Citation Nr: 21063770 Decision Date: 10/15/21 Archive Date: 10/15/21 DOCKET NO. 15-00 570A DATE: October 15, 2021 REMANDED Entitlement to service connection for an esophageal disorder, diagnosed as hiatal hernia and GERD, is remanded. Entitlement to a total disability rating based upon individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 2, 1988 to April 12, 1995 and from August 29, 2005 to December 31, 2005. These matters are on appeal from a September 2013 rating decision. In December 2019 and July 2021 these matters were remanded by the Board for further development. Regrettably, additional development is still necessary. 1. Esophageal disorder In the July 2021 remand the Board found that a September 2020 VA medical opinion was inadequate as the examiner's negative opinion was based largely on a dearth of treatment records despite the Veterans reports of continuous symptoms, and the examiner failed to address any of the Veteran's reports of symptoms cited in its remand. Accordingly, the Board remanded the claim for an examiner to address the medical evidence as requested. Specifically, the examiner was asked to consider the Veteran's testimony regarding in-service treatment for acid reflux, post-service hiatal hernia surgery, and 2018 diagnosis of H. pylori. Pursuant to the Board's remand, in September 2021 a VA examiner opined that the claimed esophageal disorder is not related to the Veteran's active service. The rationale was that the claimed esophageal disorder had first been seen in the medical records as of 2009 and that she was unable to verify reports of onset in 1996. The examiner further stated that there was a 2-year gap in documented symptoms, diagnosis, and treatment and a 13-year gap since reported onset of symptoms. Therefore, she could not, without speculation, establish a nexus. However, since the examiner failed to consider the Veteran's testimony regarding in-service treatment for acid reflux, post-service hiatal hernia surgery, and 2018 diagnosis of H. pylori, as requested in the July 2021 remand, the claim must be returned to the Agency of Original Jurisdiction so that the July 2021 remand directives regarding the requested medical opinion can be completed. See Stegall v. West, 11 Vet. App. 268, 271 (1998). 2. TDIU The TDIU issue is inextricably intertwined with the outstanding esophageal disorder claim. Therefore, the Board will await the further development needed before deciding the TDIU issue. The matters are REMANDED for the following action: Obtain an appropriate addendum by an examiner, other than the September 2021 VA examiner, regarding the nature and etiology of the Veteran's claimed esophageal disorder. Unless the examiner finds that a new examination is required, the Veteran need not be examined again. The claims file, including a copy of the July 2021 remand, must be made available to the examiner for review who should indicate that the claims file was reviewed. In answering this question, expressly address the following: (a) The Veteran's testimony, as recorded on page 11 of the September 2019 hearing transcript, that the Veteran was treated for acid reflux at Camp Shelby in 1998 or 1999. (b) The Veteran's hiatal hernia surgery which, as recorded on page 12 of the September 2019 hearing transcript, was scheduled for October 1, 2019. (c) The Veteran's testimony, as recorded on page 9 of the September 2019 hearing transcript, that the Veteran was diagnosed with H. pylori in 2018 at the Houston VAMC and what impact, if any, H. pylori has on the etiology of the esophageal disorder. The Board, by this remand, makes no determination, expressed or implied, concerning the credibility of any statements on file. (Continued on the next page) The addendum should include the complete rationale for all opinions expressed. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Adams, 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.