IRRITABLE COLON SYNDROME (SPASTIC COLITIS MUCOUS COLITIS)

Summary

The Veteran, who served from April 2011 to April 2015, appeals the denial of service connection for irritable bowel syndrome (IBS), left shin splints, and right shin splints. The Board found that the evidence supporting service connection for IBS was in approximate balance, and resolving doubt in the Veteran's favor, granted service connection. The Veteran credibly testified to experiencing IBS symptoms in service and continuously thereafter, despite a gap in treatment records and a negative nexus opinion from the VA examiner. For the shin splints, the Board noted that while service treatment records showed a diagnosis in April 2011, there was a gap in treatment until 2020. However, the Veteran credibly testified to experiencing shin splints with fractures during service, requiring a profile for her entire active duty period, and continuing symptoms post-service. The Board found the lay evidence, supported by the Veteran's testimony and the initial service diagnosis, to be in approximate balance with the evidence against service connection, and thus granted service connection for both left and right shin splints by resolving doubt in the Veteran's favor. All three conditions were granted on a direct basis.

Rationale

Competent, credible lay testimony of IBS symptoms during service and continuity post-service.; RO accepted in-service notations for abdominal pain and diarrhea.; Benefit of the doubt applied due to approximate balance of evidence.

Full Decision Text

Citation Nr: A26020103
Decision Date: 03/05/26	Archive Date: 03/05/26

DOCKET NO. 210128-136576
DATE: March 5, 2026

ISSUES

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

2. Entitlement to service connection for left shin splints, variously claimed as secondary to bilateral pes planus with plantar fasciitis

3. Entitlement to service connection for right shin splints, variously claimed as secondary to bilateral pes planus with plantar fasciitis

ORDER

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

Entitlement to service connection for left shin splints disability is granted.

Entitlement to service connection for right shin splints disability is granted.

FINDINGS OF FACT

1. The competent, credible, and probative lay and medical evidence that supports the claim that the Veteran's IBS had its onset during service is in "approximate balance" or "nearly equal" to the evidence standing against it.    

2. The competent, credible, and probative lay and medical evidence that supports the claim that the Veteran's left shin splints had their onset during service is in "approximate balance" or "nearly equal" to the evidence standing against it.    

3. The competent, credible, and probative lay and medical evidence that supports the claim that the Veteran's right shin splints had their onset during service is in "approximate balance" or "nearly equal" to the evidence standing against it.  

CONCLUSIONS OF LAW

1. Resolving reasonable doubt in the Veteran's favor, IBS was incurred in service.  38 U.S.C. §§ 1110, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

2. Resolving reasonable doubt in the Veteran's favor, left shin splints were incurred in service.  38 U.S.C. §§ 1110, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

3. Resolving reasonable doubt in the Veteran's favor, right shin splints were incurred in service.  38 U.S.C. §§ 1110, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from April 2011 to April 2015. 

This matter is before the Board of Veterans Appeals (Board) on appeal from a January 2021 Appeals Modernization Act (AMA) rating decision by the Department of Veterans Affairs (VA) Regional Office (RO).  The rating decision considered the evidence of record on that date.  The Board is bound by the favorable findings.  See 38 C.F.R. § 3.104(c).  The Veteran timely appealed this decision to the Board by requesting the AMA Hearing docket.

The Veteran testified before the undersigned Veterans Law Judge (VLJ) in November 2024.  A copy of the hearing transcript has been associated with the claims file. 

Duties to Notify and Assist

The Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance.  38 U.S.C. §§ 5102, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a).

In the VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) (NOD), the Veteran elected the Hearing option; therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the appellant or his or her representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a).

The Veteran in this case has not referred to any deficiencies in either the duties to notify or assist; therefore, the Board may proceed to the merits of the claim.  See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015, cert denied, U.S.C. Oct. 3, 2016) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board....to search the record and address procedural arguments when the [app
 as well as any evidence submitted by the appellant or his or her representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a).

The Veteran in this case has not referred to any deficiencies in either the duties to notify or assist; therefore, the Board may proceed to the merits of the claim.  See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015, cert denied, U.S.C. Oct. 3, 2016) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board....to search the record and address procedural arguments when the [appellant] fails to raise them before the Board"); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to an appellant's failure to raise a duty to assist argument before the Board).

The Board has reviewed all of the evidence in the Veteran's claims file.  Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the Veteran or obtained on her behalf be discussed in detail.  Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the claims file shows, or fails to show, with respect to the claim.  See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-130 (2000).

