Citation Nr: 18158892 Decision Date: 12/18/18 Archive Date: 12/18/18 DOCKET NO. 17-04 667A DATE: December 18, 2018 REMANDED Entitlement to service connection for a gastrointestinal disorder, to include diverticulitis, to include as due to Gulf War illness is remanded. REASONS FOR REMAND The Veteran filed an April 2015 claim seeking, in relevant part, service connection for both irritable bowel syndrome and diverticulitis of the colon, to include as secondary to Gulf War syndrome. In his January 2017 appeal to the Board, the Veteran indicated that he was only appealing the issue of service connection for diverticulitis, noting that he believed his in-service gastrointestinal symptoms were related to his current disability. To better comport with the evidence of record, the Board has recharacterized the claim on appeal as entitlement to service connection for a gastrointestinal disorder, to include as due to Gulf War illness. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009) (the scope of a disability claim includes any disability that may reasonably be encompassed by the veteran's description of the claim). Entitlement to service connection for a gastrointestinal disorder, to include diverticulitis, to include as due to Gulf War illness is remanded. The Veteran has indicated that he believes his current gastrointestinal disorder is related to his service, to include as a result of his service in the Persian Gulf War. In an April 2015 statement, the Veteran indicated that since his active duty service, he has had a portion of his colon removed. Additionally, the Veteran’s August 2014 private treatment records noted that the Veteran had a history of sigmoid colectomy. However, records associated with that procedure do not appear to have been associated with the claims file. Thus, it appears there are outstanding private or VA treatment records, and a remand is necessary in order to obtain those records and any other outstanding private or VA treatment records. The Veteran has not yet received a VA examination in connection with his claimed gastrointestinal disorder. The Veteran’s private treatment records document that he is currently being treated for gastrointestinal symptoms, and has been assessed with hematochezia, proctitis, sigmoid diverticulosis, proctitis/inflammatory bowel disease. In his October 2015 notice of disagreement, the Veteran noted that he has had these problems since the Gulf War, and indicated that they may be related to exposure to environmental hazards, oil smoke, and chemicals. The Veteran’s Form DD 214 for his period of service from November 1990 through May 1991 indicated that he was ordered to active duty in support of Operation Desert Shield/Desert Storm, and a subsequent Form DD 215 indicated that the Veteran received a Southwest Asia Service Medal with three bronze service stars, a Kuwait Liberation Medal (Kuwait) and a Kuwait Liberation Medal (Saudi Arabia). Thus, he is a Veteran of the Persian Gulf War and service in Southwest Asia has been verified under 38 C.F.R. 3.317. Additionally, in his January 2017 appeal to the Board, the Veteran noted that his current gastrointestinal disorder could be related to the gastrointestinal symptoms he experienced in service. The Veteran’s service treatment records document that he received treatment for gastrointestinal symptoms several times in service. More specifically, service treatment records from August 1983, November 1983, and January 1984 document that the Veteran reported symptoms including vomiting, diarrhea, stomach cramps, and general upper abdominal pain, and during his January 1984 separation examination, the Veteran reported mild frequent indigestion. The evidence of record meets the low threshold for obtaining a VA examination in this case, and on remand, one should be provided to determine the nature and etiology of the Veteran's claimed gastrointestinal disorder. See 38 U.S.C. § 5103A (d) (2012); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matter is REMANDED for the following action: 1. Obtain any and all outstanding VA treatment records from the Kansas City VA Medical Center, or any other VA medical facility that may have treated the Veteran, and associate those documents with the claims file. 2. After securing the necessary releases, attempt to obtain any outstanding private treatment records identified by the Veteran, to include records relating to his sigmoid colectomy. If any identified records cannot be obtained and further attempts would be futile, such should be noted in the claims file and the Veteran should be notified so that she can attempt to obtain those records on her own behalf. 3. Schedule the Veteran for an examination with an appropriate clinician to determine whether the Veteran’s gastrointestinal symptoms are related to the Veteran's military service, to include as a result of the Veteran's service in the Persian Gulf War. The claims file must be made available to and be reviewed by the examiner in conjunction with the examination. Following review of the claims file and examination of the Veteran, the examiner should identify all gastrointestinal conditions currently found, including diverticulitis and irritable/inflammatory bowel disease (IBS). The examiner must state whether or not the Veteran meets the criteria for a diagnosis of IBS. For each gastrointestinal condition identified, the examiner should opine whether it is at least as likely as not (50 percent or greater probability) that the disability began in or is otherwise caused by the Veteran's active service, to include his service in the Persian Gulf in the 1990s or his documented gastrointestinal complaints in the 1980s. The examiner should address the Veteran's lay statements regarding continuity of symptomatology since onset and/or since discharge from service. All findings must be reported in detail and all opinions must be accompanied by a clear rationale. If any of the above issues cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Reed, Associate Counsel