Citation Nr: 21000579 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 11-27 070 DATE: January 5, 2021 ORDER Entitlement to service connection for a gastrointestinal (GI) disability, diagnosed as irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD), is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, the Veteran’s GI disability, diagnosed as IBS and GERD, is proximately due to or aggravated beyond its natural progression by medication prescribed for his other service-connected disabilities. CONCLUSION OF LAW The criteria for service connection for a GI disability, diagnosed as IBS and GERD, are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 2000 to June 2004. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In September 2014, the Board reopened the claim for service connection for a GI disability and remanded the claim for further development. In June 2015 and April 2019, the Board remanded the claim again. Service Connection As the Board is granting this claim based on secondary service connection, it is not necessary to address other theories of service connection herein. Service connection may be established on a secondary basis for a disability which is proximately due to or the result of a service-connected disease or injury; or, for any increase in the severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progression of the nonservice-connected disease. 38 C.F.R. § 3.310 (a)-(b); Allen v. Brown, 7 Vet. App. 439 (1995). In order to prevail under a theory of secondary service connection, there must be: (1) evidence of a current disorder; (2) evidence of a service-connected disability; and, (3) medical nexus evidence establishing a connection between the service-connected disability and the current disorder. See Wallin v. West, 11 Vet. App. 509, 512 (1998). When there is an approximate balance of evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each issue shall be given to the claimant. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. A claimant need only demonstrate an approximate balance of positive and negative evidence in order to prevail. See Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). For a claim to be denied on the merits, a preponderance of the evidence must be against the claim. See Alemany v. Brown, 9 Vet. App. 518, 519 (1996). The Veteran asserts he is entitled to secondary service connection for his GI disability as a result of the medication used to reduce the symptoms for his other service-connected disabilities. The Veteran is most recently diagnosed with IBS and GERD in a November 2019 VA examination. The first element of entitlement to service connection is met. The next element for entitlement to secondary service connection is evidence of a currently service-connected disability. The Veteran specifically contends that the medication used for his neck, back, and knee disabilities are responsible for his current GI disability. The Veteran’s service-connected disabilities include: sacroiliac joint arthritis; low back strain; left mid-body trapezius and supraspinatus tendonitis/myositis; left knee chondromalacia; and cervical strain. The second element of entitlement to secondary service connection has been met. The final element for secondary service connection requires medical nexus evidence establishing a connection between the service-connected disability and the current disorder. There is a plethora of conflicting evidence both for and against the Veteran’s claim. Viewing the evidence in the light most favorable to the Veteran, the Board finds that the evidence is in equipoise as to whether there is a nexus between the medication used to control the symptoms of his service-connected disabilities and the current GI disorder. Resolving doubt in his favor, the third element of secondary service connection has been satisfied. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. 49. Entitlement to service connection for a GI disability is granted. LAURA E. COLLINS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Department of Veterans Affairs 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.