Citation Nr: 18160686
Decision Date: 12/28/18	Archive Date: 12/27/18

DOCKET NO. 10-08 975
DATE:	December 28, 2018
REMANDED
Entitlement to service connection for arthritis of multiple joints is remanded.
REASONS FOR REMAND
The case was previously remanded in July 2017.  The agency of jurisdiction was directed to verify and remove any misfiled service treatment records, pursuant to a January 2017 Joint Motion for Partial Remand (JMPR).  
A review of the record does not indicate that the AOJ has removed the misfiled service records identified in the July 2017 decision.  
Accordingly, remand is warranted for compliance with the July 2017 remand directives.  On remand, the AOJ should review and remove any misfiled service records, to include the records identified in the July 2017 decision, which may include, but are not limited to, pages 13, 17-20, 40, 42, 47, 49, 51, 53, 58, 60, 62, 63, 65, 67, 68, 80-83, and 86 of service treatment records that were associated with the file on September 15, 2014.  The AOJ is directed to verify service records by contacting the appropriate sources and by cross-referencing service records with the Veteran’s full name, correct date of birth, branch of service, and service number.  
Thereafter, an addendum opinion should be obtained on the etiology of the claimed arthritis of multiple joints, to include whether it is as due to the Veteran’s service-connected knee, cervical, and thoracolumbar disabilities.  Additionally of note, the March 2018 examiner stated that there was no documentation that the Veteran has palindromic rheumatism.  However, this statement is inconsistent with the findings in the October 2011 VA examinations and the July 2015 addendum opinion.  In light of this, if the examiner again determines that there is no documentation of palindromic rheumatism, a rationale should be provided addressing the prior findings of palindromic rheumatism.  
Finally, any outstanding VA treatment records should be obtained and associated with the claims record.  
The matter is REMANDED for the following actions:
1. Obtain any outstanding VA treatment records relevant to the claim, to include any records from October 2018. 
2. Review the Veteran’s claims file and remove any misfiled service records.  Undertake any action required to verify that correct service treatment records are associated with the claims file, to include contacting the appropriate sources and cross-referencing service records with the Veteran’s full name, correct date of birth, branch of service, service number.  Any misfiled service treatment records should be removed from the file. 
The Board notes that misfiled documents may include, but are not limited to, pages 13, 17-20, 40, 42, 47, 49, 51, 53, 58, 60, 62, 63, 65, 67, 68, 80-83, and 86 of service treatment records associated with the file on September 15, 2014.  
If the AOJ determines that such service records are not misfiled, a memorandum should be prepared outlining the steps that were taken to verify service records.  
3. After completion of directive 2, forward the Veteran’s claims file to an appropriate clinician for an addendum opinion to determine the nature and etiology of the Veteran’s arthritis of multiple joints.  If the clinician determines that the Veteran should be provided another examination, one should be scheduled.  Following review of the file, the clinician should provide responses to the following:
a)  Whether it is at least as likely as not (a probability of 50 percent or greater) that arthritis of multiple joints, to include palindromic rheumatism, had its onset during active service, manifested to a compensable degree within one year of separation from active duty service, or is otherwise related to active service.
b)  Whether it is at least as likely as not (a probability of 50 percent or greater) that arthritis of multiple joints, to include palindromic rheumatism, is caused by or aggravated by the Veteran’s service-connected degenerative joint and disc diseases of the bilateral knees, cervical spine, or thoracolumbar spine.
If the clinician again determines that there is no documentation of palindromic rheumatism, a rationale should be provided addressing the prior findings of palindromic rheumatism in the October 2011 VA examinations and the July 2015 addendum opinion.  
The phrase ‘at least as likely as not’ means that the weight of the medical evidence both for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against.
Any opinions offered should be accompanied by the underlying reasons for the conclusions.
 
K. J. ALIBRANDO
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	S. Vang, Associate Counsel

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