Back to BVA DecisionsMIXEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 250201-527732
IRRITABLE COLON SYNDROME (SPASTIC COLITIS MUCOUS COLITIS)
MICHAEL A. HERMAN · 2026 · Case ID: A26031070
Summary
The veteran served from July 1971 to March 1975. He appeals the denial of service connection for hepatic steatosis and diverticulosis, and seeks an increased rating for unstable angina and hypertension. The Board granted service connection for an intestinal disorder, claimed as diverticulitis, as secondary to a service-connected psychiatric disability, resolving all doubt in the veteran's favor for the period prior to September 10, 2024. The Board denied service connection for hepatic steatosis, noting it was first diagnosed over 44 years after service, was not linked to service or toxic exposure, and the veteran's reported symptoms were attributed to unrelated conditions. For unstable angina, the Board denied an increased rating above 30 percent, finding the VA examiner's interview-based METS test findings probative and indicating a workload of greater than 5 to 7 METS, which did not meet the criteria for a higher rating. For hypertension, the Board denied an increased rating above 10 percent, as the record did not show readings meeting the criteria for a higher rating, and the veteran failed to report for a scheduled VA examination without good cause.
Rationale
Intestinal disorder granted as secondary to psychiatric disability; Resolved all doubt in veteran's favor; Grant effective prior to September 10, 2024
Full Decision Text
Citation Nr: A26031070 Decision Date: 04/06/26 Archive Date: 04/06/26 DOCKET NO. 250201-527732 DATE: April 6, 2026 ORDER Service connection for an intestinal disorder is granted. Service connection for hepatic steatosis is denied. An initial rating in excess of 30 percent for unstable angina is denied. A rating in excess of 10 percent for hypertension is denied. FINDINGS OF FACT 1. An intestinal disorder, claimed as diverticulitis and diagnosed as irritable bowel syndrome, is secondary to the service connected psychiatric disability. 2. Hepatic steatosis was not incurred in service and is not etiologically related to service. 3. The unstable angina does not result in a workload of 5.0 METS or less resulting in heart failure symptoms. 4. The hypertension has been manifested by diastolic pressure predominantly below 110 and systolic pressure consistently below 200. CONCLUSIONS OF LAW 1. The criteria for service connection for an intestinal disorder have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.310. 2. The criteria for service connection for hepatic steatosis have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 3. The criteria for an initial rating in excess of 30 percent for unstable angina have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.104 Diagnostic Code 7005. 4. The criteria for a rating in excess of 10 percent for hypertension have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.104 Diagnostic Code 7101. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from July 1971 to March 1975. In a September 2024 rating decision, the agency of original jurisdiction (AOJ) granted service connection for heart disease and assigned a 30 percent rating from February 9, 2023. The rating decision also reported the denial of service connection for hepatic steatosis and diverticulosis. The Veteran appealed that decision by filing a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) on February 1, 2025. He elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the September 2024 decision on appeal, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182, i.e., May 2, 2025. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801. Regarding the hypertension claim, in a July 2023 rating decision, the AOJ denied a claim for increased rating for hypertension that stemmed from a May 2023 VA 21-526EZ, Fully Developed Claim (and May 2023 "Intent to File" form). In April 2024, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of the July 2023 decision. In July 2024, the AOJ issued the HLR decision on appeal, which considered the evidence of record at the time of the prior July 2023 decision. In the February 1, 2025 VA Form 10182, the Veteran again elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the July 2023 AOJ decision, which was subsequently subject to higher-level review, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision, which was subsequently subject to higher-level review and prior to the date the Board received the VA Form 101 prior July 2023 decision. In the February 1, 2025 VA Form 10182, the Veteran again elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the July 2023 AOJ decision, which was subsequently subject to higher-level review, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision, which was subsequently subject to higher-level review and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801. The February 2025 VA Form 10182 also indicates disagreement with a November 2024 rating decision's denial of service connection for neurobehavioral effects and a September 2024 rating decision's denial of service connection for neurological muscle movement. However, the Veteran filed September 2024 and November 2024 VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of these issues prior to receipt of the February 2025 VA Form 10182. He did not withdraw these supplemental claims in conjunction with the VA Form 10182 and the claims were pending at the time of receipt of the VA Form 10182. The VA Form 10182 is not valid for these issues; these issues are not before the Board. 