[I.B.S denied service connection.]

My understanding is the VA is wrong to deny these claims, because the law does not require veterans to prove that a specific event or exposure happened in the Gulf War. So long as the veteran, (1) served in the Southwest Asia theater of operations, (2) has been diagnosed with IBS, (3) has IBS that has manifested to a degree of 10% or more prior to December 31, 2016 and (4) has IBS that is not due to a supervening event or due to willful misconduct; then service connection should be granted.

[I.B.S denied service connection.]

Hello,

First time poster but I've been around a while.

 

I've recently been denied a claim for IBS. I've included my information below. I feel they have made a CUE in processing my claim. Any thought on how I should move forward? I have diagnosis for IBS(presumptive) was in the Gulf War what else is needed?

 

Thanks

 

 

Intestinal Conditions (other than surgical or infectious),
         including irritable bowel syndrome, Crohn's disease, ulcerative
                           colitis and diverticulitis
                        Disability Benefits Questionnaire

    Name of patient/Veteran:  
   
    Is this DBQ being completed in conjunction with a VA 21-2507, C&P
Examination
    Request?
    [X] Yes   [ ] No
   

    ACE and Evidence Review
    -----------------------
    Indicate method used to obtain medical information to complete this
document:
   
    [X] In-person examination
   

    Evidence Review
    ---------------
    Evidence reviewed (check all that apply):
   
    [X] VA e-folder (VBMS or Virtual VA)
    [X] CPRS
    [X] Other (please identify other evidence reviewed):
          VistaWeb.


    1. Diagnosis
    ------------
    Does the Veteran now have or has he/she ever been diagnosed with an
    intestinal condition (other than surgical or infectious)?
    [X] Yes   [ ] No
   
       [X] Irritable bowel syndrome
              ICD code: XXXXX
              Date of diagnosis:  11/20/2017

    2. Medical history
    ------------------
    a. Describe the history (including onset and course) of the Veteran's
       intestinal condition (brief summary):
          Veteran has claimed irregular bowel patterns since service in The
Gulf.
          Veteran reports no problems with his bowels until returning from
          service in The Gulf.  Over the years, he reports developing a pattern
          of constipation alternating with diarrhea. He reports that if he takes
          medication for constipation, then he has diarrhea for weeks and admits
          he is glad for constipation. Veteran reports bloating with
constipation
          and diarrhea. He denies seeing any blood in stools and there is no FH
          of colon cancer. Veteran denies any nausea or vomiting, or
hemorrhoids.
          He denies any abnormal weight loss. Veteran does report frequent
          cramping and gas.  He admits he is afraid not to ber in the restroom
to
          pass gas as he has soiled himself at work and at home on several
          occasions. He reports his diarrhea is explosive and uncontrolled.
          Veteran denies any food that triggers his diarrhea or constipation and
          reports he eats "normal".  He does have prescribed Miralax for his
          constipation.  Veteran does see a Gastroenterologist through the VAMC.
          He has never had a colonoscopy.
         
    b. Is continuous medication required for control of the Veteran's intestinal
       condition?
       [X] Yes   [ ] No
      
           If yes, list only those medications required for the intestinal
           condition:
              Miralax for constipation
             
    c. Has the Veteran had surgical treatment for an intestinal condition?
       [ ] Yes   [X] No
      
    3. Signs and symptoms
    ---------------------
    Does the Veteran have any signs or symptoms attributable to any non-surgical
    non-infectious intestinal conditions?
    [X] Yes   [ ] No
   
           If yes, check all that apply:
          
           [X] Alternating diarrhea and constipation
                  If checked, describe:
                     Veteran reports more diarrhea than constipation (most days
                     5-6 loose stools)with occasional constipation that quickly
                     turns back into diarrhea.
                    
           [X] Abdominal distension
                  If checked, describe:
                     Veteran reports daily bloating and excessive gas.
                    

