Citation Nr: 21065034 Decision Date: 10/22/21 Archive Date: 10/22/21 DOCKET NO. 18-49 368 DATE: October 22, 2021 REMANDED Service connection for an intestinal condition, to include hemorrhoids, is remanded. Service connection for a back condition is remanded. REASONS FOR REMAND The Veteran served on active duty from May 2009 to May 2014. The Veteran testified before the undersigned Veterans Law Judge at a hearing in July 2021; a copy of the transcript is of record. At the outset, the Board notes that the Veteran originally filed his claim for service connection for irritable bowel syndrome. However, pursuant to Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009), the Board has re-characterized the issue on appeal as entitlement to service connection for an intestinal condition, to include hemorrhoids. This will provide the most potentially favorable review of the Veteran's claim in keeping with the Court's holding in Clemons. Intestinal Condition The Veteran's 2016 VA examination noted his diagnosis of internal hemorrhoids. However, the examiner did not render an opinion of the potential link between the Veteran's hemorrhoids and his active duty service. The Board finds that this examination is inadequate for adjudication purposes and a new examination is warranted. Back Condition In Saunders v. Wilkie, F.3d 1356, 1362-63 (2018), the U.S. Court of Appeals for the Federal Circuit found that the term "disability" for VA compensation purposes refers to functional impairment of earning capacity, rather than the underlying cause of the impairment. 38 C.F.R. § 4.10. The Federal Circuit thus held that pain alone, without diagnosed underlying pathology, can constitute a disability if it produces functional impairment. Saunders, F.3d 1356 at 1367-68. Conversely, subjective pain alone does not in itself constitute a disability unless it reaches the level of functional impairment of earning capacity. Id. The Board notes that the Veteran's 2016 examination contained conflicting reports of the impacts of the Veteran's back pain on his work the Veteran reported an inability to lift due to his back pain, but the examiner found no functional limitations. In this matter, the Veteran's VA examination was conducted in 2016, prior to the Saunders decision. The Board finds that the Veteran must be afforded a new VA examination and opinion to comply with Saunders. The matters are REMANDED for the following action: Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his low back pain and any diagnosed intestinal condition, to include hemorrhoids. The claims file should be made available to the examiner for review. The examiner should identify any diagnosed disability of the Veteran's low back and must opine whether it is at least as likely as not (50 percent or greater probability) that any such disability and any diagnosed intestinal condition, to include hemorrhoids, were incurred in, or due to, the Veteran's service. The examiner should also address the Veteran's reports of low back pain and opine on whether pain causes functional impairment. The examiner is asked to consider a May 2016 VA medical record regarding the range of motion of the Veteran's lumbar spine. The Veteran's lay statements regarding onset and continuity of symptomology, including his July 2021 hearing, should be recorded, and considered. A rationale for all opinions must be provided. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish, 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.