Case A26021022

Summary

The Veteran, an Air Force Veteran who served from August 1995 to August 1999, appealed the denial of service connection for endometriosis status post hysterectomy and sought an earlier effective date for this award. The Board denied the claim for an earlier effective date, finding that the Veteran's initial claim was filed on September 16, 2024, and no evidence supported an earlier date. The Board also denied an initial compensable rating for endometriosis status post hysterectomy, noting that the Veteran had no current symptoms related to the condition following her 2015 hysterectomy and removal of both ovaries, and thus did not meet the criteria for a compensable rating under Diagnostic Code 7629. However, the Board granted a separate 50 percent rating for the removal of the uterus and both ovaries, effective September 16, 2024, as per Diagnostic Code 7617. The Veteran's claim for a 10 percent rating based on multiple noncompensable service-connected disabilities was denied as moot, because she was already in receipt of a compensable rating for irritable bowel syndrome with diverticulitis.

Rationale

No current symptoms related to gynecological condition.; Did not meet criteria for compensable rating under DC 7629.; No evidence for effective date earlier than claim date.

Full Decision Text

Citation Nr: A26021022
Decision Date: 03/09/26	Archive Date: 03/09/26

DOCKET NO. 250902-581537
DATE: March 9, 2026

ORDER

Entitlement to an effective date earlier than September 16, 2024, for the award of service connection for residuals of endometriosis status post hysterectomy is denied.

Entitlement to an initial compensable rating for endometriosis status post hysterectomy is denied.

A separate 50 percent rating for removal of the uterus and both ovaries is granted effective September 16, 2024.  

Entitlement to a 10 percent evaluation based upon multiple noncompensable service-connected disabilities is denied.

FINDINGS OF FACT

1. A claim of service connection for endometriosis was received on September 16, 2024.  There is no indication that a claim was received prior to that date.

2. During the appeal period, the Veteran's endometriosis status post hysterectomy was not manifested by lesions involving bowel or bladder confirmed by laparoscopy, pelvic pain or heavy or irregular bleeding not controlled by treatment, and bowel or bladder symptoms.

3. The Veteran had surgical removal of her uterus and both ovaries in 2015. 

4. During the appeal period, the Veteran was in receipt of a compensable rating for her service-connected irritable bowel syndrome with diverticulitis.

CONCLUSIONS OF LAW

1. The criteria for an effective date earlier than September 16, 2024, for the award of service connection for residuals of endometriosis status post hysterectomy have not been met.  38 U.S.C. § 5110; 38 C.F.R. § 3.400.

2. The criteria for an initial compensable rating for endometriosis status post hysterectomy have not been met.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.3, 4.116, Diagnostic Code 7629.

3. The criteria for a separate 50 percent rating for removal of the uterus and ovaries are met beginning September 16, 2024.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.3, 4.116, Diagnostic Code 7617.  

4. During the period on appeal, the criteria for a 10 percent evaluation based upon multiple noncompensable service-connected disabilities have not been met.  38 U.S.C. § 1155; 38 C.F.R. § 3.324.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Air Force from August 1995 to August 1999.  

This matter is on appeal to the Board of Veterans' Appeals (Board) from a February 2025 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).  In the September 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran timely appealed the portion of the rating decision pertaining to the issues above and requested direct review of the evidence considered by the RO.  38 C.F.R. § 20.202.  

Therefore, the Board may only consider the evidence of record at the time of the February 2025 agency of original jurisdiction (AOJ) decision on appeal.  38 C.F.R. § 20.301.  Evidence submitted after the AOJ decision on appeal cannot be considered by the Board.  38 C.F.R. §§ 20.300, 20.301, 20.801.  

Evidence was added to the claims file during a period of time when new evidence was not allowed.  As the Board is deciding the claims of earlier effective date for residuals of endometriosis status post hysterectomy, increased rating for endometriosis status post hysterectomy, and entitlement to a 10 percent evaluation based upon multiple noncompensable service-connected disabilities, it may not consider this evidence in its decision.  38 C.F.R. § 20.300.  The Veteran may file a Supplemental Claim and submit or identify this evidence.  38 C.F.R. § 3.2501.  If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a Supplemental Claim are included with this decision.  

