Citation Nr: 21004594 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 14-15 884A DATE: January 27, 2021 REMANDED Entitlement to service connection for gastroesophageal reflux disease (GERD) is remanded. Entitlement to service connection for a toenail fungus is remanded. Entitlement to a total disability based upon individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active duty from August 1964 to August 1967. The Veteran testified at a hearing in May 2017 before a Veterans Law Judge who has since retired. The Board offered the Veteran the opportunity for a new hearing and there was no response to that letter. The Board will decide the appeal based on the evidence available including the transcript of that hearing. 1. Entitlement to service connection for GERD is remanded. 2. Entitlement to service connection for a toenail fungus is remanded. The Board is unable to make a fully informed decision because the October 2018 VA examinations for the Veteran’s GERD and toenail fungus disabilities are inadequate. The examiners impermissibly relied on a lack of records documenting the Veteran’s disabilities during service; especially when the Veteran reports that the records do not exist due to the nature of his missions during combat. On remand, the Veteran should be given a supplemental VA examination to allow the examiner to consider the Veteran’s competent and credible statements about the initial symptoms he experienced for his disabilities. 3. Entitlement to TDIU is remanded. The Board is unable to make an informed decision of the issue of TDIU because additional development is necessary. The Veteran’s representative submitted a statement in August 2020 that he was in the process of procuring the TDIU application (VA 21-8940) from the Veteran to process his TDIU claim. On remand, the Agency of Original Jurisdiction (AOJ) should facilitate the Veteran’s submission of his application for TDIU so the claim can be adequately reviewed. The matters are REMANDED for the following action: 1. The AOJ should make arrangements to obtain medical opinions for the Veteran’s gastrointestinal and skin disabilities. The claims file must be provided to the examiners for review in conjunction with the examinations and the examiners must indicate whether the claims file was reviewed. If the examiner determines that an opinion cannot be provided without an examination, one should be scheduled. The examiners are asked to accomplish the following: a. Provide an opinion as to any diagnosis of a gastrointestinal disability, to include a stomach condition and/or gastroesophageal reflux disease, present during or proximate to the appeal. Then provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that any diagnosed gastrointestinal disability began in service, was caused by service, or is otherwise related to service. b. Provide all diagnoses of skin conditions present during or proximate to the appeal, then provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that any such diagnosed skin condition began in service, was caused by service, or is otherwise related to service. The examiner may NOT rely on the absence of a medical record or evidence of medical treatment as the sole rationale for any negative medical nexus opinion. A complete rationale must be provided for all opinions, citing to supporting factual data and medical literature, as appropriate. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training) and note what, if any, additional evidence would permit such an opinion to be made. (Continued on the next page)   2. Provide the Veteran with a VA Form 21-8940, Application for TDIU, and request that he submit the completed form, with all appropriate information. Thereafter, take all appropriate action on the TDIU claim. ROBERT C. SCHARNBERGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. G. Perkins, 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.