Case 26001880

THOMAS L. ENGLISH · 2026 · Case ID: 26001880

MIXED

Summary

The veteran, who served from November 1971 to November 1973, appeals a March 2015 rating decision. The Board of Veterans' Appeals (Board) reviewed claims for service connection for a back condition, right and left hip conditions, right and left knee conditions, right and left ankle conditions, left lower extremity peripheral neuropathy, headaches, and right lower extremity radiculopathy. The Board dismissed the claims for the back, hips, knees, ankles, and left lower extremity peripheral neuropathy, as these were granted by the AOJ in October 2025, making them no longer before the Board. Service connection for headaches, secondary to service-connected PTSD with persistent depressive disorder, generalized anxiety disorder, and insomnia, was granted. The Board found the Veteran's reported headaches, linked to anxiety increases, constituted a current diagnosis, and granted secondary service connection, noting the AOJ had not obtained a nexus opinion but finding the evidence sufficient. Service connection for right lower extremity radiculopathy was also granted. The Board found the AOJ's negative nexus opinions inadequate due to conflicting findings and the Veteran's competent reporting of radicular symptoms, granting the claim based on objective findings for the left lower extremity and the Veteran's reported symptoms. Claims for right and left carpal tunnel syndrome were remanded for a supplemental nexus opinion addressing the Veteran's conceded toxic exposure risk activity (TERA) related to his MOS and exposures to fine particulate matter and solvents.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

17-26 839

Full Decision Text

Citation Nr: 26001880
Decision Date: 02/10/26 Archive Date: 02/10/26

DOCKET NO. 17-26 839
DATE: February 10, 2026

ORDER

Service connection for a back condition is dismissed.

Service connection for a right hip condition is dismissed.

Service connection for a left hip condition is dismissed.

Service connection for a right knee condition is dismissed.

Service connection for a left knee condition is dismissed.

Service connection for a right ankle condition is dismissed.

Service connection for a left ankle condition is dismissed.

Service connection for left lower extremity peripheral neuropathy is dismissed.

Service connection for headaches, as secondary to the service-connected posttraumatic stress disorder (PTSD) with a persistent depressive disorder, generalized anxiety disorder, and insomnia, is granted.

Service connection for right lower extremity radiculopathy is granted.

REMANDED

Service connection for right carpal tunnel syndrome is remanded.

Service connection for left carpal tunnel syndrome is remanded.

FINDINGS OF FACT

1. An October 2025 rating decision granted service connection for a back condition.

2. An October 2025 rating decision granted service connection for a right hip condition.

3. An October 2025 rating decision granted service connection for a left hip condition.

4. An October 2025 rating decision granted service connection for a right knee condition.

5. An October 2025 rating decision granted service connection for a left knee condition.

6. An October 2025 rating decision granted service connection for a right ankle condition.

7. An October 2025 rating decision granted service connection for a left ankle condition.

8. An October 2025 rating decision granted service connection for left lower extremity peripheral neuropathy.

9. The Veteran's headaches are secondary to his service-connected PTSD with a persistent depressive disorder, generalized anxiety disorder, and insomnia.

10. The Veteran's right lower extremity radiculopathy is secondary to his service-connected degenerative disc disease of the lumbar spine.

CONCLUSIONS OF LAW

1. The October 2025 Agency of Jurisdiction (AOJ) award of service connection for a back condition constitutes a full grant of the benefits sought, and this issue is no longer before the Board of Veterans' Appeals (Board). Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997).

2. The October 2025 AOJ award of service connection for a right hip condition constitutes a full grant of the benefits sought, and this issue is no longer before the Board. Grantham, supra.

3. The October 2025 AOJ award of service connection for a left hip condition constitutes a full grant of the benefits sought, and this issue is no longer before the Board. Grantham, supra.

4. The October 2025 AOJ award of service connection for a right knee condition constitutes a full grant of the benefits sought, and this issue is no longer before the Board. Grantham, supra.

5. The October 2025 AOJ award of service connection for a left knee condition constitutes a full grant of the benefits sought, and this issue is no longer before the Board. Grantham, supra.

6. The October 2025 AOJ award of service connection for a right ankle condition constitutes a full grant of the benefits sought, and this issue is no longer before the Board. Grantham, supra.

7. The October 2025 AOJ award of service connection for a left ankle condition constitutes a full grant of the benefits sought, and this issue is no longer before the Board. Grantham, supra.

8. The October 2025 AOJ award of service connection for left lower extremity peripheral neuropathy constitutes a full grant of the benefits sought, and this issue is no longer before the Board. Grantham, supra.

