Citation Nr: 21063960 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 17-53 876 DATE: October 18, 2021 REMANDED The issue of entitlement to service connection for a neck condition is remanded. The issue of entitlement to service connection for an esophageal condition is remanded. VETERAN CONTENTIONS The Veteran contends that during his time in service he was involved in two motor vehicle accidents and, in at least one, he hit his head on the steering wheel. He asserts that he has continuously experienced neck pain and food getting stuck in his esophagus since the accident and both have progressively become worse. REASONS FOR REMAND The Veteran served on active duty in the United States Army from April 2002 to May 2006. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2016 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran timely appealed that decision to the Board and requested a hearing review. In July 2020, the Veteran testified before the undersigned Veterans Law Judge (VLJ); a transcript of the proceeding is of record. This matter was previously before the Board in March 2021 at which time it was remanded for further development. 1. The issue of entitlement to service connection for an esophageal condition is remanded. The Board is obligated to review all issues which are reasonably raised from a liberal reading of the appellant's substantive appeal, including all documents or oral testimony submitted prior to the Board decision. Fanning v. Brown, 4 Vet. App. 225, 229 (1993). Here, the Veteran was afforded a VA examination regarding his esophageal condition in October 2014. However, that examiner relied on the absence of in-service treatment records which reflected complaints or treatment for the Veteran's esophageal condition to provide a negative nexus and was thus inadequate for VA purposes. See Dalton v. Nicholson, 21 Vet. App. 23, 40 (2007). November 2017 and June 2021 private medical opinions were also associated with the record, but those opinions were conclusory and therefore inadequate for VA purposes. See Stefl v. Nicholson, 21 Vet. App. 120 (2007); Bloom v. West, 12 Vet. App. 185, (1999). In response to the March 2021 remand, the Veteran was afforded an additional VA examination to assess the status and etiology of his esophageal condition. See 6/14/2021 C&P Examination. With respect to that remand, the Board finds that the directives were substantially complied with. See Stegall v. West, 11 Vet. App. 268, 271 (1998). However, while the June 2021 opinion, which determined that the Veteran's condition was not related to service, was adequate for VA purposes, the examiner noted that generally there seems to be an association between hypercontractile esophagus (the Veteran's condition) and psychiatric illness. Because the Veteran is already service connected for PTSD, a VA opinion evaluating whether the Veteran's esophageal condition is secondary to his PTSD is warranted. 2. The issue of entitlement to service connection for a neck condition is remanded. When VA undertakes to provide an examination for a claim of service connection, even if not statutorily obliged to do so, it must provide an adequate one. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Here, the Veteran was afforded two VA examinations which addressed his neck condition. Both the October 2014 and June 2021 examiners relied on the absence of in-service treatment records to provide a negative nexus opinion. Thus, both opinions are inadequate for VA purposes. See Dalton, 21 Vet. App. 23 at 40. November 2017 and June 2021 private medical opinions were associated with the record, but those opinions were conclusory and therefore also inadequate for VA purposes. See Stefl, 21 Vet. App. 120 at 123. Therefore, the Board remands the claim for a neck condition to obtain an addendum opinion. The matters are REMANDED for the following action: 1. Return the claims file to the VA examiner who conducted the June 10, 2021 C&P Examination, if available. If that examiner is not available, send the claims file to another examiner to address the following: (a) Is it at least as likely as not (50 percent probability or greater) that the Veteran's hypercontractile esophagus had its clinical onset during the Veteran's active service or is otherwise related to active service, or that there is a continuity of symptomology from service attributable to the Veteran's hypercontractile esophagus. (b) Is it at least as likely as not that the condition was caused by a service-connected disability, to include the Veteran's service-connected post-traumatic stress disorder (PTSD)? Please explain why or why not. (c) If not caused by a service-connected disability, is it at least as likely as not that the condition has been worsened beyond normal progression by a service-connected disability, to include PTSD? Please explain why or why not. (d) If the examiner finds that the condition has been worsened beyond normal progression (aggravated) by a service-connected disability, please describe the degree in aggravation beyond the baseline level of hypercontractile esophagus that is attributed to the service-connected disability. A complete rationale for the examiner's opinion should be provided, citing to specific evidence of record, as necessary. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). 2. Return the claims file to the VA examiner who conducted the June 10, 2021 C&P Examination, if available. If that examiner is not available, send the claims file to another examiner to address the following: Is it at least as likely as not (50 percent probability or greater) that the Veteran's neck condition is causally related to his active service, specifically including as a result of motor vehicle accidents in 2002 and 2004? In answering this question, please specifically consider and address the November 2017 and June 2021positive opinions provided by the Veteran's treating chiropractor. For the purpose of providing the opinion requested, please accept as valid the Veteran's statements regarding his involvement in motor vehicle accidents in 2002 and 2004. (The Board reminds the Veteran that in asking the examiner to accept the history he provided, the Board is not assessing the credibility of his statements at this time). A complete rationale for the examiner's opinion should be provided, citing to specific evidence of record, as necessary. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). S.C. Krembs Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Z. Sloley, Associate 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.