Citation Nr: 21001502 Decision Date: 01/08/21 Archive Date: 01/08/21 DOCKET NO. 16-39 798 DATE: January 8, 2021 ORDER The issues of service connection for arteriosclerosis, right knee disorder, bilateral ankle disorder, bilateral eye disorder, bilateral hip disorder, bilateral shoulder disorder, cervical disorder, headache disorder, low back disorder, acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and depression, bilateral hearing loss, vertigo, dental disorder, entitlement to a total disability rating based on individual unemployability (TDIU) and an initial rating higher than 10 percent from September 18, 2012 and continuing thereafter for tinnitus are dismissed. Service connection for a left knee disorder, to include patellofemoral dysfunction, chronic derangement, overuse syndrome and degenerative joint disease is granted. Service connection for right foot onychomycosis is granted. Service connection for obesity is denied. Service connection for coronary artery disease, to include as secondary to service-connected bronchitis is denied. Service connection for a skin disorder, to include tinea cruris, tinea pedis, psoriasis and seborrheic dermatitis is denied. REMANDED The issue of service connection for left foot onychomycosis is remanded. The issue of service connection for diverticulitis is remanded. The issue of an initial compensable rating from September 18, 2012 and continuing thereafter for bronchitis is remanded. FINDINGS OF FACT 1. The Veteran’s verbal withdrawal as to the issues of service connection for arteriosclerosis, right knee disorder, bilateral ankle disorder, bilateral eye disorder, bilateral hip disorder, bilateral shoulder disorder, cervical disorder, headache disorder, low back disorder, acquired psychiatric disorder, bilateral hearing loss, vertigo, dental disorder, entitlement to a TDIU and an initial rating higher than 10 percent from September 18, 2012 and continuing thereafter for tinnitus was explicit, unambiguous, and done with a full understanding of the consequences of such action by the Veteran. 2. With resolution of the doubt in his favor, the Veteran’s left knee disorder was caused by service. 3. With resolution of the doubt in his favor, the Veteran’s right foot onychomycosis was caused by service. 4. The Veteran’s obesity is not a disability for VA compensation purposes. 5. The Veteran did not undergo an in-service event, injury or disease as to his coronary artery disease. 6. The Veteran’s coronary artery disease was not caused or aggravated by his service-connected bronchitis. 7. The Veteran is not credible as to his account of an in-service event, injury or disease pertaining to his skin disorder. CONCLUSIONS OF LAW 1. The criteria for withdrawal of the notice of disagreement as to the issues of service connection for arteriosclerosis, right knee disorder, bilateral ankle disorder, bilateral eye disorder, bilateral hip disorder, bilateral shoulder disorder, cervical disorder, headache disorder, low back disorder, acquired psychiatric disorder, bilateral hearing loss, vertigo, dental disorder, entitlement to a TDIU and an initial rating higher than 10 percent from September 18, 2012 and continuing thereafter for tinnitus have been met. 38 U.S.C. § 7105 (2012); 38 C.F.R. § 20.205 (2019). 2. The criteria to establish entitlement to service connection for a left knee disorder have been met. 38 U.S.C. § 1131 (2012); 38 C.F.R. § 3.303(d) (2019). 3. The criteria to establish entitlement to service connection for right foot onychomycosis have been met. 38 U.S.C. § 1131 (2012); 38 C.F.R. § 3.303(d) (2019). 4. The criteria to establish entitlement to service connection for obesity have not been met. 38 U.S.C. § 1131 (2012); 38 C.F.R. § 3.303(d) (2019). 5. The criteria to establish entitlement to service connection for coronary artery disease have not been met. 38 U.S.C. § 1131 (2012); 38 C.F.R. §§ 3.303(d), 3.310 (2019). 6. The criteria to establish entitlement to service connection for a skin disorder have not been met. 38 U.S.C. § 1131 (2012); 38 C.F.R. § 3.303(d) (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Army from March 1982 to March 1986. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision of the San Juan, Puerto Rico Regional Office (RO). In September 2019, the Veteran was afforded a videoconference hearing before the undersigned Veterans Law Judge (VLJ). During the hearing, the VLJ engaged in a colloquy with the Veteran toward substantiation of the claims. Bryant v. Shinseki, 23 Vet. App. 488, 496-97 (2010). A hearing transcript is in the record. Dismissal on Withdrawal Under 38 U.S.C. § 7105, the Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. Withdrawal may be made by the appellant or by his or her authorized representative and must be in writing, unless an appeal withdrawal is on the record at a hearing. 