INTESTINE SMALL RESECTION OF

JENNIFER HWA · 2026 · Case ID: A26034767

MIXED

Summary

The Veteran served from June 1967 to April 1970, including service in Vietnam and receipt of the Purple Heart medal. The Veteran appealed the denial of service connection for a stomach condition and sought service connection for residuals of a small intestine resection. The Board granted service connection for the small intestine residuals, finding it was secondary to service-connected gunshot wounds and related treatment. The Veteran had a laparoscopy in June 2024 due to adhesions and narrowing of the small bowel, which the surgeon attributed to residual scarring from the gunshot wound treatment. Although the VA examiner initially stated no nexus, the Board found the opinion inadequate for failing to address the surgeon's specific findings linking the resection to the service-connected gunshot wound treatment. The Board found sufficient independent medical information to grant secondary service connection. The claim for a stomach condition was denied. The Veteran reported intestinal complaints, including flatulence, but lacked a current diagnosis of a separate stomach condition. The Board found the symptoms did not demonstrate functional impairment of earning capacity and were attributed to existing service-connected disabilities, thus not meeting the criteria for a separate stomach condition. The benefit of the doubt doctrine was considered but found not applicable as the evidence weighed against the claim.

Rationale

Private surgeon's notes directly linked resection to service-connected gunshot wound treatment.; VA examiner's opinion was inadequate for failing to address causation/aggravation.; Board found sufficient independent medical information to grant secondary service connection.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

260102-609513

Full Decision Text

Citation Nr: A26034767
Decision Date: 04/15/26 Archive Date: 04/15/26

DOCKET NO. 260102-609513
DATE: April 15, 2026

ORDER

Entitlement to service connection for residuals of resection of small intestine is granted.

Entitlement to service connection for a stomach condition is denied.

FINDINGS OF FACT

1. The Veteran's resection of small intestine was due to remaining internal scar tissue from service-connected gunshot wound residuals.

2. The Veteran does not have a documented current diagnosis of a stomach condition.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for residuals of resection of small intestine have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

2. The criteria for entitlement to service connection for a stomach condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from June 1967 to April 1970 with service in the Republic of Vietnam and receipt of the Purple Heart medal.

In the January 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket.

Therefore, the Board may only consider the evidence of record at the time of the January 2025 agency of original jurisdiction (AOJ) 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. 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.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) 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 claims, 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. Entitlement to service connection for resection of small intestine

The Veteran contends that he had a resection of the small intestine as a result of prior treatment for gunshot wound in service. After a thorough review of the evidence, the Board finds entitlement to service connection for resection of small intestine is warranted.

To establish entitlement to service-connected compensation benefits, a Veteran must 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 be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d).

If the evidence for and against a claim is in approximate balance, the claim will be granted. 38 C.F.R. § 4.3. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

Service connection may also be warranted on a secondary basis for "disability which is proximately due to or the result of a service-connected disease or injury." 38 C.F.R. § 3.310(a). Secondary service connection is also warranted for "[a]ny increase in severity of a nonservice-connected disease or injury that is proximately due to or the result
doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

Service connection may also be warranted on a secondary basis for "disability which is proximately due to or the result of a service-connected disease or injury." 38 C.F.R. § 3.310(a). Secondary service connection is also warranted for "[a]ny 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." 38 C.F.R. § 3.310(b).

The Veteran is service-connected for gunshot wound of the right buttock, gunshot wound of the left buttock, associated scars, and wound of anal canal and sphincter with exploratory laparotomy and temporary colostomy as a result of gunshot wound in Vietnam.

In June 2024, the Veteran presented to the hospital with abdominal pain. After evaluation, the medical providers admitted the Veteran for surgery. While exploring the Veteran's intestine laparoscopically, the surgical team determined that, "there were also adhesions of small bowel to the lower midline corresponding to the previous laparotomy site. There were other adhesions in the left lower quadrant at the site of the previous ostomy... The small bowel appeared narrowed at the site of the adhesion. A resection of the narrowed segment of small bowel was felt necessary," and continues with description of the resection process. See private treatment records June 2024.