1. Effective Date for Residuals of Endometriosis Status Post Hysterectomy 

Generally, the effective date of an evaluation and award of compensation based on an
10 percent evaluation based upon multiple noncompensable service-connected disabilities, it may not consider this evidence in its decision.  38 C.F.R. § 20.300.  The Veteran may file a Supplemental Claim and submit or identify this evidence.  38 C.F.R. § 3.2501.  If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a Supplemental Claim are included with this decision.  

1. Effective Date for Residuals of Endometriosis Status Post Hysterectomy 

Generally, the effective date of an evaluation and award of compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim, or the date entitlement arose, whichever is later.  38 U.S.C. § 5110; 38 C.F.R. § 3.400.  

If a claim for disability compensation is received within one year after separation from service, the effective date of entitlement is the day following separation or the date entitlement arose.  38 C.F.R. § 3.400(b)(2).  Otherwise, it is the date of receipt of claim, or the date entitlement arose, whichever is later.  38 C.F.R. § 3.400.  

In this case, the Veteran submitted a September 16, 2024, intent to file a claim for compensation.  On the same day, the Veteran submitted fully developed claim for service connection for endometriosis.  A February 2025 rating decision granted service connection for residuals of endometriosis status post hysterectomy and assigned an effective date of September 16, 2024, the date of claim.  

The Veteran seeks an effective date earlier than September 16, 2024, for the award of service connection for her service-connected residuals of endometriosis status post hysterectomy.  

Upon review of the evidence of record, the Board finds that an effective date earlier than September 16, 2024, for the award of service connection for residuals of endometriosis status post hysterectomy.  The Veteran contends that she should be assigned an earlier effective date and argues that she has been "fighting for 20 years and only backpay till Oct 2024."  See September 2025 Notice of Disagreement.  

The evidence does not support the Veteran's claim for the assignment of an earlier effective date.  The record shows that the Veteran submitted an intent to file a claim and a completed claim for endometriosis of September 16, 2024.  A February 2025 rating decision granted the claim of service connection for residuals of endometriosis status post hysterectomy and assigned an effective date of September 16, 2024, the date of claim.  The evidence does not show a claim received within a year of separation from service.  Further, contrary to the Veteran's assertion, there was no record of a claim for service connection benefits received until September 16, 2024, for the issue of endometriosis.  

Accordingly, the Board finds that the most persuasive evidence of record is against an effective date earlier than September 16, 2024, for the grant of service connection for residuals of endometriosis status post hysterectomy, and the claim is denied.  

2. Disability Rating for Residuals of Endometriosis Status Post Hysterectomy

Disability ratings are determined by evaluating the extent to which a Veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule).  See 38 U.S.C. § 1155; 38 C.F.R. § 4.1.  Different ratings may be assigned for different periods of time for the same disorder if the facts show distinct time periods with different levels of disability.  Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).  If two ratings are potentially applicable, the higher rating will be assigned if the disability more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned.  See 38 C.F.R. § 4.7.  Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran.  See 38 C.F.R. § 4.3.  

The Veteran's endometriosis status post hysterectomy is currently assigned a noncompensable (zero percent) disability rating pursuant to 38 C
enderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).  If two ratings are potentially applicable, the higher rating will be assigned if the disability more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned.  See 38 C.F.R. § 4.7.  Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran.  See 38 C.F.R. § 4.3.  

The Veteran's endometriosis status post hysterectomy is currently assigned a noncompensable (zero percent) disability rating pursuant to 38 C.F.R. § 4.116, Diagnostic Code 7629, for endometriosis.  This claim stems from a September 16, 2024, claim.  

Under Diagnostic Code 7629, a 10 percent rating warranted for pelvic pain or heavy or irregular bleeding requiring continuous treatment for control.  A 30 percent rating is warranted for pelvic pain or heavy or irregular bleeding not controlled by treatment.  A 50 percent rating is warranted for lesions involving bowel or bladder confirmed by laparoscopy, pelvic pain or heavy or irregular bleeding not controlled by treatment, and bowel or bladder symptoms.  