Service Connection

To establish service connection a Veteran must generally 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."  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).  Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303 (d).

For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "Chronic."  When the disease identity is established (leprosy, tuberculosis, multiple sclerosis, etc.), there is no requirement of evidentiary showing of continuity.  Continuity of symptomatology is required only where the condition noted during service (or in the presumptive period) is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned.  When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim.  38 C.F.R. § 3.303 (b).  

We note that for certain chronic diseases additional presumptive theories of entitlement are relevant in addition to direct service connection.  See 38 C.F.R. §§ 3.303, 3.307, 3.309.  Under 38 C.F.R. § 3.303 (b), service connection may be established by demonstrating continuity of symptomatology.  Continuity may be established if a claimant can demonstrate (1) that a condition was "noted" during service; (2) evidence of post-service continuity of the same symptomatology; and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology.  The provisions of 38 C.F.R. § 3.303 (b) only apply to diseases recognized by VA as "chronic."  See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); 38 C.F.R. §§ 3.303 (b), 3.309(a).  Chronic diseases that become manifest to a degree of 10 percent or more within one year of termination of active duty may be presumed to have been incurred in service.  38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309.

Except as provided in § 3.300(c), disability which is proximately due to or the result of a service-connected disease or injury shall be service connected.  When service connection is thus established
 F.3d 1331 (Fed. Cir. 2013); 38 C.F.R. §§ 3.303 (b), 3.309(a).  Chronic diseases that become manifest to a degree of 10 percent or more within one year of termination of active duty may be presumed to have been incurred in service.  38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309.

Except as provided in § 3.300(c), disability which is proximately due to or the result of a service-connected disease or injury shall be service connected.  When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition.  38 C.F.R. § 3.310 (a).  Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected.  However, VA will not concede that a nonservice-connected disease or injury was aggravated by a service-connected disease or injury unless the baseline level of severity of the nonservice-connected disease or injury is established by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the nonservice-connected disease or injury.  38 C.F.R. § 3.310 (b). 

VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits.  38 U.S.C. § 1154 (a).  Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional.  Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).

Lay evidence cannot be determined not credible merely because it is unaccompanied by contemporaneous medical evidence.  Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006).  However, the lack of contemporaneous medical evidence can be considered and weighed against a Veteran's lay statements.  Id.  The Board, as fact finder, is obligated to, and fully justified in, determining whether lay evidence is credible in and of itself, i.e., because of possible bias, conflicting statements, etc.  Id.  Further, a negative inference may be drawn from the absence of complaints for an extended period.  See Maxson v. West, 12 Vet. App. 453, 459 (1999), aff'd sub nom.  Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000).

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

By way of background, there were no signs, symptoms, or complaints of IBS at separation.  

Next, the January 2021 VA examiner reached a negative nexus opinion for direct service connection in 3B.  Secondary service connection is blank.  The VA examiner reasoned in part "service treatment records chronic GI symptoms, seen sporadic to unrelated constipation in 2011, then for diarrhea in 2014, acute GE in 2013, with symptoms started in less than 3 days, no chronic or recurrent GI condition in service were of record, in addition you were diagnosed with likely IBS in 2020."  

Nonetheless, the January 2021 rating decision favorably found:

You have a qualifying event, injury or disease in service. Your service treatment records note a complaint of abdominal pain and diarrhea on June 27, 2013 and abdominal pain and cramping with diarrhea on December 30, 2014.

You have been diagnosed with a IBS disability on January 21, 2021 VA examination.

The claimed disability is a chronic disease which may be presumptively linked to your military service Military service in Afghanistan from July 26, 2013 to April 21, 2014.

The critical evidentiary issue remained a nexus to service or service-connected disability. 

Next, the Veteran testified at the November 21, 2024 hearing.  She testified that she experienced IBS symptoms in service and continued to have them after separation.  p. 7.  The VLJ reminded the Veteran and her representative to submit
, 2013 and abdominal pain and cramping with diarrhea on December 30, 2014.

You have been diagnosed with a IBS disability on January 21, 2021 VA examination.

The claimed disability is a chronic disease which may be presumptively linked to your military service Military service in Afghanistan from July 26, 2013 to April 21, 2014.

The critical evidentiary issue remained a nexus to service or service-connected disability. 

