Citation Nr: 22006017 Decision Date: 02/03/22 Archive Date: 02/03/22 DOCKET NO. 15-00 099A DATE: February 3, 2022 REMANDED Entitlement to service connection for a condition of the bilateral upper arms is remanded. Entitlement to service connection for a condition of the bilateral legs is remanded. Entitlement to service connection for a condition of the bilateral wrists is remanded. Entitlement to service connection for a condition of the bilateral elbows is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1970 to December 1971. These matters come before the Board of Veterans' Appeals (Board) on appeal from rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded these matters in December 2019. They return now to the Board for appellate review. 1. The claims for entitlement to service connection for conditions of the bilateral upper arms, legs, wrists, and elbows, are remanded. Although it regrets the additional delay, the Board finds remand of these claims necessary to obtain adequate VA examinations and medical opinions as to etiology. The VA examiner with whom the Veteran met in April 2021 for evaluation of each of the above-enumerated conditions opined that because "[t]here are no records documenting complaints, diagnosis or treatment in service...a nexus is negative," adding that the Veteran's upper extremity conditions may relate to cervical spondylosis (for which the Veteran has never filed a claim for benefits,) and that the absence of evidence of continuity of care supports his conclusion. The Board finds this opinion wanting. First, the Veteran has been adamant that symptoms affecting the bilateral upper arms, legs, wrists, and elbows began in service and have continued unabated since. That competent lay evidence was not addressed by the VA examiner. Second, the opinion affords undue consideration to the apparent lack of treatment sought or received in service and/or since separation. Finally, the reasoning underpinning the examiner's ultimate conclusions with respect to etiology are not fully explained. On remand, new VA examinations must be conducted and adequate opinions as to etiology obtained, which opinions must be rendered with due consideration afforded the Veteran's credible lay statements with respect to onset and continuity of symptomatology. The matters are REMANDED for the following action: 1. After obtaining the necessary authorization, update the claims file with any relevant outstanding VA and/or private treatment records. 2. Then, schedule the Veteran for a VA examination or examinations to explore the etiology of his claimed disabilities of the bilateral upper arms, bilateral elbows, bilateral wrists, and bilateral lower extremities, preferably with an examiner who has not yet participated in this matter. All indicated tests and studies should be conducted and all clinical findings reported in detail. The entire claims file should be made available to and be reviewed by the examiner in conjunction with this request. The examiner is directed to list all diagnoses of the upper extremities, elbows, wrists, and lower extremities. For each identified condition, the examiner is requested to state whether, on an at least as likely as not basis, the condition had its onset in active-duty service or is etiologically related to active-duty service. All opinions expressed must be supported by thorough rationale. In particular, the examiner is directed to afford consideration to the Veteran's lay statements regarding onset and continuity of symptomatology. If the examine finds the Veteran's statements not credible, that finding must be thoroughly explained. 3. Then, readjudicate the claims. GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Z. Sahraie, 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.