Citation Nr: 21024490 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 15-14 375A DATE: April 22, 2021 ORDER Entitlement to a disability rating more than 10 percent for irritable bowel syndrome (IBS) is denied. FINDING OF FACT During the period under consideration, the Veteran’s IBS has manifested by intermittent pain and alternating diarrhea and constipation of no more than moderate severity with frequent episodes of bowel disturbance with abdominal distress; more or less constant abdominal distress is not shown. CONCLUSION OF LAW The criteria for a disability rating more than 10 percent rating for IBS are not met. 38 U.S.C. § 1155; 38 C.F.R. § 4.114, Diagnostic Code 7319. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1997 to January 2001. This appeal stems from a May 2010 rating decision from a VA Regional Office. The Veteran filed a Notice of Disagreement in July 2010 seeking a higher rating for irritable bowel syndrome. A Statement of the Case was issued in November 2010, and the Veteran filed a VA Form 9 in February 2011. A Supplemental Statement of the Case (SSOC) was issued in April 2015, the Veteran filed another VA From 9 in May 2015, and another SSOC was issued in February 2016. The appeal was thereafter certified to the Board. The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a February 2021 hearing. A transcript of the proceeding is of record. The VLJ clarified the issue on appeal, explained the concept of increased ratings claims, inquired as to whether there was additional evidence to be submitted, and held the file open for 60 days to allow for submission of evidence. These actions complied with any duties owed during a hearing. 38 C.F.R. § 3.103. Increased rating for irritable bowel syndrome (IBS). The Veteran’s IBS is rated as 10 percent disabling under 38 C.F.R. § 4.114, Diagnostic Code 7319 (irritable colon syndrome). Under Diagnostic Code 7319, a noncompensable rating is warranted for mild symptomatology, with disturbances of bowel function with occasional episodes of abdominal distress. A 10 percent disabling rating is warranted for moderate symptomatology with frequent episodes of bowel disturbance with abdominal distress. A maximum 30 percent disability rating is warranted for severe symptomatology with diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress. The Veteran was provided a VA examination in February 2010. She reported nausea, vomiting, diarrhea, and constipation. The constipation was constant with episodic bouts of loose stools. Abdominal pain and cramps occurred twice per month and lasted 1-2 hours. There was minor abdominal discomfort noted on physical examination. The Veteran reported the episodes of abdominal cramps and loose stools interfered with work, activities of daily life, and socialization. The Veteran has submitted multiple statements in support of her claim reporting alternating periods of diarrhea and constipation at least once or twice per month with abdominal pain during these periods. See, e.g., February 2011 Statement, May 2015 Correspondence. While the Veteran does not receive routine medical care for IBS, VA treatment records do document intermittent complaints relating to IBS. February 2010 primary care notes show the Veteran complained of episodes of gastric cramping, vomiting, and diarrhea twice per month and that she takes docusate for constipation. In April 2017 she reported low and middle abdominal pain for two weeks with some nausea and constipation but no vomiting or diarrhea. September 2018 notes show constipation and diarrhea due to IBS. However, the VA records also show the Veteran routinely denied any gastrointestinal symptoms. For example, a November 2016 OB-GYN consultation was negative for nausea, vomiting, diarrhea, and constipation. In October and December 2017, she denied symptoms including nausea, vomiting, diarrhea, and constipation. She denied abdominal pain, constipation, diarrhea, nausea, and vomiting in February 2018, and July 2018 clinic notes shows review of gastrointestinal symptoms was negative for nausea, vomiting, abdominal pain, melena, hematochezia, hematemesis, constipation, and diarrhea. April 2020 telephone notes show she denied abdominal pain, constipation, or diarrhea. At the February 2021 Board hearing, the Veteran testified that her symptoms come and go depending on what she eats, with flareups at least twice per month. She also reported that the symptoms were about the same as had been documented in the February 2010 VA examination. The Board finds that a rating more than 10 percent is not warranted for the Veteran’s IBS at any time during the appeal period under consideration. Specifically, the Board finds that the evidence does not show that the Veteran’s IBS symptoms are severe, in that there is no finding of constant abdominal distress which is required for a higher 30 percent rating. The Board acknowledges the Veteran’s reports of alternating diarrhea and constipation, and that her symptoms have been the same since she was last afforded a VA examination. however, the Veteran has regularly reported that she has diarrhea and abdominal distress approximately twice per month. VA treatment records throughout the appeals period show she denied abdominal symptoms, including constipation and diarrhea, far more frequently than such symptoms were present. The VA examination indicates the absence of constant abdominal distress. There are no medical findings to the contrary such that constant abdominal distress is evidenced. Further, the Veteran’s lay statements and Board hearing testimony indicate she experiences abdominal distress approximately twice per month. Although the IBS has been documented to affect the Veteran’s ability to work, the evidence shows intermittent episodes of abdominal distress and bowel disturbance. More or less constant abdominal distress, which is required for a 30 percent evaluation under Diagnostic Code 7913, is not shown. As such, the Board finds that a rating more than 10 percent is not warranted for the Veteran’s IBS. The claim is denied. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Morse 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.