Citation Nr: 18157395 Decision Date: 12/12/18 Archive Date: 12/12/18 DOCKET NO. 16-49 937 DATE: December 12, 2018 REMANDED Entitlement to service connection for left shoulder impingement is remanded. Entitlement to service connection for low back condition is remanded. Entitlement to service connection for left knee condition is remanded. Entitlement to service connection for dry eye syndrome is remanded. Entitlement to service connection for restrictive airway disease is remanded. Entitlement to service connection for hiatal hernia is remanded. REASONS FOR REMAND The Board notes the Veteran’s service connection claims were denied in part for a lack of in service complaints or treatment. Consequently, the Veteran was not afforded the opportunity to have a VA examination for his disabilities. However, the Board finds the Veteran’s service records show complaints and treatments for each disability. Additionally, in his Notice of Disagreement, the Veteran states that he has continuously taken medication for his hernia and his reactive airway disease, that he uses eye drops for his dry eyes, and that he has had persistent symptoms of a left knee, left shoulder, and low back disabilities. This indicates that there may be persistent symptoms. Thus, the Board finds that the low threshold for requiring a VA examination is met. McLendon v. Nicholson, 20 Vet. App. 79, 86 (2006). The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination with an appropriate clinician for his left shoulder impingement disability. The entire claims file and a copy of this remand must be made available to the examiner for review. The examiner must provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s left shoulder impingement began during active service or is related to an incident of service, including his October 2006 service records noting his complaints for left shoulder pain. The examiner is advised that the Veteran has asserted that he has had persistent symptoms of a left shoulder disability since service. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 2. Schedule the Veteran for an examination with an appropriate clinician for a low back disability. The entire claims file and a copy of this remand must be made available to the examiner for review. The examiner must provide an opinion as to whether it is at least as likely as not that the Veteran’s low back disability began during active service or is related to an incident of service, including his multiple in-service complaints and his April 2010 separation examination noting recurrent back pain. The examiner’s attention is drawn to the Veteran’s October 2016 Form 9, where he asserts he injured his back during training and combat operations, and that it has persisted since that time. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 3. Schedule the Veteran for an examination with an appropriate clinician for left knee disability. The entire claims file and a copy of this remand must be made available to the examiner for review. The examiner must provide an opinion as to whether it is at least as likely as not that the Veteran’s left knee disability began during active service or is related to an incident of service, including his March 2000 complaint of left knee pain after a motorcycle accident. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 4. Schedule the Veteran for an examination with an appropriate clinician for his dry eye syndrome. The entire claims file and a copy of this remand must be made available to the examiner for review. The examiner must provide an opinion as to whether it is at least as likely as not that the Veteran’s dry eye syndrome began during active service or is related to an incident of service, including his December 1999 PRK surgery. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 5. Schedule the Veteran for an examination with an appropriate clinician for restrictive airway disease. The entire claims file and a copy of this remand must be made available to the examiner for review. The examiner must provide an opinion as to whether it is at least as likely as not that the Veteran’s restrictive airway disease began during active service or is related to an incident of service, including multiple in-service treatment records documenting his treatment for restrictive airway disease or his exposure to smoke and gases as a Gulf War Veteran. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 6. Schedule the Veteran for an examination with an appropriate clinician for his hiatal hernia. The entire claims file and a copy of this remand must be made available to the examiner for review. The examiner must provide an opinion as to whether it is at least as likely as not that the Veteran’s hiatal hernia began during active service or is related to an incident of service, including his February 2007 and October 2007 in service treatment. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. (Continued on the next page)   7. Then, readjudicate the claims. If any decision is unfavorable to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Brunot, Associate Counsel