Citation Nr: 21004768 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 16-46 364 DATE: January 28, 2021 REMANDED Entitlement to service connection for Guillain Barre syndrome and chronic inflammatory demyelinating polyneuropathy (GBS/CIDP) is remanded. REASONS FOR REMAND The Veteran had active naval service from December 1967 to November 1971. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision issued by the VA Regional Office (RO). In connection with this appeal, the Veteran testified at a hearing before the undersigned Veterans Law Judge in December 2019. A transcript of that hearing has been associated with the claims file. The Board finds that additional development is required before the appeal is decided. The Veteran reported that he has had symptoms associated with GBS/CIDP since his active service. He submitted a timeline in June 2014 describing a history of symptoms and treatment. He identified the Centers of Disease Control and Prevention (CDC) and the National Vaccine Injury Compensation Program (VICP) as organizations that support a relationship between GBS/CIDP and influenza vaccine and/or other vaccinations. Additionally, he referenced a publication pertaining to the history of GBS in December 2019. Pursuant to an April 2020 Board remand, the Veteran was afforded a VA examination in July 2020. The examiner opined that it was less likely as not that the Veteran’s GBS/CIDP was related to his active service. Specifically, the examiner explained that the proposed mechanism of GBS was that an antecedent infection evoked an immune response which in turn cross-reacted with peripheral nerve components. The examiner found no symptoms consistent with GBS/CIDP in the Veteran’s service treatment records. Additionally, the examiner could not find enough evidence to support influenza vaccination as a causative agent for GBS or the chronic form of GBS – CIDP. The Board finds that the April 2020 VA examination is inadequate for adjudication purposes. In this regard, the examiner’s rationale did not address the Veteran’s lay assertions above. As such, a remand is warranted for an addendum VA medical opinion. The matter is REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Then, return the claims file to a VA examiner with sufficient expertise for an addendum opinion to determine the nature and etiology of any currently present GBS/CIDP. The claims file must be made available to and reviewed by the examiner. If a new VA examination is required, then one should be scheduled. Based on a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that any currently present GBS/CIDP is etiologically related to the Veteran’s active service. The examiner must address the Veteran’s June 2014 description of symptoms and treatment since service, any supporting evidence by the CDC and/or VICP, and the Veteran’s December 2019 citation to an article on the history of GBS. The rationale for all opinions expressed must be provided. 3. Confirm that the VA medical opinion comports with this remand, and undertake any other development determined to be warranted. 4. Then, readjudicate the appeal. If a decision remains adverse to the Veteran, issue a supplemental statement of the case and allow the appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Ware, 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.