HYPERTENSION

Summary

The veteran, who served in the Army from May 1985 to May 1986, appeals the denial of service connection for hypertension and seeks an increased rating for his service-connected polypectomy with colectomy and adhesions. The Board denied service connection for hypertension, finding no evidence of in-service incurrence, aggravation, or continuity of symptomatology, and noting the Veteran's testimony that he did not have high blood pressure during service. A VA examiner opined that the hypertension was less likely than not related to service, attributing it to genetics, obesity, and lifestyle, and found no causal link to the Veteran's service-connected conditions. For the polypectomy with colectomy and adhesions, the Veteran sought an increased rating. The Board acknowledged the Veteran's consistent reporting of symptoms like abdominal pain, constipation, and distention since surgery, and his need for daily pads. Applying the benefit of the doubt doctrine due to relative equipoise in the evidence, the Board found the symptoms warranted the maximum pre-May 2024 rating of 50 percent for polypectomy with colectomy and adhesions from May 5, 2010, to November 15, 2020. However, the Board denied an increased rating beyond 50 percent from November 16, 2020, finding the evidence did not support the criteria for severe obstruction under the current rating schedule.

Rationale

No evidence of in-service diagnosis or continuity of symptomatology.; VA examiner opined less likely than not related to service.; Hypertension attributed to genetics, obesity, and lifestyle.

Full Decision Text

Citation Nr: 26000629
Decision Date: 01/20/26	Archive Date: 01/20/26

DOCKET NO. 11-22 046
DATE: January 20, 2026

ORDER

Entitlement to service connection for hypertension, to include as secondary to service-connected disabilities, is denied.

Entitlement to a disability rating of 50 percent, but no higher, is granted from May 5, 2010, to November 15, 2020, for polypectomy with colectomy and adhesions; a disability rating in excess of 50 percent from November 16, 2020, for service-connected polypectomy with colectomy and adhesions is denied.

FINDINGS OF FACT

1. The Veteran's hypertension is not causally or etiologically related to an in-service injury, event or disease and was not caused or aggravated by polypectomy with colectomy and adhesions, major depressive disorder, urethral stricture, or erectile dysfunction.

2. For the entire period on appeal, the Veteran's polypectomy with colectomy and adhesions has been severe, with partial obstruction residuals including symptomatology of distension, abdominal pain, diarrhea and constipation; after May 19, 2024, the Veteran did not have a persistent partial bowel obstruction that is inoperable and refractory to treatment or required total parenteral nutrition for obstructive symptoms.

CONCLUSIONS OF LAW

1. The criteria for service connection for hypertension have not been met.  

38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.303, 3.310.

2. The criteria for a 50 percent rating, but no higher, for polypectomy with colectomy and adhesions have been met from May 5, 2010, to November 15, 2020.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.114, Diagnostic Code (DC) 7329-7301.

3. The criteria for a rating in excess of 50 percent from November 16, 2020, have not been met.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.114, DC 7329-7301.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from May 1985 to May 1986, with additional service in the Army National Guard.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in September 2010 by a Department of Veterans Affairs (VA) Regional Office, the Agency of Jurisdiction (AOJ). 

In July 2011 the Veteran testified at a hearing before a Decision Review Officer (DRO).  In June 2012, the Veteran testified at a hearing before a Veterans Law Judge (VLJ).  Copies of both proceedings are associated with the electronic claims file.  Unfortunately, the VLJ who conducted the June 2012 hearing is no longer available to participate in the Veteran's appeal.  In September 2025, the Veteran was informed that he has the right to request another optional Board hearing.  The Veteran did not respond to the letter and so it is presumed he has waived his right to testify before another VLJ. 

The issues on appeal were previously remanded by the Board in May 2014, November 2017, September 2020, June 2021, April 2024, and April 2025 for further development; the case now returns for further appellate review.  The Board finds there has been substantial compliance with its remand directives.  See Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board has previously addressed the issue of TDIU on appeal and granted entitlement to an earlier effective date for this issue in an April 2025 Board decision.  The Board has reviewed the record and the effectuating AOJ decision.  After consideration of the record and the evidence of file, the Board finds that the issue of TDIU is not further raised by the record and need not be addressed again as part and parcel of this decision.