Next, the Veteran testified at the November 21, 2024 hearing.  She testified that she experienced IBS symptoms in service and continued to have them after separation.  p. 7.  The VLJ reminded the Veteran and her representative to submit evidence including a private medical opinion by February 18, or within 90 days from the hearing.  p. 5.  The Veteran's representative confirmed the cutoff date was February 19.  p. 6.

Unfortunately, VA received evidence including a private medical opinion on February 21, 2025, beyond 90 days from the hearing.  This is outside the reviewable window.  One of the effects of the AMA is to narrow the set of circumstances in which the Board must remand appeals to the AOJ for further development instead of immediately deciding them directly.  See Pub L. No. 115-55 section (2)(d); 38 C.F.R. § 20.802 (a).

The Veteran contends that she is entitled to service connection for irritable bowel syndrome (IBS).

The Veteran competently reports ongoing bouts of IBS during service and continuing after separation.  She is competent to report such factors.  She is also competent to report a diagnostic impression of IBS as accepted by the RO.  The Board finds these reports to be credible, as they are supported by the contemporaneous records.  In making all determinations, the Board must fully consider the lay assertions of record.  A layperson is competent to provide "evidence not requiring that the proponent have specialized education, training, or experience."  38 C.F.R. § 3.159 (a)(2).  "Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person."  See id.  A layperson is also competent to report on the onset and continuity of their current symptomatology.  See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a veteran is competent to report on that of which he or she has personal knowledge).  When considering whether lay evidence is competent, the Board must determine, on a case-by-case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007).  She competently related a diagnostic impression from Dr. M., and suggests those symptoms began in service.  p. 7.  

Here, the first element of service connection of a current disability is satisfied when the RO acknowledged treatment during service, a gap, and then "You have been diagnosed with a IBS disability on January 21, 2021 VA examination."

Second, for the in-service incurrence, the RO accepted notations in service from shortly before separation.  The VLJ noted at the November 2024 hearing that the Veteran immediately filed claims for these and other disabilities following separation, many of which were ultimately granted.  p. 6.  The Veteran credibly testified in November 2024 that she experienced IBS symptoms in service and continued to have them after separation.  p. 7.  

Third, is the remaining element of a nexus to service.  The VA examiner reached a negative nexus opinion citing sporadic symptoms in the record.  However, the Veteran credibly supplemented the lack of documentation with lay testimony that she experienced diarrhea occurring in service, and continuously since separation.  These symptoms were eventually formally diagnosed by Dr. M. and the VA examiner as IBS year later.  The VLJ also noted that the Veteran filed her claim immediately after service, partially filling the gap cited by the VA examiner.  p. 6.  Although vague, the RO still favorably found, "You have a qualifying event, injury or disease in service."

At this juncture, the claim has now been under development and appellate review for several years.  The Veteran has maintained her competent reports of functional impairment due to IBS symptoms.  VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim
 with lay testimony that she experienced diarrhea occurring in service, and continuously since separation.  These symptoms were eventually formally diagnosed by Dr. M. and the VA examiner as IBS year later.  The VLJ also noted that the Veteran filed her claim immediately after service, partially filling the gap cited by the VA examiner.  p. 6.  Although vague, the RO still favorably found, "You have a qualifying event, injury or disease in service."

At this juncture, the claim has now been under development and appellate review for several years.  The Veteran has maintained her competent reports of functional impairment due to IBS symptoms.  VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits.  38 U.S.C. § 1154 (a).  To remand for additional development would at best lend additional support to the credible lay evidence of continuity of symptomology since service.  At worst it could develop additional negative evidence against the appeal.

At the very least, the competent, credible, and probative lay and medical evidence that supports the claim that the Veteran's IBS was manifest in service is in "approximate balance" or "nearly equal" to the evidence standing against it.  See Lynch v. McDonough, No. 20-2067 (Fed. Cir. 2021).  Therefore, resolving reasonable doubt in the Veteran's favor, the Board finds that it is at least as likely as not that the Veteran's IBS was incurred in service.  She has had IBS continuously since service.  We note the constancy of the Veteran's reports throughout the appeal period.  The Veteran is therefore entitled to the benefit of the doubt.  See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102.  Therefore, service connection for IBS is warranted.  38 C.F.R. § 3.303 (d).  The Board notes that this grant on a direct basis is more favorable than secondary service connection.  

2. Entitlement to service connection for left shin splints, variously claimed as secondary to bilateral pes planus with plantar fasciitis

3. Entitlement to service connection for right shin splints, variously claimed as secondary to bilateral pes planus with plantar fasciitis

By way of background, there were no signs, symptoms, or complaints of shin splints at separation.  

