Citation Nr: 21000643 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 14-11 016 DATE: January 5, 2021 REMANDED Service connection for a gastrointestinal disability is remanded. Entitlement to an increased rating higher than 10 percent for the service-connected patellar chondromalacia right knee is remanded. Entitlement to an increased rating higher than 10 percent prior to August 8, 2017 and higher than 20 percent thereafter for the service-connected degenerative arthritis of the spine with mild disc protrusion and lumbar strain is remanded. Entitlement to an increased rating higher than 0 percent prior to February 4, 2020 and higher than 50 percent thereafter for the service-connected headaches is remanded. REASONS FOR REMAND The Veteran served on active duty from September 2004 to January 2009 and from May 2016 to April 2018. The matter is before the Board of Veterans’ Appeals (Board) on appeal from July 2015 and May 2016 rating decisions. Most recently, the Board remanded the above matters, as well as claims of service connection for bilateral foot and left knee disorders, in January 2020 for VA examinations and medical opinions. The RO granted service connection for a bilateral foot disability and left knee disability in an August 2020 rating decision. This decision constitutes a full grant of both claims; therefore, they are no longer on appeal before the Board. However, the appeal must be remanded again for a Supplemental Statement of the Case. In November 2020, VA notified the Veteran and his attorney that relevant evidence was uploaded to his electronic claims file after the August 2020 Statement of the Case and requested waiver of initial RO consideration of this evidence. Neither the Veteran nor his attorney responded within 45 days as requested by the letter. Accordingly, this appeal must be remanded to the RO for initial consideration of the new evidence and a Supplemental Statement of the Case. See 38 C.F.R. §§ 19.9(a), 20.1304(c). Further, the Board finds that an addendum medical opinion is required for the gastrointestinal service connection claim because the medical opinions obtained in February 2020 were inadequate. Specifically, the examiner relied on the lack of treatment for GERD in service as the sole basis for the negative direct service connection opinion. Additionally, the examiner did not provide a rationale for the negative secondary service connection opinion. Finally, as the matter is being remanded, updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Obtain the Veteran’s Huntington VAMC treatment records from November 2019 to the present. 2. Forward the Veteran’s claims file to an appropriate VA examiner for a nexus opinion regarding the claim of service connection for a gastrointestinal disability. An in-person examination is unnecessary unless otherwise determined by the examiner. After a review of the claims file, the examiner should respond to the following: (a.) Is it at least as likely as not that the Veteran’s GERD or IBS began in or is otherwise related to service? The examiner cannot rely on the lack of in-service treatment as the sole basis for the opinion. (b.) If not, is it at least as likely as not that the Veteran’s GERD or IBS is proximately due to a service-connected disability to include PTSD? (c.) Is it at least as likely as not that the Veteran’s GERD or IBS has been aggravated (worsened beyond the natural progression of the disorder) by a service-connected disability to include his PTSD? The examiner must provide a complete rationale for each conclusion rendered. 3. Afterward, the RO should review the evidence received since the August 2020 Supplemental Statement of the Case, readjudicate the claims, and return the matter to the Board, if appropriate. MICHELLE L. KANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Lavan, 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.