Citation Nr: 21063122
Decision Date: 10/13/21	Archive Date: 10/13/21

DOCKET NO. 16-22 454
DATE: October 13, 2021

REMANDED

Entitlement to an initial compensable rating for gastritis and duodenitis is remanded.

REASONS FOR REMAND

The Veteran had active service from June 1971 to June 1975.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in July 2012.  This matter was previously denied by the Board in a May 2019 decision.  That denial was appealed to the United States Court of Appeals for Veterans Claims (Veterans Court) and remanded pursuant to a Joint Motion for Partial Remand (Joint Motion) in October 2020.  This matter was again before the Board and remanded in March 2021.

Entitlement to an initial compensable rating for gastritis and duodenitis

An additional remand in this matter is required for clarification of the July 2021 addendum opinion.  In that opinion, the clinician discusses the Veteran's symptoms as reported in January 2021: stomach pain, bouts of regurgitation, and bowel incontinence that interfere with sleep and the ability to urinate while standing.  However, the clinician does not address other symptoms that the clinician was specifically requested to consider and provide VA adjudicators with guidance regarding such as diarrhea, constipation, and bloating, as the Veteran reported in May 2016.  Consequently, an addendum opinion is required for a more thorough consideration of the Veteran's reported symptoms.

Accordingly, this matter is REMANDED for the following actions:

1. Obtain an addendum opinion from an appropriate clinician regarding the scope of the known symptoms of the Veteran's service-connected gastritis and duodenitis symptoms.  The Veteran appears to ascribe all of his gastrointestinal difficulties at all stages to his service-connected conditions: from loss of appetite, to heartburn and regurgitation, to stomach discomfort like pain and bloating, to diarrhea and bowel incontinence.  The July 2021 addendum opinion distinguishes some symptoms (bowel incontinence) as inconsistent with the diagnosis of gastritis or duodenitis, but it is not clear how VA adjudicators should more broadly distinguish the symptoms that are part of the Veteran's service-connected conditions from those that are not.  The clinician should provide an opinion that will aid adjudicators in making these distinctions.

2. After the above development, and any additionally indicated development, has been completed, readjudicate the issue on appeal.  If the benefit sought is not granted to the Veteran's satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide them an opportunity to respond.  If necessary, return the case to the Board for further appellate review. 

No action is required of the Veteran until he is notified by VA. However, he is advised of his obligation to cooperate in ensuring the duty to assist is satisfied. Kowalski v. Nicholson, 19 Vet. App. 171 (2005). His failure to report for a VA medical examination may impact the determination made. 38 C.F.R. § 3.655. The Veteran is also advised that he has the right to submit additional evidence and 

(CONTINUED ON NEXT PAGE)

argument with respect to this matter. Kutscherousky v. West, 12 Vet. App. 369 (1999). This appeal must be afforded prompt treatment. 

 

 

THERESA M. CATINO

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Steven H. Johnston, 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.