Citation Nr: 25007686 Decision Date: 06/09/25 Archive Date: 06/09/25 DOCKET NO. 18-02 998 DATE: June 9, 2025 REMANDED The appeal for entitlement to an initial disability rating in excess of 40 percent for gastrointestinal disability manifested by nausea, dizziness, and epigastric distress is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1990 to April 1995, to include service in the Persian Gulf arena. This matter comes before the Board of Veterans' Appeals (Board) from a June 2014 decision by the Agency of Original Jurisdiction (AOJ) which granted service connection for nausea and vomiting as an undiagnosed disability related to the Veteran's Persian Gulf service. A 20 percent disability rating was assigned at that time but was increased to 40 percent disabling effective for the entire appeal period in an October 2017 decision. The Board remanded the appeal in July 2019 and again in November 2022. In January 2024, the Board denied a disability rating in excess of 40 percent for the Veteran's gastrointestinal disability. The Veteran perfected a timely appeal of the January 2024 decision to the United States Court of Appeals for Veterans Claims (Court). In January 2025, the Court approved a joint motion for remand filed by both parties to the case, vacated the Board decision, and remanded for further action consistent with the joint motion. The authors of the joint motion raised questions involving two aspects of the Board's January 2024 decision. The first was a duty to assist issue. In the July 2019 Board remand, the Board had observed that May 2015 VA treatment records reflected reports of loose stools about five times a day and subsequently remanded the matter, as the evidence reflected a worsening of the Veteran's symptoms since the May 2014 VA examination. In particular, the Board's remand directives indicated that "[t]he examiner should note that the Veteran is competent to attest to factual matters of which he has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should state this with a fully reasoned explanation." In turn, VA provided the Veteran with a medical opinion in November 2020; however, the VA examiner did not mention the May 2015 reports of loose stools. Therefore, another VA medical opinion should be obtained to address this deficiency. The second issue involved Diagnostic Code 7305 under which the Veteran's undiagnosed gastrointestinal illness is rated by analogy. Because Diagnostic Code 7305 does not contemplate the specific symptom of loose stools, the authors of the joint motion question whether rating under this Diagnostic Code is sufficient to cover all of the Veteran's gastrointestinal symptoms. Upon remand, the AOJ will examine this question, and when this legacy appeal is returned to the Board, the Board will analyze the issue again. The Veteran's VA treatment records should be updated for the file, as well. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from July 2023 to the present for inclusion in the claims file. 2. AFTER obtaining the Veteran's updated VA treatment records, provide the Veteran's claims file to a VA reviewer with appropriate medical expertise. The reviewer should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability throughout the appeal period from October 2012 to the present. The reviewer is requested to provide a retrospective medical opinion regarding the impact of the Veteran's loose stools upon his gastrointestinal disability and his daily functioning during this time period. The loose stools should be viewed in relation to the rest of the Veteran's gastrointestinal symptomatology for this purpose. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should state this with a fully reasoned explanation. The complete rationale for all opinions expressed should be fully explained. If the reviewer deems that a clinical examination would be helpful, such an examination should be scheduled, to include all helpful tests and studies. 3. If the benefits sought on appeal remain denied, the Veteran and his representative should be furnished a Supplemental Statement of the Case specifically addressing the rating of the Veteran's loose stools and given the opportunity to respond thereto. The Veteran has the right to submit additional evidence and argument on the matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This legacy appeal must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board or Court for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Harter, Heather J. 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.