Citation Nr: 21041691 Decision Date: 07/09/21 Archive Date: 07/09/21 DOCKET NO. 09-33 801 DATE: July 9, 2021 ORDER Entitlement to service connection for irritable bowel syndrome (IBS) is granted. FINDING OF FACT The Veteran's IBS began in service and has continued since service. CONCLUSION OF LAW The criteria for entitlement to service connection for IBS have been met. 38 U.S.C. §§ 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303(d) (2021). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1979 to April 1988. This matter came before the Board of Veterans Appeals (Board) on appeal from a June 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). This case has a lengthy procedural history and has been twice appealed to the United States Court of Appeals for Veterans Claims (Court). Most recently, in May 2021, the Court granted a Joint Motion for Remand (JMR), which vacated the November 2020 Board decision that denied entitlement to service connection for IBS and remanded the issue on appeal for readjudication in accordance with the JMR. 1. Entitlement to service connection for irritable bowel syndrome (IBS) The Veteran contends that his IBS began during service and has continued since service. Upon review of the evidence of record, the Board concludes that the Veteran's IBS was incurred during active service and that service connection is therefore warranted. Service connection may be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). 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 disability or injury; and (3) a nexus between the claimed in-service disability 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). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154(a). Lay testimony is competent to prove that a claimant exhibited certain lay-observable symptoms and the time that those symptoms appeared. Layno v. Brown, 6 Vet. App. 465, 470 (1994). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). For benefits to be denied, "the preponderance of the evidence must be against the claim." Id. at 54. In this case, service treatment records show the Veteran developed digestive symptoms during service. Specifically, June 1985 service treatment records indicate the Veteran was treated for stomach aches, cramping, nausea, and diarrhea. February 1986 service treatment records show daily "stomach aches since April 1985" as well as nausea and vomiting. The Veteran's IBS symptoms are well documented after service. May 1989 private medical records noted the Veteran was vomiting on and off for three weeks and also noted cramps. April 2002 private medical records show the Veteran was experiencing intermittent lower abdominal pain. March 2008 private medical records also show abdominal pain. In addition, August 2009 private medical records noted complaints of diarrhea, 4 to 5 times per day, abdominal bloating, cramping, and loose stools. Lastly, December 2010 private medical records show a diagnosis of IBS and symptoms to include abdominal pain with cramps, bloating and diarrhea 3 to 4 times per day. The Board notes that prior Board and CAVC decisions found the March 2011 and July 2016 VA opinions to be inadequate. As the opinions have already been found to be inadequate, the Board will not address them herein. A March 2020 VA examination diagnosed the Veteran with IBS. The examiner noted that the Veteran reported onset of IBS during active duty. Additionally, the examiner listed the 1980s as the date of diagnosis. While the examiner opined that the Veteran's IBS is less likely than not proximately due to the Veteran's service-connected GERD, the examiner did not address the theory of direct service connection. In regard to the diagnosis of IBS noted by the March 2020 examiner, the Board finds the examination and diagnosis rendered adequate for appellate review. There is no evidence that the examiner was not competent or credible, and as the report is based on the Veteran's statements, in-person examination and the examiners' observations, the Board finds it is entitled to significant probative weight. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 30205 (2008). As noted, however, the only opinion provided was as to secondary service connection and not as to direct service connection. As such, the opinion is not relevant as to the question of whether the diagnosed IBS was incurred in service. In a November 2010 statement, the Veteran said he had been going to the doctor for 17 months with "very bad diarrhea" and that he was finally diagnosed with IBS, which he stated would explain his belly pain, cramps and diarrhea in the military. In his July 2011 Notice of Disagreement, he stated that he experienced pain, bloating, gas, cramping and diarrhea in service. In an August 2016 statement, the Veteran said he went to sick call three times for diarrhea, cramping and weight flux. The Board notes that the Veteran is competent to report his lay observable symptoms, such as abdominal pain, cramps and diarrhea, and their onset. Therefore, the Board assigns his statements significant probative weight. The Board finds that the competent evidence of record indicates that the Veteran has a current diagnosis of IBS that was incurred during service and has been continuous since service. Service treatment records document symptoms of IBS in service, the March 2020 VA examiner diagnosed the Veteran with IBS and the competent lay evidence of record indicates that symptoms of IBS began in service and have continued since service. Significantly, the March 2020 VA examiner listed a diagnosis in the 1980s, consistent with the Veteran's reports of onset. Therefore, there simply is no basis upon which to disassociate the current symptoms of IBS from the documented manifestations in service and after service. Accordingly, service connection is warranted. 38 C.F.R. §§ 3.102, 3.303(d). E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Y. Akkad 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.