Citation Nr: 18156337 Decision Date: 12/07/18 Archive Date: 12/07/18 DOCKET NO. 16-62 901 DATE: December 7, 2018 REMANDED Entitlement to service connection for pelvic inflammatory disease is remanded. Entitlement to service connection for hysterectomy and/or its residuals is remanded. Entitlement to service connection for major depressive disorder, to include as secondary to pelvic inflammatory disease, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1974 to December 1974. The Board of Veterans’ Appeals (Board) notes that it has recharacterized the Veteran’s claim of entitlement to service connection for hysterectomy, as set forth above, on the title page, and below. 1. Entitlement to service connection for pelvic inflammatory disease, hysterectomy and/or its residuals, and major depressive disorder, to include as secondary to pelvic inflammatory disease, are remanded. In November 2015, the Veteran has submitted a Notice of Decision from the Social Security Administration (SSA). However, the claims file does not contain the medical records and other evidence upon which that decision was based. The decision indicates that the Veteran was granted Social Security Disability Income based on a number of disabilities including but not limited to obesity and a psychiatric disorder. The Veteran has claimed that she gained weight and developed a psychiatric disorder as the result of her claimed pelvic inflammatory disorder and/or hysterectomy. As such, the Board finds that the Veteran’s records from the SSA may be relevant to the issues on appeal. Therefore, on remand, those records should be sought and obtained, if possible. Additionally, the Board finds that more medical evidence and clarification of the medical evidence of record would be helpful prior to its adjudication of these matters. The Veteran claims that her pelvic inflammatory disease was caused by a venereal disease that she contracted during her active duty service, and she also claims that her pelvic inflammatory disease, in turn, was the reason that she had to have the claimed hysterectomy. See, e.g., Statement in Support of Claim received in April 2010. An August 2010 VA examination indicates that the Veteran’s pelvic inflammatory disease is not caused by or related to any military duties, but the rationale that was set forth in support of that opinion is unclear and confusing. A November 2016 medical opinion indicates that “[t]he veteran’s diagnosis of pelvic inflammatory disease is less likely than not (less than 50 percent) incurred in or caused by (the) abdominal pain during service.” However, the Board finds that further questions require addressing in this case, given the facts, and these are detailed below in the remand instructions. The matters are REMANDED for the following action: 1. Obtain all Social Security Administration (SSA) records pertaining to the Veteran’s claims for SSDI benefits, to include any determinations and the medical records used in support of her claim and associate with the Veteran’s claims folder. All attempts to obtain these records should be documented in the claims folder. Efforts to obtain the requested records should be ended only if it is concluded that the records sought do not exist or that further efforts to obtain those records would be futile. Because these are federal records, if they cannot be located or no such records exist, the Veteran should be notified in writing. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any: 1) pelvic inflammatory disease and 2) hysterectomy and/or its residuals. The examiner must opine whether each is at least as likely as not (a 50 percent or greater probability) related to an in-service injury, event, or disease, including any venereal diseases incurred during her active military service. The examiner should also opine whether the Veteran’s pelvic inflammatory disease clearly and unmistakably (undebatable) preexisted the Veteran’s service. If the examiner finds it did clearly and unmistakably preexist service, the examiner must opine whether it was clearly and unmistakably not aggravated by service. The examiner should also opine whether any current residual symptoms of the Veteran’s hysterectomy are at least as likely as not (1) proximately due to her pelvic inflammatory disease, or (2) aggravated beyond their natural progression by her pelvic inflammatory disease. (Continued on the next page)   A complete rationale must be provided for all opinions expressed and conclusions reached. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Banks, Associate Counsel