Citation Nr: 21069981 Decision Date: 11/22/21 Archive Date: 11/22/21 DOCKET NO. 19-08 934A DATE: November 22, 2021 ORDER Entitlement to service connection for an undiagnosed illness manifested by menstrual disorders is granted. FINDINGS OF FACT 1. The Veteran is a Persian Gulf Veteran. 2. The Veteran has an undiagnosed illness manifested by menstrual disorders that necessitated a 2017 hysterectomy. CONCLUSION OF LAW The criteria have been met for service connection for an undiagnosed illness manifested by menstrual disorders. 38 U.S.C. §§ 1110, 1117, 1118, 1155, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.317. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran had active service from February 2000 to June 2000; from February 2003 to February 2004; and from October 2004 to December 2005. She served in Iraq. Service Connection for an Undiagnosed Illness Service connection may be granted for a recurrent disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection may be granted on a presumptive basis for Persian Gulf veterans who exhibit objective indications of a qualifying chronic disability, provided that such disability became manifest either during active service in the Southwest Asia theater of operations, or to a degree of 10 percent or more not later than December 31, 2021, and which by history, physical examination, and laboratory tests, cannot be attributed to any known clinical diagnosis. 38 U.S.C. § 1117; 38 C.F.R. § 3.317(a)(1). For purposes of presumptive service connection for Persian Gulf veterans under 38 C.F.R. § 3.317, a "qualifying chronic disability" includes a chronic disability resulting from any of the following (or any combination of the following): an undiagnosed illness; or a medically unexplained chronic multi-symptoms illness (MUCMI) that is defined by a cluster of signs or symptoms, such as chronic fatigue syndrome, fibromyalgia, or functional gastrointestinal disorders. 38 C.F.R. § 3.317(a)(2)(i). Under 38 C.F.R. § 3.317, signs or symptoms which may be manifestations of undiagnosed illness include, but are not limited to, menstrual disorders. 38 C.F.R. § 3.317(b). The Veteran served in Kuwait and Iraq from October 2004 to December 2005. She is therefore a Persian Gulf Veteran. 38 C.F.R. § 3.317(e). An April 2017 operative note from J. Mirabile, M.D., states that the Veteran had a history of "abnormal uterine bleeding for several years" and had "continuous bleeding and cramping with the exhaustion of all conservative options." An assessment of "menorrhagia despite conservative options with incapacitating dysmenorrhea" was advanced. The Veteran subsequently underwent a total laparoscopic hysterectomy. An October 2018 evaluation from M. Poppa, D.O., conveys that he had reviewed the Veteran's entire record. The doctor observed that: the Veteran's hysterectomy "was the result "of an unexplained menstrual disorder with symptoms of dysmenorrhea, menorrhagia and dysplasia and endometriosis that could not be controlled by more conservative methods;" "these are symptoms that do not comprise a single identifiable diagnosis or have resulted in a disease;" and "these symptoms are of an unknown etiology." Dr. Poppa opined that "the hysterectomy and residuals [the Veteran] experiences are as likely as not the result of her time in the Gulf War and certainly had their onset while in the military." (Continued on the next page) A September 2019 evaluation from W. Hoeper, R.N., states that she had reviewed the Veteran's records include Dr. Poppa's evaluation. She concurred with the doctor's opinion. Ms. Hoeper concluded that "it is as likely as not that she is suffering from a Gulf-related undiagnosed illness that has caused her painful menstrual disorders, to include cramping and irregular, heavy bleeding related to the female reproductive system." The Veteran is a Persian Gulf Veteran. Dr. Poppa and Ms. Hoeper have determined that the Veteran has an undiagnosed illness manifested by menstrual disorders that necessitated a 2017 hysterectomy and thus became manifested to compensable degree prior to December 31, 2021. Resolving all reasonable doubt in the Veteran's favor, the Board concludes that service connection for an undiagnosed illness manifested by menstrual disorders is warranted. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Smith, 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.