38 C.F.R. § 3.2500(d). The February 2025 VA Form 10182 also reveals disagreement with July 2023 and May 2020 rating decisions; as noted in a March 2025 letter, the appeal was not timely with regard to the issues decided in these specific decisions. Service Connection Service connection may be established for disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be granted for any disease initially diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). The Veteran's personnel records indicate that he was stationed at Camp Lejeune. Persons residing or working at the U.S. Marine Corps Base Camp Lejeune between August 1953 and December 1987 were potentially exposed to drinking water contaminated with volatile organic compounds. Service connection for certain disabilities may be presumed for those who served at Camp Lejeune for no less than 30 days during this period. 38 C.F.R. § 3.309(f). Intestinal Disorder In May 2022, the Board denied a claim for service connection for "colitis, claimed as stomach condition." In the decision, the Board treated the claimed disorder as "colitis/diverticulitis." In February 2024, VA received an Intent to File. In March 2024, VA received a VA form 21-526EZ with claims including a claim for service connection for diverticulitis. This claim was decided in the September 2024 rating decision on appeal, which was appealed in the February 2025 VA Form 10182. Prior to receipt of the February 2025 VA Form 10182, the Veteran filed a supplemental claim for service connection for colitis. This claim was denied in a January 2025 rating decision, which was appealed in a January 2025 VA Form 10182. This appeal was remanded by the Board in January 2026, at which time, the Board recharacterized the issue as entitlement to service connection for an intestinal disorder, claimed as colitis. In a March 2026 rating decision, the AOJ granted service connection for an intestinal disability effective September 10, 2024, which was the date of receipt of the supplemental claim for colitis. The diverticulitis claim stems from a February 2024 Intent to File; as such, the Board finds the March 2026 rating decision that granted service connection for an intestinal disorder did not fully satisfy this appeal; it remains before the Board for the period prior to September 10, 2024. After consideration of the record, particularly the March 2026 rating decision that granted service connection for an intestinal disorder as secondary to the service-connected psychiatric disability and resolving for an intestinal disorder, claimed as colitis. In a March 2026 rating decision, the AOJ granted service connection for an intestinal disability effective September 10, 2024, which was the date of receipt of the supplemental claim for colitis. The diverticulitis claim stems from a February 2024 Intent to File; as such, the Board finds the March 2026 rating decision that granted service connection for an intestinal disorder did not fully satisfy this appeal; it remains before the Board for the period prior to September 10, 2024. After consideration of the record, particularly the March 2026 rating decision that granted service connection for an intestinal disorder as secondary to the service-connected psychiatric disability and resolving all doubt in favor of the Veteran, the Board finds service connection is warranted for an intestinal disability, claimed as diverticulitis for this period. Hepatic Steatosis Service treatment and examination records are negative for any finding or history indicative of hepatic steatosis or other liver abnormality, and a July 1974 treatment record reports that SMA-6 and SMA-12 tests were within normal limits. May 1987 inpatient records reveal that bloodwork was normal. The Veteran did not report a history of high liver enzymes. July 1987 inpatient records reveal findings of high liver enzymes. The Veteran reported a history of "high enzymes" "after he got out of the military but now they are normal." August 1998 inpatient records report that bloodwork revealed normal liver disease profile. October 2007 VA treatment record reports that liver function tests were normal. A August 2008 treatment record indicates that a computerized tomography (CT) scan revealed fatty infiltration of the liver. July 2011 bloodwork revealed normal liver function tests. A March 2012 CT scan revealed fatty infiltration of the liver. March 2015 and March 2017 VA treatment record reports that liver function tests were normal. A November 2019 CT scan showed steatotic liver. A March 2024 VA examination record reveals diagnosis of hepatitis steatosis (fatty liver). The examiner determined the condition was not related to toxic exposure risk activities, including after considering the total potential exposure through all applicable deployments and the synergistic combined effect to all toxic exposure risk activity. The examiner provided a rationale. After consideration of the record, the Board finds service connection is not warranted for hepatic steatosis. Hepatic steatosis is not shown to have been incurred in service or otherwise etiologically related to service. The record does not suggest that hepatic steatosis was present until years after service - it was first noted more than 44 years after separation - and the Veteran has not reported symptoms later attributed to hepatic steatosis during and since service or abnormal liver findings during and since service. Notably, although the Veteran reported a history of increased liver enzymes in 1987, he reported that the previous finding of increased liver enzymes was "after service." The Veteran reported symptoms during service which he attributed to the hepatic