Citation Nr: 21011517 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 14-20 645A DATE: March 2, 2021 REMANDED Service connection for gastroenteritis.   REASONS FOR REMAND The Veteran served on active duty from December 1971 to January 1977, with additional service in the Naval Reserve. The claim is on appeal from a December 2011 rating decision. In January 2018, the Veteran testified at a Board hearing. The case was previously before the Board in April 2018 and November 2019, with the issue of service connection for gastroenteritis remanded for additional development. Service connection for gastroenteritis. The Veteran has a current diagnosis of gastroenteritis, and he contends that the disorder is related to service. Service treatment records (STRs) show treatment of diarrhea and stomach cramps for one week due to gastroenteritis in September 1972, and a diagnosis of “viral gastroenteritis” with nausea and diarrhea in December 1972. The Veteran was afforded a VA examination in November 2011. The examiner confirmed the gastroenteritis diagnosis, but opined that the stomach condition is less likely than not related to service. The rationale provided was that the reports of gastrointestinal symptoms during service were due to acute conditions that resolved before separation, and the current gastroenteritis has a different etiology. In January 2018, the Veteran submitted an opinion from a private physician in which it was stated that gastroenteritis was due to service, as caused by or a result of a “viral illness.” No other explanation or rationale for this conclusion was provided. The Board remanded the claim in April 2018 for a new examination and medical opinion with consideration of the Veteran’s January 2018 Board testimony, and January 2018 private medical opinion. The Veteran was scheduled for a VA examination in October 2018; however, the Veteran failed to report or declined the scheduled examination. The Board remanded the claim again in November 2019 in an effort to acquire a medical opinion with consideration of the Veteran’s lay statements of continuous symptoms since service provided in January 2018 Board testimony, and addressing the January 2018 private medical opinion. In December 2019, the opinion of an internal medicine doctor was obtained. He indicated that he reviewed the Veteran’s claims file, and listed evidence of the September 1972 and December 1972 reports of gastroenteritis in his STRs, in addition to no reported issues at the time of enlistment or separation from the military. He then opined that the claimed gastroenteritis condition was less likely than not incurred in or caused by service with the rationale that there was no recurrence throughout the rest of active service other than the two reported events in his STRs. The Board finds that another medical opinion is still warranted. The Board notes that the Veteran credibly contends that symptoms of his gastroenteritis had their onset during service, and continued soon after, suggesting possible continuity of symptoms. He also described using over-the-counter medication in attempts to self-medicate both during service and thereafter. See January 2018 Board Hearing Transcript. The Board notes that when an examiner does not offer an opinion based on a veteran’s lay statements, and that information is necessary for the Board to make an informed decision on the claim, the examination is inadequate. See Miller v. Wilkie, 32 Vet. App. 249, 262 (2020). It also appears that the positive January 2018 private medical opinion was not listed as evidence that was considered in the December 2019 examiner’s opinion, as directed by the November 2019 remand directives. Thus, a new medical opinion is warranted. The matters are REMANDED for the following action: Forward the claims file to an appropriate clinician for a medical opinion as to the nature and etiology of the Veteran’s gastroenteritis. The record, including a complete copy of this remand, should be made available for review. Following a review of the record, the examiner should then opine whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s gastroenteritis had its onset during, or is otherwise related to, active service. The examiner is asked to specifically consider and discuss: (1) the Veteran’s lay statements of continuous symptoms of gastroenteritis since service; (2) the September 1972 and December 1972 STR entries of gastroenteritis; and (3) the positive January 2018 private medical opinion. If the absence of treatment before or after service plays a role in the formation of the opinion, the medical importance of this should be explained. The examiner should provide rationale for all opinions expressed, including by citing to the record. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Morford, 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.