Citation Nr: 21076228 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 16-52 292 DATE: December 22, 2021 REMANDED Entitlement to service connection for immune system malfunction with food allergies, to include as due to psoriasis is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1969 to December 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2017 rating decision of the VA regional office. This matter was previously before the Board in July 2021. Entitlement to service connection for immune system malfunction with food allergies, to include as due to psoriasis is remanded. Pursuant to July 2021 Board remand instructions, a VA medical opinion was obtained in August 2021. This negative etiological opinion contained no rationale. An addendum was then obtained in October 2021, wherein the examiner sought clarification. Specifically, the examiner indicated being unclear what was being referred to as "an immune system malfunction with food allergies", explaining that this is not a diagnosable condition. When VA undertakes to obtain an examination/opinion, it must ensure that the examination/opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). A medical opinion/examination is considered adequate "where it is based on consideration of the veteran's prior medical history and examinations and also describes the disability, if any, in sufficient detail so that the Board's evaluation of the claimed disability will be a fully informed one." Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). The Board finds the VA opinion obtained by the AOJ to be inadequate for adjudication purposes. In this regard, the opinion is entirely unresponsive to the questions posed in the July 2021 Board remand, which requested an etiological opinion regarding "any immune system malfunction with food allergies or any related symptoms". The Board further pointed to specific diagnoses of food allergies and psoriasis in the VA medical record, and instructed the examiner to consider the Veteran's lay testimony. An opinion, such as that provided by the examiner, comprised entirely of the conclusory remark that the Veteran's claim is not that of a diagnosable condition, is also violative of Clemons v. Shinseki, 23 Vet. App. 1, 4-5 (2009), holding that a claim must be characterized and addressed based on the reasonable expectations of the non-expert claimant and the evidence in processing the claim. The Board finds that the examiner neither addressed the Veteran's claim with due consideration of the Veteran's status as a layperson, nor did she address the specific facts presented by the Board remand of July 2021. Thus, remand is regrettably necessary yet again for an adequate VA opinion. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to obtain an opinion as to whether the Veteran's immune system malfunction with food allergies and any related symptoms, is related to service or is caused or aggravated by service-connected disability. If an examination cannot be scheduled, obtain the requested opinion. The clinician should indicate whether it is at least as likely as not (a 50 percent or greater probability) that any immune system malfunction with food allergies or any related symptoms experienced by the Veteran since approximately November 2016 had its onset during service or is otherwise related to service. Also, the clinician must indicate if any immune system malfunction with food allergies or any related symptoms experienced by the Veteran since approximately November 2016 is at least as likely as not (1) caused by steroids used to treat service-connected psoriasis; OR (2) aggravated by steroids used to treat service-connected psoriasis. (Continued on the next page) If the examiner finds that there is no disability OR functional impairment manifested by immune system malfunction with food allergies, the examiner should provide a rationale as to why such is the case. A detailed rationale supporting the examiner's opinions must be provided. If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. See Jones v. Shinseki, 23 Vet. App. 382 (2010). R. Erdheim Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Comninos, Georgio 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.