Citation Nr: 23039149 Decision Date: 07/14/23 Archive Date: 07/14/23 DOCKET NO. 17-29 112 DATE: July 14, 2023 REMANDED Entitlement to service connection for an ovarian and/or nabothian cyst, to include as secondary to a service-connected C-Section scar, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1998 to March 2003. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) which is the Agency of Original Jurisdiction (AOJ). The Veteran expressed timely disagreement with the AOJ's determination, and the present appeal ensued. In July 2021, the Veteran testified at a Board hearing that was conducted by the undersigned Veterans Law Judge (VLJ) via videoconferencing equipment. A transcript of the hearing is associated with the electronic claims file. The Veteran's claim, among others, was previously before the Board in March 2022 and March 2023. In March 2023, the Board remanded the Veteran's claim for further development with respect to a diagnosed nabothian cyst. That requested development will be discussed more fully below. However, in an effort to ensure that the requested development is accomplished as directed, the Board has recharacterized the issue on appeal pursuant to Clemons v. Shinseki, 23 Vet. App. 1 (2009), to alternatively include the issue of entitlement to service connection for a nabothian cyst. 1. Entitlement to service connection for an ovarian and/or nabothian cyst, to include as secondary to a service-connected C-Section scar Pursuant to the March 2023 remand directives, an addendum medical opinion was obtained in April 2023. The examiner provided a nexus opinion regarding a dermoid cyst; however, the examiner was directed to provide an opinion regarding the Veteran's diagnosed nabothian cyst. Additionally, the Veteran had submitted a medical journal article regarding this type of cyst that was not addressed in the April 2023 opinion. As analysis was not provided regarding a nabothian cyst, the Board finds a remand necessary in order to obtain an adequate addendum opinion regarding this specific type of disorder. The matters are REMANDED for the following action: Obtain an addendum opinion from the May 2022 and April 2023 VA examiner. The examiner should review the records that the Veteran submitted in October 2021. The examiner should also review the medical article that the Veteran submitted in October 2021. After a review of these records, the examiner should provide answers to the following questions: (a.) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's nabothian cyst, had its onset in service or is caused by or related at least in part to her active service? (b.) Is it as least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's nabothian cyst was caused by the Veteran's service-connected C-Section scar? (c.) Is it as least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's nabothian cyst was aggravated by the Veteran's service-connected C-Section scar? In providing the requested opinions, the examiner should consider the Veteran's competent lay claims regarding the observable symptoms she has experienced. The VA examination report must include a complete rationale for all of the opinions expressed. Michael J. Skaltsounis Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. W. Morgan, Associate 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.