Citation Nr: 21011889 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 07-01 393 DATE: March 2, 2021 ORDER Service connection for gastroesophageal reflex disorder and peptic ulcer disease (PUD) is granted. FINDING OF FACT The Veteran’s current gastroesophageal reflex disorder and PUD is related to her military service. CONCLUSION OF LAW The criteria for service connection for gastroesophageal reflex disorder and PUD are 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 in the United States Navy from April 1974 to July 1980. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2006 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). In October 2015, the Veteran appeared at a hearing before a Veterans Law Judge. In February 2018, the Board denied the Veteran’s claim of entitlement to service connection for a stomach disorder. In November 2019, the United States Court of Appeals for Veterans Claims (Court), on the basis of a Joint Motion for Remand (Joint Motion), vacated the denial and remanded the matter to the Board to address entitlement to an additional hearing under Quinn v. Wilkie, 31 Vet. App. 284 (2019). In November 2020, the Veteran appeared at a hearing before another Veterans Law Judge. Generally, Veterans Law Judges who conduct hearings must participate in making the final determination of the claims involved. 38 U.S.C. § 7107(c); 38C.F.R. §20.707. By law, appeals can be assigned only to an individual Veterans Law Judge or to a panel of not less than three members. 38 U.S.C. § 7102(a). When a Veteran has hearings before two separate Veterans Law Judges during the appeal and these hearings covered one or more common issues, a third Veterans Law Judge is assigned to the panel after the second Board hearing has been held. The Court of Appeals for Veterans Claims (Court) has interpreted 38 C.F.R. § 20.707 as requiring that an appellant must be provided the opportunity for a hearing before all three Veterans Law Judges involved in a panel decision. Arneson v. Shinseki, 24 Vet. App. 379, 386 (2011). During the November 2020 Board hearing, the Veterans Law Judge advised the Veteran of her right to a third hearing before a third Veterans Law Judge. The Veteran waived her right to appear at an additional hearing before a third Veterans Law Judge, who would be assigned to decide her appeal. Entitlement to service connection for gastroesophageal reflex disorder and PUD. The Veteran seeks service connection for a gastrointestinal disorder, which she contends began in service, has been recurrent since service, and has been aggravated by her service-connected psychiatric disorder. During her November 2020 Board hearing, the Veteran reported recurrent gastrointestinal symptoms, to include abdominal pain and swelling, since in-service treatment for abdominal swelling and gastro enteritis and that she feels her symptoms coming on during episodes of increased stress. See also Brief (November 25, 2020). Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability). See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); 38 C.F.R. § 3.303(a). Service connection is also warranted for disabilities that are proximately due to or the result of service-connected disabilities. 38 C.F.R. § 3.310. Initially, the Board acknowledges that the evidence shows that the Veteran was treated for abdominal swelling and gastroenteritis during service in November 1974 and is in receipt of service connection for major depressive disorder, which has been productive of signs and symptoms such as stress and anxiety. See VA examination (May 2019). The evidence further shows that the Veteran has had a gastrointestinal disorder, diagnosed as gastroesophageal reflex disorder and PUD, during her appeal. See Private treatment record (October 10, 2003); VA examinations (January 2007; February 2015). Accordingly, this case turns on whether the Veteran’s current gastroesophageal reflex disorder and PUD are related to service or a service-connected disability. In October 2020, a surgeon opined that is it more likely than not that the Veteran’s chronic abdominal pain with gastroesophageal reflex and peptic esophagitis began during service. The surgeon reasoned that the disorder began with dysbiosis and was aggravated by the stresses of military service. While the October 2020 medical opinion lacks a comprehensive explanation, the examination report shows that the opinion was based on a thoroughly detailed review of the Veteran’s medical history. Moreover, the report sufficiently informs the Board of a medical expert’s judgment regarding the etiology of the Veteran’s current disability and the essential rationale for that opinion. Accordingly, the October 2020 medical opinion is persuasive as it finds support in the record and allows for the Board to make a fully informed determination. See Monzingo v. Shinseki, 26 Vet. App. 97, 105-06 (2012). After resolving any doubt in the Veteran’s favor, the Board finds that the Veteran’s competent, credible report of recurrent abdominal pain and swelling since her documented in-service treatment for the same and the surgeon’s October 2020 opinion establish that the Veteran’s current gastroesophageal reflex disorder and PUD are related to her military service. In reaching this opinion, the Board considered the February 2015 opinion that her claimed gastrointestinal disorder is not directly related to service and the September 2017 VHA opinion that such disorder is not secondary to her service-connected major depression. Although these VA medical opinions are at odds with that of the private surgeon, each medical professional is competent to render a medical opinion, and a rationale was provided for each opinion. At worst, the evidence with respect to whether the Veteran’s current gastrointestinal disorder is related to her military service is in service is in relative equipoise.   For these reasons, service connection for gastroesophageal reflex disorder and PUD is warranted. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals S.C. Krembs Veterans Law Judge Board of Veterans’ Appeals STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Joshua R. Castillo, 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.