Citation Nr: 20037535 Decision Date: 06/02/20 Archive Date: 06/02/20 DOCKET NO. 17-32 178 DATE: June 2, 2020 ORDER Entitlement to service connection for hemorrhoids is denied. FINDING OF FACT While the Veteran was treated for hemorrhoids in service, the preponderance of the evidence is against a finding that the Veteran’s current diagnosis of hemorrhoids is etiologically related to disease or injury incurred during military service. CONCLUSION OF LAW The criteria for entitlement to service connection for hemorrhoids have not been met. 38 U.S.C. §§ 1112, 1113,1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from October 1963 to October 1965. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In April 2019, the Veteran testified before the undersigned Veterans Law Judge during a Board video conference hearing. This matter was previously before the Board in August 2019 but was remanded for development. In a January 2020 supplemental statement of the case (SSOC), his claim for service connection for hemorrhoids was denied. This matter is again before the Board for adjudication. This appeal has been advanced on the Board’s docket pursuant to 38 U.S.C. § 7107 (a)(2); 38 C.F.R. § 20.900 (c). 1. Hemorrhoids The Veteran seeks service connection for internal hemorrhoids. Specifically, he contends that his current hemorrhoids are related to his hemorrhoids in service in 1964 and 1965. Additionally, he states had a surgery for hemorrhoids within a year after service in 1966. See January 2016 NOD and June 2017 VA Form 9. He testified that the condition has not been constant from service discharge until present. (See Hearing Transcript at 4.) Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1131. Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303 (a). Certain chronic diseases are subject to presumptive service connection if it manifests to a compensable degree within one year from separation from service even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307 (a)(3), 3.309(a). Pursuant to 38 C.F.R. § 3.303(b), where a chronic disease is shown as such in service, subsequent manifestations of the same chronic disease are generally service connected. If a chronic disease is noted in service but chronicity in service is not adequately supported, a showing of continuity of symptomatology after separation is required. Entitlement to service connection based on chronicity or continuity of symptomatology pursuant to 38 C.F.R. § 3.303 (b) applies only when the disability for which the Veteran is claiming compensation is due to a disease enumerated on the list of chronic diseases in 38 U.S.C. § 1101(3) or 38 C.F.R. § 3.309 (a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Hemorrhoids is not listed as a chronic disease subject to presumptive service connection. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). With regards to the Veteran’s claim for service connection, the Board finds that there is no dispute that he has a current hemorrhoid disability as an October 2014 private treatment record reported internal hemorrhoids during a colonoscopy report. Additionally, his STRs reflect he was treated for a thrombosed external hemorrhoid in October 1964 which required incision and draining. In April 1965, he was treated conservatively for thrombosed external hemorrhoids which were not tense or tender. Therefore, the Board finds that there is evidence of an in-service diagnosis and treatment of hemorrhoids. However, the evidence fails to establish a medical nexus. In a February 2015 VA examination, the examiner noted his treatment of hemorrhoids in service and a current finding of hemorrhoids in October 2014 but opined that his hemorrhoids were less likely than not related to military service. The examiner stated there was objective evidence of thrombosed hemorrhoids in service in 1964 and 1965. The examiner further noted there is no objective evidence of chronic debilitating hemorrhoids continuing after service and that his VA treatment records do not mention a hemorrhoid condition. The examiner stated that it was not until October 2014, 50 years after service, that a colonoscopy report showed internal hemorrhoids. The Board acknowledge the Veteran’s contention that he had surgery for hemorrhoids in 1966 at a VA medical center in Miami, Florida. The RO has attempted multiple times to locate relevant treatment records for the period of January 1, 1966 to January 1, 1967 from the VA medical center identified by the Veteran. However, personnel from the Miami VA facility reported that there are no available records for the Veteran for the requested period. See VA 21-0820-Report of General Information and March 2020 Correspondence. Although his October 2014 colonoscopy report indicated a history of personal polyps, there was no report that he had surgery for hemorrhoids. Further, a November 2014 VA treatment record noted he had a hemorrhoidectomy somewhere else, but no date or name of a facility was reported. With regards to entitlement to presumptive service connection based a chronic disease, hemorrhoids are not a chronic disease subject to presumptive service connection under 38 C.F.R. § 3.309. Thus, the Veteran is not entitled to presumptive service connection. In considering the Veteran’s lay testimony, he has provided credible evidence of treatment for hemorrhoids in service, and despite the fact that there is no medical record, his testimony was credible with respect to treatment in the first post-service year. He did not testify that he had continuous hemorrhoids since service discharge. He is not competent to link his current hemorrhoid condition to the hemorrhoid condition in service. (Continued on the next page)   Accordingly, the Board finds that the preponderance of the evidence is against a finding that his current hemorrhoids is etiologically related to service. In reaching this conclusion, the Board has considered of the benefit of the doubt doctrine but find it is not applicable. Thus, the Veteran’s claim for service connection for hemorrhoids is denied. M. Tenner Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Xiong, 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.