Citation Nr: A19001583
Decision Date: 09/26/19	Archive Date: 09/26/19

DOCKET NO. 190325-6454
DATE: September 26, 2019

REMANDED

The service connection claim for gastroesophageal reflux disease (GERD) is remanded.

REASONS FOR REMAND

The Board notes that the rating decision on appeal was issued in March 2019.  The Veteran appealed that decision to the Board and selected the “Direct Review by a Veterans Law Judge” option which permits the Board to review the claim based on the evidence of record at the time of the decision.   

The issue of entitlement to service connection for GERD is remanded to correct a duty to assist error that occurred prior to the March 2019 rating decision on appeal.  The Agency of Original Jurisdiction (AOJ) obtained a January 2019 medical opinion.   However, this medical opinion does not provide an adequate rationale regarding whether the Veteran’s GERD is caused by or aggravated by his/her service-connected gastric ulcer; and whether his GERD had its onset in service or is otherwise related to the Veteran’s service.

After his January 2019 VA examination for GERD, a VA examiner opined that the Veteran’s GERD is less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s service-connected condition.  As the rationale for this opinion, the VA examiner explained, in pertinent part, that gastric ulcer does not cause GERD, and that GERD is caused by a defect in the lower esophageal sphincter.  

However, the VA examiner failed to determine and/or render an opinion on whether the Veteran’s GERD was aggravated by his service-connected gastric ulcer.  

Although the VA examiner briefly indicated that “no GERD [was] noted during active service time,” he failed to render an opinion on direct service connection, and specifically, opining whether the Veteran’s GERD was incurred in and/or the result of an illness, injury or event in service, with an adequate, sufficient rationale to support the opinion.  

The matters are REMANDED for the following action:

1. Schedule the Veteran for a new VA examination to determine the nature and etiology of the Veteran’s GERD, with a physician (VA examiner) who has not yet evaluated the Veteran.  The VA examiner must review the claims file and must note that review in the report.  A copy of this REMAND must be made available to the VA examiner.  The VA examiner must undertake the following:

a.	Opine whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s GERD was incurred in service; the result of an illness, injury, disease, or event in service; and/or is otherwise related to his active service.

b.	Opine whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s GERD is caused by his service-connected gastric ulcer.

c.	Opine whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s GERD is aggravated by his service-connected gastric ulcer.

In rendering an opinion, the Veteran’s lay statements about onset, continuity, and symptomatology should be considered.

A detailed explanation is requested for all opinions provided.  If an opinion cannot be provided without resort to speculation, provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be rendered.

 

 

M. Tenner

 Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	Vanessa-Nola Pratt, Associate Counsel

The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.