As a final preliminary matter, the Board acknowledges that a VA examiner submitted materials that contained a hyperlink to content that is not otherwise part of the record on appeal.  While the Board could review evidence submitted via hyperlink, because hyperlinked information may not be static, the Board would be unable to determine whether what the Board saw when
 issue of TDIU on appeal and granted entitlement to an earlier effective date for this issue in an April 2025 Board decision.  The Board has reviewed the record and the effectuating AOJ decision.  After consideration of the record and the evidence of file, the Board finds that the issue of TDIU is not further raised by the record and need not be addressed again as part and parcel of this decision.

As a final preliminary matter, the Board acknowledges that a VA examiner submitted materials that contained a hyperlink to content that is not otherwise part of the record on appeal.  While the Board could review evidence submitted via hyperlink, because hyperlinked information may not be static, the Board would be unable to determine whether what the Board saw when it accessed the hyperlinked information was what the examiner intended to rely on.  As the Board cannot create evidence, what was found at the hyperlinked address would not be part of the record.  In turn, the United States Court of Appeals for Veterans Claims (Court) would be unable to perform meaningful appellate review of evidence that is not in the record.  Given the foregoing, the Board advises that hyperlinked references were not reviewed.

1. Entitlement to service connection for hypertension, to include as secondary to service-connected disabilities. 

The Veteran is seeking service connection for hypertension. 

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1131, 5107; 38 C.F.R.     § 3.303.  The three-element test for direct service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

In order to establish entitlement to service connection on a secondary basis, there must be: (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a nexus (i.e., link) between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).  Secondary service connection may be granted for a disability that is proximately due to, or aggravated by, a service-connected condition. 38 C.F.R. § 3.310.

Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease.  38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.303, 3.307, 3.309; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

Presumptive service connection on the basis of exposure to certain herbicide agents is warranted where a veteran sustained exposure to such herbicide agents during active military, naval, or air service, and subsequently manifested a specific disease, including hypertension, to a degree of 10 percent within a specified period. See 38 U.S.C. § 1116 (a); 38 C.F.R. §§ 3.307 (a)(6), 3.309(e). 

The evidence of record does not raise the issue of exposure to herbicide agents during the Veteran's year of military service, and the Veteran does not contend exposure to such.  Thus, this theory of service connection will not be discussed further.

Next, the Board notes that hypertension is considered a chronic disability. However, the record does not show that the Veteran's hypertension manifested or was diagnosed during active-duty service or within a year following separation of active-duty service, and the Veteran has not asserted a continuity of symptomatology has been established. Therefore, service connection is not warranted on this basis.

Direct Service Connection

The Veteran was diagnosed with hypertension in approximately 2002.  

The Veteran's medical examination upon entering military service and subsequent service treatment records (STRs) do not reveal a chronic issue with high blood pressure or a diagnosis of hypertension.  Additionally, during his Board hearing in June 2012, the Veteran testified that he did not have problems with hypertension during service.  Furthermore, there is no other competent or credible evidence indicating the Veteran's hypertension had its onset during service.

The Veteran was afforded a VA examination in January 2024 and the examiner concluded that the
 separation of active-duty service, and the Veteran has not asserted a continuity of symptomatology has been established. Therefore, service connection is not warranted on this basis.

Direct Service Connection

The Veteran was diagnosed with hypertension in approximately 2002.  

The Veteran's medical examination upon entering military service and subsequent service treatment records (STRs) do not reveal a chronic issue with high blood pressure or a diagnosis of hypertension.  Additionally, during his Board hearing in June 2012, the Veteran testified that he did not have problems with hypertension during service.  Furthermore, there is no other competent or credible evidence indicating the Veteran's hypertension had its onset during service.

The Veteran was afforded a VA examination in January 2024 and the examiner concluded that the Veteran's hypertension is less likely than not incurred in or caused by an in-service injury, event, or illness.  The examiner noted that while the STRs show incidental increase in blood pressure, the Veteran was not diagnosed with hypertension until nearly 16 years after service.  Additionally, medical treatment records document that the Veteran's high blood pressure was related to obesity and diet.  