steatosis at the VA examination. There is no medical evidence of symptoms due to the Veteran's fatty liver, including those reported at the VA examination, and the record indicates that fatty liver "most often causes no problems." Additionally, medical records suggest that the reported symptoms are due to unrelated conditions, such as the psychiatric disability and intestinal disorder. The record does not suggest that the Veteran is competent to make diagnostic determinations, such as determining the etiology of reported symptoms. Thus, the Board finds the Veteran's history is not probative evidence that the fatty liver was present during service. In sum, the Board finds the record does not suggest that fatty liver was incurred in service. The Veteran contends that the fatty liver is due to exposure to contaminated water at Camp LeJeune. Fatty liver is not a disease presumed due to that exposure, and a VA examiner has determined that the fatty liver is not related to service, including that exposure. An Internet article submitted by the Veteran about reported health effects linked with TCE, PCE, benzene, and VC exposure also does not list fatty liver as a possible health effect. Although the Veteran believes such a link exists, the record does not suggest that the Veteran is competent to make that determination. Thus, the Board finds the fatty liver is also not etiologically related to service. The claim must be denied. Increased Ratings Unstable Angina Unstable angina is rated under a General Rating Formula for Diseases to the Heart. 38 C.F.R. § 4.104 Diagnostic Code 7005. The General Rating Formula provides a 60 percent rating required more than one episode of acute congestive heart failure in the Veteran about reported health effects linked with TCE, PCE, benzene, and VC exposure also does not list fatty liver as a possible health effect. Although the Veteran believes such a link exists, the record does not suggest that the Veteran is competent to make that determination. Thus, the Board finds the fatty liver is also not etiologically related to service. The claim must be denied. Increased Ratings Unstable Angina Unstable angina is rated under a General Rating Formula for Diseases to the Heart. 38 C.F.R. § 4.104 Diagnostic Code 7005. The General Rating Formula provides a 60 percent rating required more than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent. Heart failure symptoms are noted to include, but not be limited to, breathlessness, fatigue, angina, dizziness, and syndrome. The use of medication is contemplated by the General Rating Formula. After review of the record, which includes a March 2024 VA examination record and VA and non-VA treatment records, the Board finds a rating in excess of 30 percent is not warranted under Diagnostic Code 7005. The record does not indicate that the Veteran has a workload of at most 5 METS. Notably, the March 2024 VA examiner determined the heart disease would result in a workload of greater than 5 to 7 METS resulting in breathlessness and angina based on interview. The examiner determined exercise stress testing was not required as part of the treatment plan and was not without significant risk; the Board finds the examination record complies with VA regulation, including 38 C.F.R. § 4.104, Note (2). The Board finds the interview-based METS test findings are probative. Thus, the claim is denied. Hypertension Diagnostic Code 7101 provides a 20 percent rating for diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. 38 C.F.R. § 4.104 Diagnostic Code 7101. The use of medication is contemplated by the rating criteria. A VA examination was scheduled for June 2023. The record indicates that the Veteran refused the examination. The Veteran did not provide good cause for the failure to report or request that the examination be rescheduled. When entitlement or continued entitlement to a benefit cannot be established or confirmed without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination, or reexamination, action shall be taken. 38 C.F.R. § 3.655(a). When a claimant fails to report for an examination scheduled in conjunction with a claim for increase, the claim shall be denied. 38 C.F.R. § 3.655(b). A current examination was not necessary to determine the proper rating for the hypertension. The Board finds the matter may be adjudicated based on the record. 38 C.F.R. § 3.655(a). A rating in excess of 10 percent is not warranted because the evidence does not suggest diastolic pressure predominantly 110 or more or systolic pressure predominantly 200 or more. The record includes no readings with systolic pressure at or above 200 diastolic reading at or above 110; medical records consistently document diastolic pressure below 110 and systolic pressure below 200. The Veteran has not reported home blood pressure readings matching the criteria for a higher rating at any time during the period of the appeal. The Board finds the record documents that diastolic pressure has been predominantly below 110 and systolic pressure has been below 200 for the entire period of the claim. The claim for an increased initial rating is denied. In making this determination, the Board notes that the Veteran has presented no contention in support of the claim for an increased rating. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Snyder, N. 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. making this determination, the Board notes that the Veteran has presented no contention in support of the claim for an increased rating. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Snyder, N. 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.