Citation Nr: 21023684 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 18-24 726 DATE: April 21, 2021 ORDER Service connection for stomach adhesions is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his stomach adhesions are reasonably shown to be caused by or incurred during his active military service. CONCLUSION OF LAW The criteria for service connection for stomach adhesions have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1960 to October 1962. In April 2021, a videoconference hearing was held before the undersigned Veterans Law Judge. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). The Veteran seeks service connection for stomach adhesions, which he contends were caused by or incurred during his active military service. See May 2018 VA Form 9. The Veteran reported that medical testing in approximately 1964 showed abdominal adhesions in three locations. Id. Post-service treatment records indicate that the Veteran has a diagnosis of stomach adhesions. See October 2010 private treatment record, received by VA in November 2017. Therefore, the Board finds that the first element of a service connection claim, a current disability, has been met. The Veteran’s service treatment records (STRs) show that he underwent an appendectomy in February 1962 for appendicitis. Surgical complications of abscess formation, hemorrhage, and wound infection were noted, and treatment continued through June 1962. As such, the second element of a service connection claim is substantiated, as the record establishes that the Veteran experienced in-service events as a result of his appendicitis, appendectomy, and surgical complications. What remains to be established is that the Veteran’s current stomach adhesions are related to the in-service occurrences. As will be explained below, the Board finds that the evidence of record demonstrates that such is reasonably shown. On March 1963 VA examination, it was noted that the Veteran underwent an appendectomy during service that was perforated with prolonged drainage and complicated by a residual abscess. The Veteran reported that he believed he had adhesions, and reported intermitted postoperative abdominal pain, pulling sensation, and cramping. Private treatment records show that the Veteran underwent a colonoscopy in October 2010. The private physician noted that the Veteran had a very long and tortuous colon, which he found was likely related to the Veteran’s ruptured appendicitis and associated adhesions. On September 2016 VA examination, the VA examiner found there was insufficient evidence to diagnose stomach adhesions. The Veteran reported periodic pronounced abdominal pain with 4 or more recurring episodes of severe symptoms per year. In a December 2017 VA addendum opinion, the VA examiner found that there was no evidence to support a diagnosis of a chronic abdominal condition due to adhesions. The VA examiner found that the Veteran’s stomach condition during military service was acute only. The VA examiner noted that the Veteran had abdominal surgery during service due to a ruptured appendix, and adhesions were possible with any intra-abdominal surgery. The VA examiner acknowledged that the October 2010 colonoscopy report indicated that the Veteran had a tortuous colon but concluded that there was no objective evidence to support a chronic medical condition requiring continuous care and treatment. In a November 2018 private medical opinion, the private physician found that the Veteran’s recurrent abdominal pain was due to adhesions from surgery. The private physician found that it was as likely as not that the adhesions were due to the Veteran’s two abdominal surgeries for appendicitis, and that the Veteran’s record and statements indicated there were no problems with abdominal pain or adhesions prior to his surgeries. The Veteran testified during the April 2021 Board hearing that he underwent a subsequent colonoscopy in approximately 2016, and that the physician conducting the procedure indicated that the Veteran’s current stomach adhesions were related to his in-service ruptured appendix. The Veteran further testified that he had not sought treatment for his stomach adhesions because he had been advised both by physicians in service and in the present that there was no treatment available. After reviewing the evidence of record, the Board finds the November 2018 private medical opinion to be highly probative as the treating private physician based his opinion on a thorough review of the Veteran’s medical history and provided well-reasoned rationale. It is also supported by the October 2010 private medical opinion. Although that private physician did not indicate that the Veteran’s entire medical record was reviewed in preparation of the opinion, he did reference the Veteran’s in-service ruptured appendix and associated adhesions, and indicated that he had reviewed enough of the Veteran’s relevant medical history to opine as to the etiology of the stomach adhesions. The Board further finds the Veteran’s lay statements of record and hearing testimony to be credible and are afforded much probative value. The Board acknowledges the negative nexus opinions of record from the September 2016 VA examination and December 2017 VA addendum opinion. However, the September 2016 VA examination provided a conflicting opinion, as it acknowledged the October 2010 finding that the Veteran’s stomach adhesions were “probably” related to the ruptured appendix, but still concluded that there was no medical diagnosis of stomach adhesions without any explanation. Similarly, the December 2017 VA medical opinion indicated that the evidence did not show that the Veteran had a chronic abdominal condition requiring continuous care and treatment due to stomach adhesions. However, the opinion failed to address the Veteran’s lay statements and reports of continuous abdominal pain since military service, which is notable considering his statements throughout the record in which he also explains he has not sought treatment because he has been told there is no treatment available. Moreover, the opinion appears to be contradictory in nature, as the VA examiner essentially noted that stomach adhesions existed, but they do not require continuous care or treatment. Accordingly, the September 2016 and December 2017 VA medical opinions are afforded little probative value. Regarding the reported 2016 colonoscopy and medical opinion, the Board notes that the medical documentation for this procedure have not been associated with the record. However, as this decision represents a full grant of benefits sought, remand in order to obtain the records is not warranted. In conclusion, the Board finds that the evidence is at least in equipoise as to whether the Veteran has current stomach adhesions that were caused by or incurred during his military service. Resolving reasonable doubt in the Veteran’s favor, as is required in these circumstances, service connection for stomach adhesions is granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Griffin, 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.