Citation Nr: 21069995 Decision Date: 11/22/21 Archive Date: 11/22/21 DOCKET NO. 13-23 722 DATE: November 22, 2021 REMANDED Service connection for a left shoulder disability, to include rotator cuff tear status post decompression and rotator cuff repair surgery as secondary to the service-connected low back disability is remanded. Service connection for a right shoulder disability, to include rotator cuff tear status post decompression and rotator cuff repair surgery as secondary to the service-connected low back disability is remanded. Service connection for a gastrointestinal condition, diagnosed as internal hemorrhoids and intermittent rectal bleeding is remanded. REASONS FOR REMAND The Veteran, who is the appellant in this case, had service in the U.S. Army from February 1978 to June 1986, and subsequently served as a member of the Georgia National Guard, completing periods of active duty for training (ACDUTRA) and inactive duty training (INACDUTRA) as follows: (a) ACDUTRA from June 12, 2004 to June 26, 2004; and January 3, 2005 until January 27, 2005, and from April 2, 2005, until April 6, 2005, and additional periods of unverified ACDUTRA and INACDUTRA. In April 2016, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge (VLJ); a transcript of the hearing is associated with the claims file. The Board previously considered this appeal in January 2021, and remanded these issues for additional development. After the development was completed, the case returned to the Board for further appellate review. Subsequently, a June 2021 rating decision granted service connection for a left and right hip disability. As this represents a full grant of the benefits sought, the issues are no longer on appeal. 1. Service connection for a left shoulder disability, to include rotator cuff tear status post decompression and rotator cuff repair surgery as secondary to the Veteran's service-connected low back disability. 2. Service connection for a right shoulder disability, to include impingement status post decompression and debridement surgery as secondary to the Veteran's service-connected low back disability. The Board cannot make a fully-informed decision on the issues of a left and right shoulder disability because no VA examiner has opined whether the left and right shoulder disabilities are caused or aggravated by the low back disability. 3. Service connection for a gastrointestinal condition, diagnosed as internal hemorrhoids and intermittent rectal bleeding. The Board cannot make a fully-informed decision on the issue of a gastrointestinal condition, diagnosed as internal hemorrhoids and intermittent rectal bleeding because the June 2021 VA examiner did not provide an opinion that accounted for the Veteran's current diagnosis for internal hemorrhoids. Instead, the VA examiner stated there were no current symptoms on examination and there were not current external hemorrhoids without any opinion on the internal hemorrhoids that were diagnosed during the appeal period. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding the Veteran's left and right shoulder disability. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: Is the left and right shoulder disability at least as likely as not proximately due to the service-connected low back disability? Is the left and right shoulder disability at least as likely as not aggravated, i.e., worsened beyond its natural progression, by the service-connected low back disability? Provide a rationale to support the opinion(s). In providing the requested opinion, consider the Veteran's description of his in-service injury and symptoms as well as his post-service symptoms. 2. Obtain an addendum opinion from an appropriate clinician regarding the Veteran's gastrointestinal condition, diagnosed as internal hemorrhoids and intermittent rectal bleeding. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: Is the gastrointestinal condition, diagnosed as internal hemorrhoids and intermittent rectal bleeding at least as likely as not related to service? The examiner must opine on any internal hemorrhoids and intermittent rectal bleeding diagnosed during the appeal period despite whether the Veteran had any current symptoms during the June 2021 VA examiner. Provide a rationale to support the opinion. In providing the requested opinion, consider the Veteran's description of his in-service injury and symptoms as well as his post-service symptoms. H. SEESEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Connally, 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.