Citation Nr: 18160415
Decision Date: 12/27/18	Archive Date: 12/26/18

DOCKET NO. 16-38 542
DATE:	December 27, 2018
Entitlement to service connection residuals of Guillain–Barré Syndrome is remanded.
The Veteran served in the U.S. Army on active duty from October 1988 to October 1991.
Entitlement to service connection residuals of Guillain–Barré Syndrome.
The Veteran is seeking service connection for the residuals of Guillain–Barré Syndrome (GBS).  The Veteran was diagnosed with GBS in October 1992, a year and several days after separating from service.  However, the Veteran testified before the undersigned, in February 2017, that his symptoms began prior to his separation from service.  The Veteran testified that after his return from the Persian Gulf he was stationed in Germany and worked on the base in a gym.  He stated that he noticed when he played racquetball his stamina diminished severely.  He also reported that he complained in service about his fatigue and muscle weakness.  He testified that he began seeking treatment with a private physician upon separation from the military and prior to seeking treatment with VA in 1992.  Upon close examination, these records do not appear to be part of the claims file.  Therefore, a remand is necessary to obtain the missing private records. 
Additionally, the Veteran was examined by VA in September 2012 and the VA examiner opined that “it [is] less likely than not any inoculations or vaccinations received during military duty was causally related to the onset of GBS symptoms based upon the protracted time course of at least three years to the first episode.”  See September 2012 Central Nervous System VA Examination.  This examination considered the Veteran’s statements about his stamina decrease while playing racquetball but categorized this event as occurring post-service.  The Veteran testified at the February 2017 hearing that he noticed his difficulties playing racquetball incurred during service while he worked at a gym on base in Germany, not post-service.  A remand is also necessary for a new examination which fully considers the Veteran’s lay statements.
The matter is REMANDED for the following action:
1. Obtain any and all relevant VA treatment records and associate them with the claims file.
2. Contact the Veteran and request that he complete and return a VAF 21-4142, Authorization and Consent to Release, for treatment of the claimed disorder from the private treatment providers he testified about at the February 2017 videoconference hearing, to include Erieside Medical Group and Lake-West Hospital.
Any documents received by VA pursuant to the request for private treatment records should be associated with the record.  At least two requests for the private records should be made, unless it is made evident by the first request that a second request would be futile in obtaining 
such records.  Any negative responses should be properly documented in the record.  Notify the Veteran and the representative if the private treatment records are unavailable.
3. Schedule the Veteran for an examination with the appropriate VA professional to determine the following:
(a.) Whether the Veteran’s Guillain–Barré Syndrome residuals are at least as likely as not (50 percent or greater probability) related to his active service.
The examiner shall consider all relevant lay statements of record, to include his February 2017 hearing testimony, as well as the Veteran’s STR entries regarding cold symptoms on April 4, 1989 and complaints of fatigue on March 30, 1990.  The examiner shall also consider the Veteran’s submitted article regarding his condition along with any newly medically acknowledged relationships between military inoculations and Guillain–Barré Syndrome.  The examiner shall discuss all of the afore-mentioned considerations.
Any and all opinions offered shall include a clear and concise rationale.
4. Thereafter, readjudicate the issues on appeal.  If any benefit sought on appeal remains denied, provide the Veteran and his representative with a supplemental 
statement of the case and allow an appropriate period of time for response before the case is returned to the Board.
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	T. N. Shannon, Associate Counsel

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