Citation Nr: 18157781 Decision Date: 12/14/18 Archive Date: 12/13/18 DOCKET NO. 10-47 578 DATE: December 14, 2018 REMANDED Entitlement to service connection for a neck disability is remanded. Entitlement to service connection for gastroesophageal reflux disease (GERD), to include as secondary to his service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran had active service in the United States Marine Corps from February 1999 to June 2001. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a June 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In a March 2018 Memorandum decision, the Court vacated part of the March 2017 Board decision which denied service connection for the Veteran’s neck disability and his GERD disability. The Court then remanded the issues for further actions in accordance with its decision.   1. Entitlement to service connection for a neck disability is remanded. As mentioned above, the Court remanded, in part, the Board’s denial for service connection for a neck disability. The memorandum decision explains that the March 2016 nexus opinion either ignored or overlooked relevant evidence, and as such, found the nexus opinion to be inadequate. Additionally, the memorandum stated that the VA examiner must consider the June 2001 private medical record noting that the Veteran had moderate to severe neck pain shortly prior to leaving service. In light of the memorandum decision, the Board finds that a remand is needed for additional development. 2. Entitlement to service connection for GERD, to include as secondary to his service-connected disabilities, is remanded. As mentioned above, the Court remanded, in part, the Board’s denial for service connection for GERD. The memorandum decision explains that the July 2016 VA examination did not comply with the Board’s remand directives from June 2013. The Court stated that the examiner did not opine as to the etiology of the Veteran’s GERD. Additionally, the examiner did not address whether the Veteran’s gastrointestinal condition was related to his service-connected back disability. Lastly, the Court found that the examiner’s opinion was conclusory and lacked supporting rationale. In light of the memorandum decision, the Board finds that a remand is needed for additional development. The matters are REMANDED for the following actions: 1. Obtain any outstanding VA treatment records, to include all recent VA records addressing the Veteran’s cervical neck and GERD. All requests and responses for the records must be documented. If any identified records cannot be obtained, notify the Veteran of the missing records, the efforts taken, and any further efforts that will be made by VA to obtain such evidence, and allow him an opportunity to provide the missing records. Request the Veteran to submit any relevant private treatment reports or provide VA with authorization to obtain any such records. 2. After associating any treatment records with the claims file, schedule the Veteran for an appropriate VA examination for the cervical neck. The claims file is to be made available to the examiner and should be reviewed in conjunction with the examination to understand the Veteran’s pertinent medical history. Then, address: (a.) Is it at least as likely as not (50 percent or greater) that the Veteran’s cervical neck disability was caused by a disease or injury in service? (b.) If no, then is it at least as likely as not (50 percent or greater) that the Veteran’s neck disability, was either 1) proximately due to OR 2) aggravated by any service-connected disability? **Please specifically account for, review, and acknowledge the Veteran’s medical record from June 2001 that documents moderate to severe neck pain.** 3. After associating any records, schedule the Veteran for an appropriate VA examination for the Veteran’s gastrointestinal disability, to include GERD. The claims file is to be made available to the examiner and should be reviewed in conjunction with the examination to understand the Veteran’s pertinent medical history. Then, address: (a.) Is it at least as likely as not (50 percent or greater) that the Veteran’s gastrointestinal disability, to include GERD, was caused by a disease or injury in service? (b.) If no, then is it at least as likely as not (50 percent or greater) that the Veteran’s gastrointestinal disability, to include GERD, was either 1) proximately due to OR 2) aggravated by any service-connected disability, to include his service-connected lower back disability? The term “aggravated” refers to a worsening of the underlying condition beyond the natural progression of the disease, as opposed to temporary or intermittent flare-ups or symptoms that resolve with return to the baseline level of disability. If aggravation is found, please state, to the extent possible, the baseline level of disability prior to aggravation. (Continued on the next page)   For each requested opinion above, a comprehensive rationale for all opinions must be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be provided without resorting to speculation, the examiner must explain why this is so and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD G. Morales, Associate Counsel