Citation Nr: 25005489 Decision Date: 04/23/25 Archive Date: 04/23/25 DOCKET NO. 20-18 844 DATE: April 23, 2025 REMANDED Service connection for gastroesophageal reflux disease (GERD) is remanded. An initial compensable rating for bilateral hearing loss prior to February 14, 2023, and higher than 40 percent thereafter is remanded. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran honorably served in the U.S. Coast Guard from September 1967 to February 1973. This appeal comes to the Board of Veterans' Appeals (Board) from a December 2015 Department of Veterans Affairs (VA) Regional Office (RO) rating decision. In the April 2020 VA Form 9, Appeal to Board of Veterans' Appeals, the Veteran elected to participate in a hearing before the Board. A hearing was held on September 30, 2021, before the undersigned. A transcript is of record. A February 2023 Board decision remanded the claims for consideration of new evidence and the issuance of a Supplemental Statement of the Claim (SSOC). After the SSOC was issued in March 2024, the appeal was returned to the Board. REASONS FOR REMAND GERD When the Secretary provides a veteran with a VA medical examination or opinion, it must be adequate. A medical opinion is adequate when it is based upon consideration of the veteran's prior medical history and describes the disability in detail sufficient for the Board's evaluation of the claimed disability to be fully informed. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); See also Martinak v. Nicholson, 21 Vet. App. 447 (2007). A medical opinion is inadequate when it fails to address all raised theories of entitlement. See El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013) (stating that a secondary service connection medical opinion was inadequate because it did not discuss aggravation); Stefl v. Nicholson, 21 Vet. App. 120, 123-24 (2007) (holding that a medical nexus opinion finding a condition is not related to service because the condition is not entitled to presumptive service connection, without first considering direct service connection, is inadequate on its face); Combee v. Brown, 34 F.3d 1039, 1043-44 (Fed. Cir. 1994) (holding that direct service connection must be discussed when presumptive service connection is not warranted). During a November 2020 VA medical appointment, the Veteran reported having increased symptoms secondary to his service-connected nasopharyngeal carcinoma. This included throat pain, hoarseness, "left otalgia/jaw pain," and worsening GERD. In the January 2024 VA examination, the examiner found the Veteran's GERD was not related to asbestos exposure. However, they did not discuss whether GERD was related to any other service-connected disability as raised by the record above. Therefore, remand is required to obtain a medical opinion addressing this reasonably raised theory of entitlement. Bilateral hearing loss The VA has a duty to assist veterans in developing their claims. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. The VA will make reasonable efforts to help a claimant obtain evidence necessary to substantiate the claim. Id. at (c). Here, June 2019 and April 2021 VA treatment records indicate the Veteran participated in hearings tests, but the results were not associated with the claims file. Therefore, remand is required to obtain those testing results to permit the Board to make a fully informed decision. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all hearing-related testing results, to include those referenced in VA treatment records. 2. Obtain a supplemental medical opinion which considers whether the Veteran's GERD is caused or aggravated by any of the Veteran's service-connected disabilities. 3. After completing the above development, readjudicate the claim. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Guarnieri, 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.