The Board affords the January 2024 medical examination and opinion probative value.  The report shows the examiner contemplated the relevant evidence of record, the Veteran's relevant medical history, and provided a thorough rationale.   

In sum, the probative evidence of record is against finding direct service connection, thus, the Veteran's claim must be denied on a direct service connection theory of entitlement.  

Secondary Service Connection

Moving to the theory of secondary service connection, the Veteran has asserted that his blood pressure issues are a result of the problems with his bowels and stress.  He also asserted the hypertension is due to his colon surgery and residuals.  See December 2011 VA examination.  

The Veteran is service-connected for polypectomy with colectomy and adhesions from November 1, 1987, major depressive disorder associated with polypectomy from May 5, 2010, urethral stricture from May 5, 2010, abdominal scars associated with polypectomy from May 5, 2010, erectile dysfunction associated with major depressive disorder from May 5, 2010, and hemorrhoids associated with polypectomy from May 5, 2010. 

VA provided a medical opinion in April 2025, and the examiner opined that it is less likely than not that the Veteran's hypertension is proximately due to or the result of the Veteran's polypectomy, major depressive disorder, urethral stricture or erectile dysfunction.  While the examiner did not opine as to whether hypertension is secondary to his abdominal scars or hemorrhoids, the Board finds that those issues have not been raised by the Veteran or the record and thus, an opinion is not required.  The examiner determined that medical literature does not support a causal connection between hypertension, polypectomy, major depressive disorder, urethral stricture or erectile dysfunction.  The examiner also noted that while there is not a single, clear cause for hypertension, it may develop due to environmental or genetic causes, or it may be secondary to renal, vascular and endocrine causes. None of the Veteran's service-connected conditions involve the renal, vascular, or endocrine systems.  The examiner further opined that the Veteran's hypertension is more than likely due to the Veteran's genetics of a father with hypertension, morbid obesity, and lifestyle choices. 

The VA examiner specifically addressed whether stress causes development of hypertension and concluded it does not.  Medical literature does support that stress causes the heart to beat faster than usual, enabling the heart to pump more blood to the body organs and muscles, thus causing a short-term rise in blood pressure.  However, the aetiology of hypertension involves the complex interplay of environmental and pathophysiological factors that affect multiple systems, as well as genetic predisposition.  So while stress is a symptom of a mental health condition, medical literature does not support the hypothesis that depression leads to cardiovascular disease by increasing blood pressure.  

The VA examiner also concluded that the Veteran's hypertension is less likely than not aggravated beyond its natural progression by the Veteran's polypectomy, major depressive disorder, urethral stricture, and erectile dysfunction.  The examiner explained that blood pressure tends to rise with age because blood vessels naturally thicken and stiffen over time, and the medical literature does not support aggravation due to the service-connected conditions.  The VA examiner stated that although there is no evidence that aggravation has occurred, if it has, it is likely due to aging. 

Although obesity has been cited as a factor or cause in the development of the Veteran's hypertension, the Board finds that the record does not raise the question of whether a service-connected disability led to the hypertension, with obesity as an intermediary step.  The Board finds that the
 beyond its natural progression by the Veteran's polypectomy, major depressive disorder, urethral stricture, and erectile dysfunction.  The examiner explained that blood pressure tends to rise with age because blood vessels naturally thicken and stiffen over time, and the medical literature does not support aggravation due to the service-connected conditions.  The VA examiner stated that although there is no evidence that aggravation has occurred, if it has, it is likely due to aging. 

Although obesity has been cited as a factor or cause in the development of the Veteran's hypertension, the Board finds that the record does not raise the question of whether a service-connected disability led to the hypertension, with obesity as an intermediary step.  The Board finds that the opinions of record address the theories raised by the Veteran or otherwise raised by the record.

Upon review, the Board affords the VA examiner's opinions probative value.  In particular, the report shows the examiner contemplated the relevant evidence of record and provided clear rationales and conclusions, supported by medical literature.  Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions").  

