Citation Nr: 21002772 Decision Date: 01/14/21 Archive Date: 01/14/21 DOCKET NO. 14-23 950 DATE: January 14, 2021 ORDER Entitlement to service connection for an abdominal condition is denied. FINDING OF FACT The preponderance of the evidence of record is against finding that the Veteran has had an abdominal condition of any sort at any time during or approximate to the pendency of this claim. CONCLUSION OF LAW The criteria are not met for entitlement to service connection for an abdominal condition. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active military service in the U. S. Army Reserves from October 2001 to March 2002, from February 2003 to May 2004, and from March 2013 to July 2014. He received numerous commendations – including the Global War on Terrorism Service Medal. He also has had additional service in the way of inactive duty training (INACDUTRA) over about a decade. This appeal to the Board originates from a July 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In February 2019, the Board remanded this claim back to the RO, i.e., back to the Agency of Original Jurisdiction (AOD), for further development and consideration – including so a medical examiner could first determine whether the Veteran has this abdominal condition being claimed, even if external and more akin to a muscle or soft tissue injury to his abdomen. Only if confirmed he does would the examiner then need to also indicate the likelihood this condition is attributable to the Veteran’s military service – meaning either directly incurred during his service or, alternatively, if determined that his left knee disability also being claimed is attributable to his service, then whether it caused or aggravates his abdominal condition or muscle or soft tissue injury to, in turn, warrant secondarily relating the abdominal, muscle or soft tissue injury or condition to his service. That additional development of this claim since has been accomplished, as directed. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Thus, the Board is proceeding to deciding the appeal of this remaining claim. Entitlement to Service Connection for an Abdominal Condition is Denied. As already alluded to, the Veteran is alleging entitlement to service connection on both direct and secondary bases. Direct service connection is granted for disability directly resulting from disease or injury incurred in or aggravated by active military service in the line of duty. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a relevant disease or an injury; and (3) a causal relationship (“nexus”) between the current disability and the disease or injury in service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Secondary service connection is warranted when a service-connected disability caused or aggravates the condition being additionally claimed. 38 C.F.R. § 3.310(a) and (b); see also Allen v. Brown, 7 Vet. App. 439 (1998). Fundamental to the claim, however, irrespective of whether predicated on the notion of direct or instead secondary service connection, or both, is the Veteran first establishing he has the claimed condition – else, for all intents and purposes, there is no current disability to, in turn, relate or attribute to his military service. And, while the Board acknowledges the lay statements that have been presented in this case regarding his abdominal symptoms, it simply has not been shown that he has any ratable disability referable to his abdomen, either internally or externally. See Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). In September 2013, in response to this claim, the Veteran underwent a VA Intestinal Conditions (including Irritable Bowel Syndrome (IBS), Crohn’s disease, ulcerative colitis, and diverticulitis) examination, and the examiner determined the Veteran did not at that time have an intestinal condition of any sort. Indeed, even the Veteran, himself, readily conceded that he did not have an intestinal condition at the time of that examination. However, that notwithstanding, there was a lay witness statement in the file from an individual who had served with the Veteran indicating the claimed “abdominal problem” was more of a physical, external condition consisting of, for instance, “muscular and soft tissue imbalances.” Therefore, the Board remanded this claim in February 2019 for an additional VA examination and supplemental medical comment on this “abdominal condition” being claimed, even if external and more akin to a muscle or soft tissue injury to his abdomen. Only if confirmed he has this claimed condition would the examiner then need to also indicate the likelihood this condition is attributable to his military service – meaning either directly incurred during his service or, alternatively, if determined that his left knee disability also being claimed is attributable to his service, then whether it caused or aggravate his abdominal condition or muscle or soft tissue injury to, in turn, warrant secondarily relating the abdominal, muscle or soft tissue injury or condition to his service.   This additional medical comment was provided in January 2020, and this additional examiner also did not find reason to conclude the Veteran has a current disability or diagnosis referable to his abdomen, either internally or externally. While he indicates he has experienced transient lower abdominal pain due to ambulation problems related to his left knee injury during service, the fact remains there is no probative evidence of a current pelvic girdle muscle injury. In addition, he also did not indicate he has experienced abdominal pain, absent an underlying diagnosis accounting for this pain, which in turn is causing functional impairment of his earning capacity to warrant considering the complaints of pain, absent an underlying diagnosis, as a ratable disability for VA compensation purposes. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (finding that pain in the absence of a presently diagnosed condition can cause functional impairment and, thereby, could constitute a disability for VA purposes). The existence of a current disability is the cornerstone of a claim for VA disability compensation. See Degmetich v. Brown, 104 F.3d 1328 (1997). A current disability means a disability shown by competent and credible (probative) evidence to exist. See Chelte v. Brown, 10 Vet. App. 268 (1997). Therefore, here, because there is no abdominal disability – either intestinal or muscular in nature – upon which benefits could be granted, the appeal for compensation for this purported disability must be denied. See 38 C.F.R. §§ 3.102, 3.303.   The preponderance of the evidence is against this claim, not instead supportive of it or even in relative balance (equipoise), so the benefit-of-the-doubt doctrine is inapplicable. See generally Gilbert v. Derwinski, 1 Vet. App. 49 (1990); Ortiz v. Principi, 274 F.3d 1361 (Fed Cir. 2001). KEITH W. ALLEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. B. Kucera 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.