Citation Nr: 21062628 Decision Date: 10/08/21 Archive Date: 10/08/21 DOCKET NO. 17-38 350 DATE: October 8, 2021 REMANDED Entitlement to service connection for acid reflux is remanded. Entitlement to service connection for sinusitis is remanded. Entitlement to service connection for a lumbar spine disability is remanded. Entitlement to service connection for shin splints of the left leg is remanded. Entitlement to service connection for shin splints of the right leg is remanded. Entitlement to service connection for right upper extremity carpal tunnel syndrome is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1997 to January 2000 and February 2003 to November 2003. A Board hearing was held in October 2019, but the transcript was unavailable. A second Board hearing was held in October 2020. A transcript is of record. This matter was previously before the Board in March 2021, when it was remanded for further development, to include VA examinations and obtaining of records. 1. Entitlement to service connection for acid reflux is remanded. 2. Entitlement to service connection for sinusitis is remanded. 3. Entitlement to service connection for a lumbar spine disability is remanded. 4. Entitlement to service connection for shin splints of the left leg is remanded. 5. Entitlement to service connection for shin splints of the right leg is remanded. 6. Entitlement to service connection for right upper extremity carpal tunnel syndrome is remanded. Pursuant to Board remand instructions of March 2021, the Veteran was afforded VA examinations to assess the nature and etiology of his aforementioned claimed disabilities in May 2021. When VA undertakes to obtain an examination/opinion, it must ensure that the examination/opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). A medical opinion/examination is considered adequate "where it is based on consideration of the veteran's prior medical history and examinations and also describes the disability, if any, in sufficient detail so that the Board's evaluation of the claimed disability will be a fully informed one." Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). The May 2021 VA examiner opined that the Veteran's claimed disabilities are all less likely than not related to service, offering essentially the same rationale for every disability addressed. Specifically, the examiner reasoned that there are no medical records showing diagnosis or treatment of the claimed disabilities in service without anything further. The Board notes that the absence of documented treatment in service or thereafter is not fatal to a service connection claim, and the absence of evidence in the service treatment records is an insufficient basis, by itself, for a negative opinion. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Additionally, the Board notes that VA has made findings that the Veteran has been exposed to both burn pit toxins and high levels of particulate matter. See February 2021 fact sheets. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file any outstanding VA and private treatment records pertinent to the remanded claims herein. 2. Thereafter, schedule the Veteran for VA examinations for her claimed acid reflux, right upper extremity carpal tunnel syndrome, back disability, and bilateral shin splints. The examiner must review the claims file. The examiner is asked to opine as to the following: Whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran's diagnosed disabilities claimed herein (Acid Reflux/GERD; sinusitis; lumbar spine disability; bilateral lower extremity shin splints; right upper extremity carpal tunnel) are related to service, including the Veteran's assertion that the disabilities began in service, have continued since, as well as exposure environmental hazards including toxins and particulate matter? The examiner must address the Veteran's lay statements concerning any symptomatology during and after service. The examiner must also address the Veteran's conceded exposure to environmental hazards including toxins and particulate matter. The entire claims file must be made available to the examiner for his or her review in providing these opinions. A complete rationale for all opinions must be provided. If the examiner cannot provide a requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. The examiner must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the examiner must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. Mills Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Comninos, Georgio 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.