38 C.F.R. § 20.205 (2019). In Acree v. O’Rourke, 891 F.3d 1009 (Fed. Cir. 2018), the Court held that the three-part test set out in Delisio v. Shinseki, 25 Vet. App. 45, 57-58 (2011), must be satisfied for a verbal withdrawal of an appeal at a Board hearing to be effective. An effective verbal withdrawal of an appeal at a Board hearing requires that the withdrawal is (1) explicit, (2) unambiguous and (3) done with a full understanding of the consequences of such action by the claimant. Delisio, 25 Vet. App. at 57. In the September 2019 Board hearing, the VLJ indicated that the Veteran requested to withdraw his claims of service connection for arteriosclerosis, right knee disorder, bilateral ankle disorder, bilateral eye disorder, bilateral hip disorder, bilateral shoulder disorder, cervical disorder, headache disorder, low back disorder, acquired psychiatric disorder, bilateral hearing loss, vertigo, dental disorder, a claim of entitlement to a TDIU and an initial rating higher than 10 percent from September 18, 2012 and continuing thereafter for tinnitus. See Hearing Transcript at 2. The colloquy with the Veteran indicated that the verbal withdrawal was explicit and unambiguous because the Veteran clearly indicated his intent to withdraw the claims. The Veteran’s verbal withdrawal was done with a full understanding of the consequences because the VLJ indicated to the Veteran that he would have to file new claims, and the Veteran testified that he understood the instructions from the VLJ. The Veteran also testified that no one had forced him to withdraw the claims. The Board finds that the Delisio standard has been met and the claims of service connection for arteriosclerosis, right knee disorder, bilateral ankle disorder, bilateral eye disorder, bilateral hip disorder, bilateral shoulder disorder, cervical disorder, headache disorder, low back disorder, acquired psychiatric disorder, bilateral hearing loss, vertigo, dental disorder, a claim of entitlement to a TDIU and an initial rating higher than 10 percent from September 18, 2012 and continuing thereafter for tinnitus are dismissed. Service Connection Service connection may be granted for a current disability arising from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131 (2012). Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2019). Service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of an in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Left knee disorder The Veteran contends that his left knee disorder resulted from an in-service left knee injury and due to the rigors of service, such as long road marches with heavy equipment. The claim will be granted. The Veteran’s report of separation from the armed forces (DD Form 214) reflects that his duty specialty was in forward area radar repair. Due consideration shall be given to the places, types, and circumstances of such veteran's service as shown by such veteran's service record, the official history of each organization in which such veteran served, such veteran's medical records, and all pertinent medical and lay evidence. 38 U.S.C. § 1154(a) (2012). As a forward area radar technician, the Veteran would have carried heavy equipment during road marches. A May 1984 service treatment record (STR) reflects the Veteran’s report of experiencing left knee pain due to a softball having hit his left knee. The service medical examiner noted that the Veteran’s left knee had full range of motion, no effusion, discoloration or swelling. The Veteran was diagnosed with a left knee sprain. In his January 1986 pre-separation medical history report, the Veteran answered in the negative to the question of whether he then had, or once had a trick or locked knee. In the Veteran’s January 1986 pre-separation medical examination report, no lower extremity abnormalities were noted. An August 2014 VA treatment record reflects the Veteran’s report of experiencing left knee pain. In the September 2014 VA examination, the Veteran reported experiencing left knee pain from an in-service softball game and a road march. The Veteran was diagnosed with left knee patellofemoral dysfunction. The examiner opined that the Veteran’s left knee disorder was not caused by service because the claims file did not reflect any evidence of a left knee disorder. The VA medical opinion is of low probative value because an August 2014 VA treatment record reflects the Veteran’s report of experiencing left knee pain and the examiner’s medical opinion was not supported by sufficient rationale. See Bloom v. West, 12 Vet. App. 185, 187 (1999) (the value of a physician's statement is dependent, in part, upon the extent to which it reflects "clinical data or other rationale to support his opinion"). VA treatment records dated March 2015 and October 2015 reflect the Veteran’s report of experiencing left knee pain. A November 2015 left knee radiograph revealed mild narrowing of the medial femorotibial weight-bearing joint, mild subchondral articular sclerosis, cystic changes, marginal bony outgrowth and small enthesophytes in the superior patellar poles. The Veteran was diagnosed with left knee pain and degenerative