Citation Nr: 21075328 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 19-18 948 DATE: December 20, 2021 REMANDED Entitlement to service connection for gastroesophageal reflux disease (GERD), to include as secondary to service-connected posttraumatic stress disorder (PTSD), is remanded. Entitlement to service connection for a respiratory disability, to include chronic bronchitis and chronic obstructive pulmonary disease (COPD), to include as secondary to GERD, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from December 1965 to December 1967, to include service in Vietnam. His decorations include the National Defense Service Medal and the Vietnam Campaign Medal. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a February 2018 rating decision issued by a Department of Veterans Affairs (VA) Regional Office. The issues on appeal were previously before the Board in September 2019, January 2021, and August 2021, when they were remanded to the agency of original jurisdiction (AOJ) for additional development. On each occasion, after taking further action, the AOJ confirmed and continued the prior denials and returned the case to the Board. Although the Board regrets the delay, another remand is required to ensure there is a complete record on which to decide the Veteran's claim and to afford him every possible consideration. 1. Entitlement to service connection for GERD is remanded. The Veteran is seeking service connection for GERD. He contends that his GERD is either directly related to service or caused or aggravated by his service-connected PTSD. See October 2021 Remarks to Supplemental Statement of the Case Dated August 28, 2021. In October 2021, the representative referred to and provided a copy of new medical research suggesting that veterans with PTSD are at a higher risk for gastrointestinal conditions, including GERD. In light of this new evidence, an addendum medical opinion is warranted. 2. Entitlement to service connection for a respiratory disability is remanded. Service connection for a respiratory disability is being claimed, in part, as secondary to GERD. Therefore, the two issues are inextricably intertwined. Harris v. Derwinski, 1 Vet. App. 180 (1991). Because the GERD claim is being remanded, the Board will remand the respiratory claim as well. These matters are REMANDED for the following action: 1. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 2. After the foregoing development has been completed, make arrangements to provide the record on appeal to the VA examiner who previously offered an opinion with respect to the etiology of the Veteran's GERD in August 2021. After reviewing the record, the examiner should offer an opinion as to whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that the Veteran has a gastrointestinal condition, including GERD, that has been (a) caused or (b) aggravated (i.e., permanently or temporarily worsened beyond natural progression) by his service-connected PTSD. In so doing, the examiner should discuss the medical significance, if any, of the medical literature in the record, including that submitted by the Veteran's representative in October 2021. If the August 2021 VA examiner is no longer employed by VA or is otherwise unable to provide the opinion(s) requested, arrange to obtain the requested information from another qualified examiner. The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner selected to offer the requested opinion(s). A complete medical rationale for all opinions expressed must be provided. 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issues on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Joseph T. Leonard, 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.