Citation Nr: 21061724
Decision Date: 10/05/21	Archive Date: 10/05/21

DOCKET NO. 17-49 794
DATE: October 5, 2021

REMANDED

Entitlement to service connection for ulcerative colitis, to include as secondary to service-connected posttraumatic stress disorder (PTSD) and chronic anxiety disorder, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from August 1974 to August 1977. 

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

It is noted that the Veteran has claimed direct service connection for her ulcerative colitis, first diagnosed in 2008, as related to her in-service cramping, and secondary service connection, as related to her service connected psychiatric disability.  (She is service connected for a disability characterized as PTSD and chronic anxiety disorder, currently evaluated as 100 percent disabling.)  A medical examination and opinion were obtained that addressed the direct service connection question, but one has not been obtained addressing the secondary service connection question.  While not competent to establish a connection between the two, the Veteran would be in a position to reasonably associate symptoms of one with the other.  In view of that, a medical opinion should be sought on the question.  

The matters are REMANDED for the following action:

1. Updated treatment records should be sought and associated with the claims file.

2. Thereafter, provide the claims file to an appropriately qualified person to determine the following: 

(a.) Whether it as least as likely as not (50 percent probability or better) that the Veteran's ulcerative colitis was caused by her service-connected PTSD and chronic anxiety disorder. 

(b.) Whether it as least as likely as not (50 percent probability or better) that the Veteran's ulcerative colitis was aggravated beyond its natural progression by her service-connected PTSD and chronic anxiety disorder.

Aggravation is defined as a worsening beyond the natural progression of the disability. If aggravation is present, the examiner should indicate, to the extent possible, the approximate level of disability (i.e., a baseline) before the onset of aggravation. To the extent possible, the opinion should include a detailed description of symptoms as a baseline, and a similar description of symptoms considered in determining whether any aggravation occurred. 

The need for an examination of the Veteran is left to the discretion of the person offering the opinions. 

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A complete rationale for all findings and conclusions with citation to relevant evidence found in the claims file should be provided for all opinions.

3. Readjudicate the claim.

 

 

MICHAEL KILCOYNE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Dodd, Ryan

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.