Citation Nr: 21075334 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 19-03 049 DATE: December 20, 2021 REMANDED A compensable rating for gastroesophageal reflux disease (GERD) is remanded. Service connection for coronary artery disease claimed, including as due to GERD, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1983 to January 2003. In July 2021, the Veteran testified before the undersigned Veterans' Law Judge. A copy of the transcript is associated with the record. GERD The Veteran has not undergone a VA examination to determine the severity of his GERD since 2016. In his 2021 hearing, the Veteran reported that his GERD had increased in severity. As such, a new VA examination is warranted. CAD The Veteran has stated that his CAD is due to the medication taken to treat his gastrointestinal issues as well as his GERD. See 2021 hearing testimony. Upon review of the record, the Board notes that no examination of the claimed condition in regard to this theory has been afforded to the Veteran; additionally, the Board notes that the prior VA examination regarding the etiology of the Veteran's CAD did not address direct service connection but focused solely on a link to an in-service medical record. Thus, remand is necessary as the low threshold for obtaining such an examination and medical opinion has been surpassed in this case. See 38U.S.C. §5103A (d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The matters are REMANDED for the following action: Schedule the Veteran for a VA examination to determine the severity of his GERD and the nature and etiology of his CAD. The claims file, including a copy of this Remand, must be made available to the examiner and the examiner should indicate in his/her report whether or not such was reviewed. All necessary tests and studies should be accomplished. As to the Veteran's GERD, the examiner is asked to determine whether the Veteran has symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; other symptom combinations productive of severe impairment of health; persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health; or any of the above. As to the Veteran's CAD, the examiner must opine whether it is at least as likely as not (50 percent or greater probability): a. that the Veteran's CAD was incurred in, or due to, the Veteran's service, to include the medication taken by the Veteran in-service; or b. that the Veteran's CAD was proximately due to or aggravated beyond its natural progression by any of the Veteran's service connected disabilities, including his GERD and any medication taken to treat his GERD. The Veteran's lay assertions as to onset and continuity of symptomatology should be recorded and considered. A rationale for all opinions must be provided. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish 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.