Citation Nr: 21014879 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 15-03 329 DATE: March 16, 2021 REMANDED The claim of entitlement to service connection for gastroesophageal reflux disease (GERD) and Barrett’s esophagus is remanded. The claim of entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1969 to October 1972. This appeal is from a February 2014 rating decision. A hearing was held before the undersigned Veterans Law Judge (VLJ) in December 2018. In April and July 2020, the Board remanded these claims for additional development. Unfortunately, the appeals continue to require development, as discussed below. 1. Entitlement to service connection for GERD and Barrett’s esophagus In the prior remand, the Board pointed out that an April 2020 VA medical provider failed to consider pertinent medical evidence as well as the Veteran’s reports of inservice and post service symptoms. Another opinion was obtained in December 2020. However, the VA contract nurse practitioner provided a conclusive opinion and did not address the evidence as requested by the Board in the prior remand. Another opinion should be obtained. 2. Entitlement to service connection for hypertension. In the prior remand, the Board pointed out that an April 2020 VA medical provider failed to consider pertinent medical evidence as well as the Veteran’s reports of inservice and post service symptoms. Another opinion was obtained in December 2020. However, the VA contract nurse practitioner provided a conclusive opinion and did not address the evidence as requested by the Board in the prior remand. Another opinion should be obtained. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Thereafter, request an addendum opinion by an appropriate clinician on whether it is as likely as not (50/50 probability) that GERD and/or Barrett’s esophagus is related to service. The examiner is asked to review the record prior to the examination. The Veteran asserts that he began to have symptoms of GERD while in service, and that he self-treated with Tums and Rolaids. He reported that he went to the emergency room for these symptoms. His STRs contain emergency room records from November 5th and 6th 1971, which show the impression was viral gastrointestinal infection on November 5th, and he was prescribed two drugs. He returned November 6th with continued stomach and chest pain and it appears it was suggested that he be given additional testing, but there are no further test results. The Veteran asserts that these prescriptions provided some relief, and he continued to have symptoms of GERD thereafter. He was officially diagnosed with GERD in 1985. The examiner is asked to elicit from the Veteran a detailed description of his symptoms in and since service, and his treatment thereof, and to provide an opinion on whether it is as likely as not that GERD and/or Barrett’s esophagus incepted in service or are related to the symptoms complained during service, to include the notations in November 1971. All opinions must be accompanied by explanation. All opinions must reflect full consideration of the lay and medical evidence of record. 3. After completing directive #1, request an addendum opinion by an appropriate clinician on whether it is as likely as not that hypertension incepted while in service or is related to service. The examiner is asked to review the record prior to the examination. The Veteran asserts that he gained weight during his initial training, which caused him to develop hypertension. He reports that he had elevated readings during service and that he was first prescribed medication for hypertension in the 1970s. He points to records from April 1997 to show that he had high blood pressure without a formal diagnosis. The examiner is asked to review the blood pressure readings and medications prescribed over the years. The examiner is asked to elicit from the Veteran a detailed history of his blood pressure, including when and what he was prescribed with in the 1970s, how long he took it, and what his blood pressure readings were, to the extent that he can remember. All opinions must be supported with explanation. All opinions must be accompanied by explanation. All opinions must reflect full consideration of the lay and medical evidence of record. Nathaniel Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.D. Jackson, 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.