IRRITABLE COLON SYNDROME (SPASTIC COLITIS MUCOUS COLITIS)

KRISTIN HADDOCK · 2026 · Case ID: A26038797

MIXED

Summary

The veteran, who served from April 1991 to April 1995, including service in Southwest Asia, appeals the denial of service connection for hypertension, a psychiatric disability, and skin cancer, and seeks an increased rating for irritable bowel syndrome (IBS) with chronic diarrhea and colon polyps. The Board granted an initial 30 percent rating for IBS with chronic diarrhea and colon polyps, finding that the veteran's symptoms, including frequent diarrhea, abdominal distress, and episodes of bowel disturbance, met the criteria for this rating under both pre-amended and amended regulations. The Board noted that while the veteran has other abdominal conditions, the IBS symptoms were not separately ratable under other diagnostic codes. The claims for hypertension, psychiatric disability, and skin cancer were remanded. For hypertension, the Board found the VA examination inadequate as it failed to address the veteran's lay statements and service treatment records showing elevated blood pressure, and did not consider conceded toxic exposure risk activities (TERA). For the psychiatric disability, the Board found the VA examination inadequate for failing to address lay statements regarding military sexual trauma and service-related stress, and for missing mental health clinic visit details from service records. For skin cancer, the Board noted the AOJ conceded TERA and current basal cell carcinoma, but the VA examination did not consider sun exposure and TERA. The case was remanded for new VA examinations and opinions addressing the etiology and service connection for these remanded conditions, including consideration of TERA and specific stressors.

Rationale

Veteran's IBS with chronic diarrhea and colon polyps more nearly approximated severe IBS with diarrhea or alternating diarrhea and constipation, with more or less constant abdominal distress.; 30 percent rating is the maximum allowable schedular rating for IBS.; No indication colon polyps caused additional symptoms warranting higher rating.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250127-510822

Full Decision Text

Citation Nr: A26038797
Decision Date: 04/27/26 Archive Date: 04/27/26

DOCKET NO. 250127-510822
DATE: April 27, 2026

ORDER

Entitlement to an initial 30 percent rating, but not higher, for irritable bowel syndrome (IBS) with chronic diarrhea and colon polyps is granted.

REMANDED

Entitlement to service connection for hypertension is remanded.

Entitlement to service connection for a psychiatric disability is remanded.

Entitlement to service connection for skin cancer is remanded.

FINDING OF FACT

The Veteran's IBS with chronic diarrhea and colon polyps more nearly approximated severe IBS with diarrhea or alternating diarrhea and constipation, with more or less constant abdominal distress.

CONCLUSION OF LAW

The criteria for an initial 30 percent rating for IBS with chronic diarrhea and colon polyps have been met. 38 U.S.C. §§ 1155, 5107 (2024); 38 C.F.R. §§ 4.3, 4.7, 4.20, 4.114, Diagnostic Code 7319 (2025).

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active air service from April 1991 to April 1995, including service in Southwest Asia. These matters come before the Board of Veterans' Appeals (Board) on appeal from a December 2024 rating decision issued by the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ).

In the January 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 December 2024 rating 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 (2025).

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 (2025). If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

However, because the Board is remanding the service connection claims on appeal, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii) (2025).

Increased Rating

The Veteran claims that her IBS with chronic diarrhea and colon polyps is worse than that contemplated by the currently assigned rating. Her IBS with chronic diarrhea and colon polyps is rated 0 percent disabling pursuant to Diagnostic Code 7319. 38 C.F.R. § 4.114.

During the pendency of the appeal, the rating criteria for evaluating digestive system under 38 C.F.R. § 4.114 were amended effective May 19, 2024. 89 Fed. Reg. 19743 (Mar. 20, 2024). These amendments revised select diagnostic codes "to ensure that the rating schedule uses current medical terminology and provides detailed and updated criteria for evaluation of digestive conditions for disability rating purposes." Therefore, the Board will consider the Veteran's claim under the old criteria prior to May 19, 2024, and both the old and new rating criteria from May 19, 2024. The criteria that is more favorable to the Veteran will be applied.

