Citation Nr: 21015921 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 16-18 563 DATE: March 18, 2021 REMANDED Entitlement to service connection for duodenal ulcer is remanded. Entitlement to service connection for an esophageal disability to include gastroesophageal reflux disease (GERD) is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Marine Corps from August 1965 to August 1969. When this appeal was last before the Board in September 2019, the issue of entitlement to service connection for hemorrhoids was remanded for further development. In November 2020, however, service connection internal and external hemorrhoids was granted. As the benefit sought on appeal has been granted, this issue is no longer before the Board. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997). The Veteran appeals the denial of service connection for a duodenal ulcer and GERD. The Veteran argues that he was stationed at Camp Lejeune which exposed him to contaminated water which may have resulted in his duodenal ulcer and GERD. When these issues were last before the Board in September 2019, it was determined that further development was needed for proper adjudication of the claims to include affording the Veteran a VA examination. In August 2020, the VA examiner found that the Veteran did not have signs or symptoms due to any esophageal conditions including GERD. As a diagnosis of GERD was not established, the examiner stated that a medical opinion was not indicated. The examiner also found that per upper GI endoscopy in December 2016, there are no gastric or duodenal ulcers in evidence. He noted that the Veteran’s current symptoms were consistent with post gastrectomy syndrome. The examiner further indicated that there was a lack of contemporaneous medical records to determine the underlying etiology or the diagnosis which led to the Billroth 1 procedure with any certainty. However, the record does contain a February 1973 private medical report indicating that the Veteran has been hospitalized in 1971, 1972 and 1973 with “ulcer disease confirmed by x-rays.” The examiner’s opinion is not adequate as it failed to consider highly relevant evidence already associated with the claims folder. A Board remand confers upon the appellant the right to compliance with that order. Stegall v. West, 11 Vet. App. 268, 271 (1998). Accordingly, a remand is warranted. The Board also notes that the VA examiner found that while the opinion of Dr. M appears carefully considered, he was unable to comment on its validity as no medical literature was cited for reference. Without such reference, the VA examiner stated that Dr. M’s opinion “remains his personal, professional opinion.” The Board finds that notation to be confusing at best as the VA examiner seems to indicate that Dr. M’s opinion is personal but also indicates that it is professional at the same time. For the reasons stated, another opinion on this matter is needed. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination(s)to determine the nature and etiology of his duodenal ulcer/GERD and/or postgastrectomy syndrome. Access to the electronic record must be made available to the examiner(s) in conjunction with the examination. As to each and every stomach disability diagnosed at the examination, or diagnosed in the record, the examiner must opine whether it is at least as likely as not that any diagnosed disorder is related to an in-service injury, event, or disease, to include the exposure to contaminated water at Camp Lejeune. In doing so, the examiner must address:(a) the December 2016 opinion of Dr. M, (b) the Veteran’s claim that his ulcer and GERD are due to exposure to contaminated water at Camp Lejeune, (c) the January 1968 in service complaint of chest pain and (d) a February 1973 private medical report (See Third Party Correspondence received February 16, 1973) reporting the Veteran’s hospitalization in February 1971, March 1972, September 1972 and January 1973 “with ulcer disease confirmed by x-rays.” The VA examiner should provide a complete rationale for any opinions provided. The examiner must reconcile any opinion with the service treatment and personnel records, any post-service diagnoses, lay statements and testimony of the Veteran. If he or she rejects the lay evidence, an explanation must be provided, and the examiner should note that the mere passage of time without treatment is not a sufficient basis for finding that no relationship between a current disability and service exists. (continued on the next page) 2. Thereafter, readjudicate the claims. If any benefit sought on appeal remains denied, furnish the Veteran and his representative a supplemental statement of the case and allow an appropriate period of time to respond. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T.S. Willie 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.