Citation Nr: 21071038 Decision Date: 11/29/21 Archive Date: 11/29/21 DOCKET NO. 21-00 777 DATE: November 29, 2021 REMANDED Entitlement to service connection for gastroesophageal reflux disease (GERD), hiatal hernia, and Barrett's esophagus, to include as due to herbicide exposure, is remanded. Entitlement to service connection for adenocarcinoma of gastric cardia, to include as due to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran had active military service from August 1963 to January 1973. This matter comes before the Board of Veterans' Appeals (Board) from the August 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for gastroesophageal reflux disease (GERD), hiatal hernia, and Barrett's esophagus, to include as due to herbicide exposure, is remanded. 2. Entitlement to service connection for adenocarcinoma of gastric cardia, to include as due to herbicide exposure, is remanded. The Veteran contends that his GERD and adenocarcinoma of gastric cardia conditions are related to his military service. Specifically, the Veteran alleges that his conceded herbicide exposure while in Vietnam caused these disabilities. The Veteran's most recent VA examinations were in October 2021. The examiner provided the same opinions for both the Veteran's GERD, hiatal hernia, and Barrett's esophagus condition and adenocarcinoma of gastric cardia disability. The examiner concluded that these conditions are less likely than not related to the Veteran's military service, to include herbicide exposure. The examiner explained that the Veteran's entrance and separation examinations are negative for diagnoses of the conditions or signs or symptoms during military service. Additionally, the examiner stated that the conditions are not presumptive. (The Board assumes the examiner is indicating presumption for herbicide exposure.) The examiner also stated that the lay evidence, June 2021 private medical opinion, and research information were taken into consideration. The examiner concluded that no nexus can be established. However, it does not appear that the examiner considered the online article that the Veteran submitted linking esophageal adenocarcinoma in Vietnam veterans due to herbicide exposure. Additionally, although the examiner stated that the lay statements were considered, it does not appear that the examiner considered the indication that the Veteran has had these conditions since his military service as noted by the lay statements and the Veteran's self-reports during the VA examinations. Therefore, the Board finds that a remand is warranted for addendum opinions to be obtained. The matters are REMANDED for the following action: 1. Obtain addendum opinions by an appropriate clinician to determine the nature and etiology of the Veteran's claimed conditions. a) The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's GERD, hiatal hernia, and/or Barrett's esophageal conditions are related to an in-service injury, event, or disease, including herbicides. b) The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's adenocarcinoma gastric cardia is related to an in-service injury, event, or disease, including herbicides. The examiner must consider the Veteran's lay statements that he has had gastrointestinal issues since his military service. The examiner should also discuss the online article that the Veteran submitted linking esophageal adenocarcinoma in Vietnam veterans due to herbicide exposure (received 07/24/2020). Additionally, although not presumptive conditions, the examiner must consider whether the Veteran's alleged conditions are caused by herbicide exposure. All opinions provided must be thoroughly explained and an adequate rationale for any conclusions reached must be provided. The examiner should not solely rely on the absence of evidence of in-service treatment or injury in the Veteran's service treatment records as a basis for any given opinion. If any requested opinion cannot be provided without resort to speculation, the medical professional should state and explain why an opinion cannot be provided without resort to speculation. (Continued on the next page) 2. Following completion of the above, and a review of any additional evidence received, the RO should also undertake any other development it deems to be necessary, to include, if warranted, an addendum medical opinion which considers any newly received evidence. MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Mountford, 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.