Citation Nr: A25041252 Decision Date: 05/06/25 Archive Date: 05/06/25 DOCKET NO. 211025-193300 DATE: May 6, 2025 REMANDED Entitlement to service connection for acid reflux is remanded. Entitlement to service connection for irritable bowel syndrome (IBS) is remanded. Entitlement to service connection for a left knee disorder is remanded. Entitlement to service connection for plantar fasciitis is remanded. Entitlement to service connection for peri-anal abscess (also claimed as anal fissure, hemorrhoids, and/or scars) is remanded. Entitlement to service connection for a right knee disorder is remanded. Entitlement to service connection for obstructive sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active-duty service from September 1998 to July 2002. In the October 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the December 2020 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran [or representative] with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the RO issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. However, because the Board is remanding the Veteran's 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. Entitlement to service connection for acid reflux is remanded. 2. Entitlement to service connection for irritable bowel syndrome (IBS) is remanded. 3. Entitlement to service connection for a left knee disorder is remanded. 4. Entitlement to service connection for plantar fasciitis is remanded. 5. Entitlement to service connection for peri-anal abscess (also claimed as anal fissure, hemorrhoids, and/or scars) is remanded. 6. Entitlement to service connection for a right knee disorder is remanded. 7. Entitlement to service connection for obstructive sleep apnea is remanded. The Veteran seeks service connection for: acid reflux; IBS; bilateral knee disorders; peri-anal abscess; and sleep apnea. After a review of the evidence of record, the Board finds that these claims must be remanded to correct pre-decisional duty to assist errors. At issue are the VA examinations and opinions of record. The Veteran received VA examinations for his acid reflux, IBS, knees, and peri-anal abcess, in November 2020. For the Veteran's knees and peri-anal abscess, the examiner found no diagnoses. However, this is inconsistent with the Veteran's medical records which objectively note diagnoses for these disorders. As to the Veteran's IBS and acid reflux, the examiner provided negative opinions relying on a lack of documented symptoms during service. This is an incorrect basis for the provided opinions. As such, the November 2020 examinations and opinions are inadequate and the failure of the AOJ to obtain adequate opinions is a pre-decisional duty to assist error. The Veteran has yet to be provided with an examination for his sleep apnea or plantar fasciitis. His medical records show a diagnosis for these disorders. The threshold for finding a link between a current disability and service so as to require medical examination is low. Locklear v. Nicholson, 20 Vet. App. 410 (2006); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006). The AOJ committed pre-decisional duty to assist errors in not providing an examination for the Veteran for his sleep apnea and plantar fasciitis. The matters are REMANDED for the following action: 1. Schedule the Veteran for new examinations, with an appropriate clinician, other than the November 2020 examiner, to determine the nature, extent, onset, and etiology of his acid reflux; IBS; bilateral knee disorders; peri-anal abscess; plantar fasciitis; and sleep apnea. The complete claims file should be made available to the examiner(s). The examiner(s) should provide opinions as to whether it is at least as likely as not that his acid reflux; IBS; bilateral knee disorders; peri-anal abscess; plantar fasciitis; and sleep apnea are etiologically related to the Veteran's period of service, or to another diagnosed disorder, to include as secondary to any prescribed medications. The examiner(s) is reminded that the secondary service connection opinions must discuss both causation and aggravation (beyond a natural course) separately. All provided opinions must include a discussion of the Veteran's lay statements. All opinions should be accompanied by adequate reasons and bases. If the examiner(s) cannot provide the requested opinion without resorting to mere speculation, they should provide a complete explanation stating why this is so. In so doing, the examiner(s) should explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that they have exhausted the limits of current medical knowledge in providing an answer to that particular question(s). JIMMY L. BARDIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Q. Hernan, 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.