joint disease. In VA treatment records dated January 2016 and March 2016, the Veteran reported experiencing left knee pain. Undated private treatment records reflect the Veteran’s report of experiencing left knee pain. In his September 2019 Board hearing, the Veteran testified to having injured his left knee due to an in-service softball game and a road march. In a December 2019 letter, the Veteran’s private medical doctor diagnosed the Veteran with left knee chronic derangement, overuse syndrome and degenerative joint disease. The examiner opined that the Veteran’s left knee disorder was caused by service because the Veteran underwent blunt trauma to the left knee from a softball game and the subsequent road march with heavy equipment did not allow the Veteran’s left knee to fully heal. The private medical opinion is highly probative because the examiner had an accurate and complete understanding of the Veteran’s medical history and provided a medical conclusion with sufficient rationale. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The Board will grant the claim based on the benefit-of-the-doubt doctrine. The September 2014 VA examiner’s negative etiology opinion was of low probative value. The December 2019 private examiner opined that the Veteran’s left knee disorder was caused by service. The Board will resolve all reasonable doubt in favor of the Veteran. Therefore, service connection is warranted and the claim is granted. Right foot onychomycosis The Veteran contends that his bilateral foot onychomycosis was caused by service. The Board will grant service connection for right foot onychomycosis and remand the issue of service connection for left foot onychomycosis. In a September 1984 STR, the Veteran reported having undergone a right foot toe laceration. The Veteran reported experiencing right foot pain from walking. The service medical examiner noted that the Veteran’s right foot distal pulse was normal and sensation intact. A December 1985 STR reflects the Veteran’s report of experiencing right foot pain for approximately three weeks. The Veteran was assessed with a right foot plantar wart. In the Veteran’s January 1986 pre-separation medical examination report, no foot abnormalities were noted. In his January 1986 pre-separation medical history report, the Veteran answered in the affirmative to the question of whether he then had, or once had foot trouble. In the physician’s summary section, it was noted that the Veteran’s foot trouble was related to his plantar wart. An October 1997 private treatment record reflects the Veteran’s report of experiencing right foot toe pain. VA treatment records dated June 2014 and August 2014 reflect the Veteran’s report of experiencing right foot pain. In the September 2014 VA examination, the Veteran reported experiencing plantar warts on his right foot and bilateral foot onychomycosis after having undergone a road march during service. The Veteran was diagnosed with right foot onychomycosis but the examiner indicated that the Veteran did not have plantar warts on his right foot. The examiner opined that the Veteran’s right foot onychomycosis was not caused by service because the onychomycosis appeared in 1995 – approximately nine years after service separation. The VA medical opinion was inadequate, and therefore, of low probative value because the examiner’s negative etiology opinion was supported by insufficient rationale. Bloom, supra. In a November 2014 VA treatment record, the Veteran reported experiencing right foot pain and thickened toenails. He was diagnosed with right foot onychomycosis. An October 2015 VA treatment record reflects the Veteran’s report of experiencing right foot pain. In his September 2019 Board hearing, the Veteran testified to experiencing a left foot toe laceration during service. However, the STRs reflect that the Veteran underwent a right foot toe laceration, not a left foot toe laceration. In an October 2019 statement, the Veteran’s private medical provider opined that the Veteran’s right foot onychomycosis was caused by the September 1984 right foot toe laceration because fungus inoculated into the nail due to direct trauma and had subsequently transmitted throughout the foot. The private medical opinion is highly probative. Nieves-Rodriguez, supra. The Board will grant the claim based on the benefit-of-the-doubt doctrine. The September 2014 VA examiner indicated that the Veteran did not have a diagnosis of right foot plantar warts and there is no competent evidence indicating otherwise. However, as noted above, the September 2014 VA examiner’s negative etiology opinion as to the Veteran’s right foot onychomycosis was of low probative value. The October 2019 private examiner opined that the Veteran’s right foot onychomycosis was caused by the in-service right foot toe laceration. The Board will resolve all reasonable doubt in favor of the Veteran. Therefore, service connection is warranted and the claim is granted. Obesity The Veteran seeks