Citation Nr: 20005557 Decision Date: 01/24/20 Archive Date: 01/22/20 DOCKET NO. 12-02 538A DATE: January 24, 2020 ORDER Service connection for a hysterectomy and residuals is granted. FINDINGS OF FACT 1. Uterine fibroids arose during service. 2. Probative evidence indicates the Veteran’s hysterectomy was due to fibroids. CONCLUSION OF LAW The criteria for entitlement to service connection for a hysterectomy and residuals have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1980 to September 1983. This matter comes before the Board of Veterans’ Appeals (Board) from a June 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In December 2017, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record. In April 2018, the Board remanded this matter for further development. That development having been completed, this matter has returned to the Board for further appellate review. 1. Entitlement to service connection for a hysterectomy and residuals Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Generally, to prove service connection there must be: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). The Veteran seeks service connection for a post-service hysterectomy and residuals, which she asserts is related to aggravation of a preexisting uterine disability, or alternatively, to the uterine fibroids she suffered during service. Initially, the Board notes that the evidence clearly and unmistakably shows the Veteran suffered from pelvic inflammatory disease prior service. In this regard, pre-service treatment records from July 27, 1980 indicated the Veteran had a ruptured corpus leteum cyst on the right side ovary. A laparoscopic procedure noted bilateral peritubal and periovarian adhesions. Pelvic inflammatory disease (PID) was diagnosed. Moreover, the October 2019 VA examiner concluded that while there is evidence indicating the Veteran continued to suffer from PID during service, such is typical of the condition. The examiner concluded there was no evidence of permanent aggravation beyond normal progression identified. However, the Board does not find the presence of PID prior to service to be dispositive of the claim. In a December 2017 VA treatment record, the Veteran’s treating nurse practitioner opined that the Veteran’s hysterectomy was needed due to uterine fibroids. She also opined the fibroids were at least as likely as not a direct result of the diagnosis of uterine fibroids while on active duty. The Board notes a May 1982 service treatment record reveals that a fibroid was found after the Veteran underwent an ultrasound. During the October 2019 VA examination, the examiner noted that fibroids were first noted during service and were not mentioned in the July 1980 operation report prior to the Veteran’s active service. The examiner noted that pelvic inflammatory disease and fibroids are separate, unrelated conditions. The examiner opined that the Veteran’s hysterectomy was due to uterine fibroids and heavy menses, and that the first mention of fibroids was during service. Upon review of the record, the Board finds that probative evidence indicates the Veteran’s fibroids began in service and are unrelated to the preexisting pelvic inflammatory disease. Moreover, probative evidence indicates the Veteran’s hysterectomy and residuals are related to the fibroids. Accordingly, after resolving all doubt in the Veteran’s favor, the Board finds that service connection for hysterectomy and residuals is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Lance, Law Clerk 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.