ANKLE IMPAIRMENT OF

J. PARKER · 2026 · Case ID: A26006754

MIXED

Summary

The veteran, who served from June 1978 to September 1992, appeals the denial of an increased rating for tinnitus and migraine headaches, and the denial of an earlier effective date for migraine headaches. The Board granted service connection for bilateral ankle sprains, hemorrhoids, and major depression with psychotic features. For the ankle claims, the Board found that while ankle strain is not a chronic condition, the evidence, including service treatment records and lay statements, tended to show direct service incurrence, resolving reasonable doubt in the veteran's favor. Service connection for hemorrhoids was granted based on a VA examiner's opinion that they manifested during service and were at least as likely as not incurred in service. Major depression with psychotic features was granted service connection, rated together with the already service-connected PTSD, as the Board found the same in-service stressors applied to both conditions. The claims for an increased rating for tinnitus and migraine headaches were denied as a matter of law, as the maximum schedular ratings of 10% and 50% respectively were already assigned and the veteran did not raise claims for extraschedular ratings. The appeal for an earlier effective date for migraine headaches was denied because the claim to reopen was filed more than one year after service separation and no earlier claim was received. Several issues were remanded for additional development, including increased ratings for right leg compartment syndrome, gastrointestinal disorder, vasomotor rhinitis, and bilateral hearing loss, as well as service connection for a back disorder, residuals of a left index finger laceration, and a sleep disorder, due to duty to assist errors. Eligibility for a special home adaptation grant was also remanded pending further development.

Rationale

Service treatment records show treatment for left ankle pain during service.; VA examiner noted injuries to both ankles during service.; Veteran credibly advanced continuous symptoms since service separation.; Resolving reasonable doubt in Veteran's favor, found directly incurred in service.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

241230-515088

Full Decision Text

Citation Nr: A26006754
Decision Date: 01/26/26 Archive Date: 01/26/26

DOCKET NO. 241230-515088
DATE: January 26, 2026

ORDER

Service connection for a left ankle disability is granted.

Service connection for a right ankle disability is granted.

Service connection for hemorrhoids is granted.

Service connection for major depression with psychotic features, to be rated together with the already service-connected posttraumatic stress disorder (PTSD), is granted.

An increased disability rating in excess of 10 percent for tinnitus, as a matter of law, is denied.

A higher initial disability rating in excess of 50 percent for migraines, including migraine variants (migraine headaches), as a matter of law, is denied.

An effective date prior to August 28, 2024 for service connection for migraine headaches is denied.

REMANDED

An increased disability rating in excess of 10 percent for the service-connected right leg compartment syndrome is remanded.

An increased disability rating in excess of 30 percent for the service-connected hiatal hernia with gastroesophageal reflux and gastritis (gastrointestinal disorder) is remanded.

An increased disability rating in excess of 10 percent for the service-connected vasomotor rhinitis is remanded.

An increased (compensable) disability rating for the service-connected bilateral hearing loss is remanded.

Service connection for a back disorder is remanded.

Service connection for residuals of a laceration of the left index finger is remanded.

Service connection for a sleep disorder, to include obstructive sleep apnea, is remanded.

Eligibility for a special home adaptation grant is remanded.

FINDINGS OF FACT

1. The evidence shows current diagnoses of bilateral ankle sprains, and during service the Veteran sprained both ankles, the symptoms of which have been present from service separation until the subsequent post-service diagnosis of bilateral ankle sprains.

2. Currently diagnosed hemorrhoids first manifested during active service.

3. Currently diagnosed major depression with psychotic features was caused by the same in-service stressors that warranted service connection for PTSD.

4. For the entire increased rating period on appeal from August 28, 2024, the service-connected tinnitus has been assigned the maximum 10 percent schedular disability rating available, under Diagnostic Code 6260.

5. For the entire initial rating period on appeal from August 28, 2024, the service-connected migraine headaches has been assigned the maximum 50 percent schedular disability rating available, under Diagnostic Code 8100.

