IRRITABLE COLON SYNDROME (SPASTIC COLITIS MUCOUS COLITIS)

Summary

The Veteran served from September 1988 to July 1992. This case comes before the Board of Veterans' Appeals (Board) following a remand in September 2024. The Veteran initially appealed the denial of service connection for several conditions, including irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), hypertension, obstructive sleep apnea (OSA), diabetes mellitus type II (DM), lower back disability, bilateral hip degenerative arthritis, abdominal aortic aneurysm, and a heart condition. Subsequent rating decisions from January and March 2025 granted service connection for hypertension, OSA, DM, lumbar spondylosis, bilateral hip arthritis, abdominal aortic aneurysm, GERD, and a heart condition. As these issues were fully granted, they are no longer before the Board. The sole remaining issue is entitlement to service connection for IBS. The Board reviewed a VA opinion from October 2024, which found that the Veteran's IBS was likely aggravated by his service-connected PTSD. The clinician noted that chronic psychological stress from PTSD can worsen IBS symptoms. While other negative nexus opinions were of record, they did not address the aggravation of IBS by PTSD. The Board found it was at least as likely as not that IBS was aggravated by PTSD, thus granting service connection for IBS. A direct service connection analysis was deemed unnecessary as it would not provide additional relief, given the clinician could not establish a baseline IBS severity prior to aggravation.

Rationale

VA opinion found likely aggravation by PTSD; Chronic psychological stress from PTSD can worsen IBS symptoms; Service connection warranted due to aggravation

Full Decision Text

Citation Nr: 25008737
Decision Date: 07/02/25	Archive Date: 07/02/25

DOCKET NO. 06-11 813
DATE: July 2, 2025

ORDER

Entitlement to service connection for irritable bowel syndrome (IBS) is granted.

FINDING OF FACT

The evidence establishes that it is at least as likely as not that the Veteran's IBS was aggravated by his service-connected posttraumatic stress disorder (PTSD).

CONCLUSION OF LAW

The criteria for service connection for IBS have been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from September 1988 to July 1992.  This matter comes to the Board of Veterans' Appeals (Board) on appeal from a June 2009 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).

This matter was most recently remanded in September 2024.  The case has been returned to the Board at this time for further appellate review.

The Board notes that the claims of entitlement to service connection for gastroesophageal reflux disease (GERD), hypertension, obstructive sleep apnea (OSA), diabetes mellitus, type II, (DM), a lower back disability, bilateral hip degenerative arthritis, abdominal aortic aneurysm, and a heart disability were remanded in September 2024.  Subsequently, service connection for hypertension, OSA, DM, degenerative disc disease with lumbar spondylosis, left hip arthritis, right hip arthritis, and abdominal aortic aneurysm (also claimed as heart condition) were granted in a January 2025 rating decision.  In addition, service connection for GERD was granted in a March 2025 rating decision.  

As these decisions constitute a full grant of the benefits sought on appeal, the issues of entitlement to service connection for GERD, hypertension, OSA, DM, a lower back disability, bilateral hip degenerative arthritis, abdominal aortic aneurysm, and a heart disability are no longer before the Board.  See Grantham v. Brown, 114 F.3d 1156, 1158-59 (1997) (ratings and effective dates are downstream issues, which must be separately appealed).

Finally, the Board notes that, as the issue on appeal is being granted in full, any failure to comply with prior remand directives is not prejudicial to the Veteran.

Entitlement to service connection for IBS is granted.

Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service.  38 U.S.C. §§ 1110; 38 C.F.R. § 3.303.

Establishing service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the current disability.  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Service connection may also be granted when a claimed disability is found to be proximately due to or the result of a service-connected disability, or when any increase in severity (aggravation) of a nonservice-connected disease or injury is found to be proximately due to or the result of a service-connected disability.  38 C.F.R. § 3.310.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant.  38 U.S.C. § 5107; 38 C.F.R. § 3.102.

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A VA opinion was obtained in October 2024 which reflects the clinician's opinion that the Veteran's IBS has likely been aggravated beyond its natural progression by his service-connected PTSD.  Specifically, the clinician noted that the chronic psychological stress and anxiety associated with PTSD can lead to increased gastrointestinal distress, thereby worsening the symptoms of IBS, underscoring the importance of addressing both the psychological and physiological aspects of the Veteran's health.  The Board acknowledges the other negative nexus opinions of record from October 2024 and February 2025, however, they do not address aggravation of the Veteran's IBS by his service-connected PTSD.  Accordingly, the Board finds that it is at least as likely as not that the Veteran's IBS was aggravated by his service-connected PTSD, and
 which reflects the clinician's opinion that the Veteran's IBS has likely been aggravated beyond its natural progression by his service-connected PTSD.  Specifically, the clinician noted that the chronic psychological stress and anxiety associated with PTSD can lead to increased gastrointestinal distress, thereby worsening the symptoms of IBS, underscoring the importance of addressing both the psychological and physiological aspects of the Veteran's health.  The Board acknowledges the other negative nexus opinions of record from October 2024 and February 2025, however, they do not address aggravation of the Veteran's IBS by his service-connected PTSD.  Accordingly, the Board finds that it is at least as likely as not that the Veteran's IBS was aggravated by his service-connected PTSD, and thus, service connection for IBS is warranted.

In this regard, the Board notes that an analysis of whether entitlement to service connection for IBS is warranted on a direct service connection basis is not necessary, as this would not lead to any effectual relief whatsoever to the Veteran.  Specifically, the October 2024 VA opinion reflects that the clinician found that they could not determine a baseline level of severity of the Veteran's IBS prior to aggravation by the service-connected PTSD.  Therefore, there should not be any deduction to the rating for his now service-connected IBS, and granting service- connection on a direct basis would not lead to any effectual relief whatsoever to the Veteran.

 

 

M. HYLAND

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Elias, M

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.