Citation Nr: 21077534 Decision Date: 12/30/21 Archive Date: 12/30/21 DOCKET NO. 12-07 622 DATE: December 30, 2021 REMANDED Entitlement to service connection for pancreatitis, to include as secondary to the service-connected left hallux valgus, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from September 1973 to March 1986. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In an August 2019 decision, the Board dismissed the Veteran's appeal after finding that the Veteran's service connection claim was not within the Board's jurisdiction. The Veteran subsequently appealed the August 2019 Board decision to the United States Court of Appeals for Veterans Claims (Court). In May 2021, the Court issued a memorandum decision in which it reversed the August 2019 Board decision, finding that the Board has jurisdiction over the Veteran's claim, and remanded the claim to the Board for adjudication on the merits. Entitlement to service connection for pancreatitis, to include as secondary to the service-connected left hallux valgus Although the Board regrets the delay, a remand is warranted to ensure that due process is followed and that there is complete record upon which to decide the Veteran's claim. First, a remand is warranted for an addendum medical opinion as the April 2014 opinion is inadequate. In this regard, the April 2014 VA examiner opined that the Veteran's diagnosed chronic pancreatitis is not caused or aggravated by his hallux valgus. As rationale, the examiner stated that his disability is due to alcohol abuse disorder and that there is no medical nexus of causation from hallux valgus to pancreatitis. The Board finds that this opinion is inadequate because the VA examiner provided no rationale for the aggravation element of secondary service connection, and instead, only addressed causation. The Board notes that a medical opinion must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record. See Stefl v. Nicholson, 21 Vet. App. 102, 124-25; see also Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008) (a medical examination opinion must contain clear conclusions with supporting data, and a reasoned medical explanation connecting the two). Additionally, once VA undertakes to provide a VA examination or opinion, it must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Therefore, this claim must be remanded to afford the Veteran an addendum medical opinion that includes sufficient rationale. Additionally, although the Veteran reported treatment at the VA hospital in Atlanta for his pancreatitis, the evidence of record does not appear to contain records of this treatment. See February 2014 VA Form 21-526EZ; February 2015 Correspondence. As such, on remand, the Agency of Original Jurisdiction (AOJ) should attempt to obtain any and all outstanding VA treatment records from the Atlanta VA Medical Center (VAMC). Finally, the Veteran has indicated that he was found disabled from the state of Florida as related to his pancreatitis. See February 2015 Correspondence. Although Social Security Administration (SSA) records are associated with the claims file, on remand, the AOJ should also attempt to obtain any state disability medical records. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file any outstanding VA treatment records, to include treatment records from the Atlanta VAMC. If such records are unavailable for review or cannot be located, such should be noted in the claims file and the Veteran and his representative should be notified accordingly. 2. With any necessary assistance from the Veteran, attempt to obtain all records pertaining to his claim for disability benefits from the State of Florida. Specifically, request that the Veteran complete an authorization form for VA to obtain these records and for any other outstanding private treatment records pertinent to his claim. Inform the Veteran that he may also submit these documents himself. After obtaining any necessary authorization from the Veteran, all identified, outstanding records should be obtained and associated with the claims file. 3. Obtain an addendum VA opinion from an appropriate VA examiner to address the Veteran's claim for service connection for pancreatitis. The claims file, to include a copy of this Remand, should be made available to and be reviewed by the VA examiner. The examiner is asked to respond to the following: (a) Is it at least as likely as not (50 percent probability or greater) that the Veteran's pancreatitis had an onset in or is otherwise related to active service? (b) Is it at least as likely as not (50 percent probability or greater) that the Veteran's pancreatitis is caused by his service-connected right and left hallux valgus, to include any associated medication? (c) Is it at least as likely as not (50 percent probability or greater) that the Veteran's pancreatis is aggravated by his service-connected right and left hallux valgus, to include any associated medication? (d) If the examiner finds that the Veteran's chronic pancreatitis is caused by alcohol abuse, is it at least as likely as not (50 percent probability or greater) that his alcohol abuse was either (1) caused by OR (2) aggravated by his service-connected disabilities, to include any associated medication? (Service connection has been established for tinnitus, right and left hallux valgus.) In providing the above opinions, the VA examiner should provide an opinion for BOTH causation and aggravation. If aggravation is found, the examiner should quantify the degree of aggravation, if possible, and state whether there was a medically ascertainable increase in disability regardless of permanence. An opinion that simply states that one disorder does not cause another, without supporting rationale or justification, will be deemed inadequate The examiner must provide a complete rationale for all opinions expressed and should consider the medical and lay evidence of record. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). MARJORIE A. AUER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Amanda Purcell, 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.