IRRITABLE COLON SYNDROME (SPASTIC COLITIS MUCOUS COLITIS)

MICHAEL J. SKALTSOUNIS · 2026 · Case ID: A26030314

MIXED

Summary

The veteran, who served from June 2005 to April 2009, appeals the denial of service connection for bilateral hearing loss and seeks service connection for irritable bowel syndrome (IBS), peripheral vestibular disorder, vertigo (diagnosed as benign paroxysmal positional vertigo or BPPV), and Meniere's disease. The Board found that the evidence was in approximate balance for IBS, peripheral vestibular disorder, vertigo, and Meniere's disease. For IBS, the Board noted a current diagnosis and the Veteran's testimony regarding in-service digestive symptoms, which the Board found sufficient to meet the second element of service connection, especially given the presumption of exposure to burn pits due to service in Qatar under the PACT Act. However, the VA examiner opined that IBS was less likely than not related to service due to lack of in-service complaints and delayed onset. A private medical opinion countered this, finding IBS at least as likely as not caused by in-service toxic exposure, citing research linking IBS to burn pit chemicals. The Board found the evidence in approximate balance and applied the benefit of the doubt to grant service connection for IBS. For the vestibular disorders, the Board noted current diagnoses and the Veteran's testimony attributing symptoms to in-service noise exposure. The Board found the second element met due to the RO's concession of in-service hazardous noise exposure by granting service connection for tinnitus. The VA examiner opined these conditions were less likely than not related to service due to lack of in-service complaints, while a private opinion found them at least as likely as not caused by auditory trauma, citing research on delayed onset. Again, the Board found the evidence in approximate balance and applied the benefit of the doubt to grant service connection for these conditions. For bilateral hearing loss, the Board noted the claim was based on noise exposure. However, the VA audiological examination showed no current hearing loss meeting VA criteria, and the Veteran's service treatment records were devoid of complaints. Despite the Veteran's report of noise exposure, the Board found the objective clinical testing outweighed the lay evidence and denied service connection for hearing loss due to lack of a current disability.

Rationale

Evidence in approximate balance; Benefit of the doubt applied; Private opinion found nexus

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210527-162538

Full Decision Text

Citation Nr: A26030314
Decision Date: 04/02/26 Archive Date: 04/02/26

DOCKET NO. 210527-162538
DATE: April 2, 2026

ORDER

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

Entitlement to service connection for peripheral vestibular disorder is granted.

Entitlement to service connection for vertigo, diagnosed as benign paroxysmal positional vertigo (BPPV), is granted.

Entitlement to service connection for Meniere's disease is granted.

Entitlement to service connection for bilateral hearing loss is denied.

FINDINGS OF FACT

1. The evidence is at least in equipoise as to whether the Veteran's IBS is related to service.

2. The evidence is at least in equipoise as to whether the Veteran's peripheral vestibular disorder is related to service.

3. The evidence is at least in equipoise as to whether the Veteran's vertigo is related to service.

4. The evidence is at least in equipoise as to whether the Veteran's Meniere's disease is related to service.

5. The Veteran does not currently have bilateral hearing loss for VA benefits purposes.

CONCLUSIONS OF LAW

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

2. The criteria for entitlement to service connection for peripheral vestibular disorder have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for entitlement to service connection for vertigo have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for entitlement to service connection for Meniere's disease have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for entitlement to service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.309, 3.385.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from June 2005 to April 2009.

These matters come before the Board of Veterans' Appeals (Board) on appeal from the April 2021 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) which denied service connection for hearing loss, IBS, vertigo, peripheral vestibular disorder, and Meniere's disease.

In the May 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on February 6, 2024, and a transcript is in the record. Therefore, the Board may only consider the evidence of record at the time of the April 2021 agency of original jurisdiction (AOJ) decision on appeal, and any evidence submitted by the Veteran or representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection requires: (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 the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

For chronic disorders, including hearing loss, service connection may be granted on a presumptive basis if there is evidence
§ 3.303(a). Service connection requires: (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 the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

For chronic disorders, including hearing loss, service connection may be granted on a presumptive basis if there is evidence of: (1) an in-service diagnosis of a chronic condition; (2) manifestations within the applicable period (usually a year); or (3) a showing of continuity of symptomatology. 38 C.F.R. § 3.309(a). Even where service connection may not be presumed, service connection may still be established on a direct basis.

Further, lay statements may serve to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C. § 1153(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).

In evaluating the evidence in an appeal, it is the responsibility of the Board to weigh the evidence and decide where to give credit and where to withhold same and, in doing so, accept certain medical opinions over others. Schoolman v. West, 12 Vet. App. 307 (1999).

In this regard, the Board has been charged with the duty to assess the credibility and weight given to the evidence. Jandreau v. Nicholson, 492 F.3d 1372 (2007). Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of the matter, VA shall give the benefit of the doubt to the Veteran. Lynch v. McDonough, 21 F.4th 776, 781-82 (2021).

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

The Veteran seeks entitlement to service connection for IBS. See February 2020 Claim Application.

