CAVC Case 23-1474: Cervical

Accordingly,the Board determined that a new medical examination was necessary to clarify any chronic lymphatic disorder present during the appellate time period and its relationship to military service,as well as consideration as to whether any of the [appellant's]symptoms associated with 3 Case:23-1474 Page: 4 of 11 Filed:06/18/2024 the lymph nodes and/or fever,chills, and night sweats are manifestations of a chronic multisymptom illness.

Over the years,the Board found that additional development was necessary due to various deficiencies in the VA examination reports and opinions.

In its most recent remand,in August 2022,the Board found the February 2022 VA opinions inadequate because the clinician did not consider the appellant's lay statements and did not respond to all of the Board's remand directives.

Parties'Arguments The appellant first argues that the Board erred in finding that VA satisfied its duty to assist because none of the VA examinationreports or medical opinions are adequate to enable the Board to decide the claims for service connection.

ber 2016,July 2017,January 2020, February 2022,and September 2022 because respectively,the examiner failed to consider the appellant's complete medical history,the examiner failed to provide adequate rationale and consider the appellant's lay statements,the clinician did not have access to the appellant's record and the Board found the opinion inadequate,the clinician failed to address lay reports of recurrent episodes of white spots on his tonsils or medical evidence of recurrent tonsillitis/pharyngitis,the clinician provided inadequate rationale and failed to consider lay statements,and the clinician provided inadequate rationale.

ided inadequate rationale,the July 2017 clinician was not competent to opine on this matter and the Board found the opinion inadequate,the January 2020 opinion contained inadequate rationale,the Board found the September 2020 opinion inadequate,the September 2021 opinion contained inadequate rationale,the Board found the February 2022 examination report inadequate,and the September 2022 clinician offered legal or adjudicatory opinions and provided inadequate rationale.

He further argues that,although the Board found [him] competent to report his symptoms of fever,chills,and sweats, id.

Next,the appellant asserts that the Board failed to ensure substantial compliance with its August 2022 remand because the resulting September 2022 VA medical opinion is inadequate given that the physician did not address the lay evidence of recurrent white spots on tonsils,did not provide a complete rationale for his opinions, and [wrote an opinion that]is contradicted by the record.