Citation Nr: 21066999 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 12-33 265 DATE: November 3, 2021 ORDER Service connection for a stomach disorder, to include as secondary to a service-connected disability is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran's stomach disability began during active service or is otherwise related to an in-service injury or disease or a service-connected disability. CONCLUSION OF LAW The criteria for service connection for a stomach disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from December 1965 to December 1967. The Board remanded the claim in June 2021 to obtain an addendum opinion in accordance with a December 2020 Joint Motion for Partial Remand issued by the United States Court of Appeals for Veterans Claims. The Board finds that there has been substantial compliance with the remand directives. Stegall v. West, 11 Vet. App. 268 (1998). 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). Service connection is warranted for a disability which is proximately due to, aggravated by, or the result of a service-connected disability. 38 C.F.R. § 3.310. A finding of secondary service connection requires competent medical evidence to connect the asserted secondary disability to the service-connected disability. Wallin v. West, 11 Vet. App. 509, 512 (1998); Velez v. West, 10 Vet. App. 432 (1997). The Veteran contends that his stomach disability is due to his service-connected disabilities. VA medical records show the Veteran has a hiatal hernia. In August 2021, the Veteran underwent a VA examination which confirmed this diagnosis. The examiner in the August 2021 examination was also asked to determine the etiology of this disability. The examiner found that the diagnosed hiatal hernia is less likely than not proximately due to or aggravated beyond its natural progression by the Veteran's service-connected conditions. Specifically, the examiner noted that after review of the Veteran's medical records and relevant medical literature the Veteran's hiatal hernia and subsequent diagnoses are not altered by his service-connected posttraumatic stress disorder. Addressing the Veteran's lay complaints of vomiting food while in the military, the examiner noted that the Veteran, as late as 2001, did not endorse any gastrointestinal complaints. Further, the examiner explained that food sticking due to stricture is a late and dramatic result of esophagitis. The Veteran has required re-dilation of his esophagus every 5-10 years. As a result, it would be unlikely that he had a stricture for 35 years that did not progress. Rather, the examiner noted that excessive body weight is a significant independent risk factor for hiatal hernia further noting that the Veteran has gained over 120 pounds between separation and presentation with symptoms. Therefore, the examiner found that the Veteran's stomach conditions were not incurred in service, nor were they proximately due to, the result of, or aggravated beyond their natural progression by any of his service connected disabilities. Therefore, service connection on both a direct and secondary basis is not warranted. The Board acknowledges the Veteran's own assertions in support of his claim. However, as a layperson without the appropriate medical training and expertise, the Veteran has not demonstrated the competency to opine as to the etiologies in this matter. Furthermore, neither the Veteran nor his representative has presented or identified any additional medical opinion or other competent evidence that supports the Veteran's claim. Therefore, the Board finds that the preponderance of the evidence is against the claim on both a direct and secondary basis. As such, the benefit of the doubt rule is not for application, and the claim must be denied. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jorge Barroso, 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.