Citation Nr: 21066875
Decision Date: 11/02/21	Archive Date: 11/02/21

DOCKET NO. 18-26 889
DATE: November 2, 2021

REMANDED

Entitlement to service connection for residuals of heat stroke is remanded.

Entitlement to service connection for hypertension, to include as secondary to heat stroke residual, is remanded.

Entitlement to service connection for Crohn's disease, to include as secondary to heat stroke, is remanded.

REASONS FOR REMAND

While this appeal was in remand status, the RO issued a September 2021 rating decision granting service connection for major depressive disorder, and an initial 70 percent rating has been assigned thereto.  As the benefit sought on appeal has been granted, this aspect of the appeal is moot and will not be considered here.

In January 2021, the Board remanded the above-captioned claims in order to obtain additional etiological opinions from a VA examiner.  Specifically, the Board requested that a VA examiner ascertain all of the current residuals of the Veteran's in-service heat stroke.  In so doing, the Board requested the examiner to opine as to whether the Veteran's Crohn's disease, hypertension, and/or diabetes mellitus, type II, were (a) residuals of heat stroke or (b) caused or aggravated by any found heat stroke residuals.  

A series of opinions were obtained in July 2021, none of which substantially comply with the Board's remand directives.  For example, a July 2021 VA examiner rendered an opinion with respect to the Veteran's Crohn's disease that was limited in scope to direct service connection, which fails to consider secondary service connection and whether Crohn's disease is a residual of heat stroke.  Consequently, another remand is required.

The matters are REMANDED for the following action:

Provide the Veteran with the appropriate VA examinations (or telehealth interview, review of record, etc., if an in-person examination is not feasible).  The Veteran's claims file must be made available to the examiners and the examiners must specify in the report that it was contemporaneously reviewed. 

The examiners should identify all current heat stroke residuals.  In so doing, the examiners must render opinions as to whether the Veteran's Crohn's disease, hypertension, and/or diabetes mellitus, type II are (a) residuals of the Veteran's in-service heat stroke or (b) are caused or aggravated by any found heat stroke residuals.

The examiner must acknowledge and discuss the Veteran's lay statements regarding the history and chronicity of symptomatology, to include the competent lay testimony of the Veteran experiencing from heat stroke during a training period.

The examiner MUST assume as true the occurrence of the in-service event regarding heat stroke.  

All rendered opinions must be accompanied by a thorough rationale.

 

 

STEVEN D. REISS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Sean G. Pflugner, 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.