6. The Veteran separated from active service on September 1, 1992.

7. More than one year after service separation, on May 14, 2002, the Department of Veterans Affairs (VA) received the Veteran's claim for service connection for severe headaches; no claim, formal or informal, for service connection for headaches/migraines was received prior to that date.

8. Service connection for a headache disability was denied by the Agency of Original Jurisdiction (AOJ) in a December 2003 rating decision; this decision subsequently became final.

9. On August 28, 2024, VA received a VA Form 20-0995, Decision Review Request: Supplemental Claim (Supplemental Claim), seeking to reopen service connection for a headache/migraine disability.

10. No claim, formal or informal, to reopen service connection for migraine headaches was received prior to the August 28, 2024 Supplemental Clam.

CONCLUSIONS OF LAW

1. Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for a left ankle sprain disability have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.326.

2. Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for a right ankle sprain disability have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.326.

3. Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for hemorrhoids have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.326.

4. Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for major
.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.326.

4. Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for major depression with psychotic features, to be rated alongside the already service-connected PTSD, have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.326, 4.130.

5. There is no legal basis for the assignment of a disability rating in excess of 10 percent for tinnitus for any period. 38 U.S.C. § 1155; 38 C.F.R. § 4.87, Diagnostic Code 6260.

6. There is no legal basis for the assignment of a disability rating in excess of 50 percent for migraine headaches for any period. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, Diagnostic Code 8100.

7. The criteria for an effective date prior to August 28, 2024 for service connection for migraine headaches have not been met. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.156, 3.400.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran, who is the appellant, had active service from June 1978 to September 1992.

The Veterans Appeals Improvement and Modernization Act, Pub. L. No. 115-55 (codified as amended in scattered sections of 38 U.S.C.), 131 Stat. 1105 (2017), also known as the Appeals Modernization Act (AMA), creates a new framework of review for appellants disagreeing with the AOJ's decision on a claim.

Following a December 2024 VA Regional Office (RO) rating decision addressing the issues on appeal, the Veteran submitted a December 2024 VA Form 10182, Notice of Disagreement (NOD), appealing the issues addressed above. The NOD requested direct review by the Board of Veterans' Appeals (Board). Direct review is the appeal option to the Board in which a Board decision is issued based on evidence of record at the time of the prior decision. The Board cannot hold a hearing or accept into the record additional evidence in its direct review.

The Board notes that in the December 2024 NOD the Veteran listed prior decisions dating as far back as June 2004; however, the Board notes that the issues listed are duplicative of the issues addressed in the December 2024 rating decision; therefore, the Board need not address any timeliness concerns at this time.

Service Connection Legal Authority

Service connection may be granted for disability arising from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service.

When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether the persuasive weight of the evidence is against a claim, in which case, the claim is denied. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Lynch v. McDonough, 21 F.4th 776, 781-82 (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).

1. Service Connection for
any injury or disease during service.

1. Service Connection for a Left Ankle Sprain Disability is Granted.

2. Service Connection for a Right Ankle Sprain Disability is Granted.

The Veteran appeals for service connection for left and right ankle disabilities as due to various in-service ankle sprains. The evidence shows current diagnoses of bilateral ankle sprain. Per the history reported from a January 2007 VA ankle examination, the Veteran was treated in service for left ankle pain/sprains in February 1979, May 1990, and February 1992. Further, a VA examiner in February 1993 reported that the Veteran had been seen in sick call and given treatment for ankle sprains in both legs during service.

Ankle strain is not a chronic disease under 38 C.F.R. § 3.309(a). As such, the presumptive service connection provisions under 38 C.F.R. § 3.303(b) for service connection based on "chronic" symptoms in service and "continuous" symptoms since service are not applicable to the instant matter. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Nonetheless, for the reasons discussed below, resolving reasonable doubt in the Veteran's favor, the Board finds the bilateral ankle disability symptoms began during service and continued since service separation, thus tending to show direct service incurrence. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a),(d). As discussed below, the Board is granting the service connection claim based on evidence, including that pertinent to service, which establishes that the ankle disabilities began in service and were so "incurred in" service. The finding that the Veteran experienced ankle disability symptoms since service is supportive of the claim overall because it tends to show that the symptoms that began in service were the basis for the later diagnosed left and right ankle sprain disabilities. See Clyburn v. West, 12 Vet. App. 296, 301 (1999) (veteran is competent to testify regarding continuous knee pain since service).