The Board has considered the Veteran's lay assertions, and such were adequately addressed in the obtained VA opinions. The Board finds, due to the rationale and facts used, that the VA opinions are the most probative evidence of record.

For these reasons and bases, the probative evidence of record persuasively weighs against the claim for service connection on a direct or secondary basis, thus the benefit-of-the-doubt rule does not apply, and the service connection claim for hypertension must be denied.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

2. Entitlement to a rating in excess of 10 percent from May 5, 2010, to March 30, 2014, in excess of 20 percent from May 1, 2014 to November 15, 2020, and in excess of 50 percent from November 16, 2020, for service-connected polypectomy with colectomy and adhesions.

The Veteran contends entitlement to an increased rating for polypectomy with colectomy and adhesions. As previously defined by the Board and reflected in the current record, the appeal stems from May 5, 2010. 

Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity.  Separate DCs identify the various disabilities.  38 U.S.C. § 1155; 38 C.F.R. Part 4.  Each disability must be viewed in relation to its history, and the limitation of activity imposed by the disabling condition should be emphasized.  38 C.F.R. § 4.1.  Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the veteran working or seeking work.  38 C.F.R. § 4.2.  All reasonable doubt will be resolved in the claimant's favor.  38 C.F.R. § 4.3.  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.

Separate ratings can be assigned for separate periods based on the facts found - a practice known as "staged" ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).  Staged ratings are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings.  Id. 

The Board is cognizant that during the pendency of the appeal, the rating criteria for evaluating digestive disabilities under 38 C.F.R. § 4.114 were amended, effective May 19, 2024.  In cases like this, where the amendments are effectuated during the pendency of the claim, the disability on review is considered under both the pre- and post-amendment rating criteria, whichever is more favorable to the Veteran.  While the amended criteria may not be applied to a period prior to its effective date, unless the regulations
. 505 (2007).  Staged ratings are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings.  Id. 

The Board is cognizant that during the pendency of the appeal, the rating criteria for evaluating digestive disabilities under 38 C.F.R. § 4.114 were amended, effective May 19, 2024.  In cases like this, where the amendments are effectuated during the pendency of the claim, the disability on review is considered under both the pre- and post-amendment rating criteria, whichever is more favorable to the Veteran.  While the amended criteria may not be applied to a period prior to its effective date, unless the regulations explicitly provide otherwise, the pre-amendment rating criteria may be applied throughout the entire rating period on appeal.  See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003).

There are diseases of the digestive system, particularly within the abdomen, which, while differing in the site of pathology, produce a common disability picture characterized in the main by varying degrees of abdominal distress or pain, anemia, and disturbances in nutrition.  Consequently, certain coexisting diseases in this area do not lend themselves to distinct and separate disability evaluations without violating the fundamental principle relating to pyramiding.  38 C.F.R. 

§§ 4.14, 4.113.  Accordingly, ratings for certain disabilities of the digestive system under DCs 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348, inclusive, are not to be combined.  Rather, a single evaluation will be assigned under the DC which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. 38 C.F.R. § 4.114.

Hyphenated DCs are used when a rating under one DC requires use of an additional DC to identify the basis for the evaluation assigned; the additional code is shown after the hyphen. 38 C.F.R. § 4.27.

The Veteran's polypectomy with colectomy and adhesions is rated pursuant to DC 7329-7301.  Where residual adhesions constitute the predominant disability, resection of the large intestine is to be rated pursuant to DC 7301.  See Note to DC 7329, prior to May 19, 2024.  As the Veteran's diagnosed adhesions are the primary disability, the disability has been properly rated under DC 7301.  See April 2025 VA medical opinion.