Notably, the highest 50 percent evaluation requires all three criteria listed, because the conjunctive "and" is used.  See Camacho v. Nicholson, 21 Vet. App. 360, 366 (2007) (use of the conjunctive "and" in a Diagnostic Code means that "all criteria must be must to satisfy" a particular rating).  

The Veteran presented for December 2024 VA examination for gynecological conditions.   She was diagnosed with endometriosis and status post hysterectomy.  On examination, it was noted that the Veteran did not have any current symptoms related to her gynecological condition, including any diseases, injuries, or adhesions of the female reproductive organs.  Regarding treatment, it was noted that the Veteran had a diagnostic laparoscopy, fulguration of endometriosis, and lysis of adhesions in 2001.  She had complete hysterectomy in 2015 with removal of both ovaries for endometriosis.  The examiner noted that the Veteran did not currently require treatment for symptoms related to reproductive tract conditions.  The Veteran was not diagnosed with any diseases, injuries, or other conditions of the vulva or clitoris, to include vulvovaginitis.  The Veteran had not been diagnosed with any disease, injuries, or other conditions or the vagina.  She was not diagnosed with any disease, injuries, adhesions, or other conditions of the cervix.  The Veteran had adhesions of fallopian tubes secondary to endometriosis and had ectopic pregnancy.  The Veteran had surgical menopause, and it was unknown if there was complete atrophy of one or both ovaries.  The Veteran had adhesions of the bilateral ovaries.  

The Veteran did not have urinary incontinence or leakage.  She did not have rectovaginal fistula or urethrovaginal fistula.  The Veteran had been diagnosed with endometriosis, but did not have any findings, signs, or symptoms due to endometriosis.  She did not have any pelvic organ prolapse due to injury, disease, or surgical complication of pregnancy.  She did not have any other complications resulting from obstetrical or gynecological conditions or procedures.  She did not currently have, or has had, a benign or malignant neoplasm or metastases related to her endometriosis status post hysterectomy.  The Veteran did not have any other pertinent physical findings, complications, conditions, signs or symptoms related to her endometriosis status post hysterectomy.  Regarding the functional impact of her gynecological condition on her ability to work, it was noted that her endometriosis was currently resolved given her hysterectomy but has caused her significant pain and suffering over the years since onset during military service.  It was further noted that endometriosis caused her pain on a daily basis which made functioning in a traditional occupational environment difficult due to her pain and discomfort.  

Upon review of the evidence of record, the Board finds that an initial compensable disability rating for endometriosis status post hysterectomy is not warranted under Diagnostic Code 7629.  In that regard, the evidence does not show any evidence of pelvic pain or heavy or irregular bleeding requiring continuous treatment for control, or pelvic pain or heavy or irregular bleeding not controlled by treatment.  During the examination, the examiner noted that the Veteran did not have any current symptoms related to her gynecological condition, including
 her significant pain and suffering over the years since onset during military service.  It was further noted that endometriosis caused her pain on a daily basis which made functioning in a traditional occupational environment difficult due to her pain and discomfort.  

Upon review of the evidence of record, the Board finds that an initial compensable disability rating for endometriosis status post hysterectomy is not warranted under Diagnostic Code 7629.  In that regard, the evidence does not show any evidence of pelvic pain or heavy or irregular bleeding requiring continuous treatment for control, or pelvic pain or heavy or irregular bleeding not controlled by treatment.  During the examination, the examiner noted that the Veteran did not have any current symptoms related to her gynecological condition, including any diseases, injuries, or adhesions of the female reproductive organs.  

The Board acknowledges the Veteran's assertion that her symptoms warrant a higher rating.  See December 2024 Correspondence, see also September 2025 Notice of Disagreement.  Further, during the examination, the Veteran asserted that in the past, her endometriosis caused her pain on a daily basis which made functioning in a traditional occupational environment difficult due to her pain and discomfort.  

