Citation Nr: 22011985 Decision Date: 03/02/22 Archive Date: 03/02/22 DOCKET NO. 16-58 388 DATE: March 2, 2022 REMANDED Entitlement to service connection for a left leg circulation disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from October 1987 to June 1992, and from March 2003 to October 2003. This claim comes before the Board of Veterans' Appeals (Board) from an April 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The matter was remanded by the Board in an August 2021 decision for further development. 1. Entitlement to service connection for a left leg circulation disability In June 2014, the Veteran filed an informal claim for service connection for "left leg (circulation of leg)." No further contentions were provided for this claim. However, in August 2021, the Board remanded for a VA examination noting that the Veteran's service treatment records (STRs) showed complaints of left leg edema and left leg pain with noticeable swelling. Specifically, in December 1987, it was reported the Veteran was involved in a motor vehicle accident (MVA) as a result of which the left hallux was sutured. It was noted there was no apparent sequela. In May 1988, the Veteran complained of left leg pain. He did not recall any incidents which brought about pain but reported having similar pain in 1983 when he was diagnosed as having a blood clot. There was noticeable swelling reported. Later that month, the record further contains reports of left leg edema. Based upon these STRs, the Board requested that an examiner identify all current left leg circulation diagnoses and opine as to whether any were related to the left leg symptoms the Veteran had experienced in service. Pursuant to the Board's remand, the Veteran was provided a VA examination in October 2021. The Veteran reported having problems with his left leg swelling in 1998. The swelling stopped after he had hip surgery in 2014. The examiner stated the swelling may have been due to impaired lymph system functioning as a result of the Veteran's hip condition, which resolved, and noted that the Veteran had not been diagnosed with any artery or vein condition either at that time or since. On physical examination, no artery or vein condition was noted, and the examiner indicated the Veteran did not have a vascular disease. In a separate opinion to the examination, the October 2021 VA examiner reiterated that the Veteran did not have a left leg circulation diagnosis. The examiner explained that the Veteran's reported circulation issue resolved following hip surgery and there were no current objective findings for any diagnosis. Although the October 2021 VA examiner has determined that the Veteran does not have a left leg circulation diagnosis at the present time, the Board notes that the presence of a chronic disability at any time during or immediately preceding the claims process can justify a grant of service connection, even where the most recent diagnosis is negative. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowski v. Shinseki, 26 Vet. App. 289, 294 (2013) (holding the current disability requirement may be satisfied by evidence of the disability shortly before the claim is filed). As noted above, the Veteran filed his claim for service connection in June 2014. During the October 2021 VA examination it was indicated that the Veteran's left leg swelling symptoms, which started in service (1988), resolved after he underwent hip surgery in the same year that he filed his service connection claim (2014). Thus, remand for an addendum opinion is necessary to clarify whether the Veteran had a left leg circulation disability either proximate to the filing of his claim or during the pendency of the claim, even if that condition may have since resolved. See Romanowski, supra. If it is determined the Veteran has a 'current' (as defined by VA's laws and regulations) left leg circulation disability, a medical opinion is also necessary to address whether that disability is related to the Veteran's service-connected bilateral hips. In this regard, it is noted that the October 2021 VA examiner indicated the Veteran's left leg swelling may have been due to impaired lymph system functioning as a result of his hip condition, which resolved following hip surgery. The matter is REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding the nature and etiology of the Veteran's claimed left leg circulation disability. The entire claims file, including a copy of this remand, should be made available to and be reviewed by the examiner. If it is determined that a physical examination is necessary to provide the requested opinions, such should be arranged. The examiner is asked to offer an opinion on the following: (a) Did the Veteran, at the time of, or proximate to, the filing of his service connection claim (in 2014), or during the course of the claim, have a diagnosis of a left leg circulation disability, even if such condition may have since resolved? In answering the above question, the examiner should specifically consider whether such a condition was represented by the swelling in the Veteran's left leg prior to the 2014 hip surgery and which resolved as a result of that surgery. If no such diagnosis can be provided, the examiner should also consider whether the Veteran's left leg symptoms resulted in functional impairment of earning capacity. If so, then the examiner should consider them a "disability" for the purpose of providing the additional requested opinions below. (b) If the Veteran had a current left leg circulation disability at or proximate to the date of his claim filing, even if it has since resolved: a. Is it at least as likely as not (i.e. 50 percent or greater probability) that such condition had its onset during service or was otherwise causally or etiologically related to service? The examiner should specifically consider the left leg symptoms noted in the Veteran's STRs. b. Is it at least as likely as not (i.e. 50 percent or greater probability) that such condition was caused his service-connected bilateral hip condition? c. Is it at least as likely as not (i.e. 50 percent or greater probability) that such condition was aggravated beyond its normal progression by his service-connected bilateral hip condition? A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Stuedemann, A. 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.