Citation Nr: 21073244 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 17-33 210 DATE: December 7, 2021 REMANDED Service connection for gastroesophageal reflux disease (GERD) is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1989 to January 1992, from April 1993 to August 1994, and from February 2003 to May 2003. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was before the Board in April 2019 and February 2021 and was remanded for further development. Most recently, the Board remanded the claim for a VA examination. As part of the remand, the examiner was tasked with answering whether "the Veteran's GERD clearly and unmistakably [existed] prior to the Veteran's entrance into active service in January 1989, April 1993, or February 2003." The examiner noted that the claimed condition clearly and unmistakably existed prior to service but stated that GERD began in 1994. It is unclear if the examiner meant GERD existed prior to January 1989, April 1993, and February 2003 start dates, the latter two, or just February 2003. Moreover, it is unclear why the examiner believes that if GERD began in 1994, it manifested after August 1994. The examiner stated that a hiatal hernia was documented on the esophagogastroduodenoscopy (EGD) after the Veteran's service started. It is unclear if the examiner is referring to the April 2013 endoscopy or another one. If so, the examiner should explain why it is appropriate to use an April 2013 endoscopy for a matter that the examiner believes manifested in 1994, if that is what the examiner meant to articulate. The matter is REMANDED for the following action: Return the claims file to the April 2021 VA examiner to obtain an addendum opinion. Specifically, the examiner must address the below questions: Did the Veteran's GERD clearly and unmistakably exist prior to the Veteran's entrance into active service in January 1989? Is it more likely than not that the Veteran's GERD began between January 1989 and January 1992? If GERD existed prior to January 1989 does the evidence clearly and unmistakably show that such disability was not aggravated in service or that any increase in disability was due to the natural progression of the disease? Did the Veteran's GERD clearly and unmistakably exist prior to the Veteran's entrance into active service in April 1993? Is it more likely than not that the Veteran's GERD began between April 1993 and August 1994? If GERD existed prior to April 1993 does the evidence clearly and unmistakably show that such disability was not aggravated in service or that any increase in disability was due to the natural progression of the disease? Did the Veteran's GERD clearly and unmistakably exist prior to the Veteran's entrance into active service in February 2003? Is it more likely than not that the Veteran's GERD began between February 2003 and May 2003? If GERD existed prior to February 2003 does the evidence clearly and unmistakably show that such disability was not aggravated in service or that any increase in disability was due to the natural progression of the disease? If the VA examiner is unavailable, the opinions should be provided by another qualified physician following review of the claims file. The rationale for the opinions must be provided. The examiner should cite the medical records by date that he or she is relying on and explain why said medical record is relevant. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. Chalker, Associate 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.