Citation Nr: 25008948 Decision Date: 07/09/25 Archive Date: 07/09/25 DOCKET NO. 200820-104914 DATE: July 9, 2025 REMANDED Entitlement to a rating in excess of 30 percent for a pelvic condition, characterized as endometriosis, is remanded. An effective date earlier than May 7, 2020, for the grant of a 30 percent disability rating for a pelvic condition, characterized as endometriosis, is remanded. REASONS FOR REMAND The Veteran served on active-duty service from November 1995 to July 2003. These matters return to the Board of Veterans' Appeals (Board) following a February 2024 remand which directed the Agency of Original Jurisdiction (AOJ) to undertake additional development. 1. Entitlement to a rating in excess of 30 percent for a pelvic condition, characterized as endometriosis, is remanded. 2. An effective date earlier than May 7, 2020, for the grant of a 30 percent disability rating for a pelvic condition, characterized as endometriosis, is remanded. The Veteran seeks a higher rating for her service-connected pelvic condition, hereafter endometriosis, and an earlier effective date for the grant of the now-assigned 30 percent rating. After a review of the evidence of record, the Board of Veterans' Appeals (Board) concludes that the claims must, once again, be remanded as the AOJ failed to substantially comply with the prior Board remand directives. In the February 2024 remand, the Board directed the AOJ to obtain a new examination for the Veteran's pelvic disorder to ascertain the current severity of the disability and obtain a retrospective opinion to discuss the past severity of the disability and why surgery became necessary in 2019. The examinations were obtained in March 2024. The examiner indicated that they could not provide a retrospective opinion noting that they could not determine if unknown details were omitted or mischaracterized. Moreover, they did not discuss the Veteran's symptoms in the period prior to May 2020 noting that they do not rate disabilities. The examiner in this matter was either confused or not provided with enough instruction as all they were asked to do is to discuss the symptoms that are noted in the rating criteria and their severity, not rate the Veteran's disability or provide an estimated rating. The AOJ made no effort after the opinions were provided to obtain an opinion in line with the remand instructions. As such, the Board finds that the remand instructions were not substantially complied with. The increased rating claim for the Veteran's pelvic disability is inextricably intertwined with the other claim on appeal and must be remanded alongside. The matters are REMANDED for the following action: 1. A retrospective opinion regarding the severity of the Veteran's pelvic disability over time must be obtained from an appropriate clinician, other than the March 2024 examiner. The examiner is asked to evaluate and discuss how the Veteran's endometriosis symptoms have changed over time and to specifically discuss why a hysterectomy was necessary. Additionally, the examiner(s) should also discuss how the Veteran's symptoms have been manifesting since surgery. If the examiner finds that symptoms indicative of a higher rating criteria were present in the period prior to May 2020, they are asked to evaluate when these symptoms arose and speak to their severity. (The examiner is only asked to discuss the symptoms evaluated under diagnostic codes 7629 and 7618, and if they pertain to the Veteran's disability picture and at what severity, they are not being asked to provide a rating or rating estimate) All opinions should be accompanied by adequate reasons and bases. The examiner(s) is also asked to include a discussion any Veteran's lay statement of record at the time of the rating decision in their opinions. (Continued on the next page) ? If the examiner(s) cannot provide the requested opinion without resorting to mere speculation, they should provide a complete explanation stating why this is so. In so doing, the examiner(s) should explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that they have exhausted the limits of current medical knowledge in providing an answer to that particular question(s). JIMMY L. BARDIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Q. Hernan, 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.