Citation Nr: 22016307 Decision Date: 03/21/22 Archive Date: 03/21/22 DOCKET NO. 16-59 354 DATE: March 21, 2022 REMANDED Entitlement to service connection for a right elbow condition is remanded. Entitlement to service connection for a stomach condition is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Navy from August 1966 to October 1969. This matter comes before the Board of Veterans' Appeals (Board) from a November 2014 rating decision by a Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ). In the Veteran's November 2016 VA Form 9 perfecting his appeal, the Veteran indicated that he wanted a Board hearing. The Veteran postponed his scheduled hearing several times. Most recently, the Veteran requested his Board hearing scheduled in June 2021 be moved to a later date. The Board rescheduled the Veteran's hearing for February 2022 and sent a letter notifying the Veteran of date and time of the February 2022 hearing. The Veteran failed to appear for his February 2022 hearing. The Veteran did not provide good cause for his failure to appear or request to reschedule the hearing. Therefore, his hearing request is deemed withdrawn. The Veteran's representative has been appointed under the auspices of 38 C.F.R. § 14.630, as a one-time representative. Right Elbow Condition The Veteran contends that his right elbow condition is etiologically related to service, specifically due to a motorcycle accident in-service. The Veteran's service treatment records indicate that the Veteran had a laceration of the right elbow in October 1967. Also noted at the time were wounds of the left elbow and right side of the abdomen; there was no explanation for the injuries. The Veteran underwent a VA elbow and forearm examination in November 2014. The examiner diagnosed the Veteran with right side olecranon bursitis. The examiner opined that current right elbow olecranon bursitis was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner reasoned that the right elbow laceration occurred in 1967 and the current presentation is consistent with occupational and recreational history. The examiner noted there is no evidence of olecranon bursitis on active duty. The Board finds the November 2014 medical opinion is not adequate for adjudication. The examiner did not explain why the Veteran's right elbow laceration did not cause the Veteran's bursitis. The examiner provided a vague statement that the Veteran's occupational and recreational history caused the bursitis, without explaining what occupational and recreational history caused the bursitis. Further, the examiner did not address the Veteran's December 2013 statement that since his accident that caused the laceration on his right elbow, he had a fatty tumor on his right elbow. Therefore, the Board finds that a remand is required to obtain an adequate medical examination. Stomach Conditions The Veteran contends that his stomach condition is etiologically related to service. Specifically, the Veteran contends his stomach condition was related to his in-service motorcycle accident, or, in the alternative, due to exposure to chemical defoliants. The Veteran's service treatment records indicate he had abdominal pain, had vomited three times and slight diarrhea in June 1967. The service treatment records also include a note that the Veteran had a laceration on the right side of the abdomen in October 1967. The Veteran's separation examination indicates that the Veteran separated service with a scar on the lower right abdomen. Indeed, the Veteran is service connected for this scar on his abdomen. In December 2013, the Veteran stated that the in-service injury that cause his scar caused his hernia. The Veteran further stated that he was exposed to chemical defoliants in January 1968 and June 1968. The Veteran stated on those occasions he had gotten stomach cramps. In November 2014, the Veteran underwent a VA hernia examination. The examiner diagnosed the Veteran with inguinal hernia. During the examination the examiner reported that he developed an abdominal scar and secondary hernias due to a motorcycle crash during active duty. Upon examination the examiner found small hernias on the left and right side. The examiner opined that the claimed condition is less likely than not proximity due to or a result of the Veteran's service-connected condition. The examiner reasoned that Veteran's hernias are less likely than not due to the abdominal injury on active duty because the right abdominal scar area is not located in the inguinal areas but is noted 13 centimeters lateral of umbilicus. The Board finds a remand is required. First, the AOJ must attempt to confirm whether the Veteran was exposed to chemical defoliants. The Veteran consistently stated that he was exposed to chemical defoliants and that after exposure he had stomach issues. The record does not indicate any exposure to chemical defoliants was verified. Second, the Veteran must undergo another examination. The November 2014 examiner's opinion is ambiguous as to whether he was providing a direct or secondary opinion regarding the Veteran's hernias. If the examiner was providing a secondary opinion relating to the Veteran's scars, it is inadequate because it failed to address whether the hernias were aggravated by his scars. However, the examiner's opinion is clear enough to understand that the hernias were not due to the Veteran's in-service accident because the Veteran got his scar in the accident and the scar is not located where his hernias are located. This rationale does not address whether the accident caused or aggravated the Veteran's hernias despite not causing a scar. Further, the Veteran's claim was for general stomach issues, there is some indication that the Veteran had cramps. The examiner did not address whether the Veteran's documented in-service abdominal pain was related to his claim. Finally, no opinion was provide regarding whether any exposure to hazardous chemicals is related to the Veteran's claimed stomach issues. Therefore, the Board finds that a remand is required to obtain an adequate medical examination, to include a complete opinion regarding a secondary opinion related to the Veteran's abdomen scars. The matters are REMANDED for the following action: 1. Contact the Veteran to request the information regarding his alleged exposure to defoliants and chemicals in service. The type of exposure and circumstances of must be requested. If there is still insufficient information to verify exposure, issue a formal finding outlining the steps taken to assist the Veteran and notify the Veteran of VA's inability to verify the in-service hazardous chemical exposure. 2. Schedule the Veteran for a VA joints examination by an appropriate clinician to determine the nature and etiology of the Veteran's right side olecranon bursitis. The claims folder must be reviewed in conjunction with the examination. The examiner must opine as to whether the right elbow disability is at least as likely as not caused or aggravated by service, including the Veteran's report of a motorcycle accident that caused a laceration in October 1967. A full and complete rationale is required for all opinions expressed 3. Schedule the Veteran for VA gastrointestinal (stomach/duodenum) examination by an appropriate clinician to determine the nature and etiology of any stomach disability. The claims folder must be reviewed in conjunction with the examination. The examiner must identify all current gastrointestinal conditions. For each, the examiner must opine as opine as to whether such is at least as likely as not caused or aggravated by service, including the Veteran's reported motorcycle accident, in-service stomach issues reported in June 1967, and any verified exposure to hazardous chemicals. A full and complete rationale for all opinions expressed is required. 4. Then, readjudicate the claims. If any benefit sought remains denied, issue a supplemental statement of the case and return the matters to the Board if otherwise in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Robert Batten 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.