Citation Nr: 21077174 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 17-15 306 DATE: December 28, 2021 REMANDED Entitlement to service connection for a gastrointestinal disability, to include gastritis, gastrointestinal esophageal reflux disorder (GERD), Barrett's Esophagus, pyrosis, and hiatal hernia is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1987 to November 1991. This matter came to the Board of Veterans' Appeals (Board) on appeal from two rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO). In August 2013, the RO denied service connection for GERD and in May 2017, the RO Denied service connection for gastritis. The Veteran timely appealed. In September 2021, the Veteran testified during a virtual Board hearing before the undersigned VLJ with regard to both matters. A copy of the transcript has been associated with the record. A claim should not be limited to the disorder as characterized by the Veteran but must be characterized and addressed based on the reasonable expectations of the non-expert claimant and the evidence in processing the claim. Clemons v. Shinseki, 23 Vet. App. 1, 4-5 (2009). Given the multiple gastrointestinal symptoms and diagnoses in this case, the Board has recharacterized the gastrointestinal claim more broadly and consolidated the claims into a single issue for purposes of this remand. Gastrointestinal Disability The Veteran contends that his gastrointestinal disability is due to environmental exposures in Southwest Asia and/or due to hazardous materials while working on ship in Wisconsin. In his May 2017 NOD, the Veteran asserted that his gastrointestinal disability is directly associated with his military service and worsening over time to the present day. He reported exposure to the environmental hazards of oil fires, pesticides, and vaccinations Southwest Asia from 1990-1991. The Veteran also reported exposure to numerous unhealthy working conditions and hazardous materials in 1988-1989 for the refitting of Battleship 055 Wisconsin (BB-64) including radioactive and asbestos at Ingalls Shipbuilding established in 1938 in the Gulf town of Pascagoula, Mississippi. The Veteran was afforded a VA examination in September 2018. He reported that gastritis and hiatal hernia started after the Gulf War in 1991, and he has a history of Barret's esophagus on endoscopy. The examiner diagnosed the Veteran with gastritis, GERD, Barrett's Esophagus, pyrosis, and hiatal hernia. The examiner opined that the Veteran's gastritis was less likely than related to a specific exposure event experienced by the Veteran during service in Southwest Asia. The examiner's rationale included discussion of the Veteran being diagnosed with gastritis in 2001, and the Veteran's disability pattern related to gastritis is a disease with a clear and specific etiology and diagnosis. The examiner, however, failed to provide an opinion with supporting rationale addressing whether the Veteran's gastritis was related to hazardous materials while working on a ship in Wisconsin. The examiner also failed to address whether the Veteran's diagnosed GERD, Barrett's Esophagus, pyrosis, and hiatal hernia are related to the Veteran's military service. In light of the above, the Board finds the examiner's opinion is inadequate and another VA medical opinion is required. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide an examination or obtain a medical opinion, it must ensure that the examination or opinion is adequate). The matter is REMANDED for the following action: Request an opinion from an appropriate specialist physician to determine the nature and etiology of any gastrointestinal disability, to include gastritis, GERD, Barrett's Esophagus, pyrosis, and hiatal hernia. If an examination is deemed necessary, one should be conducted, to include via telehealth if warranted. The physician should review the claims file prior to rendering the opinion. The physician should answer the following question: Whether is it at least as likely as not (a 50 percent probability or greater) that any gastrointestinal disability manifested in service or is otherwise related to service, to include hazardous materials while working on ship in Wisconsin and/or due to environmental exposures experienced by the Veteran during service in Southwest Asia? (Continued on the next page) The physician must provide a detailed rationale for any opinion. The Veteran and other lay persons are competent to report on observable symptoms and their reports must be considered. If the physician rejects their lay reports, he or she must so state and explain why. An absence of contemporaneous medical treatment, standing alone, cannot be the basis for rejecting the lay reports. Jonathan Hager Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Walker, 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.