The January 2021 VA examiner reached a negative nexus opinion for direct service connection in 3B.  The VA examiner reasoned in part "STR showed veteran was seen for shin splints bilateral in 2011, 2012 then none after that although he stayed active till 2015. noted No Dx during 12/29/15 KNEE DBQ. this indicates condition was resolved in 2012. received treatment again in 2020 per (6/30/2020 PROVIDER TELEPHONE ENCOUNTER NOTE). no treatment record found in indexed set for dx/tx shin splints between 2012 and 2020."  

Nonetheless, the January 2021 rating decision favorably found, "Diagnosis of bilateral shin splints, service treatment records, dated April 29, 2011. The claimed primary disability of bilateral pes planus with plantar fasciitis is service connected."

The critical evidentiary issue remained a nexus to service or service-connected disability.  

Next, the Veteran testified at the November 21, 2024 hearing.  She testified that she experienced symptoms in service and continued to have them after separation.  p. 8.  

So, active duty, I had complained from the beginning time in basic training. I kept complaining of having tenderness, swelling, and just like starting to lose track of running because I was basically over-running. With that being said, in basic training, I was placed on quarters for, like, I think three days. And then, once I got to active duty, I continued to push through. And then, when I couldn't take it anymore, I went to the doctor, and that's when the doctor had told me that -- not only did I have shin splints, I had fractures.

So, that's when I was put on a profile. And that profile was for my whole four years of active duty. Even once I deployed or whatever, I never took my -- instead of running, I did the two- mile walk. So, that's my argument, that -

Following service she continued having shin splints in both legs. p. 8.

The VLJ discussed:

JUDGE: Yeah. So, this is another one of those cases because, again, Ms. [Veteran] filed the claims right after service, and I think they started getting wrapped up on the whole
 to the doctor, and that's when the doctor had told me that -- not only did I have shin splints, I had fractures.

So, that's when I was put on a profile. And that profile was for my whole four years of active duty. Even once I deployed or whatever, I never took my -- instead of running, I did the two- mile walk. So, that's my argument, that -

Following service she continued having shin splints in both legs. p. 8.

The VLJ discussed:

JUDGE: Yeah. So, this is another one of those cases because, again, Ms. [Veteran] filed the claims right after service, and I think they started getting wrapped up on the whole secondary thing when, in fact, there was treatment in service for shin splints, right?

MS. [Veteran]: Yes.

JUDGE: So, it's not necessarily secondary to your pes planus and plantar fasciitis. It could be what we would call a direct causation, direct from service, correct?

MS. [Veteran]: Yes.

JUDGE: Okay. And, so, you've had shin splints then. You had shin splints immediately after service, filed a claim for service connection, and you continued to have them until now?

MS. [Veteran]: Yes.   				   p. 10.  

Unfortunately, VA received evidence including a private medical opinion on February 21, 2025.  This is outside the reviewable window.  There are limited evidentiary windows under the AMA, including 90 days from the date of hearing.  See Pub L. No. 115-55 section (2)(d); 38 C.F.R. § 20.802 (a).

The Veteran contends that she is entitled to service connection for left and right shin splint disabilities.

The Veteran competently reports repeated shin splints during service, a physical profile, and continuity after separation.  She is competent to report such factors.  She is also competent to report a diagnostic impression of shin splints in service that was accepted by the RO.  The Board finds her testimony to be credible as it is supported by contemporaneous records.  In making all determinations, the Board must fully consider the lay assertions of record.  A layperson is competent to provide "evidence not requiring that the proponent have specialized education, training, or experience."  38 C.F.R. § 3.159 (a)(2).  "Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person."  See id.  A layperson is also competent to report on the onset and continuity of their current symptomatology.  See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a veteran is competent to report on that of which he or she has personal knowledge).  When considering whether lay evidence is competent, the Board must determine, on a case-by-case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007).  She competently related a diagnostic impression.  p. 8.  

Here, the first element of service connection of a current disability is satisfied when the RO acknowledged treatment for diagnosed bilateral shin splints in April 2011 during service.  There is then a gap in the treatment records.  The VA examiner later confirmed shin splints diagnosed in 2020 but opined they were separate from service.  So the diagnosis accepted during service and 2020 diagnosis bookend this appeal.  