The record reflects that the Veteran first sought service connection for a bilateral ankle disability immediately upon separating from service in September 1992. In various lay statements the Veteran has conveyed having bilateral ankle disability symptoms from service separation to the present.

The Veteran received a VA general medical examination in February 1993. Per the examination report the Veteran complained of multiple ankle injuries during service with symptoms of pain and instability. A new VA ankle examination was performed in January 2007. Per the examination report, the Veteran continued to report having bilateral ankle pain and instability from service separation to the present. The VA examiner noted the diagnosis of bilateral ankle sprain in April 1993, within one year of service separation. To the extent that the VA examiner rendered a negative nexus opinion, as the VA examiner does not appear to have addressed the Veteran's complaints of ankle pain from service separation to the present, the Board finds the opinion to be of little probative value. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that an opinion based upon an inaccurate factual premise has no probative value).

Again, resolving reasonable doubt in the Veteran's favor, the Board finds that the current ankle sprain disabilities were directly incurred in service. Service treatment records reflect that the Veteran was treated for left ankle symptoms on multiple occasions during service, and a VA examiner in February 1993, within one year of service separation, reported that the Veteran sustained injuries to both ankles during service. The Veteran has sought service connection for the ankles on multiple occasions since service separation, including directly after service, and in various lay statements the Veteran has credibly advanced having continuous bilateral ankle disability symptoms from the date of in-service injuries to the present. Such evidence tends to show that the current bilateral ankle disability symptoms had onset during service, that is, shows that the ankle symptoms were directly "incurred in" active service. See 38 C.F.R. § 3.303(d
. Service treatment records reflect that the Veteran was treated for left ankle symptoms on multiple occasions during service, and a VA examiner in February 1993, within one year of service separation, reported that the Veteran sustained injuries to both ankles during service. The Veteran has sought service connection for the ankles on multiple occasions since service separation, including directly after service, and in various lay statements the Veteran has credibly advanced having continuous bilateral ankle disability symptoms from the date of in-service injuries to the present. Such evidence tends to show that the current bilateral ankle disability symptoms had onset during service, that is, shows that the ankle symptoms were directly "incurred in" active service. See 38 C.F.R. § 3.303(d). For these reasons, the Board finds that the criteria for service connection for left and right ankle disabilities have been met. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

3. Service Connection for a Hemorrhoids is Granted.

The Veteran appeals for service connection for hemorrhoids. According to the report from a November 2024 VA hemorrhoid examination, currently diagnosed hemorrhoid first manifested during service in 1990. Per the examination report, the Veteran conveyed being constipated and noticing hemorrhoids following consumption of MREs in service. In a corresponding medical opinion, the VA examiner opined that, while the hemorrhoids were not related to a toxic exposure risk activity (TERA) during service, it was at least as likely as not that the hemorrhoids were incurred in service, as the currently diagnosed hemorrhoids first manifested during service in 1990. For these reasons, and resolving reasonable doubt in favor of the Veteran, the Board finds the criteria for direct service connection for hemorrhoids have been met. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch at 781-82.

4. Service Connection for Major Depression with Psychotic Features is Granted.

The Veteran appeals for service connection for an acquired psychiatric disorder other than the already service-connected PTSD. Per a November 2006 VA treatment letter, the Veteran was being treated by VA for both PTSD and major depression with psychotic features. An August 2003 VA mental examination report, which was the basis for the later grant of service connection for PTSD in a December 2003 AOJ rating decision, lists both PTSD and major depression in the diagnosis section.