service connection for obesity on a direct basis by claiming that his obesity was caused by participation in an in-service weight control program. Alternatively, the Veteran seeks service connection for obesity on a secondary basis by claiming that his obesity was secondary to his service-connected disabilities because he was unable to properly exercise due to the “bad pains” from his service-connected disabilities. The Veteran has not claimed that his obesity was an intermediate step. As a matter of law, obesity is not a disability for VA compensation purposes. Marcelino v. Shulkin, 29 Vet. App. 155 (2018) (holding that obesity, in and of itself, is not a disability for VA compensation purposes). A preponderance of the evidence is against the claim. Therefore, service connection is not warranted and the claim is denied. Coronary artery disease The Veteran asserts that his coronary artery disease was caused by in-service chest pains, or alternatively, as secondary to his service-connected bronchitis. The claim will be denied. A May 1982 service chest radiograph revealed pneumonia and otherwise normal findings. A July 1982 STR reflects the Veteran’s report of experiencing chest congestion. The Veteran was diagnosed with acute bronchitis. In a September 1982 STR, the Veteran reported experiencing chest congestion. A physical examination revealed a regular rate and rhythm of the heart with no murmur, gallop or rub. The Veteran was diagnosed with basilar pneumonia and probable mycoplasma. A service chest radiograph revealed pneumonia and no heart disorders. A March 1983 STR reflects the Veteran’s report of experiencing chest congestion. The Veteran was assessed with bronchitis, pneumonia and an upper respiratory infection. No heart disorders were noted. In the Veteran’s January 1986 pre-separation medical examination report, no heart abnormalities were noted. In his January 1986 pre-separation medical history report, the Veteran answered in the affirmative to the question of whether he then had, or once had chest pressure or pain. The service medical examiner indicated that the Veteran’s chest pain was attributed to his in-service diagnoses of bronchitis and pneumonia. The STRs are highly probative evidence because they were generated with the specific view of recording the events they describe. In this respect, they are akin to official records, which generally enjoy a high degree of probative value in the law. Rucker v. Brown, 10 Vet. App. 67, 73 (1997) (observing that although formal rules of evidence do not apply before the Board, recourse to the Federal Rules of Evidence may be appropriate if it assists in the articulation of the reasons for the Board's decision). In an October 2009 private treatment record, the Veteran was assessed with suspected coronary artery disease. A private multiple gated acquisition (MUGA) scan revealed cardiomegaly, mild decreased left ventricle systolic function at rest and decreased peak filling rate associated with left ventricle dysfunction. A private stress myocardial perfusion study revealed left ventricle stress induced myocardia ischemia, left ventricle soft tissue attenuation and mild decreased left ventricular function at rest. An undated private treatment record reflects the Veteran’s diagnosis of coronary artery disease. A January 2014 VA treatment record noted a history of coronary artery disease. In a July 2014 private treatment record, it was noted that the Veteran had a history of coronary artery disease and that he was prescribed Imdur. A private chest radiograph revealed cardiomegaly. An August 2014 VA treatment record noted that the Veteran had a current diagnosis of coronary artery disease. An October 2015 VA treatment record noted a history of coronary artery disease. In his September 2019 Board hearing, the Veteran testified to experiencing chest pain during service and that his heart disorder was secondary to the lung complications from his service-connected bronchitis. As noted above, the STRs reflect the Veteran’s reports of chest pain; however, service medical examiners attributed the Veteran’s chest symptoms to respiratory disorders, including the Veteran’s service-connected bronchitis. The Veteran is not competent, as a lay person, to attribute his chest symptoms to a diagnosis of coronary artery disease. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Moreover, a VA examination is not warranted based on the Veteran's surmise that his coronary artery disease may be related to his service-connected bronchitis. See Waters v. Shinseki, 601 F.3d 1274, 1278 (Fed. Cir. 2010) (noting that a veteran's conclusory generalized statement that a service illness caused his present medical problems was not enough to entitle him to a VA medical examination since all veterans could make such a statement, and such a theory would eliminate the carefully drafted statutory standards governing the provision of medical examinations and require VA to provide such examinations as a matter of course in virtually every disability case). A preponderance of the evidence is against a finding that the Veteran underwent an in-service event, injury or disease as to his coronary artery disease, or alternatively, that his coronary artery disease was caused or aggravated by his service-connected bronchitis. The STRs reflect the Veteran’s reports of chest pain; however, service medical examiners attributed the Veteran’s chest symptoms to respiratory disorders, including the Veteran’s service-connected bronchitis. No heart abnormalities were noted at service separation. The Veteran has not submitted competent evidence relating the Veteran’s coronary artery disease as secondary to his service-connected bronchitis. Therefore, service connection is not warranted and the claim is denied. Skin disorder The Veteran asserts that his skin disorder resulted from an in-service road march and that he first noticed his skin disorder towards the end of his service. The claim will be denied. STRs are silent for complaints or contemporaneous reports concerning a skin disorder, to include tinea cruris, tinea pedis, psoriasis and seborrheic dermatitis. In the Veteran’s January 1986 pre-separation medical examination report, no skin abnormalities were noted. In his January 1986 pre-separation medical history report, the Veteran answered in the negative to the question of whether he then had, or once had skin diseases. The STRs are highly probative evidence because they were generated with the specific view of recording the events they describe. In this respect, they are akin to official records, which generally enjoy a high degree of probative value in the law. Rucker, supra. In VA treatment records dated November 2013 and January 2014, a review of systems revealed normal findings for the Veteran’s skin. In a July 2014 private treatment record, a review of systems revealed no rashes, pruritis, changing moles, lumps, or lesions. Social security administration (SSA) records reflect a claimed skin condition but no competent evidence of a diagnosed skin disorder. In a September 2014 VA treatment record, a review of systems revealed normal findings for the Veteran’s skin. In a letter dated January 2015, the Veteran’s private medical doctor indicated that the Veteran was diagnosed with tinea cruris in early June 1988. No other details were provided. A February 2015 VA treatment record reflects the Veteran’s report of experiencing a skin rash. In a March 2015 VA treatment record, a physical examination revealed plaque-like skin lesions with erythema and dry scaly appearance on the Veteran’s abdomen and right upper extremity. The Veteran was diagnosed with psoriasis. A January 2016 VA treatment record reflects the Veteran’s diagnosis of seborrheic dermatitis. In a March 2016 VA treatment record, it was noted that the Veteran had a diagnosis of tinea pedis. In the September 2019 Board hearing, the Veteran testified having first noticed his skin disorder during “the last days of my service.” The Veteran’s testimony is not credible because in the Veteran’s January 1986 pre-separation medical examination and history report, no skin abnormalities were noted and the Veteran answered in the negative to the question of whether he then had, or once had skin diseases, respectively. See Curry v. Brown, 7 Vet. App. 59 (1994) (noting that contemporaneous evidence has greater probative value than the history as reported by the veteran and that earlier statements are generally more trustworthy than later ones); see also Madden v. Gober, 125 F.3d 1447, 1481 (Fed. Cir. 2000). In a September 2019 letter, the Veteran’s private medical provider opined, without rationale, that the Veteran’s tinea pedis was caused by service. This opinion is conclusory and does not provide the Board with sufficient analysis to consider and weigh the opinion. Stefl v. Nicholson, 21 Vet. App. 120, 124-125 (2007) (holding that a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision as to what weight to assign to a doctor’s opinion). A preponderance of the evidence is against a finding that the Veteran underwent an in-service event, injury or disease as to his skin. The Veteran testified having noticed his skin disorder during “the last days of my service.” However, the Veteran denied ever having a skin disease and no skin abnormalities were noted at service separation. The Veteran is not credible as to his account of an in-service event, injury or disease concerning his skin disorder. Therefore, service connection is not warranted and the claim is denied. REASONS FOR REMAND The remaining matters are remanded for the following actions: 1. BACKGROUND FOR THE RO ADJUDICATOR The September 2014 VA examiner opined that the Veteran’s left foot onychomycosis was not caused by service because the onychomycosis had onset in 1995. The negative etiology opinion is inadequate because it was supported by insufficient rationale. See Bloom v. West, 12 Vet. App. 185, 187 (1999). The October 2014 VA medical opinion was inadequate because although the examiner diagnosed the Veteran with a stomach disorder and provided a negative etiology opinion, the examiner did not indicate whether the Veteran had a diagnosis of diverticulitis and whether it was caused by service. