Citation Nr: 18155242 Decision Date: 12/03/18 Archive Date: 12/03/18 DOCKET NO. 16-57 268 DATE: December 3, 2018 REMANDED Entitlement to service connection for an eating disorder is remanded. REASONS FOR REMAND The Veteran had active duty from November 1999 to November 2003, November 2005 to March 2006, April 2006 to March 2007 and October 2007 to March 2008. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In his July 2015 Notice of Disagreement, the Veteran asserted that he has an eating disorder and that he currently works with a nutritionist to control his weight. Also, in the October 2016 Substantive Appeal, the Veteran contended that he eats when he is stressed, and due to his binge eating, he may not be able to maintain his job. The Veteran’s in-service treatment records reflect that he was referred to a dietician in July 2006 due to his weight gain while serving in Afghanistan and that he had a history of being overweight. His January 2013 post-service medical record reflects a nutritional diagnosis of obesity related to excess energy intake and physical inctivity and show that the Veteran is on VA’s MOVE! weight management program to control his weight gain. In the June 2018 Appellant’s brief, the Veteran’s representative argued that the Veteran is currently service connected for a mental health condition; therefore, the eating disorder should be service connected based on the Veteran’s written testimony. The Veteran has not been afforded with a VA examination for his alleged eating disorder. As the Veteran claims that he suffers from an eating disorder, his in-service treatment records reflect that he was referred to a dietician for weight management, he is on the VA MOVE! program to control his weight, and the Veteran is service connected for adjustment disorder with anxiety and alcohol abuse, the Board finds that the low threshold of McLendon has been met and the Veteran should be afforded a VA examination to determine the nature and etiology of his eating condition, if any. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matter is REMANDED for the following action: 1. Provide the Veteran another opportunity to identify any pertinent treatment records, VA or private, with respect to his eating condition. The RO/AMC should secure any necessary authorizations. If any requested outstanding records cannot be obtained, the Veteran should be notified of such. 2. Schedule the Veteran for a VA examination for eating disorders. The Veteran’s claims file, including this remand, should be made available for review by the examiner in conjunction with the examination. The examiner should review the claims folder and this fact should be noted in the accompanying medical report. After conducting an examination of the Veteran and performing any clinically-indicated diagnostic testing, the examiner should provide the following opinions: (i) Is it at least as likely as not (a 50 percent probability or greater) that the eating disorder, if any, is related to his active service? (ii) If not, is it at least as likely as not (50 percent probability or greater) that the Veteran’s eating disorder, if any, was caused by his service-connected adjustment disorder? (iii) If not, is it at least as likely as not (50 percent probability or greater) that the eating disorder, if any, was aggravated (worsened beyond its natural progression) by his service-connected adjustment disorder? If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation of the Veteran’s eating disorder and determine what degree of additional impairment is attributable to aggravation of the eating disorder due to his service-connected adjustment disorder. In so opining the examiner should address the lay and medical evidence of record. A detailed rationale for the opinion must be provided. If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. The examiner is reminded that the term “as likely as not” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that, in the examiner’s expert opinion, it is as medically sound to find in favor of the proposition as against it. TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Lee, Associate Counsel