Citation Nr: 22031991 Decision Date: 06/01/22 Archive Date: 06/01/22 DOCKET NO. 18-44 901 DATE: June 1, 2022 ORDER Entitlement to service connection for irritable bowel syndrome (IBS) is granted. Entitlement to service connection for residuals of left shoulder disability is granted. FINDINGS OF FACT 1. The Veteran's IBS began during active service and has existed since that time. 2. The Veteran's left shoulder disability began during active service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for IBS are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for entitlement to service connection for a left shoulder disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from September 2004 until his honorable discharge in June 2015. These matters come before the Board of Veterans' Appeals (Board) on appeal from a February 2016 rating decision by the St. Louis, Missouri Regional Office (RO) of the United States Department of Veterans Affairs (VA). In December 2021, the Veteran and his spouse testified at a virtual Board hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing has been associated with the record on appeal. During the hearing, the undersigned held the record open for 60 days to allow for the submission of additional evidence; however, no additional evidence was added to the record within that time period. 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. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service - the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In addition, service connection for certain chronic diseases, may be established on a presumptive basis by showing that the condition manifested to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258, 271-72 (2015). Although the disease need not be diagnosed within the presumptive period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). Additionally, for certain chronic diseases with potential onset during service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). 1. Entitlement to service connection for IBS The Veteran asserts that his IBS began during service and has existed since that time. First, affording the Veteran the benefit of the doubt, the Board finds that there is a current disability. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). The Veteran was afforded a VA examination in January 2016. The January 2016 VA examiner did not diagnose the Veteran with IBS. See January 2016 VA examination, p. 1 of 5. However, during the January 2021 Board hearing, the Veteran's spouse testified that she was a [nurse] practitioner and discussed the criteria for a diagnosis of IBS and diagnosed the Veteran with IBS. See Board Hearing Transcript, pp. 20-21. Second, the Board finds that there was an in-service event, injury or disease. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). During the January 2021 Board hearing, the Veteran and his spouse credibly testified that his IBS began during his active military service, and has existed since that time. Third, the Board finds that the evidence of record does support a finding that the Veteran's IBS is related to active service because it began during his active military service and has existed since that time. Accordingly, entitlement to service connection for IBS is granted. 2. Entitlement to service connection for residuals of left shoulder disability The Veteran asserts that his left shoulder disability began during service and has existed since that time. First, the Board finds that there is a current disability. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). During the Veteran's January 2022 Board hearing, the Veteran credibly testified to left shoulder pain that requires his sleeping on his back to be able to sleep. Second, the Board finds that there was an in-service event, injury or disease. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). The Veteran's service treatment records reflect numerous complaints of pain in his left shoulder beginning no later than May 2006. Third, the Board finds that the evidence of record does support a finding that the Veteran's left shoulder disability is related to active service. The record reflects an in-service onset and the Veteran credibly testified to continuity of symptomatology from his service to present. Accordingly, entitlement to service connection for left shoulder disability is granted. M. Tenner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Deemer, 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.