Citation Nr: 21011989 Decision Date: 03/03/21 Archive Date: 03/03/21 DOCKET NO. 17-40 041 DATE: March 3, 2021 REMANDED Entitlement to service connection for a psychiatric disorder, other than posttraumatic stress disorder (PTSD) is remanded. Entitlement to service connection for hemorrhoids and rectal bleeding is remanded. REASONS FOR REMAND The Veteran had honorable active duty service in the United States Army from September 1964 through September 1967. This appeal comes to the Board of Veterans’ Appeals (Board) from an April 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In March 2019, the Board remanded the issues of service connection for hemorrhoids and rectal bleeding, bilateral pes planus (flatfoot), inguinal hernia, acquired psychiatric disorder, erectile dysfunction, and a lower back condition for further development. In a March 2020 rating decision, the RO granted service connection for bilateral pes planus. As this is a full grant of benefits sought on appeal, this issue is no longer before the Board. In September 2020, the Board granted service connection for PTSD and denied service connection for inguinal hernia. The Board also remanded the issues of entitlement to service connection for an acquired psychiatric disorder, other than PTSD, hemorrhoids and rectal bleeding, erectile dysfunction, and a low back condition. In a November 2020 rating decision, the RO, in pertinent part, granted service connection for erectile dysfunction and granted service connection for degenerative arthritis of the thoracolumbar spine with intervertebral disc syndrome. As these are full grants of benefits sought on appeal, these issues are no longer before the Board. The Board recharacterized the issues accordingly. 1. Entitlement to service connection for an acquired psychiatric disorder, other than PTSD is remanded. In September 2020, the Board remanded the issue of entitlement to service connection for an acquired psychiatric disorder, other than PTSD, for a new VA examination and an opinion. The examination and opinion were obtained in October 2020. The opinion was negative. However, the RO did not readjudicate this claim and issue a supplemental statement of the case (SSOC). Accordingly, a remand for a SSOC is necessary. 38 C.F.R. § 19.31. 2. Entitlement to service connection for hemorrhoids and rectal bleeding is remanded. In September 2020, the Board remanded the issue of entitlement to service connection for hemorrhoids and rectal bleeding for a VA examination and medical opinion regarding whether the Veteran’s hemorrhoids/rectal bleeding was related to his military service, to include the incident where he stated that his problems began when he was lifting a generator. In October 2020, a VA examination was obtained. The VA examiner diagnosed the Veteran with internal or external hemorrhoids. The examiner opined that it was less likely than not that the claimed condition was incurred in or caused by his military service. The examiner explained that the military medical records did not document any rectal disorder. Therefore, based on the paucity of the evidence, the Veteran’s hemorrhoids were less than likely incurred in military service. The October 2020 VA medical opinion is inadequate because the VA examiner did not consider the Veteran’s statements that his hemorrhoids were related to the incident in service where he lifted a generator and felt something in his rectum. See October 2020 VA examination and January 2020 VA examination. As such, a remand is warranted for a new VA addendum medical opinion to take into consideration the Veteran’s lay statements. The matters are REMANDED for the following action: 1. Obtain a VA addendum medical opinion regarding the nature and etiology of the Veteran’s claimed hemorrhoids and rectal disorder. If an opinion cannot be rendered without a medical examination, then a medical examination should be performed. A copy of this remand and the claims file must be reviewed. The VA examiner should address the following: (a.) Is it at least as likely as not that the Veteran’s claimed hemorrhoids and rectal bleeding and/or any other rectal disorders are related to his military service, to include the incident where the Veteran stated that he had problems when he lifted a generator? See October 2020 VA examination and January 2020 VA examination. The VA examiner should consider the Veteran’s lay statements regarding the etiology and finds that his statements are credible. The Board notes that the Veteran was diagnosed with impairment of rectal sphincter control on his January 2020 VA examination. All opinions must be supported by a sufficient rationale. A negative opinion should not be based on the absence of medical evidence. 2. Thereafter, and after any further development deemed necessary, the issues on appeal should be readjudicated. If any benefit sought on appeal is not granted, the Veteran and his representative should be provided with a SSOC and afforded the appropriate opportunity to respond. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Crawford, 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.