an additional remand is therefore necessary.  See Stegall v. West, 11 Vet. App. 268, 271 (1998).  

In its prior decision, the Board found that the Veteran had been exposed to herbicide agents during his active-duty service.  See January 2019 Board Decision at 8.  The Board therefore assigned service connection for diabetes mellitus on the basis of this exposure, and for bilateral polyneuropathy as secondary to such diabetes mellitus.  See id. at 7-9.  

In the remand portion of its prior decision, the Board noted that no VA examiner had opined as to "whether the Veteran's bilateral carpal tunnel syndrome is related to his active-duty service, including exposure to herbicides, or secondary to his service-connected [diabetes mellitus]."  See id. at 10 (emphasis added).  The Board therefore directed that a VA examiner provide such opinions.  See id. at 10-11.

However, the record reflects that the questions subsequently put to the VA examiner by the RO, and the examiner's resulting opinion, do not substantially address the first of these remand directives.  Instead, the RO's assignment to the examiner addressed direct service connection for bilateral polyneuropathy, as well as secondary service connection for both bilateral polyneuropathy and bilateral carpal tunnel syndrome.  See September 2019 Examination Request at 1-2; see also October 2019 VA Medical Opinion at 3-5.  

As noted above, the Veteran's bilateral polyneuropathy was already service-connected on a secondary basis.  See January 2019 Board Decision at 9; see also February 2019 Rating Codesheet.  It is unclear to the Board why the RO's assignment to the examiner included bilateral polyneuropathy and did not include the requested opinion addressing direct service connection for bilateral carpal tunnel syndrome.  Accordingly, a second remand is warranted to obtain this opinion.  See Stegall, 11 Vet. App. at 271.

This matter is therefore REMANDED for the following action:

Schedule the Veteran for an appropriate examination to determine the etiology of the Veteran's bilateral carpal tunnel syndrome. A copy of the claims file must be made available to the examiner. The examiner is asked opined as to the following: 

a) Whether it is at least as likely as not (a 50 percent probability) that the Veteran's bilateral carpal tunnel syndrome is related to an injury, event, or disease that occurred during a period of active duty, including his concede exposure to herbicide agents during active service.

A complete rationale for all opinions must be provided. The examiner should note that, although carpal tunnel syndrome is not presumptively related to herbicide agent exposure, this presumption does not bar the finding of a direct etiological relationship. An opinion that it is less likely as not that the Veteran's carpal tunnel syndrome is not related to active duty service solely because this condition is not presumptively related to exposure to herbicide agents will not be found to be adequate, and will require additional remands.

 

 

Patrick M. Johnson

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	D. Blore, 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.