Citation Nr: A18000031 Decision Date: 11/13/18 Archive Date: 11/13/18 DOCKET NO. 181004-501 DATE: November 13, 2018 REMANDED Entitlement to service connection for acid reflux is remanded. Entitlement to service connection for right shoulder muscle spasms is remanded. Entitlement to service connection for left shoulder muscle spasms is remanded. Entitlement to service connection for chest muscle spasms is remanded. Entitlement to service connection for a sinus disorder is remanded. Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1970 to July 1974. On August 23, 2017, the President signed into law the Veterans Appeals Improvement and Modernization Act, Pub. L. No. 115-55 (to be codified as amended in scattered sections of 38 U.S.C.), 131 Stat. 1105 (2017), also known as the Appeals Modernization Act (AMA). This law creates a new framework for Veterans dissatisfied with VA’s decision on their claim to seek review. The Veteran chose to participate in VA’s test program RAMP, the Rapid Appeals Modernization Program. This decision has been written consistent with the new AMA framework. Subsequent to the Veteran’s selection of the RAMP processing, the RO issued a September 2018 rating decision, which denied service connection for acid reflux, bilateral shoulder muscle spasms, chest muscle spasms, a sinus disorder, and sleep apnea. The Veteran timely selected a direct-review processing, and this appeal ensued. The Board notes that in the RO’s September 2018 rating decision, it characterized the issues as service connection issues, all of which appear to have been denied on the merits, thereby finding that new and relevant has been received for these issues. As such, the RO’s reopening of the claims is viewed as a favorable determination, and thus the only issues remaining on appeal are entitlement to service connection, as noted on the title page above. Issues 1-6: Entitlement to service connection for acid reflux, bilateral shoulder muscle spasms, chest muscle spasms, a sinus disorder, and sleep apnea is remanded. The claims for service connection for acid reflux, bilateral shoulder muscle spasms, chest muscle spasms, a sinus disorder, and sleep apnea are being remanded for VA examinations. Notably, prior to the issuance of the rating decision on appeal, the Veteran was not provided VA examinations in connection with the current claims. As the Veteran contends that he has the claimed disorders and that they are all related to exposure to chemicals during service as a result of his MOS and, VA examinations are indicated. The matter is REMANDED for the following action: 1. Provide a comprehensive VA examination by an appropriate examiner to determine the nature and etiology of the Veteran’s claimed acid reflux. The claims file, and a copy of this remand, will be available to the examiner, who must acknowledge receipt and review of these materials in any report generated as a result of this remand. After reviewing the claims file in its entirety and examining the Veteran, the examiner is asked to address the following: a) Confirm whether the Veteran has a current diagnosis of acid reflux. b) Provide an opinion as to whether the Veteran’s acid reflux at least as likely was incurred in or related to active duty service. *In doing so, address the Veteran’s contention that his acid reflux is related to exposure to chemicals, such as oxidizer and fuel, during service.* A complete rationale should be provided for any opinion provided. 2. Provide a comprehensive VA examination by an appropriate examiner to determine the nature and etiology of the Veteran’s claimed right and left shoulder muscle spasms. The claims file, and a copy of this remand, will be available to the examiner, who must acknowledge receipt and review of these materials in any report generated as a result of this remand. After reviewing the claims file in its entirety and examining the Veteran, the examiner is asked to address the following: a) Confirm whether the Veteran has a current diagnosis involving bilateral shoulder muscle spasms. b) Provide an opinion as to whether the Veteran’s bilateral shoulder muscle spasms at least as likely were incurred in or related to active duty service. *In doing so, address the Veteran’s contention that his bilateral shoulder spasms are related to exposure to chemicals, such as oxidizer and fuel, during service.* A complete rationale should be provided for any opinion provided. 3. Provide a comprehensive VA examination by an appropriate examiner to determine the nature and etiology of the Veteran’s claimed chest muscle spasms. The claims file, and a copy of this remand, will be available to the examiner, who must acknowledge receipt and review of these materials in any report generated as a result of this remand. After reviewing the claims file in its entirety and examining the Veteran, the examiner is asked to address the following: a) Confirm whether the Veteran has a current diagnosis involving chest muscle spasms. b) Provide an opinion as to whether the Veteran’s chest muscle spasms at least as likely was incurred in or related to active duty service. *In doing so, address the Veteran’s contention that his chest muscle spasms are related to exposure to chemicals, such as oxidizer and fuel, during service.* A complete rationale should be provided for any opinion provided. 4. Provide a comprehensive VA examination by an appropriate examiner to determine the nature and etiology of the Veteran’s claimed sinus disorder. The claims file, and a copy of this remand, will be available to the examiner, who must acknowledge receipt and review of these materials in any report generated as a result of this After reviewing the claims file in its entirety and examining the Veteran, the examiner is asked to address the following: a) Confirm whether the Veteran has a current diagnosis of a sinus disorder. b) Provide an opinion as to whether the Veteran’s sinus disorder at least as likely was incurred in or related to active duty service. *In doing so, address the Veteran’s contention that his sinus disorder is related to exposure to chemicals, such as oxidizer and fuel, during service.* A complete rationale should be provided for any opinion provided. 5. Provide a comprehensive VA examination by an appropriate examiner to determine the nature and etiology of the Veteran’s claimed sleep apnea. The claims file, and a copy of this remand, will be available to the examiner, who must acknowledge receipt and review of these materials in any report generated as a result of this remand. After reviewing the claims file in its entirety and examining the Veteran, the examiner is asked to address the following: a) Confirm whether the Veteran has a current diagnosis of sleep apnea. b) Provide an opinion as to whether the Veteran’s sleep apnea at least as likely was incurred in or related to active duty service. *In doing so, address the Veteran’s contention that his sleep apnea is related to exposure to chemicals, such as oxidizer and fuel, during service.* A complete rationale should be provided for any opinion provided. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Jane R. Lee