Citation Nr: 22017536 Decision Date: 03/25/22 Archive Date: 03/25/22 DOCKET NO. 16-39 059 DATE: March 25, 2022 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. Entitlement to service connection for meningioma is remanded. REASONS FOR REMAND The Veteran served on active duty in the Navy from December 1968 to September 1970 and died in April 2015. This case comes before the Board of Veterans' Appeals (Board) on appeal from the September 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Paul, Minnesota. In July 2019 and June 2021, the Board remanded the claims for additional development. The Board notes that there was not substantial compliance with its June 2021 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998); D'Aries v. Peake, 22 Vet. App. 97, 105 (2008). 1. Entitlement to service connection for the cause of the Veteran's death is remanded. 2. Entitlement to service connection for meningioma is remanded. As noted above, the Board remanded the Veteran's claims for additional development, specifically requesting that the Agency of Original Jurisdiction (AOJ) adjudicate the pending request by the Veteran's spouse for substitution as claimant in the Veteran's pending claim for service connection for meningioma, as well as, provide an addendum VA medical opinion regarding the etiology of the Veteran's meningioma without the reliance on the absence of medical literature supporting a nexus. See BVA Decision, June 2021. In June 2021, the Veteran's spouse was provided an addendum VA medical opinion in response to the Board's June 2021 remand. However, upon review, the Board finds this opinion to be inadequate, as this examiner also provided a rationale solely based on the lack of medical literature supporting a causal relationship between exposures to herbicides, solvents, or petroleum products, without any further discussion as to why the lack of literature is dispositive of the claims, or discussion of the facts specific to the Veteran in relation to the medical literature. See Bailey v. O'Rourke, 30 Vet. App. 54, 60 (2018) (reliance on the absence of medical literature supporting nexus without discussing the specific facts of the case renders an opinion inadequate). The Board notes that the June 2021 remand specifically directed that a negative opinion could not be based solely on this rationale. Therefore, the Veteran's spouse should be provided an additional addendum VA medical opinion that adequately addresses the etiology of the Veteran's condition, prior to readjudication of the claim for the cause of death. Additionally, a review of the file does not reflect that the AOJ adjudicated the Veteran's spouse's pending request for substitution as claimant in the Veteran's pending claim for entitlement to service connection for meningioma, as directed by the Board in the June 2021 remand. Therefore, to ensure judicial efficiency, the AOJ must adjudication such request, as they must decide in the first instance all requests for substitution. See 38 C.F.R. §§ 3.1000(a)(1)(i); 3.1010(e). Therefore, based on the above, the Board finds that another remand is necessary to address the matters discussed above, in accordance with VA's duty to assist and in compliance with Stegall. The matters are REMANDED for the following action: 1. The AOJ should adjudicate the pending request by the Veteran's spouse for substitution as claimant in the Veteran's claim for service connection for meningioma that was pending at the time of his death. 2. Request the Veteran's spouse to identify all medical providers (VA and private) from whom the Veteran has received treatment for his meningioma and obtain any outstanding records and associate them with the Veteran's claims file. 3. After associating all newly acquired records with the claims file, provide the Veteran's spouse with an addendum VA medical opinion by an appropriate clinician, who has not previously provided an opinion in this matter, to determine the nature and etiology of the Veteran's meningioma. The entire claims file, including a copy of this remand, must be made available to the examiner, and note review of the record in the examination report. All pertinent medical complaints, symptoms, and clinical findings must be reported in detail. Following complete review of the record, the examiner must address the following: (a) Opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's meningioma had its onset during any period of active duty service, or is otherwise etiologically related to his active duty service, to include the conceded exposures to herbicides, solvents, and/or petroleum products. Please note: the examiner cannot provide a rationale based solely on the absence of medical literature supporting a nexus, and must discuss the Veteran's specific facts in the requested rationale. (b) All opinions should include a detailed rationale. The examiner should consider the entire claims file and discuss the Veteran's and his spouse's lay statements regarding the nature and onset of symptoms. The examiner is advised that the Veteran and his spouse are competent to report symptoms, and that their reports must be considered in formulating the requested opinion. (Continued on the next page) (c) If the examiner(s) is unable to offer the requested opinion(s), it is essential that the examiner offer a rational for the conclusion that an opinion could not be provided without resorting to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. See Jones v. Shinseki, 23 Vet. App. 382. (2010). DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Carter, 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.