Citation Nr: 18157725
Decision Date: 12/13/18	Archive Date: 12/13/18

DOCKET NO. 16-38 383
DATE:	December 13, 2018
REMANDED
Entitlement to service connection for multiple sclerosis.

INTRODUCTION
The Veteran served on active duty from March 1988 to March 1992.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office in Houston, Texas.  
In October 2016, the Veteran testified at a hearing with the undersigned Veterans Law Judge.  A transcript of this hearing has been associated with the Veteran’s claims file.
REASONS FOR REMAND
Although the Veteran has been provided several VA examinations during the pendency of this appeal, including some that assess his multiple sclerosis, none have included an opinion that addresses the etiological relationship between his multiple sclerosis and his active duty.  The Board finds that a remand is warranted to obtain such an opinion.
The matter is REMANDED for the following action:
1. Contact the Veteran and request that he submit or identify relevant treatment records, especially any private treatment records, that have not already been associated with the claims file.  Undertake efforts to obtain any identified evidence.
2. Contact a VA examiner in order to obtain a supplemental opinion.  The Veteran’s electronic claims file must be made available to and reviewed by the examiner.  The examiner should be asked to provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s multiple sclerosis was incurred in or due to his active duty, to include any in-service exposures (claimed as environmental exposures, such as smoke).  In so doing, the examiner is asked to consider and discuss whether the Veteran’s lay observable, in-service symptoms (headaches, vomiting, irregular bowel movements, etc.) were prodromal manifestations of his current multiple sclerosis.  
Additionally, the examiner is asked to opine as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s multiple sclerosis manifested to a compensable degree within 7 years of his discharge from active duty.
A thorough rationale is required for any rendered opinion.  If the examiner determines that an examination is required, one must be provided to the Veteran.
3.  Once the above actions have been completed, re-adjudicate the claim.  If any benefit remains denied, a supplemental statement of the case must be provided to the Veteran and his representative.  After they have had an adequate opportunity to respond, the appeal must be returned to the Board for further appellate review.
 
T. REYNOLDS
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Sean G. Pflugner, Counsel