Citation Nr: 20021718 Decision Date: 03/26/20 Archive Date: 03/26/20 DOCKET NO. 17-11 735 DATE: March 26, 2020 ORDER Entitlement to an increased evaluation of 100 percent for mesenteric adenitis effective February 13, 2014 is granted, subject to the laws and regulations governing the award of monetary benefits. FINDINGS OF FACT Examination findings in June 2014, less than 6 months after separation from service produced findings warranting a 100 percent rating, with history that the symptoms had been ongoing for several months. It is as likely as not, and he has so testified, that the symptoms in June were essentially the symptoms at separation from service in February 2014. CONCLUSIONS OF LAW Resolving reasonable doubt in the Veteran’s favor, the requirements for a disability rating of 100 percent for mesenteric adenitis from February 13, 2014 have been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.321, 4.1, 4.3, 4.7, 4.113, 4.114, diagnostic code 8210-7306 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had a period of active service from September 2005 to February 2014. He testified at a Travel Board hearing on appeal before the undersigned in January 2020. A transcript is on file. By way of history, in a March 2014 rating decision, the Veteran was granted service connection for mesenteric adenitis and assigned a 10 percent evaluation effective February 13, 2014. It was noted that the Veteran’s mesenteric adenitis reflected symptoms of occasional episodes of diarrhea and nausea. The Veteran was also granted service connection for gastroparesis with antral gastropathy and assigned a non-compensable evaluation effective February 13, 2014. The Veteran filed an April 2014, notice of disagreement, and in May indicated that a 100 percent rating was warranted. In an August 2014 rating action, the regional office (RO) assigned a compensable evaluation of 100 percent effective May 16, 2014 for the Veteran’s gastroparesis with antral gastropathy. This was said to be the date of the claim reflecting an increase. Increased Ratings Disability evaluations are determined by the application of the facts presented to VA’s Schedule for Rating Disabilities (Rating Schedule) at 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise the lower rating will be assigned. 38 C.F.R. § 4.7. Reasonable doubt will be resolved in the Veteran’s favor. 38 C.F.R. § 4.3. A Veteran’s entire history is to be considered when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Where an increase in the level of a service-connected disability is at issue, the primary concern is the present level of disability. Francisco v. Brown, 7 Vet. App. 55 (1994). Staged ratings are appropriate when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. See Fenderson v. West, 12 Vet. App. 119, 126 (1999). The 100 percent rating currently assigned is under Codes 8210-7306 for the neurological and gastrointestinal impairment. The rating contemplates pronounced and persistent symptoms. Entitlement to an increased evaluation for mesenteric adenitis that was rated at 10 percent disabling from February 13, 2014 to May 16, 2014 In a January 2020 Travel Board hearing before the undersigned, the Veteran’s representative asserted that the regional office (RO) erred when it used an old December 2012 examination to determine the symptoms of the Veteran’s mesenteric adenitis at the time of his February 2014 discharge from service. The Veteran’s representative explained that the December 2012 examination relied upon by the regional office RO to assign a 10 percent evaluation was approximately 16 months old. The Veteran’s representative explained that the December 2012 examination did not reflect the Veteran’s symptoms of constant abdominal pain, nausea, vomiting, and diarrhea diagnosed at his June 2014 VA examination shortly after discharge from service. The Veteran was discharged from service in February 2014. Shortly thereafter, he underwent a June 2014 VA C&P stomach and duodenal conditions disability questionnaire in June 2014. He also underwent a VA C&P cranial nerve conditions disability benefits questionnaire. The examiner diagnosed the Veteran with gastroparesis with antral gastropathy. During the examination, the Veteran reported that the severity of his diarrhea has increased in the past year and reported the following symptoms: explosive diarrhea with soiled clothing; and weight loss. Recurring episodes of severe symptoms associated with the Veteran’s gastrointestinal disorder were noted at four or more times a year with an average duration of one to nine days an episode. Abdominal pain was noted to occur weekly with symptoms that are pronounced, periodic, and unrelieved by ulcer therapy. Weight loss was noted at 191.7 lbs. to 183 lbs. with recurrent nausea and vomiting noted at four or more times a year with an average duration of one to nine days an episode. Incapacitating episodes were noted at seven to ten times per day at for four to five days at an average of four or more times a year. Regarding functional limitations, the Veteran reported flare-ups which occur two to four times a month with severe peri-epigastric region nausea, vomiting and diarrhea lasting four to five days. The examiner noted that because of the severity of the Veteran’s symptoms, he is unable to perform any type of work during flare-ups. As noted, after that examination a 100 percent rating was assigned, effective May 2014, said to be the date the Veteran submitted a claim for an increase. He has testified, and the history on the examination suggests, that the same symptoms existed when he left service In view of that testimony, and the history provided on the examination, it appears that is the case. As such, resolving reasonable doubt in his favor, the 100 percent rating should be assigned the day following separation from service, February 13, 2014. MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Elliot Harris, Associate Counsel 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.