However, the Board notes that the examiner took consideration the Veteran's lay statement regarding her pain.  Of note, the examiner opined that while the Veteran was diagnosed with endometriosis, she did not have any findings, signs, or symptoms due to endometriosis.  There was no indication of heavy bleeding, irregular bleeding, or pelvic pain as a result of her endometriosis.  The diagnosed endometriosis did not require continuous treatment or was not controlled by treatment.  Further, the Veteran did not have bladder or bowel symptoms from endometriosis.  

She previously had a diagnostic laparoscopy, fulguration of endometriosis, and lysis of adhesions in 2001, and a complete hysterectomy in 2015 with removal of both ovaries for endometriosis.  However, the examiner noted that the Veteran did not currently require treatment for symptoms related to reproductive tract conditions.  Thus, a higher rating under Diagnostic Code 7629 was not supported by the medical evidence of record.  

Accordingly, the Board finds that the most persuasive evidence of record is against an initial compensable rating for service-connected endometriosis status post hysterectomy under Diagnostic Code 7629.  

The Veteran has been in receipt of special monthly compensation under the provisions of 38 U.S.C. § 1114(k) for loss of use of a creative organ since September 16, 2024.  

3. Separate rating for removal of the uterus and both ovaries

Under Diagnostic Code 7617, a 100 percent rating is warranted for three months following removal of the uterus and both ovaries.  38 C.F.R. § 4.116.  A 50 percent is warranted thereafter.  Id.  The February 2025 VA examiner stated that in 2015, the Veteran had a hysterectomy with complete removal of the uterus and both ovaries due to her endometriosis.  Therefore, a separate 50 percent rating for removal of the uterus and both ovaries is granted.  

The 100 percent criteria are not met because she had her surgery in 2015 and did not file a claim until 2024.  The three months following her surgery had expired by that time.  

September 16, 2024 is the appropriate effective date for the award of the 50 percent rating.  This is the date of her intent to file.  Entitlement arose prior to that date because her surgery was in 2015.  

4. Entitlement to a 10 Percent Evaluation Based Upon Multiple Noncompensable Service-connected Disabilities

The Veteran contends that she is entitled to a 10 percent evaluation based upon multiple noncompensable service-connected disabilities.  

When a Veteran has two or more separate permanent service-connected disabilities of such character to clearly interfere with normal employability, even though none of the disabilities may be of a compensable degree under VA's Schedule for Rating Disabilities, the rating agency is authorized to apply a 10 percent rating, but not in combination with any other rating.  38 C.F.R. § 3.324.  Consideration of such benefits is predicated on the existence solely of noncompensable service-connected disabilities.  See Butts v. Brown, 5 Vet. App. 532 (1993).  

The provisions of 38 C.F.R. § 3.324 are predicated on the existence solely of multiple noncompensable service-connected disabilities.  As such, once a compensable rating for any service-connected disability has been awarded, the applicability of 38 C.F.R. §3.324 is rendered moot
's Schedule for Rating Disabilities, the rating agency is authorized to apply a 10 percent rating, but not in combination with any other rating.  38 C.F.R. § 3.324.  Consideration of such benefits is predicated on the existence solely of noncompensable service-connected disabilities.  See Butts v. Brown, 5 Vet. App. 532 (1993).  

The provisions of 38 C.F.R. § 3.324 are predicated on the existence solely of multiple noncompensable service-connected disabilities.  As such, once a compensable rating for any service-connected disability has been awarded, the applicability of 38 C.F.R. §3.324 is rendered moot.  

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?

Here, the Veteran has been in receipt of compensable (20 percent) rating since September 16, 2024.  During the July 2025 rating decision, the Veteran was awarded service connection for irritable bowel syndrome with diverticulitis (previously rated as diverticulitis) and assigned a 20 percent rating effective September 16, 2024.  

Accordingly, as the Veteran has been in receipt of a compensable rating throughout the period on appeal, a compensation under 38 C.F.R. § 3.324 is rendered moot by the assigned rating.  Therefore, the claim must be denied as a matter of law.  See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994).

 

 

D. Martz Ames

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Mathew, 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.