Citation Nr: 21012118
Decision Date: 03/03/21	Archive Date: 03/03/21

DOCKET NO. 14-34 988A
DATE: March 3, 2021

REMANDED

Entitlement to service connection for irritable bowel syndrome (IBS), to include as secondary to service-connected chronic groin pian and medication, is remanded.

REASONS FOR REMAND

The Veteran served on active duty in the United States Navy from July 1985 to August 1985.

1. Entitlement to service connection for irritable bowel syndrome (IBS), to include as secondary to service-connected chronic groin pian and medication, is remanded.

The Board notes that the Veteran was provided a VA examination in November 2020 for his claim for service connection for IBS, as secondary to his service-connected groin condition, and associated medication.  However, after a review of the examination report, the Board finds that the opinion to be inadequate and incomplete.  When medical evidence is incomplete, as it is here, VA must supplement the record by seeking an advisory opinion or ordering another medical examination.  Colvin v. Derwinski, 1 Vet. App. 171 (1991); Hatlestad v. Derwinski, 3 Vet. App. 213 (1992).  Therefore, additional development is required for the Board to fulfill its duty to the Veteran.

Specifically, the Board notes that a close review of the November 2020 VA examination and opinion, reveals that while the VA examiner concluded that the Veteran’s IBS was not caused or aggravated by the Veteran’s groin disability, and medication for that disability, the examiner failed to provide any rationale regarding secondary aggravation.  Here, the examiner’s opinion regarding secondary aggravation was completed on separate form, and only offered a single sentence finding that the IBS was not aggravated by the Veteran’s groin disability.  Nothing else was noted.  Even considering the rationale regarding secondary causation, such rationale is inapplicable to aggravation and falls short of an adequate medical basis for the examiner ultimate negative finding.  Consequently, as the examiner’s opinion regarding secondary aggravation is silent for any rationale or reasoning, the Board must find that opinion to be inadequate, and remand is required to acquire an adequate opinion. 

The matters are REMANDED for the following action:

 Obtain an addendum opinion from an examiner with sufficient expertise regarding the Veteran’s IBS. Whether an in-person examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) is necessary should be determined by the examiner.  The entire claims file must be provided to and reviewed by the examiner.  The examiner should address the following: 

(a) Whether it is at least as likely as not (50 percent or greater probability) that current IBS is related to an in-service injury or disease; 

(b) Whether it is at least as likely as not that current IBS is (1) proximately due to chronic groin pain or the pain medication for chronic groin pain, or (2) aggravated beyond its natural progression by chronic groin pain or the medication for the chronic groin pain. 

If the examiner cannot give an opinion 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).  

 

 

DELYVONNE M. WHITEHEAD

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	Ziheng Zhu, 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.