As the analysis found within the August 2003 VA medical examination linking the PTSD to one or more in-service stressors also applies to the major depression with psychotic features, the Board will resolve reasonable doubt in favor of the Veteran to find that the criteria for direct service connection for major depression with psychotic features have been met. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch at 781-82. The Board notes that, as the symptoms of the two acquired psychiatric disorders are indistinguishable from one another, both the PTSD and the major depression with psychotic features will be rated together under the General Rating Formula for Mental Disorders. See 38 C.F.R. § 4.130.

Disability Rating Legal Authority

Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule) found in 38 C.F.R. Part 4. 38 U.S.C. § 1155. It is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. Total disability is considered to exist when there is any impairment which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. Total disability may or may not be permanent. 38 C.F.R. § 3.340(a)(1). Total ratings are authorized for any disability or combination of disabilities for which the Rating Schedule prescribes a 100 percent evaluation. 38 C.F.R. § 3.340(a)(2).

Where there is a question as to which of two disability ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. It is the defined and consistently applied policy of VA to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant.
prescribes a 100 percent evaluation. 38 C.F.R. § 3.340(a)(2).

5. An Increased Disability Rating for Tinnitus is Denied.

For the entire increase rating period on appeal from August 28, 2024, the service-connected tinnitus is rated at 10 percent under Diagnostic Code 6260. The Veteran generally requests an increased rating for the tinnitus.

Tinnitus is rated under Diagnostic 6260, which provides a 10 percent maximum disability rating for recurrent tinnitus. 38 C.F.R. § 4.87. Note (2) further explains that the Board must assign only a single rating for recurrent tinnitus, whether the sound is perceived in one ear, both ears, or in the head. The United States Court of Appeals for the Federal Circuit (Federal Circuit) affirmed VA's long-standing interpretation of Diagnostic Code 6260 as authorizing only a single 10 percent rating for tinnitus, whether perceived as unilateral or bilateral. Smith v. Nicholson, 451 F.3d 1344 (Fed. Cir. 2006). As the regulations preclude a rating in excess of a single 10 percent rating for tinnitus, the appeal for a disability rating greater than 10 percent for tinnitus must be denied as a matter of law. Further, the Veteran has not contended that the schedular rating criteria do not account for all symptoms and functional impairments of the service-connected tinnitus; thus, a claim for an extraschedular rating (38 C.F.R. § 3.321(b)) has not been raised by the evidence or by the Veteran.

6. A Higher Initial Disability Rating for Migraine Headaches is Denied.

For the entire initial rating period on appeal from August 28, 2024, the Veteran's service-connected migraine headaches are rated at 50 percent under Diagnostic Code 8100. The Veteran generally requests an increased rating for the migraine headaches.

Migraine headaches are rated under Diagnostic 8100, which provides a 50 percent maximum disability rating for very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. 38 C.F.R. § 4.124a. As the regulations preclude a rating in excess of 50 percent for migraine headaches, the appeal for a disability rating greater than 50 percent for migraine headaches must be denied as a matter of law. Further, the Veteran has not contended that the schedular rating criteria do not account for all symptoms and functional impairments of the service-connected migraine headaches; thus, a claim for an extraschedular rating (38 C.F.R. § 3.321(b)) has not been raised by the evidence or by the Veteran.

7. An Earlier Effective Date for Migraine Headaches is Denied.

Except as specifically provided, the effective date of an evaluation and award for pension, compensation, or dependency and indemnity compensation based on an original claim, a claim reopened after a final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400. Title 38 of the Code of Federal Regulations clarifies that an award of direct service connection will be effective on the day following separation from active military service or the date on which entitlement arose if the claim is received within one year of separation from service; otherwise, the effective date shall be the date of receipt of the appellant's claim or the date on which entitlement arose, whichever is later. 38 C.F.R. § 3.400(b)(2)(i).

As to what constitutes a claim, a specific claim in the form prescribed by the Secretary must be filed in order for benefits to be paid or furnished to any individual under the laws administered by VA. 38 U.S.C. § 5101(a); 38 C.F.R. § 3.151(a). The term "claim" means a communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a
arose if the claim is received within one year of separation from service; otherwise, the effective date shall be the date of receipt of the appellant's claim or the date on which entitlement arose, whichever is later. 38 C.F.R. § 3.400(b)(2)(i).

