HIATUS HERNIA

Summary

The Veteran, who served in the United States Marine Corps from August 1984 to September 1987, appeals the denial of service connection for an esophageal disability. The Veteran claims his symptoms, including hiatal hernia, GERD, stricture of the esophagus, gastritis, and eosinophilic esophagitis, began in 1986 during service. The record shows current diagnoses for these conditions, satisfying the first element of service connection. For the second element, the Veteran provided consistent lay testimony that his digestive issues started in late 1986 while stationed at Camp Lejeune, where he received antacid medication from a free health clinic. Although the specific 1986 medical records are unavailable, later treatment records from 1992-1994 document ongoing testing and treatment for epigastric pains, gastritis, and dyspepsia. The Board found the Veteran's lay statements credible and competent, establishing the in-service incurrence of symptoms. The Board also found that the evidence supported a continuity of symptoms since service, establishing the nexus element, particularly given the lack of adequate medical opinions. Applying the benefit of the doubt, service connection for the esophageal disability was granted.

Rationale

Current diagnoses of hiatal hernia, GERD, stricture of esophagus, gastritis, and eosinophilic esophagitis established.; Veteran's lay testimony regarding onset of symptoms in 1986 at Camp Lejeune found credible and competent.; Continuity of symptoms since service established, linking to current esophageal disability.; Benefit of the doubt afforded due to lack of adequate medical opinions and persuasive lay evidence.

Full Decision Text

Citation Nr: A26035846
Decision Date: 04/16/26	Archive Date: 04/16/26

DOCKET NO. 250817-575353
DATE: April 16, 2026

ORDER

Service connection for esophageal disability, to include hiatal hernia, gastroesophageal reflux disease (GERD), stricture of the esophagus, gastritis, and eosinophilic esophagitis, is granted.

FINDING OF FACT

Affording the benefit of the doubt, the Veteran's symptoms of esophageal disability began during active service and have continued until the present.

CONCLUSION OF LAW

The criteria for establishing entitlement to service connection for esophageal disability, to include hiatal hernia, gastroesophageal reflux disease (GERD), stricture of the esophagus, gastritis, and eosinophilic esophagitis, has been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.317.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the United States Marine Corps from August 1984 to September 1987.

The rating decision on appeal was issued in March 2025; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.  

In the August 17, 2025, 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 March 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 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. Service connection for esophageal disability is granted.

This matter was previously before the Board. In a March 2024 decision, the Board remanded the claim to the AOJ in order to attempt to locate certain identified, relevant private treatment records and in order to provide the Veteran with an adequate VA medical examination.

Service connection may be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred during service. 38 C.F.R. § 3.303(d). Generally, to establish service connection, 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).

Additionally, service connection may be granted for specified chronic diseases when shown in service with subsequent manifestations at a later date, however remote, unless clearly attributable to intercurrent causes. 38 C.F.R. § §§ 3.303(b), 3.307. Some chronic diseases are subject to presumptive service connection, although, not otherwise established as incurred or aggravated by service if manifest to a compensable degree within an applicable time limit, provided that the rebuttable presumption provisions of § 3.307 are also satisfied. See also, 38 C.F.R. §§ 3.303, 3.309.

Alternatively, to show a chronic disease in service, there is a required combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If a condition noted during service is not shown to be chronic, then generally, a showing of continuity of symptoms after service is required for service connection. 38
 3.303(b), 3.307. Some chronic diseases are subject to presumptive service connection, although, not otherwise established as incurred or aggravated by service if manifest to a compensable degree within an applicable time limit, provided that the rebuttable presumption provisions of § 3.307 are also satisfied. See also, 38 C.F.R. §§ 3.303, 3.309.

Alternatively, to show a chronic disease in service, there is a required combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If a condition noted during service is not shown to be chronic, then generally, a showing of continuity of symptoms after service is required for service connection. 38 C.F.R. § 3.303(b). 

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 C.F.R.  § 3.159; see Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Lay testimony is competent to establish the presence of observable symptomatology, where the determination is not medical in nature and is capable of lay observation. See Barr v. Nicholson, 21 Vet. App. 303 (2007).

The United States Court of Appeals for the Federal Circuit (the Federal Circuit) has held that "[l]ay 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); see also Buchanon v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) ("[T]he Board cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence").

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b).

The Veteran contends that his symptoms of esophageal disability began in 1986 during service and have intensified thereafter. 

The record shows that the Veteran has current disabilities of hiatal hernia diagnosed in June 2014, GERD diagnosed in April 1993, stricture of the esophagus diagnosed in November 2009, gastritis diagnosed in June 2014, and eosinophilic esophagitis diagnosed in September 2024. Therefore, the first element of service connection has been established.

Next, the Board finds that the evidence supports an in-service incurrence, the second element of service connection. The Veteran maintains that his symptoms of GERD began during active service. He stated that he started having "stomach/digestive issues" in late 1986 while stationed at Camp Lejeune. The Veteran reported that while on leave, he visited a free health clinic, and they provided him with antacid medication which alleviated the issues for the time he was on leave. Subsequently, a June 1987 medical board found the Veteran medically unfit for service due to his bilateral podiatric disabilities, and he was honorably discharged.

Although the 1986 medical treatment records are not of record as they were discarded by the treatment provider due to their age, there are records from the same free health clinic from five years following separation. In a 1992 medical treatment note the Veteran was undergoing a series of tests and trying various antacid medications to attempt to reduce his epigastric pains. In November 1992 it was noted that the Veteran had trialing Zantac for a month "and prior to this he was on Tagamet". In April 1994, the Veteran was diagnosed with mild gastritis and non-ulcerative dyspepsia. 

The Board notes that the Veteran is competent to report symptoms and observable events within the realm of his personal knowledge. Layno v. Brown, 6 Vet. App. 465, 470-71 (1994). Furthermore, the Board finds no reason to doubt the credibility of these statements, as they have been consistent throughout his appeal. Accordingly, the Board finds that the competent and credible lay statements made by the Veteran sufficiently establishes the in-service incurrence element of this claim.

As for the nexus between the Veteran's in-service incurrence and his current diagnoses affecting the esophagus, unfortunately there is no adequate medical opinion of record.

The Board finds that the Veteran is
 mild gastritis and non-ulcerative dyspepsia. 

The Board notes that the Veteran is competent to report symptoms and observable events within the realm of his personal knowledge. Layno v. Brown, 6 Vet. App. 465, 470-71 (1994). Furthermore, the Board finds no reason to doubt the credibility of these statements, as they have been consistent throughout his appeal. Accordingly, the Board finds that the competent and credible lay statements made by the Veteran sufficiently establishes the in-service incurrence element of this claim.

As for the nexus between the Veteran's in-service incurrence and his current diagnoses affecting the esophagus, unfortunately there is no adequate medical opinion of record.

The Board finds that the Veteran is competent to report the onset and continuity of his symptoms, and the Board finds no reason to doubt the credibility of these statements. 38 C.F.R. § 3.303; see also Jandreau, 492 F.3d at 1377.

The Board gives the competent and credible statements made by the Veteran significant weight. Given that the medical opinions of record are not adequate, the remaining evidence is persuasively in support of a continuity of esophageal disability symptoms since service.

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Accordingly, the Board finds that the most probative evidence of record establishes a nexus between service and the Veteran's current esophageal disability. Therefore, the Board finds that the Veteran's esophageal disability was incurred during his active service and has continued since then. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. As such, the appeal is granted. 38 C.F.R. § 3.303.

 

 

T. MAINELLI

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Biggs, Andrew J.

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.