Citation Nr: 21069717 Decision Date: 11/19/21 Archive Date: 11/19/21 DOCKET NO. 17-14 905 DATE: November 19, 2021 ORDER Entitlement to service connection for a depressive disorder secondary to service-connected joint disabilities is granted, subject to the laws that govern the payment of monetary benefits. Entitlement to service connection for a lower gastrointestinal disability, claimed as irritable bowel syndrome (IBS), is denied. FINDINGS OF FACT 1. The Veteran is service connected for bilateral knee disabilities and for a low back disability, all of which are productive of pain. 2. The Veteran has been diagnosed to have depressive disorder related to chronic pain. 3. The probative medical evidence of record is at least in equipoise with regard to whether the Veteran's depressive disorder is causally related to service-connected disabilities of the back and bilateral knees. 4. The probative medical evidence of record does not reveal that the Veteran currently has or had a diagnosis of IBS or any other lower gastrointestinal disorder. CONCLUSIONS OF LAW 1. With the resolution of reasonable doubt in favor of the Veteran, depressive disorder related to chronic pain is proximately due to service-connected disabilities of the back and bilateral knees. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. 2. A lower gastrointestinal disorder, to include IBS, has not been shown as due to military service or any service-connected disability. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1993 to September 1993 and from October 1999 to September 2000. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In July 2021, the Veteran testified before the undersigned Veterans Law Judge (VLJ) at a Board hearing. A transcript of the proceeding has been associated with the claims file. Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303 (a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). The claimant bears the burden of presenting and supporting his/her claim for benefits. 38 U.S.C. § 5107 (a). See Fagan v. Shinseki, 573 F.3d 1282 (Fed. Cir. 2009). The Board shall consider all information and lay and medical evidence of record. 38 U.S.C. § 5107 (b). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Board shall give the benefit of the doubt to the claimant. Id.; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 1. Depressive Disorder The record shows the Veteran has been diagnosed to have depressive disorder related to chronic pain. (See the report of VA examination conducted in December 2014.) The Veteran is service connected for patellofemoral syndrome of the left and right knee, as well as for degenerative joint disease of the lumbar spine. These are productive of pain. Although the 2014 VA examiner included the remark in her opinion that it would be resorting to mere speculation to conclude the Veteran's depressive disorder was due to his knee disabilities, since she affirmatively stated the disorder was due to chronic pain, the evidence is at least in equipoise on the questioner of whether the service connected disabilities productive of chronic pain caused the depressive disorder. Therefore, resolving reasonable doubt in the Veteran's favor, service connection for the depressive disorder is granted. 2. IBS The Veteran contends that he currently suffers from a lower gastrointestinal disability, described as IBS. In this regard, the Veteran has attributed this condition to medications he has taken to treat his service-connected joint disabilities of the back and bilateral knees. The Veteran has also revealed that he has yet to be diagnosed with a disability in this regard or that any medical providers have attributed his lay symptoms to medication usage. A review of the Veteran's service treatment records reveals it is silent for any showing of complaints, treatment, or diagnoses of any lower gastrointestinal disorders, to include IBS. A review of the Veteran's post-service outpatient treatment records does not reveal any complaints, treatment, or diagnoses of any of any lower gastrointestinal disorders, to include IBS. Although the Veteran testified at the 2021 Board hearing that evidence would be forthcoming regarding a current diagnosis, no such evidence appears to have been submitted despite adequate time to submit it. The threshold requirement for the granting of service connection is evidence of a current disability. In the absence of evidence of a current disability there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The requirement in a claim of service connection of current disability "is satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim and that a claimant may be granted service connection even though the disability resolves prior to the Secretary's adjudication of the claim." See McClain v. Nicholson, 21 Vet. App. 319 (2007). Here, the totality of the evidence does not reflect that the Veteran has or has had a diagnosis of any lower gastrointestinal disorders, to include IBS, during the relevant period on appeal. Rather, the Veteran has shown normal findings in this regard throughout the appeal period. A review of current medical evidence since the filing of the Veteran's claims does not show any relevant current diagnosis for the claimed disability. Last, the Board notes that the Veteran is competent to testify as to a condition within his knowledge and personal observation. Barr v. Nicholson, 21 Vet. App. 303, 308-310 (2007). However, it is clear, based on a detailed review of the statements overall, that the Veteran has no actual specialized knowledge of medicine in general and that he is merely speculating as to whether he has a current diagnosis of any lower gastrointestinal disorders, to include IBS. In this regard, he is not competent to diagnose such disability, as it requires specialized medical knowledge and specific testing. See 38 C.F.R. § 3.159 (stating that competent medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions). As such, the Veteran's statements to the effect that he has a current diagnosis of any lower gastrointestinal disorders, to include IBS, are lacking in probative value. Therefore, the most probative evidence of record reflects that the Veteran lacks a diagnosis of any lower gastrointestinal disorders, to include IBS, during the appeal period. Absent the required diagnosis of the claimed disability at any time during the appeal period, there is no current disability to attribute to the Veteran's military service. Brammer, 3 Vet. App. at 223. For the reasons provided above, the preponderance of evidence is against the Veteran's claim. The evidence in this case is not so evenly balanced so as to allow application of the benefit-of-the-doubt rule as required by law and VA regulation. Gilbert, 1 Vet. App. at 49; 38 C.F.R. § 3.102. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Dodd, Ryan 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.