Citation Nr: 22013589 Decision Date: 03/10/22 Archive Date: 03/10/22 DOCKET NO. 18-06 367 DATE: March 10, 2022 REMANDED Entitlement to service connection for a hemorrhoid disability is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1970 to July 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from the October 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). A Board video-conference hearing was held in October 2021 before the undersigned Veterans Law Judge; a transcript of the hearing has been associated with the record. The Board finds that remand is needed to obtain a new etiology opinion. As an initial matter, the Veteran is currently diagnosed with an external hemorrhoid disability. See August 2017 Discharge Instructions and October 2017 VA Examination Report. The Veteran asserts that his hemorrhoid disability first began while in service. The Veteran reports that he had symptoms of hemorrhoids when he had scrotal swelling. His service treatment records do not show any hemorrhoid complaints but do show a diagnosis of left varicocele by a Medical Board. In October 2017, the Veteran was provided a VA compensation examination and a medical opinion was obtained. The examiner opined that the Veteran's hemorrhoid disability was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In so doing, the examiner noted the Veteran's lay reports of having had hemorrhoids along with scrotal swelling while in service, and of having had similar symptoms after service. The Board finds the October 2017 VA opinion deficient. First, the opinion is conclusory in that the examiner simply listed portions of the Veteran's medical history as rationale without any supportive explanation as to why the evidence does not support a nexus. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (a medical opinion that contains only data and conclusions is accorded no weight). Second, although the examiner did recite the Veteran's report of having had hemorrhoidal symptoms in service, it is unclear whether the examiner considered his reports as competent evidence. Indeed, the Veteran is competent to report his observable hemorrhoidal symptoms. Accordingly, a new medical opinion should be obtained. The matter is REMANDED for the following action: 1. Ensure that all outstanding VA treatment records are associated with the claims file. 2. Thereafter, forward the Veteran's claim file to a gastroenterologist for the purpose of obtaining a medical opinion as to the etiology of the Veteran's current hemorrhoid disability. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. All indicated studies, tests, and evaluations must be conducted, and all findings reported in detail and correlated to a specific diagnosis. After a review of the claims file, the examiner is asked to respond to the following: (a) Provide an opinion, with complete rationale, as to whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that the current hemorrhoid disability manifested in service or is otherwise related to it. In doing so, the examiner should: (b) Address the Veteran's competent report of his in-service hemorrhoidal symptoms and varicocele occurring concurrently. (c) Clarify whether there is any etiological relationship between the Veteran's current hemorrhoids and the in-service varicocele, as both are venous diseases. (d) Address the Veteran's belief that running in service caused hemorrhoidal symptoms. **Although a complete review of the record is imperative, attention is called to the following evidence: (i) the March, April, May, and June 1970 STRs regarding a knot on the Veteran's scrotum, physical profile due to epididymitis, and diagnosis of left varicocele; (ii) the October 1970 VA examination report; (iii) the August 2017 VA discharge instructions with dx of external hemorrhoids; and (iv) the Veteran's lay statements, including those in the October 2021 hearing transcript, regarding the onset and nature of his hemorrhoid disability. A complete rationale for all proffered opinions must be provided. 3. Thereafter, readjudicate the claim. S. B. MAYS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Moldawer, 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.