HYPERTENSION

MICHELLE L. KANE · 2026 · Case ID: A26024639

DENIED

Summary

The veteran, who served in the National Guard/Reserve from 1984 to 2008 with periods of active duty in 1984-1985 and 2003, appeals the denial of service connection for hypertension, erectile dysfunction, and a foot condition. The Board found no service connection for any of the claimed conditions. For hypertension, the veteran reported no issues at multiple service examinations, and while later VA treatment records noted hypertension, no provider linked it to service, nor was it diagnosed during active duty or active duty training. The veteran's claims of pain medication contributing to hypertension were not supported by medical opinion. For erectile dysfunction, service records were silent, and while a VA diagnosis existed in 2019, no provider linked it to service, nor did the veteran's testimony or private records establish a service nexus. The Board noted the veteran's new contentions about secondary causation were not timely raised. For the foot condition, service records showed treatment for foot fungus in Reserve status, but the veteran denied foot trouble on active duty separation and later Reserve physicals. While VA treatment in 2019 noted foot pain and other diagnoses, no provider linked these to service, and the veteran's gait was noted as normal. The Board found no probative evidence of a current foot condition linked to service, nor was secondary causation to back/knee conditions established. The veteran's claims were denied as the evidence did not preponderate in his favor.

Rationale

No diagnosis or treatment for hypertension during active duty or active duty training.; Service records from 1984-2006 did not show hypertension.; Veteran's claims of pain medication contributing to hypertension were not supported by medical opinion.

Service Branch

NATIONAL GUARD/RESERVE

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210323-149616

Full Decision Text

Citation Nr: A26024639
Decision Date: 03/18/26 Archive Date: 03/18/26

DOCKET NO. 210323-149616
DATE: March 18, 2026

ORDER

Service connection for hypertension is denied.

Service connection for erectile dysfunction is denied.

Service connection for a foot condition is denied.

FINDINGS OF FACT

1. The probative evidence does not show that the Veteran's hypertension was incurred in service or due to service including active duty for training or inactive duty for training.

2. The probative evidence does not show that the Veteran's erectile dysfunction was incurred in service or due to service including active duty for training or inactive duty for training.

3. The probative evidence does not show that the Veteran had a foot condition that was incurred in service or due to service including active duty for training or inactive duty for training.

CONCLUSIONS OF LAW

1. The criteria for service connection for hypertension have not been met. 38 U.S.C. § 38 U.S.C. 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.304; Diagnostic Code 7101.

2. The criteria for service connection for erectile dysfunction have not been met. 38 U.S.C. § 38 U.S.C. 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.304; Diagnostic Code 7522.

3. The criteria for service connection for a foot condition have not been met. 38 U.S.C. § 38 U.S.C. 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.304; Diagnostic Code 5284.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran was a member of the National Guard/Reserve from 1984 to 2008 and had active duty training from November 1984 to April 1985 and active duty from February 2003 to May 2003.

The Veteran has a combined evaluation for compensation of 100 percent from March 2022.

These matters are before the Board of Veterans' Appeals (Board) on appeal from a March 2021 rating decision by the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ).

In the March 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on October 31, 2024 before the undersigned Veterans Law Judge. The transcript of the hearing is of record.

In the March 2021 decision, the AOJ conducted a higher-level review of an October 2020 AOJ decision and confirmed and continued the denials for service connection for hypertension, erectile dysfunction and foot trouble. In this appeal the Board may only consider the evidence of record at the time of the October 2020 AOJ decision, which was subsequently subject to higher-level review, as well as any evidence submitted by the Veteran at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). The Board notes that the Veteran submitted additional evidence within the 90-day evidentiary window following the Board hearing which the Board will consider.

If evidence was submitted either (1) during the period after the AOJ issued the decision, which was subsequently subject to higher-level review and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

The Board notes that the Veteran has not requested a pre-decisional hearing in this matter.VA regulations provide that, "[u]pon request, a claimant is entitled to a hearing on any issue involved in a claim . . . before VA issues notice of a decision on an initial or supplemental claim." 38 C.F.R. § 3.103(d)(1). That regulation does not indicate that the claimant is entitled to pre-decisional notice of this optional hearing. In fact, 38 C.F.R. § 3.103(b)(1) provides that, following a decision, "[c]laimants and their representatives are entitled to notice of any decision made by VA affecting the payment of benefits or the granting of relief . . . [including] the right to a hearing on any issue involved in the claim as provided in paragraph (d) of this section ...." Read together with § 3.103(d), the only notice § 3.103(b) requires is that a claimant be provided notice of the right for a hearing with notification of the decision (by definition, a post-decisional notice). In November 2022, VA amended VA Form 21-526EZ and in May 2024 VA amended VA Form 20-0995 to inform claimants of the right to a hearing at any time during the claims process.

