Citation Nr: 21065059 Decision Date: 10/23/21 Archive Date: 10/23/21 DOCKET NO. 16-04 717 DATE: October 23, 2021 REMANDED Entitlement to service connection for residuals of a hernia is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1954 to December 1957. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in October 2014 by a Department of Veterans Affairs (VA) Regional Office. In December 2020, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In January 2021 and August 2021, the Board remanded the case for additional development and it now returns for further appellate review. Entitlement to service connection for residuals of a hernia. As the Board found that VA opinions addressing the etiology of the Veteran's claimed residuals of a hernia obtained in April 2014, May 2021, and June 2021 were inadequate to decide the claim, the Board remanded the case in August 2021 in order to obtain an addendum opinion addressing such matter. In this regard, the remand directed that, following a review of the record, a VA examiner should offer an opinion as to whether a hernia, identified as ventral and inguinal hernias at the April 2014 VA examination, had its onset in, or is otherwise related to, the Veteran's military service, to include his report of an in-service injury when opening and lifting a hangar door where he felt a pop right above his belly button, and his in-service treatment for stomach complaints in May 1957 and report of stomach trouble at his November 1957 separation examination, If so, the examiner was requested to identify all residuals. In August 2021, following a review of the record, an interview with the Veteran, and a physical examination where diagnoses of ventral and inguinal hernias were noted, a VA examiner opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In support thereof, she stated that ventral hernia pain is not usually associated with eating, and requires minimal physical examination to be documented as it can be seen when rising from a lying to a seated position, often with standing. The examiner further described a ventral hernia as a fairly large protrusion without multiple lumps. As pertinent to the claim of whether the Veteran's "stomach issues" being mistaken for hernia complaints, she observed that there was an exit examination and found that the 30+ year difference [in injury and treatment] for a ventral hernia seemed almost implausible for the Veteran not to have sought treatment, as such disorder can be quite annoying, and the Veteran reported no issues during the interim time frame. However, the Board finds such opinion to be inadequate to decide the claim. In this regard, at his December 2020 Board hearing, the Veteran testified he has treated his hernia over the years with a homemade belt or truss and, in a July 2021 statement, stated that, since his claimed injury, he has pain, acid reflux, and digestive issues. However, the examiner did not consider the Veteran's reports of treating his hernia at home or his residual symptoms in her rationale. Moreover, while she diagnosed the Veteran with ventral and inguinal hernias, her rationale was specific to the ventral hernia only, and she did not consider the Veteran's report of his in-service injury as directed in the August 2021 remand. Stegall v. West, 11 Vet. App. 268, 271 (1998). Consequently, the Board finds that a remand is necessary in order to obtain an addendum opinion addressing such matters. The matter is REMANDED for the following action: Forward the record, to include a copy of this remand, to an appropriate clinician, other than the May/June 2021 and August 2021 examiners, in order to obtain an opinion addressing the nature and etiology of the Veteran's claimed residuals of a hernia. Following a review of the record, the examiner should offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that (1) a ventral hernia and/or (2) an inguinal hernia (as diagnosed at the April 2014 and August 2021 VA examinations) had its onset in, or is otherwise related to, the Veteran's military service, to include his report of an in-service injury when opening and lifting a hangar door where he felt a pop right above his belly button, and his in-service treatment for stomach complaints in May 1957 and report of stomach trouble at his November 1957 separation examination. If so, please identify all residuals. The examiner must consider the Veteran's report of self-treating his hernia since service, and experiencing pain, acid reflux, and digestive issues since his reported in-service injury. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. M. Kelly, 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.