Citation Nr: 21042725 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 17-60 738 DATE: July 13, 2021 REMANDED Entitlement to service connection for collagenous colitis with recurrent diarrhea, including as secondary to service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served honorably in the United States Army from July 1960 to July 1963 and from June 1964 to June 1965. This matter returns to the Board of Veterans' Appeals (Board) after a March 2021 remand for additional development following a July 2020 decision from the U.S. Court of Appeals for Veterans Claims (CAVC or Court). The Board's remand requested the Department of Veterans Affairs (VA) Regional Office (RO) which is the agency of original jurisdiction (AOJ) to obtain addendum medical opinions related to the Veteran's claim for entitlement to service connection for his collagenous colitis with recurrent diarrhea condition (hereinafter referred to as colitis), based on various theories of entitlement. The AOJ obtained the requested addendum medical opinions in April 2021 and issued a Supplemental Statement of the Case (SOC), also in April 2021, which continued the denial of the Veteran's claims. Based on our review of the record, the Board finds that substantial compliance with the Board's March 2021 remand instructions was completed. See Stegall v. West, 11 Vet. App. 268 (1998). In May 2021 the Veteran submitted to the AOJ both a statement in support of his claim, and 2 medical article abstracts which he claims relate to and support his claim for compensation due to colitis. The AOJ issued a subsequent SSOC in June 2021, however, the AOJ did not obtain addendum medical opinions to address this new evidence. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c); 38 U.S.C. § 7107(a)(2). 1. Entitlement to service connection for collagenous colitis with recurrent diarrhea, including as secondary to service-connected disabilities is remanded. Remand is necessary to obtain additional addendum medical opinions to review and consider the impact, if any, of the medical articles submitted by the Veteran in response to and in disagreement with the April 2021 SSOC. The AOJ did issue a SSOC in June 2021 which acknowledged receipt of the new evidence submitted by the Veteran but continued the denial of the claim. This SSOC cited a single article submitted by the Veteran, that being: Alexandra Labanski, et. al., Stress and the brain-gut axis in functional and chronic-inflammatory gastrointestinal diseases: A transdisciplinary challenge, Psychoneuroendocrinology (November 2019). It then asserted that this article did not link to the Veteran's specific conditions, and therefore, the claim remained denied. The AOJ did state that if an examiner were to review this new evidence and is able to provide a positive link and rationale to support the Veteran's claim, the AOJ will reconsider the claim at that time. The Board finds the reasoning in the June 2021 SSOC to be incorrect and not helpful to the Board, and notes that the SSOC itself recognizes that a medical review of the articles is required before the AOJ and the Board can make a proper adjudication of the matter. Therefore, remand is necessary to obtain new addendum opinions which advise whether the new evidence is probative on the Veteran's claims, as they relate to each of the theories of entitlement already addressed, and if so, how does the new evidence impact the previous opinions. The Board acknowledges that the new evidence may or may not change the recent addendum opinions, but without proper medical review, the Board cannot make that determination on its own. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991) (VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions); Willis v. Derwinski, 1 Vet. App. 66 (1991). The Board notes that the Veteran also submitted an abstract to the medical article: David Banfi, et al., Impact of Microbial Metabolites on Microbiota-Gut-Brain Axis in Inflammatory Bowel Disease, Int J Mol Sci. 2021 Feb; 22(4): 1623. Published online 2021 Feb 5. doi: 10.3390/ijms22041623. However, this article was not referenced in the June 2021 SSOC. On remand the AOJ should direct the assigned VA examiner to obtain a complete copy of this article and attach it to the Veteran's file, along with a complete copy of the above referenced article which is cited in the SSOC; as well as any additional articles received on remand in relation to the Veteran's claim. The Veteran is to be permitted reasonable time to submit additional evidence and argument on the remanded matter, including the specific arguments raised here on appeal, and the Board is required to consider any such relevant evidence and argument. See Kutscherousky v. West, 12 Vet. App. 369, 372-73 (1999) (per curiam order); see also Kay v. Principi, 16 Vet. App. 529, 534 (2002) (stating that, on remand, the Board must consider additional evidence and argument in assessing entitlement to the benefit sought). The Veteran is also permitted to advise that he will not submit additional evidence to permit quicker a review and decision in this matter. The matters are REMANDED for the following action: 1. Attempt to obtain complete copies of the medical articles referenced by the Veteran in his April 2021 evidence submission. 2. Return the matter to the VA examiner who prepared the April 2021 addendum opinions or another qualified clinician. The examiner is directed to review the Veteran's entire file, including this remand and any additional evidence received, in conjunction with authoring the opinions requested herein. After review of the Veteran's file the examiner should address the following: (a.) The examiner should issue an addendum medical opinion as to whether the additional medical articles, or other evidence received on this remand, impact any of the addendum opinions prepared in April 2021, and if so, how, as they related to the etiology of the Veteran's colitis condition. For any requested opinion where the additional evidence does impact the previously provided opinion from April 2021, the examiner should provide a rationale, citing the objective medical findings leading to the conclusions. 3. Readjudicate the appeal. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Bannach, Keith 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.