Citation Nr: 21003123 Decision Date: 01/19/21 Archive Date: 01/19/21 DOCKET NO. 10-15 191 DATE: January 19, 2021 ORDER Entitlement to service connection for pancreatitis, as secondary to service-connected gastroesophageal reflux disease (GERD) with cholecystectomy residuals, is denied. FINDING OF FACT The evidence of record is against a finding that the Veteran’s pancreatitis was caused or aggravated by her service-connected GERD with cholecystectomy residuals. CONCLUSION OF LAW The criteria for service connection for pancreatitis are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty for training (ACDUTRA) in the United States Army from March 1977 to July 1977. The Veteran testified before the Board at an October 2014 videoconference hearing. A transcript has been associated with the claims file. In a December 6, 2020 letter, the Veteran was notified that the Veterans Law Judge who presided over her October 2014 hearing was no longer available to participate in the adjudication of her appeal. The Veteran was provided an opportunity to schedule a new hearing before the Board, and both she and her attorney were afforded thirty days to respond. The letter specified that if a response was not received within 30 days, the Board would assume the Veteran did not wish to appear at another hearing. The Board has not received a response from the Veteran or her attorney and will proceed with adjudication. The Veteran’s appeal was remanded for an addendum medical opinion by the Board in May 2020. The appeal has been returned to the Board for appellate review. Entitlement to service connection for pancreatitis, to include as secondary to service-connected GERD with cholecystectomy residuals, is denied. The Veteran contends that she has a current diagnosis of pancreatitis that was caused or aggravated by her service-connected GERD with cholecystectomy residuals. Because the Veteran has not raised, and the record does not reasonably raise, entitlement to service connection on a direct basis, the Board’s adjudication will consider only entitlement to secondary service connection. Service connection may be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. Concerning a current disability, the August 2020 examiner observed that the Veteran is not noted to have experienced a recurrence of pancreatitis since 2007. That said, the Board will consider the requirement that a current disability exist to be satisfied. See McClain v. Nicholson, 21 Vet. App. 319 (holding that the requirement of the existence of a current disability is satisfied when a Veteran has a disability at the time he files his claim for service connection or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim); see also Romanowski v. Shinseki, 26 Vet. App. 289, 294 (2013) (noting that a diagnosis shortly before a claim is filed, but relevant to the disability claimed, should be considered by the Board). That stated, the August 2020 examiner specifically opined against a relationship, both causal or based on aggravation, between the Veteran’s pancreatitis and her service-connected GERD with cholecystectomy residuals. By way of rationale the examiner observed that, at the time of the Veteran’s pancreatitis diagnosis, she was noted to have been using hydrochlorothiazide (HCTZ), which was since discontinued. She was also noted to have an allergy to this medication in her VA records. The examiner related that, per the medical literature, pancreatitis has been reported in those using hydrochlorothiazide. The Board notes that, in March 2007, the Veteran submitted a statement in which she reported being prescribed hydrochlorothiazide for blood pressure, which caused her to develop pancreatitis, and which was thereafter discontinued by her physician. February 2007 VA treatment records document that the etiology of the Veteran’s pancreatitis was unclear at the time, and possibly related to ethanol (alcohol) use, hypertriglyceridemia, or hydrochlorothiazide use. These records note that the Veteran had underwent a cholecystectomy surgical procedure in the past; however, the records draw no connection between the Veteran’s pancreatitis and her cholecystectomy. Furthermore, a prior April 2015 VA examiner reported: “With one exception, all symptoms listed in the 2507 [medical form] are associated either with cholecystitis, the surgical treatment thereof, the revision of that treatment, or the complications of that. The one exception is the diagnosis of pancreatitis which is unrelated and has a specific etiology, that of a drug toxic effect, when HCTZ was prescribed for control of blood pressure.” The April 2015 examiner also reported: “She had pancreatitis due to treatment with HCTZ for HBP [high blood pressure], but this condition was acute and resolved when the drug was discontinued. She is now on Amlodipine instead.” Concerning both a causal relationship, or relationship based on aggravation between the Veteran’s service-connected GERD with other cholecystectomy residuals and her previously diagnosed pancreatitis, the August 2020 VA examiner reported that the weight of the literature did not support such relationships. The examiner also reiterated that the Veteran’s pancreatitis had not recurred since 2007, and that she similarly had not been taking hydrochlorothiazide since her 2007 pancreatitis episode. There are no medical opinions of record addressing the etiology of the Veteran’s pancreatitis that are contrary to those of the August 2020 VA examiner. The August 2020 examiner’s opinion is based on an accurate understanding of the Veteran’s medical history and medical research, and is well-explained. The Board finds the opinion highly probative. Insofar as the Veteran herself asserts her pancreatitis is related to her service-connected disabilities, she lacks the medical training to competently opine on the matter. Thus, after considering the entirety of the record, the Board finds the preponderance of the evidence is against a showing that the Veteran’s pancreatitis was caused or aggravated by her service-connected disability. The benefit sought on appeal must therefore be denied. V. Chiappetta Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Hennessy, 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.