    4. Symptom episodes, attacks and exacerbations
    ----------------------------------------------
    Does the Veteran have episodes of bowel disturbance with abdominal distress,

   or exacerbations or attacks of the intestinal condition?
    [X] Yes   [ ] No
   
           If yes, indicate severity and frequency: (check all that apply)
          
           [X] Episodes of bowel disturbance with abdominal distress
          
               If checked, indicate frequency:
                  [ ] Occasional episodes
                  [ ] Frequent episodes
                  [X] More or less constant abdominal distress

    5. Weight loss
    --------------
    Does the Veteran have weight loss attributable to an intestinal condition
    (other than surgical or infectious condition)?
    [ ] Yes   [X] No
   
    6. Malnutrition, complications and other general health effects
    ---------------------------------------------------------------
    Does the Veteran have malnutrition, serious complications or other general
    health effects attributable to the intestinal condition?
    [ ] Yes   [X] No
   
    7. Tumors and neoplasms
    -----------------------
    a. Does the Veteran have a benign or malignant neoplasm or metastases
related
       to any of the diagnoses in the Diagnosis section?
       [ ] Yes   [X] No
      
    8. Other pertinent physical findings, complications, conditions, signs,
       symptoms and scars
   
-----------------------------------------------------------------------------
    a. Does the Veteran have any other pertinent physical findings,
       complications, conditions, signs or symptoms related to any conditions
       listed in the Diagnosis Section above?
       [X] Yes   [ ] No
      
           If yes, describe (brief summary):
              On exam, Veteran has hyperactive bowel sounds with tender abdomen
              to palpation.
             
    b. Does the Veteran have any scars (surgical or otherwise) related to any
       conditions or to the treatment of any conditions listed in the Diagnosis
       Section above?
       [ ] Yes   [X] No
      
    c. Comments, if any:
        
    9. Diagnostic testing
    ---------------------
    a. Has laboratory testing been performed?
       [X] Yes   [ ] No
      
           If yes, check all that apply:
          
           [X] CBC (if anemia due to any intestinal condition is suspected or
               present)
                  Date of test:  11/19/2016
                  Hemoglobin:  14.3
                  Hematocrit:  42.5
                  White blood cell count:  9.13
                  Platelets:  246

           [X] Other, specify:  Ova and Parasites, Giardia, Culture
                  Date of test:  01/05/2017
                  Results:  Negative, Negative,  No Salmonella, Shigella,
                  Campylobacter, Shiga-toxin E. coli isolated
                 
    b. Have imaging studies or diagnostic procedures been performed and are the
       results available?
       [ ] Yes   [X] No
      
    c. Are there any other significant diagnostic test findings and/or results?
       [ ] Yes   [X] No
      
    10. Functional impact
    ---------------------
    Does the Veteran's intestinal condition impact his or her ability to work?
    [X] Yes   [ ] No
   
        If yes, describe the impact of each of the Veteran's intestinal
        conditions, providing one or more examples:
           Veteran reports he would have difficulty with performing occupational
           tasks that would require him to work away from a rest room or that
           would not allow him to go to the rest room as needed.
          
          
    11. Remarks, if any:
    --------------------
        10.  Veteran reports he works at a desk in finance and reports he is
        allowed to go to the rest room as needed. 

        ****************************************************

        VBMS, CPRS, VistaWeb were reviewed by this examiner for this claim.
        Veteran was given a diagnosis of IBS (Irritable Bowel Syndrome)
        11/20/2017.  There is specific etiology stated and there is no mention
on
        the GI consultation notes of when the symptoms started or reference to
        him serving in The Gulf.  Veteran give an account of bowel problems
being
        present since returning from The Gulf in 1991.  Veteran has only been
        seen by the VAMC providers since 2016 with no records discovered to
        support IBS symptoms being present since returning to the USA from The
        Gulf in 1991 (25 years later).  This Veteran's claimed IBS is less
likely
        than no due to his service in The Gulf. 
 

Rated Disabilities

Table of Rated Disabilities

Disability	Rating	Decision	Related To	Effective Date
tinnitus	10%	Service Connected		11/24/2016
Sensori-neural hearing loss		Not Service Connected
obstructive sleep apnea		Not Service Connected	Environmental Hazard in Gulf War
chronic fatigue syndrome		Not Service Connected	Environmental Hazard in Gulf War
esophageal stricture	0%	Service Connected	Burn Pit Exposure	01/25/2017
eosinophilic esophagitis by biopsy with GERD	10%	Service Connected	Burn Pit Exposure	01/25/2017
allergic rhinitis		Not Service Connected	Environmental Hazard in Gulf War
headaches, unexplained chronic multi-symptom illness	10%	Service Connected	Environmental Hazard in Gulf War	11/24/2016
post traumatic stress disorder (also claimed as memory loss)	30%	Service Connected	PTSD - Combat	11/24/2016
erectile dysfunction	0%	Service Connected		06/28/2017
fibromyalgia (to include joint and muscle pain)	40%	Service Connected	Environmental Hazard in Gulf War	07/09/2017
hypertension		Not Service Connected	Environmental Hazard in Gulf War
irritable bowel syndrome		Not Service Connected	Environmental Hazard in Gulf War