Citation Nr: 22067077
Decision Date: 12/02/22	Archive Date: 12/02/22

DOCKET NO. 14-16 229
DATE: December 2, 2022

REMANDED

Service connection for a disability claimed as fatigue is remanded.

REASONS FOR REMAND

The Veteran, who is the appellant, had active service from November 1967 to June 1969.  This matter is on appeal from a May 2011 rating decision.  In October 2017, the Veteran testified at a virtual hearing before the undersigned.  

In October 2020, the Board denied service connection for a disability claimed as fatigue.  The Veteran appealed the decision to the U.S. Court of Appeals for Veterans Claims (Court or CAVC).  In a March 2022 Memorandum Decision, the Court vacated the Board's decision on the basis that the Board relied on an inadequate medical opinion when denying service connection for a disability claimed as fatigue because it was not supported by sufficient rationale.  More specifically, the Court noted that the August 2022 VA examiner did not explain how fatigue having a myriad of possible causes made it less likely than not that the Veteran's fatigue was related to in-service malarial infection or herbicide exposure.  The Court wrote that the August 2022 VA examiner improperly based the medical opinion solely on the lack of scientific consensus linking fatigue to malaria or herbicide exposure and did not provide a reasoned explanation connecting the conclusion to supporting data.  

To comply with the orders of the Memorandum Decision, a remand for a VA examination with a medical opinion is warranted.

The issue is REMANDED for the following actions:

Schedule a VA records review for medical opinion on the question of etiology of a disorder manifested by fatigue.  The examiner should review the record.

If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below.

The examiner is asked to provide an opinion in response to the following question:

Is any current disability claimed as fatigue at least as likely as not related to the in-service malarial infection and/or presumed herbicide exposure?  

The examiner should provide rationale for the medical opinion that includes the following: 

Explain why fatigue having a myriad of possible causes makes it less likely that the Veteran's fatigue is related to in-service malarial infection and/or herbicide exposure.  

Explain the connection to any supporting data relied upon.  Do not base any medical opinion solely on a lack of scientific consensus linking fatigue to malaria or herbicide exposure.  

Do not base any medical opinion solely on the fact that the disability claimed/manifested as fatigue is not on the list of diseases that are presumptively associated with exposure to herbicide agents.

 

 

J. PARKER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	C. Palmer

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.