Citation Nr: 21069230
Decision Date: 11/17/21	Archive Date: 11/17/21

DOCKET NO. 13-25 601
DATE: November 17, 2021

REMANDED

Entitlement to service connection for a stomach disorder, claimed as peptic ulcer disease (PUD) and hiatal hernia, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from June 1972 to May 1975.

This matter comes to the Board of Veterans' Appeals (Board) from a June 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).  

In July 2020, this matter was last before the Board.  At that time the Board denied the claim.  The Veteran appealed the Board's denial to the U.S. Court of Appeals for Veterans Claims (Court).  Pursuant to the parties Joint Motion for Partial Remand (JMPR), in a July 2021 Order, the Court vacated the Board's July 2020 decision denying entitlement to service connection for a stomach disorder, claimed as PUD and hiatal hernia, and remanded the matter to the Board.

 

In the JMPR, the parties agreed that the Board erred in relying on an inadequate January 2020 VA examiner's opinion.  The parties specifically agreed that the examiner failed to address the Veteran's history of viral hepatitis, with anorexia, malaise, abdominal cramps, nausea and vomiting of at least seven days duration in March 1974.  Accordingly, the claim is remanded to obtain a new opinion.  38 C.F.R. § 4.2.

The matters are REMANDED for the following action:

1. Return the claims file to the examiner that conducted the January 2020 VA examination, if available, for an addendum opinion to assess the nature and etiology of any currently assessed stomach disability, to include PUD and hiatal hernia.  Make the claims file available to the examiner for review of the case.  If the January 2020 VA examiner is not available, the claims file must be available to another appropriate health care provider for the requested opinion.

The claims folder and a copy of this remand must be made available to the examiner.  The examiner should note in the examination report that the claims folder has been reviewed.

The examiner should provide an opinion, for each stomach condition present, to include PUD and hiatal hernia, as to whether it is at least as likely as not (approximately a 50/50 probability) that the condition originated in service or is otherwise etiologically related to service.

In offering this opinion the examiner must consider and address the Veteran's reports of having been diagnosed as having stomach ulcers in 1973, as well as the March 1974 assessment of viral hepatitis with anorexia, malaise, abdominal cramps, nausea and vomiting of at least seven days duration, with possible heroin use and withdrawal.  

If the examiner attributes any current stomach disability, to include PUD and hiatal hernia, to the in-service viral hepatitis, the examiner should address whether it is at least as likely as not (approximately a 50/50 probability) that any disability is thus the result of in-service heroin use.

The examiner must provide a complete rationale for any opinion expressed, based on the examiner's clinical and medical expertise; established medical principles; and references to the evidence of record, as appropriate.

If any opinion cannot be expressed without resort to speculation, ensure that the examiner so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge.

2. After the above development, and any other development deemed necessary, readjudicate the claim.

 

K.A. KENNERLY

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Joseph R. Keselyak, 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.