Following a review of the evidence, the Board finds that the probative evidence of record is at least in approximate balance to resolve in favor of the Veteran's claim.

Regarding the first element of the Veteran's service connection claim (a current disability), the Board notes that the record documents a diagnosis of IBS. See April 2021 VA Intestinal Examination. The first element is thereby met.

As for the second element of the Veteran's claim (an in-service injury or event), service personnel records reveal that the Veteran has active service in Qatar for a day in May 2006. See December 2022 VA Toxic Exposure Memo; see also December 2023 Toxic Exposure Risk Activity (TERA) Memo. The Veteran is therefore presumed to have been exposed to burn pits and other toxins under the PACT Act. See 38 C.F.R. § 3.320(a)(5). Moreover, during his hearing with the undersigned VLJ, the Veteran testified that his digestive symptoms (i.e., diarrhea and stomach cramping) began 6 months after his deployment in Qatar and have progressively worsened since. See February 2024 Hearing Transcript, pgs. 13, 16-17. The Veteran also stated that he had reported his diarrhea during service, but the examiners only advised him to avoid certain foods. Id. at pg. 14. From the foregoing, the Board finds that the second element of service connection is met.

Finally, the Board must determine whether the Veteran's current IBS is related to his military service.

In April 2021, the Veteran underwent a VA intestinal examination, in which the examiner diagnosed IBS. The examiner also opined that the Veteran's IBS is less likely than not related to in-service toxic exposure during in Southwest Asia, as the Veteran's service treatment records (STRs) do not show any complaints of, or treatment for, IBS. Lastly, the examiner noted that the Veteran's diagnosis did not manifest until 10 years post-service.

In February 2024, the Veteran submitted a private medical opinion, in which the provider opined that the Veteran's IBS is at least as likely as not caused by his in-service toxic exposure. The examiner based this opinion on a review of the Veteran's medical history and lay statements of onset.
a VA intestinal examination, in which the examiner diagnosed IBS. The examiner also opined that the Veteran's IBS is less likely than not related to in-service toxic exposure during in Southwest Asia, as the Veteran's service treatment records (STRs) do not show any complaints of, or treatment for, IBS. Lastly, the examiner noted that the Veteran's diagnosis did not manifest until 10 years post-service.

In February 2024, the Veteran submitted a private medical opinion, in which the provider opined that the Veteran's IBS is at least as likely as not caused by his in-service toxic exposure. The examiner based this opinion on a review of the Veteran's medical history and lay statements of onset. The examiner also noted medical research that supports a causal link between IBS and chemicals found in burn pits. The examiner then found that a direct nexus could be established between the Veteran's IBS and his military service.

Weighing the above opinions, the Board finds the medical evidence to be at least in approximate balance. Indeed, while the private and VA opinions differ in conclusions, they are all based on a review of the Veteran's claims file, supporting medical literature, and professional expertise. The opinions are therefore given the same approximate probative value.

Accordingly, from the foregoing, the Board finds that the evidence for and against a medical nexus is at least in equipoise and, giving the Veteran the benefit of the doubt, the final element of service connection is met. See 38 U.S.C. § 5107(b). Entitlement to service connection for IBS is thus warranted on a direct basis.

2. Entitlement to service connection for peripheral vestibular disorder.

3. Entitlement to service connection for vertigo, diagnosed as benign paroxysmal positional vertigo (BPPV).

4. Entitlement to service connection for Meniere's disease.

The Veteran seeks entitlement to service connection for peripheral vestibular disorder, vertigo, and Meniere's disease. See February 2020 Claim Application.

Following a review of the evidence, the Board finds that the probative evidence of record is at least in approximate balance to resolve in favor of the Veteran's claims.

Regarding the first element of the Veteran's service connection claim (a current disability), the Board notes that the record documents diagnoses of peripheral vestibular disorder, BPPV, and Meniere's disease. See April 2021 VA Ear Examination. The first element is thereby met.

As for the second element of the Veteran's claim (an in-service injury or event), the Veteran has consistently attributed his various diagnoses to hazardous noise exposure during service. See March 2020 Claim Application; see also April 2021 VA Ear Examination. During his hearing with the undersigned VLJ, the Veteran testified that his ear symptoms (i.e., inner popping, dizziness, and imbalance) began around 2008 and have progressively worsened since. See February 2024 Hearing Transcript, pgs. 6-8. The Veteran also stated that these symptoms are interconnected and build on each other. Id. at pg. 6. Significantly, the Board finds that the RO conceded in-service hazardous noise exposure by granting the Veteran service connection for tinnitus in the rating decision on appeal. See April 2021 Rating Decision. The second element of service connection is thus satisfied.

Finally, the Board must determine whether the Veteran's current diagnoses are related to his military service.

In April 2021, the Veteran underwent a VA ear examination, in which the examiner diagnosed peripheral vestibular disorder, BPPV, and Meniere's disease. The examiner also opined that the Veteran's diagnosed disabilities are less likely than not related to his reported in-service exposure in Southwest Asia, as the Veteran's STRs are devoid of any complaints of, or treatment for, such conditions.

