Citation Nr: 25006972 Decision Date: 05/21/25 Archive Date: 05/21/25 DOCKET NO. 20-00 181 DATE: May 21, 2025 REMANDED Entitlement to service connection for a thyroid disorder is remanded. REASONS FOR REMAND The Veteran had active-duty service in the United States Army from February 1977 to February 1980, with additional service with a Reserve Component. In September 2023, the undersigned issued a Board of Veterans' Appeal (Board) decision that, among other things, denied the Veteran's claim of service connection for a thyroid disorder. The Veteran appealed the September 2023 Board decision to the United States Court of Appeals for Veterans Claims (Court). In a June 2024 order, which incorporated the parties Joint Motion for Partial Remand (JMPR), the Court vacated and remanded the September 2023 Board decision to the extent that it denied service connection for a thyroid disorder. In October 2024, the Board remanded the claim for additional development consistent with the JMPR. Context in this case is needed: It is important to note that the Veteran is in receipt of a 100 percent disability, as well as an award of special monthly compensation (SMC). Entitlement to service connection for a thyroid disorder is remanded. When this case was previously before the Board in October 2024, it was remanded for additional evidentiary development to address the concerns of the June 2024 JMPR. Specifically, the Board remanded the appeal to provide the Veteran with a VA examination to obtain the needed etiology opinion regarding his claim for service connection for a thyroid disorder. See 38 U.S.C. § 5103A(d); Forcier v. Nicholson, 19 Vet. App. 414, 425 (2006) (holding that the duty to ensure compliance with the Court's order extends to the terms of the agreement struck by the parties that forms the basis of the joint motion to remand); cf. McBurney v. Shinseki, 23 Vet. App. 136, 140 (2009) (Board has a duty on remand to ensure compliance with the favorable terms stated in the joint motion for remand or explain why the terms will not be fulfilled). Importantly, pursuant to the October 2024 Remand directives, the Board instructed that if the RO was unable to obtain a VA examination of the Veteran for any reason, the examiner should provide answers to the questions posed by the Board Remand based on the evidence of record to the extent possible. On March 3, 2025, the VA requested an examination for the Veteran. A March 13, 2025 VA Medical Opinion Disability Benefits Questionnaire reflects that multiple attempts to contact the Veteran over the phone were made on the date of the scheduled examination, however, there was no response. Reportedly, a voicemail was left. No medical opinions were reported. In a March 27, 2025 supplemental statement of the case (SSOC), the RO continued to deny the Veteran's claim. In denying his claim, the RO referenced that the Veteran failed to report to his VA examination without good cause. Significantly, the record does not contain any letter or other document reflecting that the Veteran was properly notified of his scheduled examination. The SSOC simply stated that the Veteran failed to report to the VA examination. In a May 2025 statement, the Veteran reported that he had not been notified of the March 13, 2025, VA examination and he requested that he be rescheduled. Accordingly, the Board finds that the Veteran has presented good cause for his failure to attend the examination, and remand to provide the Veteran the examination as instructed in the Board's October 2024 Remand is warranted. See 38 C.F.R. § 3.655. In light of the fact that the Veteran is already receiving a 100 percent disability, the Veteran, in consultation with his representative, may wish to withdraw (in writing) the claim being remanded. Unless this is done, the Board must proceed on this issue. The matters are REMANDED for the following action: To comply with the JMPR, schedule the Veteran for a VA examination with a suitably qualified medical professional to address his claim of service connection for a thyroid disorder. The claims folder should be made available to and reviewed by the examiner. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. If the RO is unable to obtain a VA examination of the Veteran for any reason, the examiner should provide answers to the below questions based on the evidence of record to the extent possible. Following consideration of the evidence of record (both lay and medical) and the results of the examination, if any, the examiner is asked to address the following: 1. Provide an opinion as to whether it is "at least as likely as not" that a thyroid disorder had its' onset directly during the Veteran's service or is otherwise related to any event or injury during service. 2. Provide an opinion as to whether it is "at least as likely as not" that a thyroid disorder manifested in the first post-service year. In providing answers to the above questions the examiner should consider the Veteran's service treatment records. In providing answers to the above questions the examiner should consider the fact that the Veteran is competent to report on in-service events like taking iodine pills in service to purify his drinking water during the two months he spent in Panamanian jungle training, his post service events, and his observable adverse symptomatology. In providing answers to the above questions the examiner should provide medical reasoning for accepting or rejecting the lay claims regarding observable in-service and post-service adverse symptomatology. In providing answers to the above questions the examiner should not rely solely on negative evidence to include the Veteran not having the problem in-service or for many years after service. In providing answers to the above questions the examiner should consider and discuss the significant, if any, of the following information found in the JMPR-the internet article cited to in the 2019 attorney brief that asserted a link between iodine and thyroid conditions. In providing answers to the above questions the examiner is advised that the term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of conclusion as it is to find against it. In providing answers to the above questions please articulate the reasoning underpinning your conclusions. That is, (1) identify what facts and information--whether found in the record or outside the record--support your opinion, and (2) explain how that evidence justifies your opinion. If the examiner cannot provide an answer to any of the above questions without resort to speculation he or she should so state, and must further explain why it is not feasible to provide an answer, indicating whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or in the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training) John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Azizi, T. 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.