Citation Nr: 22017764 Decision Date: 03/26/22 Archive Date: 03/26/22 DOCKET NO. 17-57 168 DATE: March 26, 2022 ORDER Entitlement to an initial disability rating of 30 percent, and no higher, for irritable bowel syndrome (IBS) is granted. FINDING OF FACT During the appeal period, the Veteran experienced severe symptoms of diarrhea or alternating diarrhea and constipation, with more or less constant abdominal distress. CONCLUSION OF LAW The criteria for entitlement to an initial disability rating of 30 percent, and no higher, for IBS, have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.3, 4.114, Diagnostic Code 7319. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 2011 to March 2015. This matter is on appeal from an August 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO), which, in pertinent part, granted entitlement to service connection for IBS and assigned a noncompensable rating. The Veteran timely perfected an appeal. See March 2016 Notice of Disagreement; September 2017 Statement of the Case; October 2017 VA Form 9. In December 2019, the Board, in pertinent part, remanded the issue of entitlement to a compensable rating for IBS, as well as the issue of entitlement to service connection for an acquired psychiatric disorder, for additional development. Thereafter, in an August 2020 rating decision, the RO granted entitlement to service connection for PTSD. Accordingly, that issue is no longer on appeal. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997). The Board notes that the Veteran has appealed the initial rating assigned for PTSD in the August 2020 rating decision. See September 2020 VA Form 10182. However, this issue will be addressed in a later decision. Increased Rating for IBS The Veteran contends that he is entitled to a higher rating for his IBS, which is currently assigned a noncompensable rating pursuant to 38 C.F.R. § 4.114, Diagnostic Code 7319. Disability ratings are determined by the application of the VA's Schedule for Rating Disabilities. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. § Part 4. Ratings for service-connected disabilities are determined by comparing the Veteran's symptoms with criteria listed in VA's Schedule for Rating Disabilities, which is based, as far as practically can be determined, on average impairment in earning capacity. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. The Veteran's entire history is to be considered when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Where the question for consideration is the propriety of the initial evaluation assigned, evaluation of the medical evidence since the grant of service connection is required. Fenderson v. West, 12 Vet. App. 119, 126 (1999). The Board will also consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Hart v. Mansfield, 21 Vet. App. 505 (2007). In making all determinations, the Board must fully consider the lay assertions of record. A Veteran is competent to report on that of which he or she has personal knowledge. Layno v. Brown, 6 Vet. App. 465, 470 (1994). When considering whether lay evidence is competent the Board must determine, on a case-by-case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. IBS is rated pursuant to Diagnostic Code 7319, which provides that a noncompensable rating is warranted for mild symptoms of IBS with disturbances of bowel function with occasional episodes of abdominal distress; a 10 percent rating is warranted for moderate symptoms of IBS with frequent episodes of bowel disturbance with abdominal distress; and a 30 percent rating is warranted for severe symptoms of IBS with diarrhea or, alternating diarrhea and constipation with more or less constant abdominal distress. 38 C.F.R. § 4.114. Descriptive words "slight," "moderate" and "severe" as used in the various diagnostic codes are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all the evidence for "equitable and just decisions." 38 C.F.R. § 4.6. After reviewing the record, the Board resolves all reasonable doubt in the Veteran's favor and finds that he is entitled to a 30 percent rating during the entire appeal period. The totality of the evidence of record suggests that the Veteran's IBS symptoms have been manifested by severe diarrhea or alternating diarrhea and constipation, with more or less constant abdominal distress. The Veteran has consistently reported more or less constant abdominal distress due to severe diarrhea or alternating diarrhea and constipation. These statements are supported by VA treatment records, which show complaints of diarrhea and constipation. See, e.g., December 2015 VA Treatment Record (diarrhea and rectal bleeding); February 2016 VA Treatment Record (bloody diarrhea with abnormal CT scan); March 2016 VA Treatment Record (two episodes of loose stools per day with cramps); January 2018 Private Treatment Record (constipation and diarrhea). The Veteran was afforded a VA examination in August 2015. He reported diarrhea at least three times per week with cramps. The examiner indicated that the Veteran had occasional episodes of bowel disturbance with abdominal distress. The Veteran was afforded a VA examination in April 2020. He reported diarrhea five to six times per day, followed by two days of constipation with stomach pain. He also reported urgency with diarrhea and that he was hospitalized in 2016 for dehydration due to diarrhea. The examiner noted that the Veteran had alternating diarrhea and constipation, abdominal distension, and nausea. The examiner indicated that the Veteran had frequent episodes of bowel disturbance with abdominal distress. The Board finds that these IBS symptoms present a severe disability picture that warrants a 30 percent rating during the entire appeal period. While the VA examiners categorized the Veteran's episodes of bowel disturbance and abdominal distress as no more than "frequent," the Board finds that based on the Veteran's statements, which are supported by the medical record, the Veteran experiences abdominal pain and alternating diarrhea and constipation daily, and that his symptoms are in fact, severe. As such, resolving all reasonable doubt in the Veteran's favor, the Board finds that a 30 percent rating is warranted for his service-connected IBS during the entire appeal period. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.114, Diagnostic Code 7319. The Board notes that the 30 percent rating is the highest rating available for IBS, and this disability is specifically listed in the VA rating schedule. Therefore, a higher rating for IBS is not available. See Copeland v McDonald, 27 Vet. App. 333 (2015). B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Kipper, 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.