IRRITABLE COLON SYNDROME (SPASTIC COLITIS MUCOUS COLITIS)

Summary

The veteran, who served from October 1994 to July 1995, appeals the denial of service connection for hypertension and the adequacy of the rating for irritable bowel syndrome (IBS). The Board granted an increased rating for IBS to 30 percent, finding that the veteran's symptoms met the criteria for severe IBS under the prior rating schedule, which was more favorable than the amended criteria. The VA examiner confirmed the IBS diagnosis and noted frequent bowel movements, abdominal distress, and weight loss, supporting the 30 percent rating. However, the Board denied service connection for hypertension. While the AOJ noted a favorable finding of hypertension in August 2004 VA records, the Board found this note indicated no history of hypertension. Subsequent private records also failed to show a diagnosis or treatment for hypertension. The veteran's lay statements attributing night sweats to hypertension were given little weight, as he is not competent to diagnose the etiology of medical conditions. The Board concluded that the evidence weighed against a diagnosis of hypertension during the pendency of the appeal. The case was remanded for earlier effective dates for PTSD and Dependents' Educational Assistance (DEA) due to a pre-decisional duty to assist error, as mental health treatment records from the veteran's incarceration were not obtained.

Rationale

Prior rating criteria more favorable; Symptoms met criteria for severe IBS; Daily diarrhea with constant abdominal distress and weight loss

Full Decision Text

Citation Nr: A26039955
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 250205-520501
DATE: April 29, 2026

ORDER

A 30 percent rating for irritable bowel syndrome (IBS) is granted, subject to the laws and regulations governing the award of monetary benefits.

Service connection for hypertension is denied.

REMANDED

An effective date prior to September 21, 2023, for the grant of a 100 percent rating for posttraumatic stress disorder (PTSD).

An effective date prior to September 21, 2023, for the grant of basic eligibility to Dependents' Educational Assistance (DEA).

FINDINGS OF FACT

1. The Veteran served on active duty from October 1994 to July 1995; he has been 100 percent disabled since September 2023.

2. IBS has been manifested by subjective complaints of bowel movements three to four times per day; objective findings included continuous medication for control, abdominal pain with daily diarrhea, alternating constipation once every 1 to 2 months, abdominal distension, nausea, and weight loss with 6 episodes of exacerbation in the prior 12 months.

3. Hypertension has not been shown.

CONCLUSIONS OF LAW

1. The criteria for a 30 percent rating for IBS have been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107, 5110 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, § 4.114, Diagnostic Code (DC) 7319 (2024, 2025).

2. Hypertension was not incurred in service. 38 U.S.C. §§, 1110, 1112, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.307, 3.309 (2025).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

This decision has been written under the guidelines of the Veterans Appeals Improvement and Modernization Act, also known as the Appeals Modernization Act (AMA). In October 2024, the agency of original jurisdiction (AOJ) denied the claims on appeal. 

In February 2025, the Veteran appealed to the Board via a Form 10182 and elected the Evidence Submission docket. Therefore, the Board will review the evidence of record at the time of the AOJ's October 2024 decision, in addition to evidence submitted with the Form 10182 or within 90 days following receipt of the Form 10182.

Increased Rating for IBS

Turning to the relevant laws and regulations, disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4.

The Veteran is rated at 0 percent for IBS under DC 7319. During the pendency of the appeal, the rating criteria for evaluating the disabilities of the digestive system under 38 C.F.R. § 4.114 were amended effective May 19, 2024. 

If a law or regulation changes during the course of a claim or an appeal, the version more favorable to the veteran will apply, to the extent permitted by any stated effective date in the amendment in question. See 38 U.S.C. § 5110(g). If the revised version of the regulation is more favorable, the implementation of that regulation under 38 U.S.C. § 5110(g) can be no earlier than the effective date of that change. 

If the former version is more favorable, VA can apply the earlier version of the regulation for the period prior to, and from, the effective date of the change. See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). Therefore, the Board will consider the Veteran's appeal under the old criteria prior to May 19, 2024, and both the old and new rating criteria from May 19, 2024.