9. The criteria for service connection for headaches as secondary to the Veteran's service-connected PTSD with a persistent depressive disorder, generalized anxiety disorder, and insomnia have been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.310.

10. The criteria for service connection for right lower extremity radiculopathy as secondary to the Veteran's service-connected degenerative disc disease of the lumbar spine have been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from November 1971 to November 1973.

These matters come before the Board on appeal from a March 2015 rating decision
38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from November 1971 to November 1973.

These matters come before the Board on appeal from a March 2015 rating decision issued by the AOJ, a Department of Veterans Affairs (VA) Regional Office (RO).

The Board most recently remanded these claims in January 2024 to afford the Veteran with medical examinations and medical opinions. In October 2025, the AOJ issued a rating decision granting service connection for some of the above claims effective May 7, 2014. The AOJ issued a supplemental statement of the case (SSOC) in October 2025. These matters have returned to the Board for appellate consideration.

1. Service connection for a back condition is dismissed.

2. Service connection for a right hip condition is dismissed.

3. Service connection for a left hip condition is dismissed.

4. Service connection for a right knee condition is dismissed.

5. Service connection for a left knee condition is dismissed.

6. Service connection for a right ankle condition is dismissed.

7. Service connection for a left ankle condition is dismissed.

8. Service connection for left lower extremity peripheral neuropathy is dismissed.

In a October 2025 rating decision, the AOJ granted service connection for the above issues, effective May 7, 2014.

An award of service connection is considered a full grant of the benefit sought and any effective date assigned is a separately appealable issue, requiring the initiation and perfection of an appeal as to that matter. See Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997) (holding, where an appealed claim for service connection is granted during the pendency of the appeal, a second notice of disagreement must thereafter be timely filed to initiate appellate review of the claim concerning "downstream" issues, such as the compensation level assigned for the disability and the effective date).

Therefore, unless and until the Veteran completes an appeal regarding the effective date assigned, the issue of entitlement to an earlier effective date is not for appellate consideration.

Service Connection

Service connection may be established on a direct basis for a disability resulting from disease or injury incurred in, or aggravated by, active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Also, service connection may be granted for any disease diagnosed after service when all the evidence establishes the disease was incurred in service. 38 C.F.R. § 3.303 (d). In general, service connection requires (1) evidence of a current disability; (2) medical evidence, or in certain circumstances lay evidence, of an in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

A claim for secondary service connection requires medical evidence that connects the asserted secondary disability to the service-connected disability. Velez v. West, 11 Vet. App. 148, 158 (1998). To establish entitlement to service connection on this secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

The United States Court of Appeals for Veterans Claims (Court) held in the case of Ward v. Wilkie, 31 Vet. App. 233 (2019), that aggravation pursuant to 38 C.F.R. § 3.310 does not require a permanent worsening of the condition. Rather, the Court explained, "aggravation" is any incremental increase in disability attributable to the service-connected disability, i.e., any additional impairment of earning capacity that is above the degree of disability existing before the increase, regardless of its permanence. Id.

A claim will be denied if the evidence persuasively weighs against the claim.
West, 11 Vet. App. 509, 512 (1998).

A claim will be denied if the evidence persuasively weighs against the claim. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application). Any reasonable doubt regarding the degree of disability should be resolved in favor of the claimant. 38 C.F.R. § 3.102.

9. Service connection for headaches, as secondary to the service-connected PTSD with a persistent depressive disorder, generalized anxiety disorder, and insomnia, is granted.

The Veteran contends service connection for headaches is warranted. See September 2014 VA 21-4138 Statement in Support of the Claim.

As to a current diagnosis, the Board acknowledges the VA examiner who conducted the August 2024 examination did not find a diagnosis of headaches or migraines; however, the examiner documents the Veteran stated his headaches begin when his anxiety increases. Further, the Veteran reported when his condition begins, symptoms include pressure in the forehead area of the head in addition to the temples or the back of the head and neck. The Veteran further reported he treats the condition with over-the-counter medication.

A Veteran is competent to describe symptoms that he experienced in service or at any time after service when the symptoms he perceived or experienced were directly through the senses. 38 C.F.R. § 3.159; Layno v. Brown, 6 Vet. App. 465, at 469-71 (1994). Lay evidence may establish a diagnosis of a simple medical condition, a contemporaneous medical diagnosis, or symptoms that later support a diagnosis by a medical professional. Jandreau v. Nicholson, 492 F. 3d 1372, 1377 (Fed. Cir. 2007). As such, the Board finds a current diagnosis of a headache condition is present.