The July 2024 VA examiner noted that the Veteran reported resection of the small bowel due to scar tissue the prior month. However, the examiner replied "no" in the section of the report about history of small bowel resection. In the December 2024 opinion, the examiner declined to find a nexus with the old gunshot wound treatment because the Veteran had no chronic gastrointestinal issues for 40 years and stated that there was no relationship with the current pathology. The examiner did not provide an opinion as to whether the service-connected gunshot wound and anal canal disabilities caused or aggravated the intestine, thus resulting in the resection. Causation and aggravation must be addressed in any medical opinion concerning secondary service connection. See El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013). The Board finds the opinion inadequate because it did not properly reference the surgeon's notes specifically stating the reason for the resection was residual scarring from the gunshot wound treatment in Vietnam.

The Board is not permitted to provide its own medical determination on service connection claims. Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991) (VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions). However, in this instance, the June 2024 surgeon stated the cause and effect from the gunshot wound treatment in Vietnam as the etiology of the resection of the small bowel within the surgery notes. Accordingly, the Board finds that it has the necessary independent medical information to support a finding of entitlement to service connection on a secondary basis for the resection of the small intestine as a result of the service-connected gunshot wounds and related treatment during service. The Board grants the appeal.

2. Entitlement to service connection for a stomach condition

The Veteran contends that he has a stomach condition as a result of service-connected residual gunshot wounds and anal canal wound. After a thorough review of the evidence, the Board finds that entitlement to service connection for a stomach condition is not warranted.

The Veteran is service-connected for gunshot wound of the right buttock, left buttock, associated scars, and wound of anal canal and sphincter with exploratory laparotomy and temporary colostomy as a result of gunshot wound in Vietnam.

The Veteran attended a VA stomach examination in December 2024. The examiner reported no diagnosed stomach condition. The Veteran reported flatulence since the 2024 surgery.

The record reflects the Veteran has complaints of intestinal symptoms like occasional constipation as reported in the December 2024 intestinal conditions examination. However, the evidence does not support that the Veteran has a separate stomach condition.

The Veteran attended a VA stomach examination in December 2024. The examiner reported no diagnosed stomach condition. The Veteran reported flatulence since the 2024 surgery.

The existence of a current disability is the cornerstone of a claim for VA disability compensation. Degmetich v. Brown, 104 F.3d 1328 (1997). See also, Brammer v. Derwinski, 3 Vet. App. 223 (1992) where the Court concluded that the veteran was not entitled to benefits simply because he might have suffered from an illness, but rather, 38 U.S.C.S. § 1110 required that such illness resulted in a disability for the veteran to be entitled to compensation.

The Board acknowledges that a lack of a formal diagnosis is not dispositive. The term "disability" as used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability." See Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). The Board notes that the December 2024 VA examiner noted complaints of flatulence and that the Veteran otherwise has intestinal complaints. However, the Board finds that the symptoms have not impaired the Veteran's ability to perform occupational tasks and are otherwise attributed to his already service-connected disabilities, and that a separate stomach condition was not diagnosed. Thus, the Veteran's claimed stomach condition has not demonstrated functional impairment of earning capacity. Saunders, 886 F.3d at 1368.

The Veteran does not have a current diagnosis of stomach condition during the appeal period. While the Veteran is competent to report symptoms, he is not competent as a lay person to render a current diagnosis of stomach condition or differentiate stomach problems from intestinal problems, as this requires specialized medical expertise. Thus, the Veteran has no current disability of stomach condition. Accordingly, the first element of service connection, a current disability, is not satisfied. As the first element is not satisfied, there is no need to discuss the remaining elements.

Accordingly, the persuasive weight of the evidence weighs against the finding of service connection for stomach condition. The Board has considered the benefit of the doubt doctrine and determined it is not applicable. As the evidence is persuasively against the Veteran's claim, the evidence is not in approximate balance and the benefit of the doubt rule does not apply. Therefore, the claim for stomach condition must be denied. See 38 U.S.C. § 5107(b); 38 CFR § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

JENNIFER HWA

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Miller, Erin (BVA)

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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