BVA9500588 DOCKET NO. 93-06 356 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to an effective date prior to February 8, 1992, for a grant of service connection and the assignment of a 10 percent disability rating for peptic ulcer disease. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD John R. Pagano, Counsel INTRODUCTION The veteran had active military service from August 1986 to August 1990, and from January to June 1991. This matter arises from a rating decision rendered in July 1992 by the St. Petersburg, Florida, Regional Office (RO). Therein, service connection was granted and a 10 percent disability evaluation was assigned effective February 8, 1992 for peptic ulcer disease with duodenitis, gastritis and a history of anemia. The Board of Veterans' Appeals (Board) notes that, as an ancillary matter, the veteran claimed entitlement to payment or reimbursement for the cost of unauthorized private hospitalization beginning on January 30, 1992, and ending on February 4, 1992. Although the record is incomplete, it appears that the VA Medical Center at Bay Pines, Florida, denied that claim. It is unclear whether further consideration was given to that claim following the grant of service connection by the RO in July 1992. The decision that follows may also bear upon that question. Accordingly, the RO should refer a copy of this decision, along with other records pertinent to that claim to the Bay Pines Medical Center for any action deemed appropriate. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that the Department of Veterans Affairs (VA) erred in denying him entitlement to the benefit sought on appeal. More specifically, he contends that he experienced symptomatology indicative of ulcer disease while serving in the Middle East during his second period of military service. Notwithstanding this, he contends that since he is entitled to service connection for peptic ulcer disease under the presumptive provisions of law, it follows that the effective date for the award of a 10 percent disability evaluation for that disorder should be June 5, 1991, the day following the date of his military discharge. Alternatively, he contends that the record is incomplete, and that the case should be remanded for further development prior to appellate disposition. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based upon its review of the pertinent evidence in this matter, and for the following reasons and bases, it is the decision of the Board that an effective date prior to February 8, 1992, is warranted for a grant of service connection and a compensable disability evaluation for peptic ulcer disease. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. The veteran was hospitalized at a private medical facility on an emergency basis on January 30, 1992. Clinical studies revealed the presence of peptic ulcer disease, chronic gastritis and anemia. Symptomatology improved following conservative treatment, and the veteran was discharged on February 4, 1992. 3. The hospitalization beginning on January 30, 1992, resulted in the first clinical evidence of the existence of peptic ulcer disease. CONCLUSION OF LAW A grant of service connection for peptic ulcer disease with a 10 percent disability evaluation is warranted effective January 30, 1992, the date that the disease process was first manifested to a compensable degree. 38 U.S.C.A. §§ 1101, 1110, 1112, 5107, 5110 (West 1991); 38 C.F.R. §§ 3.307, 3.309, 3.400 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION As a preliminary matter, the Board finds that the veteran has submitted a claim which is "well grounded" within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). That is, he has presented a claim which is plausible and capable of substantiation. Moreover, all relevant facts have been properly developed, and VA has met its duty to assist him in the development of his claim. This is so, notwithstanding his allegation that not all records pertaining to his second period of military service have been obtained and considered; the veteran indicated that he had no past history of peptic ulcer disease during his hospitalization beginning January 30, 1992. As such, it would be futile to pursue any additional service medical records that might exist. I. Factual Background The first clinical evidence of the existence of peptic ulcer disease did not arise until subsequent to the veteran's discharge from military service. The medical records for both periods of the veteran's military service are negative for the existence of peptic ulcer disease, and, as previously noted, the veteran has not contended that he was diagnosed or treated for such a disorder during service. It was not until the veteran was hospitalized in late January 1992 at a private medical facility that this disease process became evident. The veteran was admitted to Memorial Medical Center of Jacksonville on January 30, 1992, complaining of extreme weakness, fatigue, and a syncopal episode. He indicated that he had developed flu-like symptoms approximately 4 or 5 days prior which included fever, chills, weakness, constant nausea, vomiting and diarrhea. The veteran then underwent an upper endoscopy which revealed some duodenal ulcer disease with chronic scarring and mild duodenitis. The veteran also was observed to have chronic superficial gastritis and anemia. However, symptomatology abated during the days that followed, and the veteran was discharged on February 4, 1992, to be followed on an outpatient basis. II. Analysis Service connection may be granted for peptic ulcer disease on a presumptive basis if such a disease process becomes manifest to a compensable degree within one year following the veteran's discharge from military service. 38 U.S.C.A. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. In such cases, the effective date of an evaluation and award of compensation will be the date entitlement arose if a claim is received within one year after separation from active duty. 38 U.S.C.A. § 5110; 38 C.F.R. § 3.400(b)(2)(ii) (1993). It is within this context that the veteran's claim must be examined. Although the veteran believes that he should be awarded a compensable disability evaluation for peptic ulcer disease from the day following the date of his discharge from military service in June 1991, the regulations indicate otherwise. The veteran's entitlement arose on January 30, 1992, the date that he was hospitalized. There simply is no clinical evidence that the disability at issue existed prior to that date. The veteran has contended that he had experienced gastrointestinal symptomatology prior to that date, and that he used over-the-counter medications to deal with that symptomatology. The veteran might well be the consummate historian; nonetheless, whatever symptoms he may have experienced could have been the product of any of a myriad of gastrointestinal disorders. These are questions involving medical causation. The veteran is a layman; his assumptions regarding the relationship between various events, i.e., symptomatology, and the development of a given medical disability do not constitute "evidence," per se. See Espiritu v. Derwinski, 2 Vet.App. 492, 495 (1992). Notwithstanding the foregoing, the disability at issue arose to a compensable degree within one year after the veteran's separation from active duty. He is, therefore, entitled to a compensable rating from the date that such entitlement arose. 38 C.F.R. § 3.400(b)(2)(ii). The point, here, is that monetary benefits cannot be authorized for a given disability prior to the actual date that symptomatology associated with that disability became compensable. There simply is no authority for such a grant. This is true despite the presumptive provisions of law regarding the granting of service connection which concede that certain disabilities such as the one at issue existed previously, i.e., during military service. The applicable regulations clearly distinguish between the date that a given chronic disability was likely to have had its onset and the date that entitlement to monetary benefits arises. ORDER An effective date of January 30, 1992, but no earlier, is granted for service connection and a 10 percent disability evaluation for peptic ulcer disease. WARREN W. RICE, JR. Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.