Citation Nr: 21013350 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 15-29 281 DATE: March 9, 2021 REMANDED Entitlement to service connection for gastroesophageal disease (GERD) is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1965 to June 1968. The issue comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a Board hearing in August 2019 before the undersigned Veterans Law Judge (VLJ). The record was held open for 30 days for the submission of additional evidence. A copy of the transcript is of record. The issue was previously before the Board in November 2019 and November 2020 and was remanded. The most recent remand of November 2020 was remanded for a supplemental medical opinion addressing the Veteran’s lay contentions of having taken medication for his stomach condition since service. The examiner reviewed the Veteran’s claims file. In providing her opinion, the examiner discussed the Veteran’s in-service treatment and provided a rationale for her opinion. While the Board finds the VA examination of December 2020 adequate for adjudication and substantially complied with the remand directives, it must again remand to address the secondary claim contentions raised by the Veteran in February 2021. Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to service connection for GERD is remanded. The Veteran contends that his GERD was incurred in service and has continued since. In a February 2021 statement, the Veteran argues the alternate, a secondary relationship to his service-connected major depression and psychotic disorder. There is no medical opinion of record addressing whether the Veteran’s GERD was caused or aggravated by his service-connected psychiatric disability. In support of his claim, the Veteran has provided two studies showing a relationship between GERD and psychological disorders. A remand is warranted for a supplemental opinion addressing this newly received evidence and the etiology of the Veteran’s GERD. Accordingly, the matter is REMANDED for the following action: 1. Provide the Veteran’s claim file to a qualified clinician so that a supplemental opinion may be provided addressing the secondary theory of his GERD. The entire claims file and a copy of this remand must be made available to the examiner for review. A physical examination of the Veteran or telehealth examination is only required if deemed necessary by the clinician. The Board calls the examiner’s attention to the following articles: a. Depression and Anxiety in Patients with Gastroesophageal Reflux Disorder With and Without Chest Pain, Mohammad, S., Chandio, B., Soomro, A. A., Lakho, S., Ali, Z., Ali Soomro, Z., & Shaukat, F. (2019). https://doi.org/10.7759/cureus.61032 b. Prevalence of gastroesophageal reflux disease in major depressive disorder: A population-based study, Chou, P., Lin, C., Lin, C., Tsai, C., Cheng, C., Chuo, et al. (2013, August 13). https://www.sciencedirect.com/science/article/abs/pii/S0033318213001035 The examiner must provide an opinion as to: a. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s GERD is proximately due to or the result of his service-connected major depression and psychotic disorder. b. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s GERD is aggravated beyond its natural progression by his service-connected major depression and psychotic disorder. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above-requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such a conclusion. (Continued on the next page)   2. Then, readjudicate the claim. If any decision is adverse to the Veteran, issue a supplemental statement of the case, and allow the applicable time for response. Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Stevens, 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.