Citation Nr: A25035108 Decision Date: 04/16/25 Archive Date: 04/16/25 DOCKET NO. 240205-414657 DATE: April 16, 2025 REMANDED Entitlement to service connection for gastroesophageal reflux disease (GERD) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from January 1968 to July 1972. This matter comes before the Board from a January 2024 Higher Level Review rating decision. In the February 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the December 2023 agency of original jurisdiction (AOJ) decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision which was subsequently subject to higher-level review, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. However, because the Board is remanding the claim of entitlement to service connection for GERD, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii). Entitlement to service connection for GERD is remanded. After a review of the record, the Board determines a remand is necessary to correct pre-decisional duty to assist errors. See 38 C.F.R. §20.802(a). Firstly, the Veteran was afforded VA examinations in March, September, and December 2023. In each examination, it was noted the Veteran's GERD symptoms were first noticed by his dentist due to the increased frequency of cavities. The Veteran's in-service dental records document tooth extraction due to impaction and paresthesia of the right lower lip as a result of the extraction surgery. There is no diagnosis, complaint of, or treatment for cavities noted in the Veteran's military dental records. The Board notes there are no post-service dental records currently associated with the Veteran's file and no evidence such records have been requested. As such, remand is necessary to obtain the Veteran's post-service dental records. Secondly, the Veteran, by and through his representative, asserted his GERD is secondary to his service-connected ventricular tachycardia, surgical hypothyroid, and hypertension. The Veteran was afforded several VA examinations to address these assertions. However, no examination of record addresses whether the service-connected disabilities aggravated the Veteran's GERD. As such, remand is necessary to obtain a medical opinion addressing whether the Veteran's GERD is due to, the result of, or aggravated by his service-connected ventricular tachycardia, surgical hypothyroid, and hypertension. The matters are REMANDED for the following actions: 1. With any necessary assistance from the Veteran, attempt to obtain the Veteran's post-service dental records. All steps taken to obtain the Veteran's post-service dental records must be documented within the Veteran's claims file. If the Veteran's post-service dental records are unavailable, a formal finding must be made and associated with the Veteran's claims file. 2. After any additional records are associated with the Veteran's claims file, obtain a VA opinion regarding the etiology of the Veteran's GERD. The Veteran's electronic claims file, including a copy of this remand, must be accessible to the examiner for review. The examiner must provide a detailed rationale for any opinion they provide, and the opinion must state that the examiner reviewed the Veteran's electronic claims file and this remand.?Whether an additional examination of the Veteran is warranted to provide the requested opinion is left to the discretion of the examiner. The examiner is to address the following: (a) Whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's GERD was incurred during service or is otherwise directly related to service. (b) Whether it as least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's GERD is due to, the result of, or aggravated by a service-connected disability or disabilities, to include the Veteran's service-connected ventricular tachycardia, surgical hypothyroid, and hypertension. In providing a response, the examiner must consider and discuss whether the Veteran's GERD would have been less severe "but-for" his service-connected disabilities. A full and complete rationale for all opinions must be provided, and a discussion of the facts and medical principles should be considered. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mills, D. 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.