Thе veteran appeals from a May 8, 1997, Board of Veterans’ Appeals (BVA or Board) decision denying, as not well grounded, the appellant’s claim for service connection for ankylosing spondylitis as secondary to service-connected bacillary dysentery. Reсord (R.) at 3. The Secretary has filed a motion for summary affirmance. This appeal is timely, and the Court has jurisdiction pursuant to 38 U.S.C. § 7252(a). For the reasons that follow, the Court will reverse the decision of the Board and remand the matter for adjudication.
I. FACTS
The veteran served on active duty from December 1947 to December 1951. R. at 2. In August 1948, while admitted to a service hospital for observation for malaria (R. at 53), the veteran was diagnosed with bacillary dysentery. R. at 36-37. Bacillary dysentery is “an infectious disease caused by bacteria of the genus Shigella, and marked by intestinal pain, tenesmus, diarrhea with mucus and blood in the stools, and more or less toxemia.” Dorland’s Illustrated Medical DiCtionary 514 (28th ed.1994) [hereinafter Dor-land’s]. His separation examination report shows that the spine was found to be normal and that the veteran was neurologically well. R. at 76-82. In April 1965, thе veteran was diagnosed with costal chondritis in a VA hospitalization summary. R. at 129. “Costal chondritis” is an “inflammation of the cartilage ... pertaining to a rib or ribs.” Dor-land’s at 320. The summary reveals that he had nine months of chest pain which was preceded by an upper respiratory infectiоn (R. at 129-30). The radiological report indicates moderate degenerative changes of the cervical spine, most marked at the C6-7 level. R. at 105. (The Court notes that records from St. Luke’s Hospital of Duluth, Minnesota, in both May 1969 and May 1979, indicate a history of whiplash in the 1960’s. R. at 154-63, 248). Also in April 1965, the regional office granted service connection for dysentery but determined the condition to be non-compensable. R. at 133.
Between November 1989 and August 1992, VA outpatient treatment records show treatment for the veteran’s back complaints. R. at 199-225. They are negative for а link to bacillary dysentery (id.), but records from St. Luke’s Hospital, dated October 1992, indicate that the veteran had HLA-B27 positive an-kylosing spondylitis. R. at 257. “Ankylosing spondylitis” is “the form of rheumatoid arthritis that affects the spine. It is a systemic illness of unknown etiology, affecting young males predominantly, and produсing pain and stiffness as a result of inflammation of the sacroiliac, intervertebral, and costoverte-bral joints.” Dorland’s at 1563. In his July 1993 testimony before the Board, the veteran theorized about a link between the bacillary dysentery that he had acquired in service, and his current ankylosing spondylitis. R. at 287. The veteran’s contentions were admittedly based on his own diagnosis, and he claimed to have learned of the link from reading medical texts. R. at 288. One such text, titled Understanding Arthritis and Rheumatism (Malcolm I.V. Jayson, M.D., and Allan St. J. Dixon, M.D.) states, “It is likely that [ankylosing spondylitis] is a reaction by the immune system of suscеptible individuals to bacterium that lives in the large bowel of many people. B27 positive individuals tend to develop a reactive arthritis after exposure to certain bacteria, including Shigella_” R. at 269. Accordingly, the veteran asserted that if people with the HLA-B27 gene contract bacillary dysentery, the immune system reacts and the combination of the gene and the dysentery can lead to ankylosing spon-dylitis. R. at 289. In October 1994, the veteran submitted excerpts from a medical text titled Diseases (June Norris, et al, 1993). R. at 301-07. This text states that ankylosing spondylitis usually occurs as a primary disorder, but also may occur in association with gram-negative dysentery. R. at 303. ■ .
In May 1997, the Board determined that the veteran’s claim was not well grounded. R. at 1-10. A notice of appeal was timely filed.
II. ANALYSIS
“[A] person who submits a claim for benefits under a law administered by the Secretary shall have the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded.” 38 U.S.C. § 5107(a); Carbino v. Gober,
In should be noted that secondary service connection claims must also be well grounded. 38 U.S.C. § 5107(a); Locher v. Brown, 9 Vet.App. 535, 538 (1996); Jones v. Brown,
Where the determinative issue involves etiology or a medical diagnosis, competent medical evidence that a claim is “plausible” оr “possible” is the threshold requirement for the claim to be well grounded. Heuer v. Brown,
Although this Court has previously found a veteran’s lay opinion, coupled with reliance on medical treatises, to be insufficient to satisfy the medical nexus requirements necessary to an award of service connection, the Court has not pronounced such treatise evidence as insufficiеnt to well ground a claim. In Libertine v. Brown, the Court held that the veteran’s statements, taken together with published medical authorities, did not provide the requisite medical evidence to demonstrate a causal relationship between that veteran’s claimed disability and his service.
In Beausoleil v. Brown, the Court addressed the specificity required when attempting tо link a service-incurred injury to a present condition.
In Sacks v. West, this Court held that a medical article that contained a generic statement regarding a possible link between a service-incurred mouth blister and a present pemphigus vulgaris condition, did not satisfy the nexus element of a well-grounded claim.
Similarly, the recognition of medical treatise evidence is common in other areas of the law. For example, for the purposes of trial, the Federal Rules of Evidence allow for the admissibility of such treatises. See Fed. R.Evid. 803(18). The rule provides for the admissibility of the following evidence as an exception to the hearsay rule:
To the extent called to the attention of an expert witness upon cross-examination or relied upon by the expert witness in direct examination, statements contained in published treatises, periodicals, or pamphlets on a subject of history, medicine, or other science or art, established as a reliable authority by the testimony or admission of the witness or by other expert testimony or by judicial notice. If admitted, the statements may be read into evidence but may not be received as exhibits.
Id.
Prior to Sacks, this Court had acknowledged the usefulness of medical treatise evidence as reliable authority. See Colvin v. Derwinski,
In this ease, the veteran has unquestionably satisfied the first two requirements of Caluza by obtaining a medical diagnosis of a current disability caused by ankylosing spondylitis (R. at 172), and by successfully using service medical records to demonstrate the in-service occurrence of bacillary dysentery (Shigella) (R. at 36-37). As for the third requirement of Caluza, the veteran has presented medical evidence in the form of medical treatises in an attempt to establish a nexus between his in-service disease and his current disability. He has attempted to show that, because of his genetic predisposition, he has a heightened risk of developing ankylosing spondylitis and, unlike the facts in Libertine, Beausoleil, and Sacks, the veteran in this case has submitted medical evidence that discusses the plausibility of suсh a link. The evidence here does not simply provide speculative generic statements not relevant to the veteran’s claim, as in cases previously before the Court. Instead, as allowed by the Court in Sacks, this treatise evidence “standing alone, discusses generic relatiоnships with a degree of certainty such that, under the facts of a specific case, there is at least plausible causality based upon objective facts rather than on an unsubstantiated lay medical opinion.” 11 VetApp. at 317.
In this case, the veteran has offered evidence that is deemed plausible, and thereby satisfies the initial burden of 38 U.S.C. § 5107(a) that a claim be well grounded.
III. CONCLUSION
For the reasons stated above, the Court holds the veteran’s claim to be well grounded. Thus, the Board’s May 8, 1997, decision is REVERSED and the matter is REMANDED for adjudication on the merits. A new decision must be supported by an adequate statement of reasons or bases under 38 U.S.C. § 7104(d)(1) and Gilbert v. Derwinski,