Citation Nr: A25035476 Decision Date: 04/17/25 Archive Date: 04/17/25 DOCKET NO. 240415-433604 DATE: April 17, 2025 REMANDED Entitlement to service connection for the Veteran's irritable bowel syndrome (IBS) is remanded. Entitlement to service connection for the Veteran's lumbosacral strain (back disability) is remanded. REASONS FOR REMAND The Veteran had active duty service in the United States Navy from March 2012 to March 2016. In June 2023, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of his service connection claims for IBS and back disability most recently addressed in April 2017 and December 2019 rating decisions, respectively. In August 2023, the agency of original jurisdiction (AOJ) issued the supplemental claim decision on appeal for his back disability, and in January 2024 issued the supplemental claim decision on his appeal for his IBS. In both decisions, the AOJ found that new and relevant evidence had been received and denied the claims based on the evidence of record at the time of that decision. In the April 2014 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 August 2023 and January 2024 supplemental claim decisions on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. The Board notes that the Veteran submitted evidence after the rating decisions on appeal. However, because the Board is remanding the Veteran's service connection claims, 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). 1. IBS The Veteran's IBS service connection claim is remanded to correct a duty to assist error that occurred prior to the January 2024 rating decision on appeal. In December 2023, the AOJ obtained a medical opinion; however, the examiner only considered whether the Veteran's disability was related to his conceded in service toxic exposure. The Veteran reported that his symptoms began while in service when he experienced episodes of frequent diarrhea and abdominal cramping. The AOJ should have asked for an addendum opinion. Accordingly, a VA examination that address direct service connection and his report of symptoms in service is required. 2. Back Disability The Veteran's back disability service connection claim is remanded to correct a duty to assist error that occurred prior to the August 2023 rating decision on appeal. The Veteran has received multiple VA examinations for his disability, but the Board finds another VA opinion is needed before his claim may be adjudicated. In June 2019, the VA examiner considered whether the Veteran's back disability was related to his service connected right knee disability. While the examiner provided an adequate opinion concerning whether the Veteran's right knee disability caused his back disability, the examiner failed to address secondary aggravation. The AOJ should have asked for an addendum opinion. Thus, an opinion that considers whether his service connected right knee disability aggravated his back disability is needed. Moreover, the Veteran has consistently asserted that his back disability was caused by carrying the heavy equipment in service. In June 2023, the Veteran received another VA examination and opinion that considered direct service connection. However, the examiner stated that because the Veteran's service treatment records were silent concerning any back issues there was a lack of substantiating evidence to support a nexus. The examiner did not consider the Veteran's consistent lay statements of back pain in service nor consider the June 2023 buddy statement documenting the Veteran's in service back issues and reluctance to seek treatment. The AOJ should have asked for an addendum opinion. Accordingly, a new VA opinion is needed that addresses this lay evidence. The matters are REMANDED for the following action: 1. Provide the Veteran's claims file to an examiner who so a supplemental opinion may be provided for his IBS. The entire claims file and a copy of this remand must be made available to the examiner for review. A new examination is only required if deemed necessary by the examiner. The examiner must provide an opinion as to whether the Veteran's IBS began during active service or is related to an incident of service, including his reports of frequent diarrhea and abdominal cramping in service. The examiner must provide all findings, along with 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. 2. Provide the Veteran's claims file to an examiner so a supplemental opinion may be provided for his back disability. The entire claims file and a copy of this remand must be made available to the examiner for review. A new examination is only required if deemed necessary by the examiner. The examiner must opine as to the following: a.) Whether the Veteran's back disability began during active service or is related to an incident of service, including carrying heavy equipment in service. Although an independent review of the claims file is required, the Board calls the examiner's attention to the June 2023 buddy which notes the Veteran's in service back complaints and reluctance to seek treatment. b.) Whether the Veteran's back disability was aggravated by his service-connected right knee disability. The examiner must provide all findings, along with 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. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Brunot, 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.