Citation Nr: 21001337 Decision Date: 01/07/21 Archive Date: 01/07/21 DOCKET NO. 16-44 611 DATE: January 7, 2021 REMANDED Service connection for a bowel disorder, to include irritable bowel syndrome (IBS) and colitis, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1965 to August 1967, including foreign service in Germany. Historically, this appeal was denied by the Board of Veterans’ Appeals (Board) in November 2018. In that decision, the Board also denied reopening four previously denied claims for service connection, in addition to service connection for six other claims. The Veteran appealed his case to the Court of Appeals for Veterans Claims (Court). In January 2020, the Court approved a Joint Motion for Partial Remand that vacated the Board’s denial of the issue listed above only. The Joint Motion specifically noted that the Veteran did not challenge the denial of reopening his four previously denied claims for service connection, or the other six claims for service connection that the Board denied. Accordingly, the issue listed above is the only matter currently before the Board. In June 2020, the Board remanded this claim to obtain an adequate nexus opinion as to the potential relationship between the Veteran’s service-connected psychiatric disability and his claimed bowel disorder. Regrettably, the opinion obtained in July 2020 is inadequate for several reasons. First, the examiner failed to assess the etiology of all bowel disorders diagnosed during the period on appeal or all theories of entitlement as presented by the record. Further, the examiner’s opinion appears to be based upon an inaccurate factual basis as to the Veteran’s symptomatology. See, e.g., September 2020 lay statement (reporting weight loss and daily bowel symptoms). Finally, the examiner simply cites to certain evidence in the record without discussing its relevance to the negative nexus opinion. Accordingly, an adequate opinion must now be obtained. Remand of the instant issue also provides the opportunity for the Board to obtain a complete copy of the Veteran’s VA treatment records, as the claims file currently contains only excerpts thereof. The matter is REMANDED for the following actions: 1. Obtain and associate with the record all VA treatment records for the Veteran spanning the period on appeal. All actions to obtain the requested records should be fully documented in the record. If they cannot be located or no such records exist, the Veteran and his representative should be so notified in writing. 2. Obtain an addendum opinion addressing the questions below.  If the reviewing examiner determines that the opinions requested may not be offered without first examining the Veteran, then consider whether a telehealth interview may be appropriate.  Schedule an in-person examination only if deemed necessary to answer the questions below.   The claims file and a copy of this remand must be made available for review, and the examination report must reflect that review of the claims file occurred.   In particular, the examiner is asked to offer medical opinions as to:  (a.) Identify ALL bowel disorders diagnosed during the period on appeal, to include colitis and IBS; (b.) For EACH diagnosed disorder, opine as to whether it is at least as likely as not that the condition is proximately due to, the result of, or aggravated by the Veteran’s service-connected psychiatric disorder (to include related stress) or the treatment thereof (to include medication use). Here, the examiner must explicitly address the Veteran’s testimony regarding his symptoms (to include as identified in a September 2020 lay statement) and an article submitted by the Veteran in December 2020. The examiner is also instructed that s/he must discuss the importance of any evidence cited in support of their opinion, rather than simply identifying said records. (Continued on next page) A complete rationale should be provided for all opinions or conclusions expressed. It should be noted that the Veteran is competent to attest to observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Kovarovic, 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.