Citation Nr: 22016323 Decision Date: 03/21/22 Archive Date: 03/21/22 DOCKET NO. 17-54 233 DATE: March 21, 2022 REMANDED Entitlement to service connection for right wrist sprain is remanded. REASON FOR REMAND The Veteran had active duty service from June 1988 to June 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this matter for further development in May 2019 and March 2020, and it has now returned to the Board for review. Entitlement to service connection for right wrist sprain is remanded. The Veteran contends that his right wrist sprain is related to his active service. Pursuant to the March 2020 Board Remand, the RO obtained a March 2020 addendum opinion for the Veteran's right wrist condition. The examiner was asked to provide an opinion regarding whether the Veteran's right wrist condition had its onset in service or is otherwise related to his service. A remand by the Board confers on the claimant a legal right to compliance with the remand order. Stegall v. West, 11Vet. App.268, 271 (1998). The March 2020 examiner opined that the claimed right wrist condition was not incurred in or caused by the claimed inservice injury event or illness. The examiner's rationale appears to be based entirely on a lack of chronicity of care post-service; however, the examiner noted that lay statements conveyed confirmation of the reported symptoms. The Board notes several problems with this opinion. First, in addressing chronic disabilities, VA looks to continuity of symptomatology, not to continuity of treatment. Here, the examiner identified the lack of evidence of chronicity of care as supportive of a negative nexus opinion. In doing so, the examiner did not explain why this was medically significant. If lack of treatment is significant in informing the examiner's opinion, an explanation for this significance must be explicitly provided. Whenever VA undertakes to either provide an examination or to obtain an opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). As the March 2020 addendum opinion lacks an adequate rationale, there has not been substantial compliance with the Board's March 2020 Remand directives and the appeal must be remanded to obtain an addendum opinion with adequate rationale. Id. The matter is REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate them with the claims file. 2. Obtain an addendum opinion from a medical examiner for the Veteran's right wrist disability. The electronic claims file must be made available to the examiner, and the examiner must specify in the opinion that the file, including a copy of this Remand, has been reviewed. Following a review of the medical and lay evidence of record, the examiner is asked to list all diagnosed right wrist conditions since October 31, 2013 (the date of the Veteran's claim) and provide the following opinion: Is any right wrist disability during the relevant period due to the Veteran's service, to include right wrist tendonitis in March 1990 and/or right wrist pain in November 1991? Why or why not? A detailed explanation (rationale) is requested, including citing to supporting clinical data (and/or medical literature), as appropriate. In considering any lay statements of record, the examiner should note that the Veteran is competent to attest to matters of which he had first-hand knowledge, including observable symptomatology. The Veteran's contentions should be deemed credible for the limited purposes of this examination absent evidence to the contrary. The examiner is informed that a positive opinion indicating a nexus to service does not require certainty. Rather, if the weight of the evidence is in approximate balance for and against a nexus to service, the examiner should make a determination favorable to the Veteran. Jennifer White Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Susan Leary 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.