Citation Nr: 22009112
Decision Date: 02/16/22	Archive Date: 02/16/22

DOCKET NO. 15-17 490
DATE: February 16, 2022

ORDER

Service connection for gastroesophageal reflux disease (GERD) and hiatal hernia on a secondary basis is granted.

FINDING OF FACT

The evidence as to whether the Veteran's GERD and hiatal hernia were caused or aggravated by his service-connected gout and or medication used to treat his gout is at least in relative equipoise.

CONCLUSION OF LAW

The criteria service connection for GERD and hiatal hernia on a secondary basis have been met.  38 U.S.C. §§ 1110, 1131, 5107;38 C.F.R. §§ 3.102, 3.310. 

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran testified before the undersigned Veterans Law Judge in a July 2018 videoconference hearing.  A transcript of that hearing has been associated with the file.

Service Connection

Establishing service connection generally requires medical evidence or, in certain circumstances, lay evidence of the following: (1) A current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) nexus between the claimed in-service disease and the present disability.  See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).

Secondary service connection may be granted for a disability that is proximately due to, or aggravated by, a service-connected disease or injury.  38 C.F.R. § 3.310.

As mentioned in the January 2021 Board remand, the theory of entitlement on a secondary basis has been raised by the record.  Specifically, by way of the November 2020 Brief the Veteran's representative argued that gout is a result of a build-up of uric acid crystals which takes time to gradually develop, and this gradual development can be true of GERD and hiatal hernia.  

Upon review of the record, the Board finds that service connection for GERD and hiatal hernia is warranted on a secondary basis.

The May 2021 VA Esophageal Conditions Disability Benefits Questionnaire (DBQ) confirms a diagnosis of GERD and hiatal hernia, noting the diagnosis date of each as 2006.  

In a June 2020 rating decision, the RO granted service connection for the Veteran's gout. 

In May 2021 a VA examiner provided opinions regarding the Veteran's GERD and hiatal hernia.  In one of the opinions, the examiner opined that it is at least as likely as not that the Veteran's GERD was aggravated by his service-connected gout.  The examiner went on to state that the GERD was present prior to the gout diagnosis, but that medication used to treat gout will cause progression of GERD.  

The Board acknowledges that there are negative opinions of record.  Nevertheless, given the current diagnosis and the May 2021 VA positive opinion the Board finds that the evidence of record is at least in relative equipoise.  Therefore, service connection for GERD/hiatal hernia on a secondary theory of entitlement is granted.  

 

 

H.M. WALKER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	T. Talamantes, 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.