Citation Nr: 22016490
Decision Date: 03/22/22	Archive Date: 03/22/22

DOCKET NO. 12-00 256
DATE: March 22, 2022

REMANDED

The issue of entitlement to compensation for pancreatic aneurysm, either as due to service connection or under the provisions of 38 U.S.C. § 1151, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from June 1969 to February 1971.  This matter comes before the Board of Veterans' Appeals (Board) from a March 2011 rating decision.  The Veteran testified at a Board hearing in May 2018.  

In January 2021, the Board denied compensation for pancreatic aneurysm, either as due to service connection or under the provisions of 38 U.S.C. § 1151.  

The Veteran appealed this decision to the United States Court of Appeals for Veterans Claims, which, in November 2021, granted a joint motion for remand (JMR) subscribed by the VA Secretary and the Veteran, thereby vacating the Board's January 2021 decision and remanding the Veteran's claim back to the Board.

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In December 2019, a VA specialist opined that the Veteran's pancreatic aneurysm was not caused by herbicide exposure and was not aggravated by his service-connected diabetes.  In her rationale, the VA specialist wrote, "A thorough review of all the medical records provided for the patient was completed.  Of note, 

there were no presentations for epigastric abdominal pain, dizziness, hypotension, gastrointestinal bleeding, vomiting or hematemesis, as would be expected as symptoms of this type of pancreatic lesion, if there were any."  

This statement, however, is inconsistent with other evidence of record.  Notably, 

in an October 2010 VA examination report, the examiner stated that the Veteran's symptoms included "crampy abdominal pain postprandial suggestive of vascular insufficiency to the intestinal tract."  As explained in the JMR, the December 2019 VA opinion is inadequate as it is not based upon consideration of the veteran's prior medical history and examinations.  A new medical opinion is therefore necessary.

This matter is REMANDED for the following action:

1. Obtain any outstanding VA treatment records.

2. Thereafter, obtain an addendum opinion from an appropriate specialist regarding the Veteran's claim of service connection for pancreatic aneurysm.  

The specialist must address the following:

(a.) Is it at least as likely as not (50 percent or greater probability) that the pancreatic aneurysm had its onset in or is otherwise related to the Veteran's period of service, to include due to presumed in-service herbicide agent exposure?

(b.) Is it at least as likely as not (50 percent or greater probability) that the pancreatic aneurysm has been aggravated (i.e., worsened beyond the normal progression of that disease) by the Veteran's service-connected diabetes mellitus?

The examiner must provide a complete rationale for his or her opinion(s) in the examination report.  If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion.

The opinion must show adequate consideration of all relevant evidence and must addresses the available records of the Veteran's pancreatic aneurysm symptomatology, to include the symptoms noted in the above-referenced October 2010 VA examination report.  

When opining whether the diabetes aggravated the pancreatic aneurysm, the examiner should discuss whether the Veteran's pancreatic aneurysm's symptomatology are worse than expected, and whether that worsening is due to the diabetes. 

 

 

Paul Sorisio

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	P. López, 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.