Second, for the in-service incurrence, the RO accepted notations in service from years before separation.  The RO favorably found, "Diagnosis of bilateral shin splints, service treatment records, dated April 29, 2011."  The VLJ noted at the November 2024 hearing that the Veteran immediately filed claims for these and other disabilities following separation, many of which were ultimately granted.  p. 6.  The Veteran credibly testified in November 2024 that she experienced shin splint symptoms in service and continued to have them after separation.  p. 7.  

Third, is the remaining element of a nexus to service in filling the gap.  On one hand, the VA examiner reached a negative nexus opinion citing a resolved condition in 2012.  The Board notes that a period without evidence of formal treatment from 2012 to 2020 does not necessarily prove the condition resolved.
, dated April 29, 2011."  The VLJ noted at the November 2024 hearing that the Veteran immediately filed claims for these and other disabilities following separation, many of which were ultimately granted.  p. 6.  The Veteran credibly testified in November 2024 that she experienced shin splint symptoms in service and continued to have them after separation.  p. 7.  

Third, is the remaining element of a nexus to service in filling the gap.  On one hand, the VA examiner reached a negative nexus opinion citing a resolved condition in 2012.  The Board notes that a period without evidence of formal treatment from 2012 to 2020 does not necessarily prove the condition resolved.  

On the other hand, the Veteran credibly testified about steps taken to accommodate her during service as part of her profile.  She confirmed:

JUDGE: Okay. And, so, you've had shin splints then. You had shin splints immediately after service, filed a claim for service connection, and you continued to have them until now?

MS. [Veteran]: Yes.   				   p. 10.  

She credibly supplemented the lack of documentation by explaining she experienced the same shin pain during service continuously after separation.   Evidence of pain alone which results in functional impairment, even if there is no identified underlying diagnosis, can constitute a disability.  Saunders v. Wilkie, 886 F.3d 1356 (2018).  "And then, once I got to active duty, I continued to push through. And then, when I couldn't take it anymore, I went to the doctor, and that's when the doctor had told me that -- not only did I have shin splints, I had fractures. So, that's when I was put on a profile..." p. 10.  The VLJ also noted that the Veteran filed her claim immediately after service, partially filling the gap cited by the VA examiner.  p. 6.  

The Veteran has maintained her competent reports of functional impairment due to painful shin splints.  VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits.  38 U.S.C. § 1154 (a).  The lack of documented formal treatment does not necessarily confirm the condition medically resolved in 2012 and is unrelated to the 2020 diagnosis.  In contrast, the Veteran alleges continuous pain without a formally repeated diagnosis, as supported by the physical profile and credible testimony.  The Board notes Saunders, supra.  

At the very least, the competent, credible, and probative lay and medical evidence that supports the claim that the Veteran's left and right shin splint disabilities were manifest in service is in "approximate balance" or "nearly equal" to the evidence standing against it.  See Lynch v. McDonough, No. 20-2067 (Fed. Cir. 2021).  Therefore, resolving reasonable doubt in the Veteran's favor, the Board finds that it is at least as likely as not that the Veteran's left and right shin splint disabilities were incurred in service.  She has had them continuously since service.  We note the constancy of the Veteran's reports throughout the appeal period.  The Veteran is therefore entitled to the benefit of the doubt.  See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102.  Therefore, service connection for left and right shin splint disabilities is warranted.  38 C.F.R. § 3.303 (d).  The Board notes that this grant is more favorable than secondary service connection.  

(Continued on the next page.)

 

Neither the Veteran nor her representative has raised any other issues, nor have any other issues been reasonably raised by the record.  See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).  In reaching these conclusions, the evidence persuasively in favor of the claims is in "approximate balance" or "nearly equal" to the evidence that stands against them.  See Lynch v. McDonough, No. 20-2067 (Fed. Cir. 2021) (holding "[E]vidence is not in 'approximate balance' or 'nearly equal,' and therefore the benefit-of-the-doubt rule does not apply, when the evidence persuasively favors one side or the other.") The benefit of the doubt rule has been favorably applied.  38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990
 reaching these conclusions, the evidence persuasively in favor of the claims is in "approximate balance" or "nearly equal" to the evidence that stands against them.  See Lynch v. McDonough, No. 20-2067 (Fed. Cir. 2021) (holding "[E]vidence is not in 'approximate balance' or 'nearly equal,' and therefore the benefit-of-the-doubt rule does not apply, when the evidence persuasively favors one side or the other.") The benefit of the doubt rule has been favorably applied.  38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990).  Therefore, service connection for IBS and left and right shin splint disabilities on a direct basis is granted.

 

Michael A. Pappas

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	B. Bodi

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.