Under the prior rating criteria, a higher rating for IBS was warranted when the medical evidence showed:

"	Moderate irritable colon syndrome with frequent episodes of bowel disturbance with abdominal distress (10%); or,

"	Severe
. 

If the former version is more favorable, VA can apply the earlier version of the regulation for the period prior to, and from, the effective date of the change. See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). Therefore, the Board will consider the Veteran's appeal under the old criteria prior to May 19, 2024, and both the old and new rating criteria from May 19, 2024.

Under the prior rating criteria, a higher rating for IBS was warranted when the medical evidence showed:

"	Moderate irritable colon syndrome with frequent episodes of bowel disturbance with abdominal distress (10%); or,

"	Severe irritable colon syndrome with diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress (30%).

Neither the Rating Schedule nor the regulations provide definitions for descriptive words such as "moderate" or "severe." In the absence of an express definition, words are given their ordinary meaning. Terry v. Principi, 340 F.3d 1378, 1382-83 (Fed. Cir. 2003). 

To that end, moderate is relevantly defined as "limited in scope or effect" and "not violent, severe, or intense." Merriam-Webster Dictionary Online, accessed April 15, 2026. Severe is relevantly defined as "very painful or harmful," "causing discomfort or hardship," and "of a great degree." Merriam-Webster Dictionary Online, accessed April 15, 2026.

Under the amended rating criteria, a higher rating for IBS is warranted when the medical evidence shows:

"	Abdominal pain related to defecation at least once 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 (10%);

"	Abdominal pain related to defecation for at least three days per month 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 (20%); or,

"	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 (30%).

Turning to the medical evidence, a January 2024 VA examiner confirmed the IBS diagnosis. The Veteran complained that IBS caused abdominal pain with bloating and diarrhea, alternating with constipation. The examiner found that continuous medication, Mylanta, was required to control the disorder. 

Signs and symptoms included daily diarrhea with alternating constipation once every 1 to 2 months, abdominal bloating with gas, and daily nausea. He experienced more or less constant abdominal distress with episodes of exacerbations. Exacerbations caused watery stools and occurred six times in the prior 12 months. 

Additionally, the Veteran reported that he experienced weight loss, with his current weight at 120 pounds compared to his baseline of 145 pounds; however, he exhibited no malnutrition or serious complications. He also reported 3 to 4 bowel movements per day on the September 2024 claim. 

Based on the above, the rating criteria prior to May 19, 2024, are more favorable to the Veteran. In this regard, there is no medical evidence which may be applied to the claim after May 19, 2024, and the September 2024 report of 3 to 4 bowel movements per day does not meet the current rating criteria for a compensable rating.

Further, the IBS symptoms are more nearly approximated by a 30 percent rating for severe symptoms. In this regard, daily diarrhea is accompanied by more or less constant abdominal distress, although the diarrhea also alternates with constipation every 1 to 2 months. Additionally, weight loss caused by IBS is severe, in that it is of a great degree. Thus, a 30 percent rating for IBS is warranted and the appeal is granted to this extent.

Service Connection for Hypertension

Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus
4 bowel movements per day does not meet the current rating criteria for a compensable rating.

Further, the IBS symptoms are more nearly approximated by a 30 percent rating for severe symptoms. In this regard, daily diarrhea is accompanied by more or less constant abdominal distress, although the diarrhea also alternates with constipation every 1 to 2 months. Additionally, weight loss caused by IBS is severe, in that it is of a great degree. Thus, a 30 percent rating for IBS is warranted and the appeal is granted to this extent.

Service Connection for Hypertension

Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009).

Service connection may be granted on a presumptive basis for diseases listed in § 3.309, such as hypertension, under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service.  See 38 C.F.R. § 3.307. 

Nonetheless, service connection may only be granted for a current disability; when a claimed condition is not shown, there may be no grant of service connection. See 38 U.S.C. § 1110; Rabideau v. Derwinski, 2 Vet. App. 14 (1992) (Congress specifically limited entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability). "In the absence of proof of a present disability there can be no valid claim." See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

For a disability to be service connected, it must be present at the time a claim for VA disability compensation is filed or during or contemporary to the pendency of the appeal. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). 

