Citation Nr: 18141627 Decision Date: 10/11/18 Archive Date: 10/11/18 DOCKET NO. 10-45 911 DATE: October 11, 2018 REMANDED The issue of entitlement to service connection for Barrett’s esophagitis, to include as due to herbicide exposure and as proximately due to a service-connected acquired psychiatric disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1967 to June 1971. The matter comes before the Board of Veterans’ Appeals (Board) on an appeal from a July 2010 rating decision of the Department of Veterans’ Affairs (VA) Regional Office (RO) in Boston, Massachusetts. In August 2017, the Board denied the Veteran’s claim for service connection for Barrett’s esophagitis on both a direct basis and as due to the Veteran’s presumed in-service herbicide exposure. The Veteran appealed the denial to the Court of Appeals for Veterans Claims (CAVC). In May 2018, pursuant to a joint motion for remand (JMR) filed by the VA and the Veteran, CAVC vacated the Board’s August 2017 decision and remanded it to the Board for further action. By the terms of the JMR, the December 2009 and February 2017 VA examination reports are inadequate because they do not provide opinions regarding direct service connection. Specifically, the 2009 VA examiner noted the Veteran’s “decades” of heartburn symptoms but did not conclusively opine as to whether the Veteran’s condition was symptomatic during active service. While the 2017 VA examiner concluded that Barrett’s esophagus is not a presumptive disease related to herbicide exposure, he failed to consider whether it was directly related to herbicide exposure. See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Accordingly, remand is required for a further examination in accordance with the directives in the JMR. The appeal is REMANDED to the Agency of Original Jurisdiction (AOJ). VA will notify the appellant if further action is required. The matter is REMANDED for the following action: 1. Obtain any outstanding VA treatment records relevant to the Veteran’s disability on appeal. 2. After all available records have been associated with the claims file, schedule a VA examination to determine the nature and etiology of the Veteran’s current Barrett’s esophagitis diagnosis. The entire claims file, including a copy of the JMR, must be made available to, and reviewed by, the VA examiner. All appropriate tests, studies and consultations should be accomplished and all clinical findings reported in detail. Based upon a review of the relevant evidence of record, history provided by the Veteran, physical examination and sound medical principles, the VA examiner should provide an opinion regarding whether it is at least as likely as not (50 percent probability or more) that the Veteran’s Barrett’s esophagitis first manifested during service, or is otherwise related to service. The opinion should include a determination of whether the condition is directly related to herbicide exposure. The examiner is also advised that the Veteran is competent to report symptoms and that his reports must be considered in formulating the requested opinions. If the Veteran’s reports are discounted, the examiner should provide a reason for doing so. In this regard, the examiner must address the Veteran’s statements regarding his decades of heartburn symptoms and address whether the Veteran was symptomatic during active service. A complete rationale for the examiner’s opinion should be provided, citing to specific evidence of record, as necessary. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and whether there is additional evidence that would permit the opinion to be provided. 3. After completing the requested actions, and any additional action deemed warranted, readjudicate the claim of entitlement to service connection for Barrett’s esophagitis. If the benefit sought remains denied, provide a supplemental statement of the case to the Veteran and his representative and afford them an opportunity to respond. Then, return the case to the Board for further consideration, if in order. The Veteran has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). The claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board or by CAVC for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C. §§ 5109B, 7112. S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Snyder, Associate Counsel