Effective March 24, 2015, VA amended its adjudication regulations to require that all claims governed by VA's adjudication regulations be filed on standard forms prescribed by the Secretary. See 79 Fed. Reg. 57,660 (Sept. 25, 2014). This rulemaking also eliminated the constructive receipt of VA reports of hospitalization or examination and other medical records as informal claims for increase and revised 38 C.F.R. § 3.400(o)(2).

To preserve an effective date, an intent to file a claim may be submitted to VA. 38 C.F.R. § 3.155(b). Upon receipt of the intent to file a claim, VA will furnish the claimant with the appropriate application form prescribed by the Secretary. If VA receives a complete application form prescribed by the Secretary, appropriate to the benefit sought within one-year of receipt of the intent to file a claim, VA will consider the complete claim filed as of the date the intent to file a claim was received. 38 C.F.R. § 3.155.

The applicable statutory and regulatory provisions require that VA look to all communications from a veteran which may be interpreted as applications or claims - formal and informal - for benefits. The Federal Circuit has emphasized that VA has a duty to fully and sympathetically develop a veteran's claim to its optimum, which includes determining all potential claims raised by the evidence and applying all relevant laws and regulations. See Harris v. Shinseki, 704 F.3d 946, 948-49 (Fed. Cir. 2013); Szemraj v. Principi, 357 F.3d 1370, 1373 (Fed. Cir. 2004); Moody v. Principi, 360 F.3d 1306, 1310 (Fed. Cir. 2004); Roberson v. Principi, 251 F.3d 1378 (Fed. Cir. 2001). The Board is required to adjudicate all issues reasonably raised by a liberal reading of the appeal, including all documents and oral testimony in the record prior to the Board's decision. See Brannon v. West, 12 Vet. App. 32 (1998); Solomon v. Brown, 6 Vet. App. 396 (1994). However, in determining whether an informal claim has been made, VA is not required to read the minds of the veteran or representative. Cintron v. West, 13 Vet. App. 251, 259 (1999).

The essential elements for any claim, whether formal or informal, are: (1) an intent to apply for benefits; (2) an identification of the benefits sought; and (3) a communication in writing. Brokowski v. Shinseki, 23 Vet. App. 79, 84 (2009); see also MacPhee v. Nicholson, 459 F.3d 1323, 1326-27 (Fed. Cir. 2006) (holding that the plain language of the regulations requires a claimant to have intent to file a claim for VA benefits).

The Veteran appeals for an effective date prior to March 12, 2012 for the grant of service connection for migraine headaches. Per the December 2024 NOD, the Veteran appears to argue that an earlier effective date is warranted due to the headaches manifesting during service.

The Veteran separated from active service on September 1, 1992. More than one year after service separation, on May 14, 2002, VA received the Veteran's claim for service connection for severe headaches. No claim, formal or informal, for service connection for headaches/migraines was received prior to that date. Subsequently, service connection for a headache disability was denied by the AOJ in a December 2003 rating decision. While the Veteran originally appealed this service connection denial, along with a number of other denied issues, as explained in
headaches. Per the December 2024 NOD, the Veteran appears to argue that an earlier effective date is warranted due to the headaches manifesting during service.

The Veteran separated from active service on September 1, 1992. More than one year after service separation, on May 14, 2002, VA received the Veteran's claim for service connection for severe headaches. No claim, formal or informal, for service connection for headaches/migraines was received prior to that date. Subsequently, service connection for a headache disability was denied by the AOJ in a December 2003 rating decision. While the Veteran originally appealed this service connection denial, along with a number of other denied issues, as explained in a March 2008 Board decision, the appeal was subsequently withdrawn in February 2007, and the December 2003 rating decision became final.

