Citation Nr: 21005372 Decision Date: 02/01/21 Archive Date: 02/01/21 DOCKET NO. 14-07 594 DATE: February 1, 2021 ORDER Entitlement to service connection for a gastroesophageal disorder, variously diagnosed as duodenitis, gastritis and GERD, is granted. FINDINGS OF FACT The Veteran’s gastroesophageal disorder is etiologically related to service. CONCLUSIONS OF LAW The criteria for entitlement to service connection for a gastroesophageal disorder have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1968 to November 1971 and December 1990 to June 1991. He appeals a March 2012 rating decision denying entitlement to service connection for duodenitis and GERD. The Board notes that, in June 2019, the Veteran submitted a VA Form 10182 requesting that his appeal be adjudicated under the procedures of the Veterans Appeals Modernization Act. Pub. L. No. 115-55 (codified as amended in various sections of Title 38 of the U.S. Code), 131 Stat. 1105 (2017). It does not appear that this was ever acknowledged. Nevertheless, since this decision is fully favorable, there is no prejudice in continuing this appeal. Service Connection Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. §§ 3.303(a), 3.304, 3.307, 3.309, 3.310. Generally, the evidence must show: (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 or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). Generally, a veteran is presumed to be in sound condition, except for defects, infirmities or disorders noted when examined, accepted, and enrolled for service. 38 U.S.C. §§ 1111, 1137; 38 C.F.R. § 3.304(b). Such conditions are considered to be pre-existing. Only such conditions as are recorded in examination reports are to be considered as noted. 38 C.F.R. § 3.304(b). 1. Entitlement to service connection for a gastroesophageal disorder. The Veteran contends that his stomach disorder, claimed as duodenitis and GERD, is attributable to active service. After review of the evidence, the Board finds that service connection is warranted. Review of the Veteran’s service treatment records reveals considerable treatment for gastroesophageal issues during his second period of active duty. Most notably, he was hospitalized in May/June 1991 due to the acute onset of epigastric pain. Peptic ulcer disease was considered, but a final diagnosis of mild duodenitis was rendered. The Veteran was treated with Mylanta and Zantac and released. The Veteran reports that he was diagnosed with stomach ulcers at the time, but there is no evidence of record which supports this contention. As to post-service diagnoses, the record is not entirely clear. Records indicate that the Veteran was diagnosed with GERD in 2000. In addition, the Veteran submitted a disability benefits questionnaire (DBQ) in February 2014 which noted diagnoses of, as relevant here, gastritis and duodenitis. The main symptom of the various diagnoses was epigastric pain. The Veteran was afforded a VA examination in February 2018. The examiner opined that the Veteran’s duodenitis likely existed prior to service because the Veteran had complained of similar episodes of stomach pain prior to his second period of active service. However, the examiner’s opinion, without more, does not reach the level of clear and unmistakable evidence that the Veteran’s gastroesophageal disorder preexisted active service. Hence, the Board does not find that the Veteran’s gastroesophageal disorder is a preexisting condition. The examiner further opined that he could finds no medical records that support a diagnosis of GERD. As to nexus, the Board observes that the Veteran has complained of and been treated for various chronic gastroesophageal issues since separation from service. Of note, the February 2018 VA examiner determined that the Veteran’s duodenitis and lactose intolerance offered at least a partial, if not complete, explanation of his gastroesophageal symptoms. As such, the Board finds that a continuity of symptoms from service to the present has been shown. In consideration of the medical evidence as a whole, the Board finds that the Veteran’s gastroesophageal disorder is attributable to active service. Although the February 2018 VA examiner opined that the Veteran’s gastroesophageal disorder likely preexisted service, nothing was noted upon entrance and there is no evidence of record which clearly and unmistakably shows that it did. As such, service connection for a gastroesophageal disorder is warranted. However, the Board reminds the Veteran that, since he is already service-connected for a gastrointestinal disorder, only the predominant of the two may be applied to his disability rating. See 38 C.F.R. § 4.114.   This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Daniel Ballinger, Associate Counsel