At the outset, the Board acknowledges that the Veteran is service-connected for several separate disabilities affecting the abdomen. However, there are diseases of the digestive system, particularly within the abdomen, which, while varying in the site of pathology, produce a common disability picture characterized in the main by varying degrees of abdominal distress or pain, anemia, and disturbances in nutrition. Consequently, certain coexisting diseases in this area do not lend themselves to distinct and separate disability ratings without violating the fundamental principle relating to pyramiding as outlined
Veteran's claim under the old criteria prior to May 19, 2024, and both the old and new rating criteria from May 19, 2024. The criteria that is more favorable to the Veteran will be applied.

Under the pre-amended and amended criteria, the Board notes that the Veteran's IBS with chronic diarrhea is rated under Diagnostic Code 7319. Additionally, the Veteran's colon polyps are rated under Diagnostic Code 7344, pertaining to benign neoplasms. 38 C.F.R. § 4.114. The Board will consider all applicable diagnostic codes in determining the Veteran's entitlement to any potential higher rating.

In January 2024, the Veteran presented for a VA examination. She reported having accidental episodes where she did not make it to the bathroom. She related that she would have to change clothes and would awaken in a soiled bed. The examiner indicated that the Veteran had diarrhea (three to four days) and alternating diarrhea and constipation and intermittent abdominal bloating and cramping sensation. The Veteran experienced frequent episodes of bowel disturbance with abdominal distress. Further, the Veteran had episodes of exacerbations and/or attacks which included diarrhea and constipation seven or more times in the past twelve months. The examination was unremarkable for any other pertinent physical findings, complications, conditions, signs or symptoms.

Based on the foregoing, the Board finds that the Veteran is entitled to a higher rating. Prior to May 19, 2024, the Veteran's symptomatology more nearly approximated severe IBS with diarrhea or alternating diarrhea and constipation, with more or less constant abdominal distress. Id. at Diagnostic Code 7319.

Beginning May 19, 2024, the Veteran's IBS was productive of abdominal pain related to defecation at least one day per week during the previous three months and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension. In this regard, the Veteran reported having daily diarrhea, excess gas, cramping, bloating, and constipation. The Board notes that a 30 percent rating is the maximum allowable schedular rating for IBS. The Board notes that a 30 percent rating is the maximum allowable schedular rating for IBS. Id. Throughout the appeal period, there is no indication from the record that the Veteran's colon polyps were productive of any additional symptoms. Id. at Diagnostic Code 7344.

The Board has considered assigning a higher rating under another diagnostic code. However, there is no indication from the record that the Veteran's IBS with chronic diarrhea and colon polyps causes any other functional impairment other than those contemplated by the currently assigned rating. Therefore, a higher rating under another diagnostic code is not warranted and the Veteran's symptoms are accurately reflected by the rating assigned under Diagnostic Code 7319. Id.

Consideration has been given to assigning staged ratings. However, at no time during the period in question has the disability warranted a higher schedular rating than that assigned. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).

Accordingly, the Board finds that the benefit-of-the-doubt rule is not applicable as the evidence is not in approximate balance, and entitlement to an initial 30 percent rating for IBS with chronic diarrhea and colon polyps is warranted. 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc)

REASONS FOR REMAND

1. Service Connection - Hypertension

REASONS FOR REMAND

1. Service Connection - Hypertension

The Veteran claims that her hypertension is related to her active service. Specifically, she reported that she developed hypertension from service-related stress. Prior to issuance of the rating decision on appeal, the Veteran reported for a VA examination. However, the examiner did not address the Veteran's lay statements or service treatment records (STRs) showing elevated blood pressure (BP) readings during the Veteran's active service. Additionally, the AOJ failed to obtain a VA medical opinion which considers the Veteran's toxic exposure risk activity (TERA) as conceded on the record. See Barr v. Nicholson, 21?Vet. App.?303 (2007) (holding that once VA has provided a VA examination or obtained a medical opinion, it is required to provide or obtain one that is adequate for the purpose sought). Therefore, a remand is required for corrective action. 38?C.F.R. §?20.802(a) (2025).