Peritoneal adhesions are evaluated under DC 7301, which prior to May 19, 2024, provides for a noncompensable rating for mild peritoneal adhesions.  A 10 percent rating is assigned for moderate peritoneal adhesions; pulling pain on attempting work or aggravated by movements of the body, or occasional episodes of colic pain, nausea, constipation (perhaps alternating with diarrhea) or abdominal distension.  A 30 percent rating is assigned for moderately severe peritoneal adhesions; partial obstruction manifested by delayed motility of barium meal and less frequent and less prolonged episodes of pain.  A maximum 50 percent rating is assigned for severe peritoneal adhesions; definite partial obstruction shown by X-ray, with frequent and prolonged episodes of severe colic distension, nausea or vomiting, following severe peritonitis, ruptured appendix, perforated ulcer, or operation with drainage.  38 C.F.R. § 4.114, DC 7301.  As noted, ratings for adhesions will be considered when there is history of operative or other traumatic or infectious (intraabdominal) process, and at least two of the following: disturbance of motility, actual partial obstruction, reflex disturbances, presence of pain.  38 C.F.R. § 4.114, Note to DC 7301.

From May 19, 2024, one higher rating is available under DC 7301.  A rating of 80 percent is available for persistent partial bowel obstruction that is either inoperable and refractory to treatment, or requires total parenteral nutrition for obstructive symptoms.  

The words "mild," "slight," "moderate" and "severe" as used in the various diagnostic codes are not defined in the VA Rating Schedule.  Rather than applying a mechanical formula, the Board must evaluate all of the evidence, to the end that its decisions are equitable and just.  38 C.F.R. § 4.6.  According to Merriam Webster, "mild" means "gentle in nature or behavior
, 2024, one higher rating is available under DC 7301.  A rating of 80 percent is available for persistent partial bowel obstruction that is either inoperable and refractory to treatment, or requires total parenteral nutrition for obstructive symptoms.  

The words "mild," "slight," "moderate" and "severe" as used in the various diagnostic codes are not defined in the VA Rating Schedule.  Rather than applying a mechanical formula, the Board must evaluate all of the evidence, to the end that its decisions are equitable and just.  38 C.F.R. § 4.6.  According to Merriam Webster, "mild" means "gentle in nature or behavior," "slight" means "small of its kind or in amount," "moderate" means "limited in scope or effect," and "severe" means "very painful or harmful."  

By way of background, the Veteran underwent surgery to remove polyps, and he had a resection of his large intestine in 1985 and had a temporary ileostomy.  The evidence of record shows that since surgery, he has consistently reported and been treated for abdominal pain, constipation, distention, diarrhea, adhesions, and rectal pain. 

In July 2010, the Veteran reported his symptoms occur more than two thirds of the year and as often as two to three times a day.  The number of "attacks" reported for the year was 100.  On occasion the Veteran has been hospitalized.  See July 2010 Dr. D.C. medical report.

In September 2014, the Veteran was still having frequent episodes of bowel disturbance with abdominal distress and episodes of exacerbations and/or "attacks" of the condition.  He reported seven or more in the 12 months prior.  Additionally, his peritoneal adhesions were causing pain and abdominal distention, and the Veteran said he had discomfort on a daily basis.  The examiner concluded the severity of manifestations of peritoneal adhesions was "moderate". 

In November 2020, the Veteran reported to a VA examiner that he has "episodes" at least once a month.  He had cramping, pain and bowel movement urgency.  He was wearing pads daily to avoid soiling himself.  He also reported abdominal distension.

In April 2024, the Veteran reported to a VA examiner that he has rectal pain, constipation, abdominal pain, distention and stomach pain.

In April 2025, the Veteran's records were reviewed pursuant to a Board remand and the VA examiner provided a retrospective opinion.  The examiner opined that the Veteran's service-connected condition of polypectomy with colectomy and adhesions results in gastrointestinal dysfunction as the predominant disability.  The examiner concluded that although surgical adhesions are present and documented, they do not appear to be the central factor contributing to the Veteran's sustained and disabling symptoms.  Instead, the consistent clinical findings across several evaluations highlight post-colectomy-related bowel dysfunction as the leading source of impairment.  This includes chronic and frequent diarrhea, abdominal cramping, nutritional malabsorption, and systemic fatigue resulting from impaired digestion and nutrient uptake.  Furthermore, the examiner opined that the earliest date at which the Veteran's symptomatology could be most accurately characterized as severe is August 6, 2020.  On this date, clinical notes document an escalation in symptoms, including six to seven loose bowel movements per day, sharp daily abdominal pain, and more than 10 pounds of unintentional weight loss over a short period.  Laboratory results from the same time period indicated borderline deficiencies in vitamin B12 and iron, reflecting malabsorption and systemic effects. These symptoms significantly interfered with the veteran's daily activities and social functioning and are consistent with severe gastrointestinal impairment.

