Citation Nr: 22005014 Decision Date: 01/31/22 Archive Date: 01/31/22 DOCKET NO. 15-03 555A DATE: January 31, 2022 REMANDED Entitlement to service connection for irritable bowel syndrome (IBS), to include as due to an undiagnosed illness, is remanded. Entitlement to service connection for respiratory symptoms, to include as due to an undiagnosed illness, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from November 2001 until his honorable discharge in July 2002 and from June 2004 until his honorable discharge in May 2006 with service in Iraq from November 2004 to October 2005. These matters come before the Board of Veterans' Appeals (Board) on appeal from May 2013 and October 2014 rating decisions of the Regional Office of the Department of Veterans Affairs (VA). In June 2018, the Board remanded the case to the Regional Office for further development. Specifically, the Board directed the Regional Office to obtain new VA examinations. The claims were remanded again in July 2021 for VA examinations that respond to the Board's remand requests. 1. Entitlement to service connection for irritable bowel syndrome (IBS), to include as due to an undiagnosed illness. Unfortunately, there has not been substantial compliance with the Board's previous remand directives regarding the issue of the nature and etiology of the Veteran's IBS. For the reasons set forth below, additional development is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). Where VA provides the Veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board requested the Regional Office obtain a medical opinion addressing whether it is at least as likely as not (50 percent or greater probability) that the Veteran's current colitis is etiologically related to or caused by service to include reported symptoms regarding diarrhea during his tour in Iraq. The Regional Office failed to do so. The Regional Office requested a VA opinion in October 2021. The October 2021 VA examiner stated, "No diagnoses rendered. No opinions provided. The veteran has a claim of symptoms due to an undiagnosed illness; however, symptoms on the respiratory DBQ are inconclusive and vague and there are no longer intestinal symptoms due to the veteran taking the probiotic. Therefore, there are no symptoms to classify and no undiagnosed illness." However, this is not an adequate opinion. The United States Court of Appeals for Veterans Claims (Court) has held that the "current disability" requirement is satisfied when a claimant has a disability at the time of filing the claim or during the pendency of that claim, even if the disability has since resolved. McLain v. Nicholson, 21 Vet. App. 319 (2007). The examiner's own statement "there are no longer intestinal symptoms" speaks to the fact that there once were symptoms. Additionally, he was diagnosed with colitis after a 2016 colonoscopy which the examiner failed to address. The Regional Office must ensure that a medical opinion is obtained addressing any disability that occurred during the pendency of the claim, even if the disability has resolved. 2. Entitlement to service connection for respiratory symptoms, to include as due to an undiagnosed illness. Unfortunately, there has not been substantial compliance with the Board's previous remand directives regarding the issue of the nature and etiology of the Veteran's respiratory disability. For the reasons set forth below, additional development is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). Where VA provides the Veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board requested the Regional Office obtain a medical opinion addressing whether it is at least as likely as not (50 percent or greater probability) that the Veteran's current asthma is etiologically related to or caused by service to include as due to due to exposure to sand and dust, and proximity to burn pits. The Regional Office failed to do so. The October 2021 VA examiner noted and then failed to address the Veteran's statement that at times his lungs feel "hard and heavy." The examiner also failed to address whether exposure to sand and dust or a proximity to burn pits may cause respiratory symptoms or asthma. Furthermore, the May 2020 VA examiner diagnosed him with asthma and the October 2021 examiner failed to address or reconcile their opinion with this diagnosis. As noted above, the Regional Office must ensure that a medical opinion is obtained addressing any disability that occurred during the pendency of the claim, even if the disability has resolved. For these reasons, the claim must be remanded. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from September 2021 to the Present. 2. After any records obtained have been associated with the claims file, obtain addendum opinions regarding the etiology of the Veteran's IBS, to include diagnosed colitis, and respiratory disability, to include diagnosed asthma, from a VA examiner. The entire claims file must be made available to and be reviewed by the examiner. If an examination is deemed necessary, it shall be provided. An explanation for all opinions expressed must be provided. The examiner should address the following: a. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's current colitis is etiologically related to or caused by service to include reported symptoms regarding diarrhea during his tour in Iraq. Please explain why or why not. The examiner is to reconcile their opinion with the May 2020 examiner's diagnosis of colitis based on the January 2016 colonoscopy. The examiner should also address the Veteran's assertions that he had diarrhea in service and through the post-service period until he started monthly probiotics. b. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's current asthma is etiologically related to or caused by service to include as due to due to exposure to sand and dust, and proximity to burn pits. Please explain why or why not. (Continued on the next page) The examiner is to reconcile their opinion with the May 2020 examiner's diagnosis of asthma. K. Marenna Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. A. Johnston, 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.