In February 2024, the Veteran submitted a private medical opinion, in which the provider opined that the Veteran's ear disabilities are at least as likely as not caused by in-service auditory system trauma. The examiner based this opinion on a review of the Veteran's medical history and lay statements of onset. The examiner also noted medical research that supports delayed onset of vertigo and Meniere's disease after exposure to hazardous noise. The examiner then found that a direct nexus could be established between the Veteran's ear disabilities and his military service.

Accordingly, from the foregoing, the Board finds that the
The examiner based this opinion on a review of the Veteran's medical history and lay statements of onset. The examiner also noted medical research that supports delayed onset of vertigo and Meniere's disease after exposure to hazardous noise. The examiner then found that a direct nexus could be established between the Veteran's ear disabilities and his military service.

5. Entitlement to service connection for bilateral hearing loss.

The Veteran claims entitlement to service connection for bilateral hearing loss is warranted based on noise exposure during active service. See February 2020 Claim Application. Specifically, the Veteran attributes his hearing loss to exposure to loud noises on the flight line. See February 2024 Hearing Transcript, pg. 3.

Applicable regulations provide that impaired hearing shall be considered a disability when the auditory thresholds in any of the frequencies of 500, 1000, 2000, 3000, and 4000 Hz are 40 decibels or greater; the thresholds for at least three of these frequencies are 26 decibels or greater; or when speech recognition scores are 94 percent or less. 38 C.F.R. § 3.385.

38 C.F.R. § 3.385 does not preclude service connection for a current hearing loss disability where the Veteran's hearing was within normal limits on audiometric testing at separation from service. Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Rather, when audiometric test results at a veteran's separation from service do not meet the requirements of 38 C.F.R. § 3.385, a veteran may nevertheless establish service connection for current hearing disability by submitting medical evidence that the current disability is causally related to service. Hensley v. Brown, 5 Vet. App. 155 (1993).

Where the requirements for hearing loss disability pursuant to 38 C.F.R. § 3.385 are not met until several years after separation from service, the record must include evidence of exposure to disease or injury in service that would adversely affect the auditory system and post-service test results meeting the criteria of 38 C.F.R. § 3.385. Hensley, 5 Vet. App. at 155. If the record shows (a) acoustic trauma due to significant noise exposure in active service and audiometric test results reflect an upward shift in tested thresholds while in such service, though still not meeting the requirements for "disability" under 38 C.F.R. § 3.385, and (b) post service audiometric testing produces findings which meet the requirements of 38 C.F.R. § 3.385; then the rating authorities must consider whether there is a medically sound basis to attribute the post service findings to the injury in service, or whether these findings are more properly attributable to intervening causes. Id. at 159.

As to the claim for service connection for hearing loss, the first threshold question that must be addressed is whether the Veteran has the disability for which service connection is sought. In the absence of proof of a present disability, there is no valid claim for service connection. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

The Veteran was afforded one VA audiological examination after service. In January 2021, the examination presented the following pure tone thresholds: 30 dB at 500 Hz, 20 dB at 1000 Hz, 25 dB at 2000 Hz, 30 dB at 3000 Hz, and 15 dB at 4000 Hz, for the right ear; and 20 dB at 500 Hz, 20 dB at 1000 Hz, 25 dB at 2000 Hz, 15 dB at 3000 Hz, and 20 dB at 4000 Hz, for the Veteran's left ear. Additionally, the Veteran's speech recognition ability, using the Maryland CNC test, was 100 percent for both ears.

Based on the foregoing, the audiological findings of
2021, the examination presented the following pure tone thresholds: 30 dB at 500 Hz, 20 dB at 1000 Hz, 25 dB at 2000 Hz, 30 dB at 3000 Hz, and 15 dB at 4000 Hz, for the right ear; and 20 dB at 500 Hz, 20 dB at 1000 Hz, 25 dB at 2000 Hz, 15 dB at 3000 Hz, and 20 dB at 4000 Hz, for the Veteran's left ear. Additionally, the Veteran's speech recognition ability, using the Maryland CNC test, was 100 percent for both ears.

Based on the foregoing, the audiological findings of record do not meet the required criteria for hearing loss for VA purposes. The Board also acknowledges the Veteran's reported history of military noise exposure to pneumatic tools, explosions, diesel trucks, and jets. See January 2021 VA Audio Examination. However, the Board finds that the Veteran's statements are outweighed by the above-noted objective clinical testing that shows the Veteran unfortunately does not yet have hearing loss for VA purposes. Thus, based on the VA examination results and evidence of record, service connection for bilateral hearing loss must be denied because there is no current hearing loss disability for VA benefits purposes. For the above stated reasons, the most persuasive and probative evidence is against the claim, the benefit of the doubt doctrine does not apply, and entitlement to service connection for bilateral hearing loss is not warranted.

Michael J. Skaltsounis

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Alexander, Lasheyna T.

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.

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