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (holding that where VA provides the veteran with an examination in a service connection claim, the examination must be adequate). The Veteran’s September 2019 Board hearing testimony reflects that the Veteran’s service-connected bronchitis may have worsened since the September 2014 VA respiratory examination. See Allday v. Brown, 7 Vet. App. 517, 526 (1995). 2. Return the file to the VA examiner who conducted the September 2014 and October 2014 VA examination for a file review. If the examiner is not available, have the file reviewed by a similarly qualified examiner. Another examination is not required; however, if the VA examiner indicates that he or she cannot respond to the Board’s questions without examination of the Veteran, another examination should be afforded to the Veteran. All relevant medical and non-medical records must be made available to the examiner for review of pertinent documents. The examination report should specifically state that such a review was conducted. Left foot onychomycosis: the examiner must provide the following opinion: Was the Veteran’s left foot onychomycosis caused by having engaged in road marches with heavy equipment during service? THE EXAMINER IS ADVISED THAT DUE TO THE VETERAN’S DUTY SPECIALITY OF FORWARD AREA ALERTING RADAR REPAIRER, THE VETERAN IS PRESUMED TO HAVE UNDERGONE ROAD MARCHES WITH HEAVY EQUIPMENT. Although the examiner must review the VBMS file, his or her attention is drawn to the following: • Service treatment records are silent for complaints or contemporaneous reports concerning the Veteran’s left foot. • In the Veteran’s January 1986 pre-separation medical examination report, no left foot abnormalities were noted. • In his January 1986 pre-separation medical examination report, the Veteran answered in the affirmative to the question of whether he then had, or once had foot trouble. The Veteran was referring to his right foot and not his left foot. • An October 1997 private treatment record reflects the Veteran’s report of experiencing left foot pain. • A June 2014 VA treatment record reflects the Veteran’s report of experiencing left foot pain. • An August 2014 VA treatment record reflects the Veteran’s report of experiencing left foot pain. • The September 2014 VA examiner diagnosed the Veteran with left foot onychomycosis. • In a November 2014 VA treatment record, the Veteran reported experiencing left foot pain and thickened toenails. He was diagnosed with left foot onychomycosis. • An October 2015 VA treatment record reflects the Veteran’s report of experiencing left foot pain. • In a March 2016 VA treatment record, a foot examination revealed tenia pedis; however, there was no indication as to which foot. Diverticulitis: the examiner must provide the following opinion: Does the Veteran have a diagnosis of diverticulitis? If so, was it caused by the Veteran’s in-service report of stomach pain? Although the examiner must review the VBMS file, his or her attention is drawn to the following: • A November 1983 service treatment record reflects the Veteran’s report of experiencing stomach pain. He was diagnosed with viral gastroenteritis. • In the Veteran’s January 1986 pre-separation medical examination report, no abdominal or gastrointestinal abnormalities were noted. • In his January 1986 pre-separation medical history report, the Veteran answered in the negative to the question of whether he then had, or once had frequent indigestion, stomach trouble, piles, or rectal disease. • An October 2009 private treatment record reflects the Veteran’s diagnosis of diverticulitis. • An April 2012 private abdominopelvic radiograph revealed acute descending colon diverticulitis without abscess or perforation. • A January 2013 private treatment record reflects the Veteran’s diagnosis of acute sigmoid diverticulitis. • An April 2014 VA treatment record reflects the Veteran’s report of experiencing loose bowels. • In a September 2017 VA treatment record, diverticular disease was noted as a medical problem. • In the September 2019 Board hearing, the Veteran reported experiencing abdominal pain, cramping, nausea, chills, fevers, bloating, constipation, thin stools, diarrhea and rectal bleeding during service. 3. Schedule the Veteran for a VA respiratory examination to assist in determining the current severity of his bronchitis. 4. Readjudicate the issues on appeal. If the benefits sought on appeal remain denied, the Veteran should be provided a supplemental statement of the case (SSOC). An appropriate period should be allowed for response before the case is returned to the Board. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Cohen, 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.