Citation Nr: 19136341
Decision Date: 05/10/19	Archive Date: 05/10/19

DOCKET NO. 14-36 508
DATE:	May 10, 2019

REMANDED

Entitlement to service connection for a gastrointestinal disability is remanded.

REASONS FOR REMAND

The Veteran served on active duty in the United States Army from September 1996 to January 1997, September 1999 to May 2000, February 2003 to January 2004, January 2008 to February 2009 and December 2010 to February 2012, including service in Southwest Asia, with additional Reserve service. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO).  The Veteran testified before the undersigned in December 2018.



Here, as the Veteran testified that he did not receive notice of the VA examination scheduled in relation to this appeal, the Board finds that good cause has been shown for his failure to report, and his examination should be rescheduled on remand.  Updated records should also be secured.

The matter is REMANDED for the following action:

1. Obtain all outstanding VA treatment records.

2. With any necessary assistance from the Veteran, obtain any outstanding relevant private treatment records, to include updated records from WellSpan.

3. Then schedule the Veteran for a VA examination to determine the nature and etiology of his claimed gastrointestinal disability. 

The examiner is asked to review the pertinent evidence, including the lay statements regarding onset of symptomatology, and undertake any indicated studies. Then, based on the results of the examination, the examiner is asked to address each of the following questions: 

(a) Please state whether the symptoms of the claimed condition are attributable to a known clinical diagnosis.

(b) If a diagnosis of gastroesophageal reflux disease (GERD) is rendered, please state whether GERD is a functional gastrointestinal disorder or a structural gastrointestinal disease. 

(c) Is the Veteran’s disability pattern consistent with: (1) a diagnosable but medically unexplained chronic multisymptom illness of unknown etiology, (2) a diagnosable chronic multisymptom illness with a partially explained etiology, or (3) a disease with a clear and specific etiology and diagnosis?

(d) If, after examining the Veteran and reviewing the claims file, you determine that the Veteran’s disability pattern is either a diagnosable chronic multi-symptom illness with a partially explained etiology ((c)(2) above), or a disease with a clear and specific etiology and diagnosis ((c)(3) above), then please opine as to whether it is at least as likely as not (50 percent or greater probability) related to presumed environmental exposures during the Veteran’s service in Southwest Asia. 

(e) Is it at least as likely as not (50 percent probability or greater) that any diagnosed disorder had its onset directly during the Veteran’s service or is otherwise causally related to any event or circumstance of his service? In addressing this question, please discuss the Veteran’s testimony as to an onset of gastrointestinal symptoms following his second deployment (around 2009/2010), and please do not rely on the absence of documented treatment in the service records.

If the examiner is unable to provide an opinion without resorting to speculation, an explanation as to why this is so and what, if any, additional evidence would be necessary before an opinion could be rendered should be provided. 

 

S. BUSH

Veterans Law Judge

Board of Veterans’ Appeals

ATTORNEY FOR THE BOARD	Jolethia Rogers, Associate Counsel