Citation Nr: 18141080
Decision Date: 10/09/18	Archive Date: 10/09/18

DOCKET NO. 12-17 873
DATE:	October 9, 2018
ORDER
Entitlement to service connection for a gastrointestinal condition, to include as secondary to service-connected depressive disorder is granted.
FINDING OF FACT
The Veteran’s current gastrointestinal condition is aggravated beyond its natural progression by his service-connected depressive disorder.
CONCLUSION OF LAW
The criteria for entitlement to service connection for a gastrointestinal condition, to include as secondary to service-connected depressive disorder have been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).  
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty from May 1957 to June 1977.
In April 2015, the Veteran testified at a videoconference hearing before a Veterans Law Judge (VLJ) that is no longer employed by the Board.  A transcript of the hearing is of record.  The Veteran did not respond to correspondence him of his right to a new VA hearing.  See 38 U.S.C. § 7107 (c); 38 C.F.R. §§ 19.3, 20.707.  Accordingly, the Board of Veterans’ Appeals (Board) will proceed with adjudication.
The Board previously remanded this matter for additional development in June 2015.  A December 2015 Board decision denied service connection for irritable bowel syndrome.  The Veteran appealed the decision to the United States Court of Appeals for Veterans’ Claims (Court).  In a March 2017 Memorandum Decision, the Court set aside the Board decision.  In July 2017 the Board remanded the Veteran’s claim for further development and adjudication consistent with the March 2017 Memorandum Decision.  The required development has been completed and the case is now properly before the Board.
Entitlement to service connection for a gastrointestinal condition, to include as secondary to service-connected depressive disorder. 
Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease.  To prevail on the issue of service connection there must be competent evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in-service occurrence or aggravation of a disease or injury; and competent evidence of a nexus between an in-service injury or disease and the current disability.  See Hickson v. West, 12 Vet. App. 247, 253 (1999); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).  In addition, service connection may be established on a secondary basis for a disability which is proximately due to or the result of or aggravated by a service-connected disease or injury.  38 C.F.R. § 3.310.  
When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant.  38 U.S.C. § 5107(b).  
The Veteran claims entitlement to service connection for a gastrointestinal disorder, claimed as irritable bowel syndrome (IBS), to include as secondary to service-connected depressive disorder.  An August 2017 VA intestinal conditions examination diagnosed the Veteran with a nonspecific gastrointestinal condition with constipation and diarrhea.  The Veteran is service connected for a depressive disorder.  
In July 2018, the Board obtained a Veterans Health Administration (VHA) medical opinion regarding whether the Veteran’s diagnosed gastrointestinal condition was caused or aggravated by his service-connected depressive disorder.  After review of the Veteran’s claims file, the gastroenterologist opined that the Veteran’s current gastrointestinal condition is aggravated by his depressive disorder.  The gastroenterologist noted that symptoms of constipation and diarrhea specifically can be exacerbated by the stressful situations associated with depression and the medications used to treat depression. 
There are other medical opinions to the contrary; but, the VHA opinion is the most thorough and provides the most well-reasoned explanation.  The VHA opinion is the most probative evidence of record. The preponderance of the evidence is in support of the Veteran’s claim.  Service connection for a gastrointestinal condition is warranted. 
 
D. Martz Ames
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	B. Riordan, Associate Counsel