ANEMIA

Summary

The Veteran, an Army Veteran who served from October 1974 to October 1976 and again from September 1990 to March 1991, including service in Southwest Asia during Operation Desert Shield/Desert Storm, appeals the denial of service connection for mild intermittent anemia. The Veteran contends that his anemia is related to his service-connected Irritable Bowel Syndrome (IBS). The Board found that the Veteran has a current diagnosis of anemia, with intermittent episodes of abnormal blood work dating back to 2007. The Board also confirmed that the Veteran has service-connected IBS, having been granted entitlement in January 2024. The primary issue was the nexus between the anemia and IBS. The Board found the June 2024 VA examination inadequate because it failed to consider the Veteran's history of anemia diagnoses and abnormal blood tests. Earlier VA examinations from 2007 and 2008 supported a link between the anemia and IBS. Resolving doubt in the Veteran's favor, the Board found the mild intermittent anemia to be related to or caused by the service-connected IBS. Consequently, service connection for anemia is granted.

Rationale

Veteran has current diagnosis of anemia; Veteran has service-connected IBS; Mild intermittent anemia found related to or caused by IBS

Full Decision Text

Citation Nr: 26001428
Decision Date: 01/30/26	Archive Date: 01/30/26

DOCKET NO. 14-06 048
DATE: January 30, 2026

ORDER

Entitlement to service connection for mild intermittent anemia is granted. 

FINDING OF FACT

The evidence supports mild anemia secondary to service-connected IBS. 

CONCLUSION OF LAW

The criteria for service connection for anemia due to service-connected disease or injury are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Army from October 1974 to October 1976, and from September 1990 to March 1991. 

His service includes duty in Southwest Asia in support of Operation Desert Shield/Desert Storm. 

These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2008 rating decision issued by the Department of Veterans Affairs (VA) Regional Office. 

The above claim has been remanded by the Board in November 2018, September 2021, April 2022, March 2023, and May 2024 to obtain adequate VA examinations for the disabilities on appeal, service treatment records, and military personnel records. 

Service treatment records were added to the file in July 2024. 

The claim is back before the Board for adjudication after a supplemental statement of the case (SSOC). 

SERVICE CONNECTION

A disability, with no causal relationship ("nexus") to an in-service event can be considered service-connected by being proximately due to or aggravated by a service-connected disease or injury. 38 § C.F.R. §3.310(a)-(b). To establish secondary service connection there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) competent evidence establishing a link ("nexus") between the service-connected disability and the current disability.  See Wallin v. West, 11 Vet. App. 509, 512 (1998). 

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

Entitlement to service connection for chronic anemia

The Veteran contends that he had anemia related to irritable bowel syndrome (IBS). 

The Veteran filed his claim as early as May 2007. His VA examination in December 2007 reported that he had a diagnosis of anemia due to blood loss from gastrointestinal tract. See VA Examination received in December 2007. 

Then in January 2008 his VA examination reported that he had occasional diarrhea and occasional bright red blood. The report noted he had a colonoscopy in March 2007 that reported diverticulosis and internal hemorrhoids. He was diagnosed with IBS. See VA Examination received in January 2008. 

In May 2008, a VA examination reported that he had IBS with very mild anemia associated with some gastrointestinal bleeding. See VA examination received May 2008. 

In August 2010, the Veteran had blood testing showing abnormal hematocrit (HCT), red blood cells (RBC), and hemoglobin (HGB). The Veteran was diagnosed with anemia. See CAPRI received July 2016. The gastrointestinal system review in the August 2010 VA treatment record stated that the Veteran reported episodes of rectal bleeding the week prior. Id.  

In September 2017, the Veteran was again noted with anemia. See CAPRI received July 2021. The Veteran had blood testing showing low HCT and HGB. Then in October 2017, work up or blood testing was normal. However, in August 2018 blood testing again showed low HCT and HGB. In August 2019, blood testing was again normal. Id.

First, the Board finds that the Veteran has a current disability. The evidence supports that he has had intermittent anemia within the relevant period which stretched back to 2007. 

Next, the Board finds that the Veteran has service-connected IBS. In January 2024, the Veteran was granted entitlement to IBS with an effective date of July 31, 2007. See Rating Decision-Narrative received in January 2024.  

Therefore, the main issue before the Board is whether there is a link between the Veteran's anemia and his service-connected IBS. 

As for the opinion evidence, the VA examiner in June 2024 stated that the most
 August 2019, blood testing was again normal. Id.

First, the Board finds that the Veteran has a current disability. The evidence supports that he has had intermittent anemia within the relevant period which stretched back to 2007. 

Next, the Board finds that the Veteran has service-connected IBS. In January 2024, the Veteran was granted entitlement to IBS with an effective date of July 31, 2007. See Rating Decision-Narrative received in January 2024.  

Therefore, the main issue before the Board is whether there is a link between the Veteran's anemia and his service-connected IBS. 

As for the opinion evidence, the VA examiner in June 2024 stated that the most recent blood work from 2019 to 2023 showed normal hemoglobin and hematocrit. See C&P Examination received June 2024. The VA expert summarized only limited records in their report and opinions and stated that the Veteran had no diagnosis of chronic anemia. Id.

The Board finds that the June 2024 opinion is inadequate. As summarized above, the Veteran has been diagnosed with anemia at the VA. He has blood testing showing abnormal hemoglobin and hematocrit. While his condition has been noted as mild, and he has not required any blood transfusions, or other special treatments, the condition at least meets the level of a current disability. 

The VA examiners in December 2007 and January 2008 supported that the Veteran's anemia was related to or caused by his IBS. 

Resolving any reasonable doubt in favor of the Veteran, the Board finds that the Veteran's mild intermittent anemia is related to or caused by his service-connected IBS. Accordingly, the Veteran's claim for service connection for anemia is granted.

 

B. MULLINS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Parnell, C. E.

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.