Citation Nr: 21069826 Decision Date: 11/19/21 Archive Date: 11/19/21 DOCKET NO. 17-45 703 DATE: November 19, 2021 REMANDED Entitlement to service connection for irritable bowel syndrome is remanded. Entitlement to a compensable rating for residuals fractured 4th metatarsal of the left foot (left foot disability) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 2010 to July 2011. These matters come before the Board of Veterans' Appeals (Board) on appeal from a January 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). 1. Service Connection for Irritable Bowel Syndrome is Remanded. The Veteran asserts that he has an intestinal disorder that was caused by his active duty service. See May 2017 Notice of Disagreement. The Veteran was afforded a VA examination in June 2017 for intestinal conditions where the examiner determined that the Veteran does not have a current diagnosis for an intestinal condition to include irritable bowel syndrome. In the remarks section, the examiner noted that the Veteran has chronic constipation but failed to appear at a gastroenterology appointment. In his October 2021 substantive brief, the Veteran asserts that he should be afforded a new VA examination because the June 2017 examiner did not address all of his intestinal conditions, including gastroesophageal reflux disease (GERD). In a July 2016 VA treatment, it was noted that the Veteran reported daily GERD related symptoms. Since the Veteran was unable to attend a gastroenterology appointment and his record shows report of GERD related symptoms, the Board finds it appropriate to remand the matter to afford the Veteran a new VA examination to determine the nature and etiology of any intestinal disorder, to include GERD. 2. Disability Rating for Left Foot Disability is Remanded. The Veteran was afforded a VA examination in June 2017 for his left foot disability where the examiner noted that the Veteran had reported flare-ups described as flare-up when going up hills, walking up hills, or being on his feet all day. In his October 2021 substantive brief, the Veteran asserts that while the examiner made note of the Veteran's reported flare-ups, the examiner did not ascertain any other information regarding flares such as its frequency, duration, characteristic, and severity. The Veteran should be provided an opportunity to report for another VA examination to ascertain the current severity and manifestations of his left foot disability, to include his reports of flare-ups. The matters are REMANDED for the following action: 1. Ask the Veteran to identify all outstanding treatment records relevant to his claims. All identified VA records should be added to the claims file. All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken, to include notifying the Veteran of the unavailability of the records. 2. After records development is completed, schedule the Veteran for a VA examination to determine the nature and etiology of any intestinal conditions, to include GERD, and whether it is at least as likely as not (50 percent probability or greater) that any current intestinal disorder onset during service or is otherwise related to an in-service injury, event, or disease. The examiner must review the claims file. The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran the examiner should provide a fully reasoned explanation. All pertinent symptomatology and findings must be reported in detail. 3. After records development is completed, schedule the Veteran for a VA examination to determine the current symptoms, level of severity, and functional impairment associated with his left foot disability. The claims file should be reviewed by the examiner. Full range of motion testing must be performed where possible. The joint(s) involved should be tested in both active and passive motion, in weight-bearing and non weight-bearing and, if possible, with range of the opposite undamaged joint. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain the basis for this decision. The examiner should ascertain the frequency, duration, characteristics, or severity of any reports of flare-ups. If possible, the examiner should estimate the Veteran's range of motion during a flare up. It is not sufficient to abstain from providing an opinion regarding range of motion during the flare up because the Veteran is not examined during a flare up. All pertinent symptomatology and findings must be reported in detail. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Mathew 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.