Citation Nr: 21014945 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 13-09 277A DATE: March 16, 2021 REMANDED Entitlement to service connection for gastroesophageal reflux disease (GERD) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from December 1986 to December 2006. His decorations include the Southwest Asia Service Medal and the Global War on Terrorism Service Medal. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2009 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia. The issue on appeal was previously before the Board in October 2016, January 2018, and July 2019. In October 2016 and January 2018, the claim was remanded to the agency of original jurisdiction (AOJ) for additional development. In July 2019, the Board denied service connection for the Veteran’s GERD. Thereafter, the Veteran appealed the Board’s July 2019 decision to the United States Court of Appeals for Veterans Claims (Court). In July 2020, the Court granted a Joint Motion for Remand (JMR) filed by the parties to the appeal (the Veteran, through an attorney, and representatives from VA General Counsel), thereby vacating the Board’s decision and remanding the matter for readjudication. Entitlement to service connection for GERD is remanded. In the JMR filed with the Court, the parties to the appeal agreed that the Board relied on an inadequate March 2018 VA examination report when it denied service connection for the Veteran’s GERD. More specifically, the parties noted that the examiner’s only bases for offering a negative nexus opinion were the absence of any “recurrent or chronic” complaints of heartburn or indigestion in service and the length of time that elapsed between the Veteran’s service and his diagnosis of GERD. The parties observed that the Veteran had complained of and received treatment for chest pain and indigestion on multiple occasions during service, as illustrated by in-service reports dated in December 2002, December 2003, and February 2004. The parties agreed that the March 2018 examiner did not address whether the Veteran’s in-service complaints of chest pain were causally related to his later-diagnosed GERD; that the examiner did not explain why the absence of in-service symptoms and the length of time between service and the documented onset of symptoms was significant; and that a new examination report was need that addressed the etiology of the Veteran’s GERD with an adequate rationale. Pursuant to the terms of the JMR, a new or addendum medical opinion is required. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate); see also February 2021 Appellate Brief. This matter is REMANDED for the following action: 1. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 2. After the foregoing development has been completed, make arrangements to provide the record on appeal to the VA examiner who previously offered an opinion with respect to the etiology of the Veteran’s GERD in March 2018. The examiner should be asked to review the expanded record and prepare a supplemental report with respect to the matter of whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that the Veteran’s GERD had its onset in, or is otherwise related to, his period of active service. In so doing, the examiner must discuss the medical significance, if any, of the Veteran’s in-service complaints of chest pain and indigestion, to include as documented by in-service reports dated in December 2002, December 2003, and February 2004. If it is the examiner’s opinion that it is unlikely that the Veteran’s GERD had its onset in, or is otherwise related to, his period of active service, and it remains the examiner’s opinion that the lack of chronic or recurrent in-service complaints and the length of time between service and the documented onset of symptoms weighs against a favorable nexus opinion, the examiner should provide an explanation as to why that is so. The VA examiner is advised that the Veteran is competent to report symptoms, treatment, events, and injuries in service, and that his reports must be taken into account, along with the other evidence of record, in formulating the requested opinion. If the March 2018 VA examiner is no longer employed by VA or is otherwise unable to provide the opinion(s) requested, arrange to obtain the requested information from another qualified examiner. The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner selected to offer the requested opinion(s). A complete medical rationale for all opinions expressed must be provided. 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issue on appeal should be readjudicated based on the entirety of the evidence. If the benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Joseph T. Leonard, 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.