The Veteran is service connected for PTSD with a persistent depressive disorder, generalized anxiety disorder, and insomnia. Thus, the first and second elements of a claim for secondary service connection are met. Wallin, 11 Vet. App. at 512. Thus, the crux of the case concerns whether there is a nexus between the two disabilities.

Regarding this, VA has not obtained a nexus opinion as to secondary service connection; however, the Veteran has reported experiencing headaches when there is an increase in his anxiety.

As noted above, the Court held in Ward that aggravation pursuant to 38 C.F.R. § 3.310 does not require a permanent worsening of the condition. Rather, the Court explained, "aggravation" is any incremental increase in disability attributable to the service-connected disability, i.e., any additional impairment of earning capacity that is above the degree of disability existing before the increase, regardless of its permanence. Id.

Accordingly, given the documentation of the August 2024 VA examiner's findings indicating a relationship between the Veteran's service-connected psychiatric condition and his reported headaches, entitlement to service connection for headaches as secondary to the service-connected PTSD with a persistent depressive disorder, generalized anxiety disorder, and insomnia is warranted. 38 C.F.R. 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990).

10. Service connection for right lower extremity radiculopathy is granted.

The Veteran contends service connection for a neurological condition of the right lower extremity is warranted. See September 2014 VA 21-4138 Statement in Support of the Claim. Currently, the Veteran is service connected for left lower extremity peripheral neuropathy associated with his service-connected back condition.

The Board acknowledges the May 2025 negative nexus opinion as to secondary service connection. The examiner states, "The [Veteran's] peripheral neuropathy of the lower extremities is consistent with radiculopathy which is likely due to the DJD and IVDS of the spine." The examiner then states, "These conditions are most commonly due to aging."
Service connection for right lower extremity radiculopathy is granted.

The Board acknowledges the May 2025 negative nexus opinion as to secondary service connection. The examiner states, "The [Veteran's] peripheral neuropathy of the lower extremities is consistent with radiculopathy which is likely due to the DJD and IVDS of the spine." The examiner then states, "These conditions are most commonly due to aging." Given the conflicting findings, the Board finds the opinion to be inadequate.

The AOJ obtained another negative nexus opinion in September 2025. The examiner states, "[The] Veteran does not have a confirmed diagnosis of peripheral neuropathy for the right lower extremity as findings on exam were normal for the right side," and the Veteran's "symptoms for the right side in section VIII were subjective only." The examiner also notes moderate to severe right lower extremity radiculopathy symptoms for intermittent pain, paresthesias, dysesthesias, and numbness within the August 2024 back examination report. In the back examination, the examiner states, "symptoms of right lower extremity radiculopathy are subjective only and do not rise to the level of a confirmed diagnosis given the normal neurological exam, therefore a diagnosis is not rendered." Additionally, the September 2025 negative nexus opinion acknowledges a diagnosis of a neurological condition associated with the right lower extremity, albeit subjective symptoms. Further, the Veteran is competent to report radicular symptoms. Layno, supra.

Accordingly, given the documentation of the August 2024 VA examiner's findings of radicular symptoms of the right lower extremity and they associated the objective findings for the Veteran's service-connected left lower extremity radicular condition with his service-connected back condition, entitlement to service connection for right lower extremity radiculopathy is warranted. 38 C.F.R. 3.102; Gilbert, supra.

REASONS FOR REMAND

1. Service connection for right carpal tunnel syndrome is remanded.

2. Service connection for left carpal tunnel syndrome is remanded.

The Board acknowledges the negative nexus opinions of records. However, these opinions do not address the Veteran's conceded toxic exposure risk activity (TERA). The Veteran's military occupational specialty (MOS) was in light weapons, and a February 2024 TERA memo indicates exposures to fine particulate matter and solvents.

On remand, the AOJ should provide a TERA opinion regarding the Veteran's claimed bilateral carpal tunnel syndrome. See The Sergeant First Class (SFC) Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act), Pub. L. No. 117-168 (2022); 38 U.S.C. § 1168; 38 C.F.R. § 20.802 (a).

The matters are REMANDED for the following action:

Obtain a supplemental nexus opinion for the Veteran's claim for bilateral carpal tunnel syndrome.

The Veteran's entire record should be made available to and reviewed by the examiner.

Following a review of the record, the examiner should address the following:

Is it approximately at least as likely as not (an approximate balance of positive and negative evidence) the Veteran's bilateral carpal tunnel syndrome is related to his active service to include his conceded TERA as his MOS was in light weapons, and a February 2024 TERA memo concedes exposures to fine particulate matter and solvents?

In answering this question, the examiner must consider the Veteran's conceded TERAs and address the synergistic, combined effect of all the Veteran's TERAs.

The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached.

Thomas L. English

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Buck Denton

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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