On August 28, 2024, VA received a VA Form 20-0995, Supplemental Claim, seeking to reopen service connection for a headache/migraine disability. Review of the record reflects that no claim, formal or informal, to reopen service connection for migraine headaches was received prior to the August 28, 2024 Supplemental Clam.

The Board has considered the Veteran's argument that an earlier effective date is warranted as the headaches date back to active service; however, the pertinent legal authority governing effective dates is clear and specific, and the Board is bound by such authority. While entitlement to service connection may have arisen earlier than August 28, 2024, the date entitlement arose does not decide the effective date in this case; the later date of the claim to reopen service connection controls the effective date. The controlling regulation clearly and specifically provides that the effective date shall be the date of receipt of the appellant's claim to reopen service connection or the date on which entitlement arose, whichever is later. 38 C.F.R. § 3.400. As no claim to reopen the previous denial of service connection for a headache/migraine disability was received prior to August 28, 2024, an effective date prior to August 28, 2024 is neither warranted nor available at law.

On these facts, the earliest effective date legally possible has been assigned under 38 C.F.R. § 3.400, the date of receipt of claim to reopen service connection (August 28, 2024). As an effective date for service connection earlier than August 28, 2024 (date of receipt of claim to reopen service connection) is not provided by law or regulation, the appeal for an earlier effective date as to the issue of service connection for migraine headaches is without legal merit, so must be denied as a matter of law. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (where the law is dispositive, the claim must be denied due to a lack of legal merit). For these reasons, as a matter of law, the appeal for an effective date prior to August 28, 2024 for service connection for migraine headaches must be denied.

REASONS FOR REMAND

The following issues are remanded to correct duty to assist errors that occurred prior to the rating decision on appeal. 38 C.F.R. § 20.802(a).

VA must afford a veteran a medical examination and/or obtain a medical opinion when it is necessary to make a decision on the claim. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4) (2018). A veteran is entitled to a new VA examination where there is evidence that the condition has worsened since the last examination. Weggenmann v. Brown, 5 Vet. App. 281, 284 (1993); Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994); VAOPGCPREC 11 95.

9. An Increased Disability Rating for Right Leg Compartment Syndrome is Remanded.

10. An Increased Disability Rating for a Gastrointestinal Disorder is Remanded.

11. An Increased Disability Rating for Vasomotor Rhinitis is Remanded.

12. An Increased Disability Rating for Bilateral Hearing Loss is Remanded.

Despite finding that the August 2024 Supplemental Claim raised the aforementioned increased rating issues, the AOJ did not provide new VA right leg, gastrointestinal, rhinitis, and audiometric examinations to assist in determining the current levels of disability. As the Veteran has indicated a worsening of these disabilities via the filing of an increased rating claim, the AOJ committed pre-decisional error in rendering the December 2024 rating decision on appeal prior to
Rating for Right Leg Compartment Syndrome is Remanded.

10. An Increased Disability Rating for a Gastrointestinal Disorder is Remanded.

11. An Increased Disability Rating for Vasomotor Rhinitis is Remanded.

12. An Increased Disability Rating for Bilateral Hearing Loss is Remanded.

Despite finding that the August 2024 Supplemental Claim raised the aforementioned increased rating issues, the AOJ did not provide new VA right leg, gastrointestinal, rhinitis, and audiometric examinations to assist in determining the current levels of disability. As the Veteran has indicated a worsening of these disabilities via the filing of an increased rating claim, the AOJ committed pre-decisional error in rendering the December 2024 rating decision on appeal prior to scheduling new VA examinations as to these service connected disabilities. The Board will remand to obtain these outstanding examinations.

13. Service Connection for a Back Disorder is Remanded.

Service connection for a back disability was previously denied in a December 2003 rating decision. Per the rating decision, while service treatment records reflect that the Veteran had treatment for back pain during service in April 1986, service connection was denied due to no currently diagnosed back disability.

