Citation Nr: 23027240 Decision Date: 05/08/23 Archive Date: 05/08/23 DOCKET NO. 18-15 053 DATE: May 8, 2023 REMANDED Entitlement to service connection for a left elbow disability, to include triceps tendonitis, is remanded. REASONS FOR REMAND Having reviewed the record, the Board finds remand is agan warranted for an addendum opinion for substantial compliance with prior directives. See Stegall v. West,11 Vet. App. 268 (1998). By way of history, the case has been remanded several times for examination and opinion. Most recently, a June 2022 Board decision remanded the case for an addendum opinion by an orthopedic specialist to determine the etiology of the claimed condition, with specific instructions to address (i) whether the in-service injury caused the current tendonitis given the type of injury sustained in service and the nature of tendonitis; and (ii) the Veteran's statements at his 2020 hearing regarding his left elbow pain since his injury, that he is right handed, and that he has been overusing his right arm, so he believes his tendinitis should not be from overuse of his left arm. The Veteran was thereafter afforded an addendum opinion in July 2022. However, the July 2022 examiner failed to discuss the Veteran's January 2020 hearing testimony regarding his left elbow pain since his injury, that he is right handed, and that he has been overusing his right arm, so he believes his tendinitis should not be from overuse of his left arm. As such, remand is agan warranted for an addendum opinion to substantially comply with the June 2022 directives. See Stegall v. West,11 Vet. App. 268 (1998). The Board additionally notes that in a March 2023 appellate brief, the Veteran, through his representative, challenges the competency of the July 2022 examiner. As such, the agency of original jurisdiction is instructed to provide the curriculum vitae for the examiner selected to provide the addendum opinion. Additionally, the Veteran, through his representative, contends that the examiner did not address the complexity of the elbow as at least one head of the triceps runs from and through the service-connected left shoulder to the forearm, as well as the biceps. As the Board may only consider independent medical evidence to support its findings, the examiner should also address this contention. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). Thus, in light of the above contentions, the Board finds the examiner should provide addendum opinions on whether the Veteran's left elbow disability is proximately due to or aggravated by service-connected left acromioclavicular joint osteoarthritis. In doing so, the examiner must address the Veteran's January 2020 hearing testimony and the March 2023 contention that at least one head of the triceps runs from and through the service-connected left shoulder to the forearm, as well as the biceps. Finally, the Board notes there may be outstanding private treatment records relevant to the case. In a March 2018 letter, Dr. J.Z. indicated he treated the Veteran from 2004 until March 2017 with respect to the left elbow. In light of this, an attempt should be made to obtain records from Dr. J.Z. and C. Primary Care with the Veteran's authorization. The matter is REMANDED for the following actions: 1. Ask the Veteran to complete a VA Form 21-4142 for Dr. J.Z. and C. Primary Care for treatment provided from 2004 to date. Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 2. Thereafter, obtain an addendum opinion by an orthopedic specialist M.D. regarding the Veteran's left elbow condition to discuss the Veteran's January 2020 hearing testimony. The examiner must provide the following opinions: (a) Whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's?left elbow tendonitis is etiologically related to his in-service fall in 2007. (b) Whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's?left elbow tendonitis is proximately due to service-connected left acromioclavicular joint osteoarthritis. (c) Whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's?left elbow tendonitis is aggravated by service-connected left acromioclavicular joint osteoarthritis THE EXAMINER MUST ADDRESS (i) the Veteran's January 2020 hearing testimony regarding his left elbow pain since his injury, that he is right-handed, and that he has been overusing his right arm and thus believes his tendinitis should not be from overuse of his left arm, and (ii) the March 2023 Veteran's representative's contention that the prior medical opinion did not address the complexity of the elbow as at least one head of the triceps runs from and through the service-connected left shoulder to the forearm, as well as the biceps in regard to the likelihood the elbow condition is related to service or service connected left shoulder disability. Any opinions offered should be accompanied by the underlying reasons for the conclusions. 3. Associate with the file the curriculum vitae (CV) and any other available information regarding the qualifications of the VA examiner selected to provide the addendum opinion. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Vang, 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.