Citation Nr: 18159029 Decision Date: 12/18/18 Archive Date: 12/18/18 DOCKET NO. 16-56 457 DATE: December 18, 2018 ORDER An initial rating of 10 percent, but no more, for irritable bowel syndrome (IBS) is granted. FINDING OF FACT Throughout the period on appeal, the Veteran has experienced moderate IBS, manifested by frequent episodes of bowel disturbance with abdominal distress; severe IBS manifested by diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress has not been shown. CONCLUSION OF LAW The criteria for an initial rating of 10 percent, but no more, for IBS have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.114, Diagnostic Code (DC) 7319. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 2002 to September 2002, February 2003 to January 2004, June 2009 to September 2009, and March 2012 to February 2013. As a preliminary matter, the Board notes that in his January 2015 notice of disagreement, the Veteran disagreed with the denial of his claim seeking an increased rating for his insomnia. However, he did not file a substantive appeal to the denial of this claim. Accordingly, the Board has no jurisdiction over this claim and it is not properly before the Board. Entitlement to an initial compensable rating for IBS The Veteran is seeking an initial rating of 10 percent for his service-connected IBS. Disability evaluations are determined by the application of a schedule of ratings that is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. See 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Where there is a question as to which of two separate evaluations shall be applied, the higher evaluation will be assigned if the disability more closely approximates the criteria required for that particular rating. 38 C.F.R. § 4.7. When a reasonable doubt arises regarding the degree of disability, such doubt will be resolved in favor of the veteran. 38 C.F.R. § 4.3. Where entitlement to compensation has already been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Nevertheless, where the evidence contains factual findings that show a change in the severity of symptoms during the course of the rating period on appeal, assignment of staged ratings would be permissible. See Hart v. Mansfield, 21 Vet. App. 505 (2007). In this case, the Veteran’s IBS has been assigned a noncompensable rating under 38 C.F.R. § 4.114, DC 7319. Under DC 7319, a compensable rating for IBS is warranted when the evidence shows: • moderate IBS; frequent episodes of bowel disturbance with abdominal distress (10 percent); or • severe IBS; diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress (30 percent). 38 C.F.R. § 3.114, DC 7319. After review of the evidence of record, the Board concludes that a disability rating of 10 percent, but no more, is warranted. Here, the December 2016 VA examination report reflects that without medication, the Veteran experiences four bowel movements with loose stools and abdominal distress in the morning and another bowel movement in the evening. The examination report reflects that with medication, he experiences two to three bowel movements with soft stools and abdominal distress in the morning, and another bowel movement in the evening. The examination report also shows that constant medication, including immodium and loperamide, is required for control of the Veteran’s IBS. Further, the Veteran’s treatment records, including treatment records from April 2015 and June 2016, show that he has consistently experienced chronic bowel disturbance. Finally, the Veteran has reported that he experiences episodes of bowel disturbance with abdominal distress once or twice per week and that such episodes require him to alter his morning routine when he works in the field and negatively impact his productivity. Given the number of episodes of bowel disturbance with abdominal distress shown by the medical evidence and Veteran’s credible statements, the Board concludes that the evidence is at least in equipoise as to whether the Veteran experiences moderate IBS, manifested by frequent episodes of bowel disturbance with abdominal distress. In reaching this conclusion, the Board acknowledges the negative evidence, including the December 2016 VA examiner’s opinion that the Veteran experienced occasional episodes of bowel disturbance with abdominal distress. Although the examiner provided this opinion, the Board finds that the evidence is at least in equipoise as to whether the Veteran experiences moderate IBS because he is required to take constant medication to control his IBS and because he has provided competent and credible statements regarding the number of episodes of IBS that experiences on a weekly basis and how it has impacted his occupation. By virtue of the foregoing, a disability rating of 10 percent for the period on appeal for the Veteran’s IBS is warranted. Moreover, given that he has specifically requested a rating of 10 percent on his January 2015 notice of disagreement, the Board will consider this to be a full grant of the benefits sought on appeal and will not address whether he is entitled to a disability rating higher than 10 percent. Cf. AB v. Brown, 6 Vet. App. 35 (1993). B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Crosnicker, Associate Counsel