As the December 2024 rating decision on appeal found new and relevant evidence to warrant readjudication of this issue, presumably the AOJ found evidence of a possible current diagnosis of a back disability. Despite this, the AOJ committed pre-decisional error by failing to obtain a new VA back examination to 1) clarify whether the Veteran has a current back disability, and 2) if so, whether such disability is related to the in-service back treatment. For these reasons, the Board finds remand to obtain a VA back examination and opinion to be warranted.

14. Service Connection for Residuals of a Laceration of the Left Index Finger.

In a March 2008 decision, the Board denied service connection for residuals of a laceration of the left index finger, finding that there were no currently diagnosed residuals related to the April 1985 in-service injury that required stitches to the left index finger. In the December 2024 rating decision on appeal, the AOJ found that new and relevant evidence had been received to reopen the issue of service connection for residuals of a laceration of the left index finger. As such, the AOJ inherently made a favorable finding that there was at least some new evidence of record indicating that the Veteran may now have residuals related to this in-service injury. Despite such favorable finding, the AOJ committed pre decisional error by not ordering a new VA examination addressing the presence, or absence, of any residual symptoms. As such, the Board finds remand warranted to obtain a VA finger examination addressing whether there are any diagnosable residuals of the left index finger.

15. Service Connection for a Sleep Disorder is Remanded.

Service connection for a sleep disorder was previously denied by the AOJ in a December 2003 rating decision due to the Veteran's sleep troubles being related to, and rated under, the service-connected PTSD. VA medical records from May 2023 and October 2024 reflect diagnosis and treatment for obstructive sleep apnea. An October 2024 TERA Memorandum found that the Veteran participated in a TERA during service. Despite this, the AOJ committed pre-decisional error by not obtaining a VA sleep disorder examination and opinion addressing whether the sleep apnea, or any other currently diagnosed sleep disorder, is related to a TERA during service. For these reasons, the Board finds remand warranted to complete such development.

16. Eligibility for a Special Home Adaptation Grant is Remanded.

The adjudication of claims that are inextricably intertwined is based upon the recognition that claims related to each other should not be subject to piecemeal decision-making or appellate litigation. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991).

In the instant decision the Board grants service for multiple disabilities and remands multiple issues for additional development. As the Board's directed development, along with any additional development necessary to assign initial disability ratings for the newly service-connected disabilities, may be relevant to the issue of eligibility for a special home adaptation grant, the Board finds this issue should be remanded pending completion of such development.

The matters are REMANDED for the following action:

1. Schedule VA right leg, gastrointestinal, rhinitis, and audiometric examinations to assist in determining the current severity, findings, and functional impairment caused by the service connected right leg compartment syndrome, gastrointestinal disorder, vasomotor rhinitis, and bilateral hearing loss. The VA examiner should report the extent of all disability symptoms in accordance with VA rating criteria.

2. Schedule the appropriate VA back/spine, finger, and sleep disorder examinations with medical opinions. A
necessary to assign initial disability ratings for the newly service-connected disabilities, may be relevant to the issue of eligibility for a special home adaptation grant, the Board finds this issue should be remanded pending completion of such development.

The matters are REMANDED for the following action:

2. Schedule the appropriate VA back/spine, finger, and sleep disorder examinations with medical opinions. A rationale for all opinions and a discussion of the facts and medical principles involved should be provided. The VA examiner(s) should provide the following opinions:

Back

A) Does the Veteran have a currently diagnosed back disability?

B) If the Veteran has a currently diagnosed back disability, is it at least as likely as not that the back disability is related to the in-service back pain treatment in April 1986, or is otherwise related to service?

Left Index Finger

Are there any diagnosable residual symptoms/disabilities in the left index finger related to the April 1985 in service injury resulting in stitches to the left index finger?

Sleep Disorder

Is it at least as likely as not that obstructive sleep apnea, or any other currently diagnosed sleep disorder, was caused by the synergistic, combined effect of all the toxic exposures during service, or is otherwise related to service?

3. After the above directed development has been completed, and after initial ratings are assigned for the newly service-connected disabilities, readjudicate the issue of eligibility for a special home adaptation grant.

J. PARKER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board E. Blowers, Counsel

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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