2. Service Connection - Psychiatric Disability

The Veteran claims that her psychiatric disability is related to her active service. Specifically, she reported that she experienced military sexual trauma and service-related stress. She explained that she worked in a gender biased environment while serving in Saudi Arabia and was subjected to disparate treatment and targeted cackling, inappropriate jokes and comments, and yelling. Prior to issuance of the rating decision on appeal, the Veteran reported for a VA examination. However, the examiner did not address the Veteran's lay statement regarding service-related stress. See Barr v. Nicholson, 21?Vet. App.?303. Furthermore, the details of the Veteran's mental health clinic visit in December 1991 are missing from the STRs. In a case in which a Veteran's service records are unavailable through no fault of his or her own, the Board recognizes that it has a heightened duty to assist the claimant in the development of his claim. See Cromer v. Nicholson, 19 Vet. App. 215, 217 (2005) (quoting O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). Therefore, a remand is required for corrective action. 38?C.F.R. §?20.802(a).

3. Service Connection - Skin Cancer

The Veteran claims that her skin cancer is related to her active service. Specifically, she reported that she was exposed to heat and sun while serving in Southwest Asia. The AOJ conceded that the Veteran participated in a TERA. Further, the AOJ found that the Veteran had currently present basal cell carcinoma. The Board is bound by these favorable findings. 38 C.F.R. § 3.104(c) (2025). Prior to the issuance of the rating decision on appeal, the AOJ did not obtain a VA examination which considers the Veteran's sun exposure and TERA. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Therefore, a remand is required for corrective action. 38?C.F.R. §?20.802(a).

The matters are REMANDED for the following action:

1. Return the claims file for a medical opinion by an examiner with appropriate expertise to determine the nature and etiology of the Veteran's hypertension. The claims file must be made available to and reviewed by the examiner. Any indicated tests and studies should be performed.

Based on a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's hypertension had its onset during her active service or is otherwise etiologically related to such service, to include elevated blood pressure readings in December 1991, May 1992, September 1992, and October 1992, and identified toxic exposure risk activities (TERAs). In providing this opinion, the examiner must consider and discuss: 1) the total potential exposure through all applicable military deployments; and 2) the synergistic, combined effect of all TERA i.e., environmental hazards in Southwest Asia.

A complete and detailed rationale must be provided for all opinions expressed.

2. Return the claims file for a medical opinion by a psychiatrist or psychologist with appropriate expertise to determine the nature and etiology of the Veteran's psychiatric disability. The claims file must be made available to and reviewed by the examiner. Any indicated tests and studies should be performed.

Based on a review of the record, the examiner should identify all psychiatric disabilities present during the pendency
1992, and identified toxic exposure risk activities (TERAs). In providing this opinion, the examiner must consider and discuss: 1) the total potential exposure through all applicable military deployments; and 2) the synergistic, combined effect of all TERA i.e., environmental hazards in Southwest Asia.

A complete and detailed rationale must be provided for all opinions expressed.

Based on a review of the record, the examiner should identify all psychiatric disabilities present during the pendency of the claim, or proximate thereto.

Then, the examiner should provide an opinion as to whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that a psychiatric disability had its onset during the Veteran's active service or is otherwise etiologically related to such service. In providing this opinion, the examiner must consider and discuss the Veteran's lay statements, including service-related stress.

A complete and detailed rationale must be provided for all opinions expressed.

3. Schedule the Veteran for an examination to determine the nature and etiology of any currently present skin cancer. The claims file must be made available to and reviewed by the examiner. Any indicated studies should be performed.

Based on the examination results and the review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's skin cancer had its onset during her active service or is otherwise etiologically related to such service, to include sun exposure and/or identified toxic exposure risk activities (TERAs). In providing this opinion, the examiner must consider and discuss: 1) the total potential exposure through all applicable military deployments; and 2) the synergistic, combined effect of all TERA i.e., environmental hazards in Southwest Asia.

A complete and detailed rationale must be provided for all opinions expressed.

Kristin Haddock

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board D. Ware, Counsel

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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