May 5, 2010 to March 30, 2014 and May 1, 2014 to November 15, 2020

The Veteran's disability has been rated as 10 percent disabling from May 5, 2010 to March 30, 2014 and 20 percent disability from May 1, 2014 to November 15, 2020 under DC 7329-7301.

Affording the Veteran all reasonable doubt, the Board finds that during the entire appeal, the Veteran's symptoms were severe.  While the Board acknowledges that the April 2025 VA clinician concluded his symptoms were not characterized as severe until August 2020, the Board disagrees based on the benefit of the doubt.  In July 2010, the Veteran reported his symptoms occur more than two thirds of the year and as often as two to three times a day.  The number of "attacks" reported was 100.  At every VA examination the Veteran has reported pain
, 2014 and 20 percent disability from May 1, 2014 to November 15, 2020 under DC 7329-7301.

Affording the Veteran all reasonable doubt, the Board finds that during the entire appeal, the Veteran's symptoms were severe.  While the Board acknowledges that the April 2025 VA clinician concluded his symptoms were not characterized as severe until August 2020, the Board disagrees based on the benefit of the doubt.  In July 2010, the Veteran reported his symptoms occur more than two thirds of the year and as often as two to three times a day.  The number of "attacks" reported was 100.  At every VA examination the Veteran has reported pain, and he has consistently had distention, constipation and diarrhea with bowel urgency, to the point of having to wear pads daily.  Thus, the Board concludes that under DC 7301, prior to May 19, 2024, the Veteran's disability warrants a 50 percent disability rating, which was the maximum rating permitted under DC 7301.

The Board further finds that a higher and/or separate rating is not warranted under any other potentially applicable DC for the digestive system.

From November 16, 2020

The Veteran's disability has been rated as 50 percent disabling from November 16, 2020, under DC 7301.

Pursuant to DC 7301 prior to May 19, 2024, 50 percent is the maximum rating permissible.  Under the current rating criteria for DC 7301, an 80 percent rating is warranted if the Veteran has persistent partial bowel obstruction that is either inoperable and refractory to treatment, or requires total parenteral nutrition (TPN) for obstructive symptoms.  The evidence of record does not show that the Veteran has continued obstruction, thus, an 80 percent disability rating is not warranted after May 19, 2024.  

The Board further finds that a higher and/or separate rating is not warranted under any other potentially applicable DC for the digestive system.

In making its determinations in this case, the Board has carefully considered the Veteran's contentions with respect to the nature of his service-connected disability at issue and notes that his lay statements are competent to describe certain symptoms associated with his disability.  The Veteran's history and reported symptoms have been considered, including as presented in the medical evidence discussed above, and have been contemplated by the disability rating that has been assigned.  Moreover, the competent medical evidence offering detailed specific findings pertinent to the rating criteria is probative evidence when evaluating the pertinent symptoms of the service-connected disability at issue.  As such, while the Board accepts the Veteran's testimony concerning matters that he is competent to address, the Board relies upon the competent medical evidence with regard to the specialized evaluations and details of clinical features of the service-connected disability at issue.

In sum, considering the overall probative value of the medical and lay evidence of record, the Board finds the evidence is at least in relative equipoise.  Accordingly, the benefit of the doubt doctrine is applicable, and the Board finds that the evidence supports a 50 percent rating from May 5, 2010 to November 15, 2020, for the Veteran's polypectomy with colectomy and adhesions under DC 7301, which is the maximum rating allowed.  The competent and probative evidence persuasively weighs against a rating in excess of 50 percent from November 16, 2020.  As discussed above, to the extent even higher ratings are contended, the evidence persuasively weighs against the claim and the claim is denied.  38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7.  Lynch, 21 F.4th at 776.

 

 

Nathaniel Doan

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Scherba, Heather L.

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.