Citation Nr: 21000368 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 14-02 177 DATE: January 5, 2021 REMANDED Service connection for a pituitary adenoma.   REASONS FOR REMAND The Veteran served on active duty from March 1964 to April 1968. The case is on appeal from a July 2012 rating decision. In January 2015, the Veteran testified at a Board hearing. In June 2015, the Board remanded the case for additional development. In February 2018, the Board reopened the claim of service connection for pituitary adenoma and remanded the matter for additional development. The Board also remanded the claim for additional development in February 2020 and August 2020. Service connection for a pituitary adenoma. The Veteran is seeking service connection a pituitary adenoma. He asserts his recurrent pituitary adenoma is a result of a head injury during service or is related to having a high fever due to a parasitic infection during service. See Board Hr’g. Tr. at 4-5; see also July 2020 Statement in Support of Claim. In addition, whether the Veteran’s pituitary adenoma is secondary to any of his service-connected disabilities including TBI, traumatic left occipital headaches and mild cerebellar dysfunction, hearing loss, and PTSD was raised by the record. See February 2018 Board Decision. In this case the Board finds that remand is warranted to obtain an addendum opinion as the opinions of record are not entirely sufficient to decide the claim. Pursuant to the Board’s August 2020 remand, a September 2020 VA opinion was obtained in order to specifically address the Veteran’s contention that his pituitary adenoma is related to a high fever he experienced during service as a result of a parasitic infection. In this regard, the Veteran’s service treatment records (STRs) note that he experienced a fever, was treated for gastroenteritis for one week, and was diagnosed with having a parasitic infection in June 1966. In addition, the Veteran testified at the January 2015 Board hearing that he was told by the Pituitary Network Association that his pituitary adenoma could be related to a high fever. The examiner who provided the September 2020 VA concluded that it is less likely than not that the Veteran’s pituitary adenoma is related to his parasite infection. The examiner noted that the Veteran was hospitalized for gastroenteritis that was thought to be due to a parasitic infection and noted the Veteran’s STRs indicate the infection was limited to the colon. He explained further there is no connection between the gastrointestinal tract and the brain unless a specific parasite was identified that could infect the brain. The examiner also stated that a pituitary adenoma is a benign tumor that develops over time, and no connection to parasites has been found. Thus, while addressing the relationship between the Veteran’s pituitary adenoma and his in-service parasitic infection, the examiner did not specifically address whether the high fever itself is related to the Veteran’s pituitary adenoma, as contended by the Veteran. Accordingly, a new addendum opinion addressing this theory is warranted on remand. The matters are REMANDED for the following action: Forward the claims file to an appropriate VA examiner, if possible, to the VA examiner that conducted the May 2019 examination. Following a review of all of the evidence, the examiner should provide a medical opinion as to the following: (Continued on the next page)   State whether it is at least as likely as not (50percent or greater probability) that pituitary adenoma is related to his active service, to include the fever in June 1966 noted in the Veteran’s STRs. A complete rationale should be expressed for all opinions provided. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Gray, 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.