Citation Nr: 22016532 Decision Date: 03/22/22 Archive Date: 03/22/22 DOCKET NO. 18-33 246 DATE: March 22, 2022 REMANDED Entitlement to service connection for a gastrointestinal disorder, to include as due to Gulf War Syndrome, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1980 to August 1992. This matter comes before the Board of Veteran's Appeals (Board) from a September 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In October 2021, the Veteran testified via videoconference before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the record. Entitlement to service connection for a gastrointestinal condition, to include as due to Gulf War Syndrome, is remanded. The Veteran seeks service connection for a gastrointestinal condition. At the hearing, the Veteran provided testimony regarding having stomach issues since returning from his deployment in 1991 and as to how such issues could be related to his service. In pertinent part, the Veteran asserted that while deployed he was exposed to various hazards and that he was given medication which may have contributed to his condition. He also asserted he suffers from other symptomatology, such as body aches and sinus issues. See hearing transcript. In August 2016, the Veteran was administered an Intestinal Conditions Disability Benefits Questionnaire (Intestinal DBQ) and a Stomach and Duodenal Conditions Disability Benefits Questionnaire (Stomach DBQ). No diagnosis was noted in either DBQ although the examiner noted the Veteran's report of stomach problems, including diarrhea, GERD, and stomach pains. Following the examinations, the examiner subscribed a medical opinion, noted in the remark sections of both DBQs. The examiner opined that the Veteran's diarrhea and occasional constipation can be caused by a number of factors to include viruses, foods, medications, hyperthyroidism, laxative abuse, and diabetes. He also noted the Veteran had been administered a diagnostic study that revealed normal findings except for GERD and a sliding hernia. Additionally, the examiner noted the Veteran has not been diagnosed with irritable bowel syndrome (IBS). Thus, the examiner opined the Veteran's claimed gastrointestinal condition was less likely as not related to a specific exposure event experienced by the Veteran during his service in Southwest Asia. See Intestinal DBQ and Stomach DBQ of August 2016. This opinion appears incomplete as it does not address the Veteran's diagnosis of diverticulitis or his assertion that medication he was given while deployed and/or other exposures may have caused or contributed to his condition. See private medical opinion of October 2021, noting a diagnosis of diverticulitis; see also hearing transcript. Thus, the matter must be remanded for an addendum opinion that considers the Veteran's medical records, symptomatology, and lay statements. The matter is REMANDED for the following actions: 1. Obtain outstanding VA medical records. 2. Obtain an addendum opinion addressing whether the Veteran's gastrointestinal condition is at least as likely as not related to his service, to include his exposures or medication he was administered while deployed in 1991. If the examiner determines a medical examination is necessary to provide the opinion, such should be scheduled and completed. In rendering the requested opinion, the examiner is asked to address: a. Whether the Veteran's symptomatology can be attributed to known clinical diagnoses, and/or whether the symptoms can be attributed to an undiagnosed illness or a medically unexplained chronic multi-symptom illness. The term "medically unexplained chronic multi-symptom illness" means a diagnosed illness without conclusive pathophysiology or etiology, that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. 38 C.F.R. § 3.317 (a)(2)(ii). b. Address the Veteran's service treatment records (STRs), the available post-service medical records noting a diagnosis of diverticulitis, and his lay assertions regarding symptomatology and exposures, to include that his condition may be due to medications he was given while deployed. See hearing transcript. The examiner is asked to provide a complete rationale for all opinions expressed. If the examiner cannot provide the requested opinion(s) without resorting to speculation, the report should expressly indicate this, and the examiner should explain why an opinion cannot be provided without resorting to speculation. If the inability to provide an opinion is the result of a need for additional information, the physician must identify the additional information needed. 3. After completing the above requested actions, and any additional notification and/or development deemed warranted, readjudicate the issue on appeal. If the benefit sought on appeal remains denied, furnish to the Veteran and his representative an appropriate supplemental statement of the case that includes clear reasons and bases for all determinations, and afford them the appropriate time period for response before the claims file is returned to the Board for further appellate consideration. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Gonzalez-Maldonado 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.