Citation Nr: 21063979 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 16-63 120 DATE: October 18, 2021 ORDER Entitlement to service connection for peptic ulcer disease is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has had a separate diagnosis of peptic ulcer disease or any other diagnosable ulcer condition at any time during or approximate to the pendency of the claim. CONCLUSION OF LAW The criteria for service connection for peptic ulcer disease are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty with the Air Force from April 1989 to February 2010 and has service within Southwest Asia. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a video conference hearing in October 2019. A transcript of the hearing has been associated with the claims file. The Veteran's claims were most recently remanded by the Board in a July 2021 decision. The Board finds that the RO has substantially complied with the July 2021 Board remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). The Board notes that in a September 2021 rating decision, the AOJ found that CUE had occurred and granted the Veteran an earlier effective date for the evaluations for PTSD, asthma, and cluster headaches. Thus, the Veteran has been rated at 90 percent from May 22, 2012, and at 100 percent from December 5, 2019. The Board also notes the provisions of 38 C.F.R. §§ 4.113 and 4.114 regarding pyramiding would apply to Diagnostic Code 7305 given the Veteran's other service-connected disabilities. This appeal has been advanced on docket pursuant to 38 C.F.R. § 20.900 (c); 38 U.S.C. § 7107 (a)(2). 1. Entitlement to service connection for peptic ulcer disease The Veteran contends that he has experienced chronic ulcer pain due to peptic ulcer disease since his time in military service. The Board notes that the Veteran is already separately service connected for several other digestive system conditions including irritable bowel disease (IBS) with GERD rated at 30 percent from May 22, 2012 (Diagnostic Code 7346-7319); status post ventral hernia repair rated as noncompensable effective March 1, 2010 (DC 7338); and chronic hemorrhoid pain as a residual of IBS rated as noncompensable effective May 22, 2012 (DC 7336). 38 C.F.R. §§ 4.110, 4.113, and 4.114. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 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 disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current diagnosis of peptic ulcer disease and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Board notes that it has considered Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), in which the Federal Circuit held that "pain alone, without an accompanying diagnosis of a present disease, can qualify as a disability" if it "reaches the level of a functional impairment of earning capacity." Id. at 1367-69. However, the Board finds that the VA examiner's opinion that the Veteran's lay reports of ulcer pain are likely related to his other service-connected gastrointestinal impairments. The August 2020, April 2021, and September 2021 VA examiners evaluated the Veteran and determined that, while he experienced subjective symptoms of abdominal pain that he attributed to ulcers, he did not have a diagnosis of peptic ulcer disease as established by endoscopy. Further, despite treatment and reports of abdominal pain, VA treatment records do not contain a diagnosis of peptic ulcer disease but do contain diagnoses of GERD and hemorrhoids. The examiners specifically noted negative EGD testing in March 1991 and August 2013. While the Veteran believes he has a current diagnosis of peptic ulcer disease, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education and the ability to interpret complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence and concludes that entitlement to service connection for peptic ulcer disease has not been established. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.D. Taylor, 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.