Citation Nr: 21011714 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 15-15 815 DATE: March 2, 2021 REMANDED Service connection for a back disability, other than osteopenia, to include degenerative disc disease (DDD), is remanded. Service connection for gastrointestinal reflux disease (GERD), to include as secondary to service-connected bronchial asthma, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1971 to March 1973. A July 2019 Board decision denied the Veteran’s service connection claims for a back disability, other than osteopenia, and GERD. The Veteran appealed the adverse decisions to the United States Court of Appeals for Veterans Claims (“CAVC” or “the Court”). In September 2020, the Court vacated the Board decision, as to the service connection claims for a back disability, other than osteopenia, and GERD and remanded the service connection claims for additional development in compliance with the Joint Motion for Partial Remand (JMPR). In the JMPR, the parties found that the Board failed to provide an adequate reasons and bases for denying the service connection claims. Specifically, the Court found that the August 2012 VA examinations, which the Board relied on in its denial of both service connection claims, lacked a medical opinion addressing the issue of aggravation. The Court found that the absence of an aggravation opinion regarding the back disability raised the issue of whether the opinion provided by the August 2012 VA examiner is sufficient to fully inform the Board as to whether the Veteran’s osteopenia aggravated, worsened, or contributed to his DDD or low back pain. El-Amin v. Shinseki, 26 Vet. App. 136, 2014 (2013). Similarly, the Court found that although the August 2012 VA examiner for GERD provided an opinion regarding secondary service connection, they did not specifically address the issue of aggravation. Id. As such, the Board finds that the August 2012 VA examiner’s medical opinions regarding the back disability, other than osteopenia and GERD are insufficient and remand is necessary to provide the Veteran new VA examinations that specifically address the issue of aggravation. The matters are REMANDED for the following action: 1. Schedule the Veteran for VA examination to determine the nature and etiology of his back disability, to include DDD. The examiner should review the Joint Motion for Remand (“Court of Appeals for Veterans Claims (CAVC) Decision received 9/14/20) to understand why previous examinations were found to be inadequate. The examiner should also review the Veteran’s arguments as to why service connection is warranted (“Remand BVA or CAVC” received 9/15/20). The examiner should provide the following opinions: (a) Is it at least as likely as not (50 percent or greater probability) that a back disability, to include DDD, is proximately due to or caused by the Veteran’s active duty service. Why or why not? (b) Is it at least as likely as not (50 percent or greater probability) that a back disability, to include DDD, is proximately due to or caused by the service-connected osteopenia of the lumbar spine, or any other service-connected disability? Why or why not? (c) Is it at least as likely as not (50 percent or greater probability) that a back disability, to include DDD, has been aggravated (made worse) by the service-connected osteopenia of the lumbar spine, or any other service-connected disability? Why or why not? If aggravation is found, a baseline level of a back disability prior to the aggravation should be identified. 2. Schedule the Veteran for a VA examination to determine the nature and etiology of his GERD. The examiner should review the Joint Motion for Remand (“Court of Appeals for Veterans Claims (CAVC) Decision received 9/14/20) to understand why previous examinations were found to be inadequate. The examiner should also review the Veteran’s arguments as to why service connection is warranted (“Remand BVA or CAVC” received 9/15/20). The examiner should provide the following opinions: (a) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s GERD, is proximately due to or caused by the use of medication prescribed to treat his service-connected osteoporosis. Why or why not? (b) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s GERD has been aggravated (made worse) by the either use of systemic steroids prescribed to treat his service-connected asthma; or by the use of medication prescribed to treat his service-connected osteoporosis? Why or why not? If aggravation is found, a baseline level of GERD prior to the aggravation should be identified. The examiner’s attention is directed to a correspondence from the Veteran, dated October 20, 2020, where he stated that he attributes the use of medications for his service-connected asthma and osteoporosis to have either caused or aggravated his reflux issues. In providing their medical opinions, the examiner should address the Veteran’s assertions that alendronate has increased his acid reflux. The examiner should also address what impact, if any, the Veteran’s prescribed medication for osteoporosis, to include Prolia shots and Omeprazole has on GERD. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Fu, 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.