In October 2024, the AOJ found that the Veteran had hypertension during the pendency of the claim. To that end, they stated that VA medical records from August 2004 showed a note for hypertension. This is a favorable finding, which may not be disturbed absent clear and convincing evidence. See 38 U.S.C. § 5104A.

Turning to the medical evidence, an August 2004 VA clinical note stated that the Veteran had no history of hypertension. Nonetheless, he alleged that service connection for hypertension was warranted on the September 2024 claim. He specified that he sweats during the night 3 to 4 times per week; however, failed to indicate any medical treatment for hypertension. Rather, he only indicated medical treatment for tinnitus in the September 2024 claim.

Notably, an October 2023 clinical note from Tomoka Correctional Institution reflected a medical history of tinnitus and hallux valgus of the left foot, but no current or prior diagnosis of hypertension. 

Here, the medical evidence clearly does not establish a diagnosis of hypertension during the pendency of the appeal. Rather, the August 2004 VA note relied upon by the AOJ stated that the Veteran had no history of hypertension. In addition, the October 2023 private clinical note failed to indicate treatment for or history of hypertension. These clinical records were made by competent medical professionals and are assigned high probative weight.

Although the Veteran reported symptoms of night sweats, which he attributed to hypertension, he is not competent to make this diagnosis due to the medical complexity of the matter involved. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Thus, his lay statement is given little probative weight. 

Thus, the probative weight of the evidence clearly and convincingly does not establish a diagnosis of hypertension during the pendency of this appeal. As the evidence does not support a diagnosis, the medical evidence weighs against the claim for service connection.

The Board has considered the Veteran's lay
 or history of hypertension. These clinical records were made by competent medical professionals and are assigned high probative weight.

Although the Veteran reported symptoms of night sweats, which he attributed to hypertension, he is not competent to make this diagnosis due to the medical complexity of the matter involved. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Thus, his lay statement is given little probative weight. 

Thus, the probative weight of the evidence clearly and convincingly does not establish a diagnosis of hypertension during the pendency of this appeal. As the evidence does not support a diagnosis, the medical evidence weighs against the claim for service connection.

The Board has considered the Veteran's lay statements that service, including toxic exposures, caused hypertension. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his claimed disorder due to the medical complexity of the matter involved. 

Such competent evidence has been provided by the medical evidence and by service records obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the evidence weighs persuasively against the claim for service connection for hypertension and there is no doubt to be otherwise resolved. As such, the appeal is denied.

Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).

REASONS FOR REMAND

The Veteran claims that earlier effective dates are warranted for the grants of a 100 percent rating for PTSD and DEA. However, remand is required to correct a pre-decisional duty to assist error.

The Veteran has been incarcerated at Tomoka Correctional Institution of the Florida Department of Corrections during the pendency of the appeals. Moreover, he reported in a November 2023 lay statement that he was prescribed medication for PTSD symptoms and that the doctor recommended increasing his dose. 

Additionally, a December 2023 VA examiner reported that the Veteran had ongoing medication management and therapy for PTSD. Nonetheless, Tomoka Correctional Institution records related to mental health treatment have not been associated with the claims file. These records are potentially relevant to the evaluation of PTSD. Remand is required to attempt to obtain these treatment records.

The issue of an earlier effective date for DEA is inextricably intertwined with the PTSD earlier effective date claim and must also be remanded.

The matters are REMANDED for the following action:

Contact the Veteran and request that they complete and return a VA Form 21-4142, Authorization and Consent to Release Information, for all medical records related to mental health treatment for the period September 21, 2022, through October 23, 2024, from Tomoka Correctional Institution, Florida Department of Corrections.

If the Veteran completes and returns the VA Form 21-4142, Authorization and Consent to Release Information, contact the appropriate medical care provider(s) and request medical records. Associate any and all records of treatment with the claims file.

At least two requests for the private records should be made, unless it is made evident by the first request that a second request would be futile in obtaining such records.

?

Any negative responses should be properly documented in the record. Notify the Veteran if the treatment records are unavailable.

 

 

L. HOWELL

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Stratton, C.

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.