IBS & irritable bowel decisions — 2011

The Veteran's IBS with history of GERD and sliding hiatal hernia is not rated higher than 10 percent for the period from July 1, 2005 to May 25, 2009. For the period since May 26, 2009, a separate rating of 30 percent for chronic laryngitis due to GERD is granted. Service connection was denied for right wrist disability and duodenitis/PUD.

The Veteran's irritable bowel syndrome is found to be secondary to his service-connected duodenal ulcer, and the claim for service connection is granted.

The Board has determined that the Veteran's digestive system disability, including gastritis, irritable bowel syndrome (IBS), and small hiatal hernia, began in service and has continued since. Therefore, service connection is granted.

The Veteran's IBS and hiatal hernia are currently manifested by complaints of constipation, diarrhea, pain, gas, noisy stomach, hard bowels, regurgitation, heartburn, and intermittent upper abdominal pain. These symptoms have been rated as moderate in severity.

The Board granted service connection for a sleep disorder, muscle discomfort as secondary to PTSD and headaches, bilateral hearing loss, tinnitus, irritable bowel syndrome, and gastroesophageal reflux disease. The Veteran's right ankle disability was rated at 20 percent, with an additional 10 percent rating for the scar resulting from surgery in September 2008.

The Veteran's service-connected IBS was rated at 10% from July 1998 to April 4, 2009. Effective April 4, 2009, the Veteran is entitled to a 30% disability rating for his service-connected IBS.

The Veteran is granted service connection for CFS and IBS, which are medically unexplained chronic multisymptom illnesses. Service connection is also granted for bilateral carpal tunnel syndrome (CTS) as it can be presumed due to Persian Gulf War service. The claim for an acquired psychiatric disorder remains pending.

The Board has granted service connection for irritable bowel syndrome, finding that it is presumptively associated with the Veteran's service in the Southwest Asia theater of operations during the Persian Gulf War.

The Veteran's service-connected perforation of the liver and cecum status-post cholecystectomy is rated at 10 percent, reflecting moderate symptoms such as pulling pain on attempting work or aggravated by movements of the body, occasional episodes of colic pain, nausea, constipation (perhaps alternating with diarrhea) or abdominal distension. The Veteran's GERD and IBS are not service-connected.

The Veteran's service-connected disabilities, by themselves, do not render him unemployable. His combined disability rating is 70 percent.

The Veteran's service-connected musculoskeletal low back pain with sciatic neuropathy is currently rated at 20 percent, but the evidence does not support a higher rating.,Separate ratings of 10 percent each are assigned for neuropathy of the right and left lower extremities due to the service-connected low back disability.,The Veteran's irritable bowel syndrome and GERD do not meet the criteria for a separate rating in excess of 10 percent.,There is no evidence that the Veteran's anterior lipomas, fusion of the right foot and ankle, right leg reflex sympathetic dystrophy, chronic nerve pain of the right leg, or atrophy of the right leg are related to her service-connected low back disability or other service-connected conditions.,Service connection for these conditions cannot be established.

The Veteran's claims for service connection for recurrent otitis externa, hemorrhoids, and irritable bowel syndrome have been granted with a 30 percent initial rating effective May 2007.

The Board found that the Veteran's irritable bowel syndrome was incurred during active service, resolving reasonable doubt in his favor.

The Board found that the Veteran's gastrointestinal disorders, including ulcer, GERD and IBS with chronic constipation, were not incurred during service or related to her service-connected disabilities.

The Board denied the Veteran's claim for an increased rate of SMC on the basis of the need for aid and attendance of another person for purposes of accrued benefits, finding that evidence in VA's possession at the time of the Veteran's death was insufficient to establish a factual need for regular aid and attendance due to service-connected disabilities.

The Board has granted service connection for PTSD, irritable bowel syndrome (IBS), and denied service connection for fibromyalgia. The Veteran's PTSD is presumed to be due to military sexual trauma during service in the Southwest Asia Theater of operations. IBS is presumed to be related to service in the Gulf War. Fibromyalgia was not found to be incurred or aggravated by service.

The Veteran's appeal was dismissed because he did not file a timely substantive appeal within the required timeframe.

The Veteran's initial ratings for non-specific headaches and irritable bowel syndrome with gastroesophageal reflux disease have been granted, but the rating for irritable bowel syndrome is at its maximum allowable under VA regulations.

The Veteran's service-connected left arm condition is not productive of limitation of motion to midway between the side and shoulder level or at the shoulder level, even taking into account repetitive motion testing and his complaints of pain.,The Veteran's service-connected left knee condition is not productive of flexion limited to 45 degrees or less nor extension limited to 10 degrees or more, even taking into account repetitive motion testing and his complaints of pain. The Veteran's left knee instability is only slight.,The Veteran's service-connected right knee condition does not meet the criteria for a compensable evaluation as it is productive of no more than slight instability.,The Veteran's service-connected CAD is not productive of a workload of greater than 5 METs but not greater than 7 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope, or evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray.,The Veteran's service-connected left carpal tunnel syndrome and cubital tunnel syndrome with ulnar neuropathy is productive of no more than moderate incomplete paralysis of the ulnar nerve.,The Veteran's service-connected right carpal tunnel syndrome does not meet the criteria for a compensable evaluation as it is only mild incomplete paralysis of the median nerve.,The Veteran's service-connected arthritis of the right hand does not meet the criteria for a compensable evaluation as there are no more than noncompensable limitations in range of motion of the right wrist and each finger on the right hand, with no evidence of incapacitating exacerbations.,The Veteran's service-connected GERD is not productive of diastolic pressure predominantly less than 100 or systolic pressure predominantly less than 160.

The Veteran's claims for service connection for PTSD, tinnitus, gastrointestinal disability, irritable bowel syndrome, and hypertension have been denied. The case is remanded to obtain further medical opinions regarding the etiology of these conditions.