The claims in this appeal were filed on an older claim form and therefore the Veteran was not advised in the form of his right to a pre-decisional hearing. However, the Board finds that any error in the failure to inform the Veteran of the right to a pre-decisional hearing before the Regional Office (RO) was harmless error. In Bowen, the Court found that when a claimant is denied a hearing before the RO, there is no due process violation if he is subsequently offered the opportunity for a hearing before the Board, even if a hearing was not requested or conducted, as long as there is no violation of due process concerning the Board hearing opportunity. Bowen v. Shinseki, 25 Vet. App. 250, 253-4 (2012). The facts in the case can be differentiated on several levels, to include that the Veteran did not actually request an RO hearing and the issue in Bowen was not one of notice. Regardless, the Board cannot find a basis to conclude that the underlying holding and logic of the Bowen case would not lead to the same finding of no prejudicial error under the procedure and facts of this case. The notification letter informing the Veteran of the rating decision on appeal included a VA Form 20-0998, Your Right to Seek Review of Our Decision, outlining the Veteran's appeal options, to include a hearing before the Board. Additionally, in his Notice of Disagreement, the Veteran was provided with an option to request a hearing with a Veterans Law Judge which he requested and has taken place. Because the Veteran was afforded a Board hearing there was no due process violation in the processing of the claim or any suggestion that the Veteran was prejudiced by the failure of VA to provide a hearing at the RO level. See Bowen.

Service Connection

Service connection may be granted for a current disability arising from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110. 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). Service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of an in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also 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).

Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38
4). Service connection may also 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).

Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

A disability can also be service connected on a secondary basis if it is proximately due to or the result of a service-connected condition. 38 C.F.R. § 3.310 (a). Secondary service connection, as contemplated by 38 U.S.C. § 1110, is warranted when a service-connected disability directly causes a nonservice-connected disability (a pure direct etiological cause), or when the nonservice-connected disability becomes functionally worsened due to an inability to treat the condition because of a service-connected disability (broad, indirect causation or "resulting from" but not proximately due to). Spicer v. McDonough, 61 F.4th 1360, 1364 (Fed. Cir. 2023).

Service Connection - Active Duty for Training and Inactive Duty Training

Active military, naval, and air service includes active duty, any period of active duty training (ACDUTRA) during which the individual concerned was disabled or died from a disease or injury incurred or aggravated in line of duty, and any period of inactive duty training (INACDUTRA) during which the individual concerned was disabled or died from an injury incurred or aggravated in line of duty (or from an acute myocardial infarction, a cardiac arrest, or a cerebrovascular accident which occurred during such training). 38 C.F.R. § 3.6(a). Active duty means full-time duty in the Armed Forces, other than ACDUTRA. 38 C.F.R. § 3.6(b)(1). ACDUTRA means full-time duty in the Armed Forces performed by Reserves for training purposes. 38 C.F.R. § 3.6(c).

When a claim for service connection is based on a period of ACDUTRA or INACDUTRA, there must be evidence that the claimant became disabled as a result of a disease or injury incurred or aggravated in the line of duty during that period of ACDUTRA or INACDUTRA to include travel to and from the trainings. See 38 U.S.C. §§ 101 (2), (22), (24); 38 C.F.R. § 3.6 (a); Donnellan v. Shinseki, 24 Vet. App. 167, 172 (2010); Acciola v. Peake, 22 Vet. App. 320, 324 (2008) (citing Mercado-Martinez v. West, 11 Vet. App. 415, 419 (1998); Paulson v. Brown, 7 Vet. App. 466, 470 (1995)). In the absence of such evidence, the period of ACDUTRA or INACDUTRA would not qualify as "active military, naval, or air service," and the claimant would not qualify as a "veteran" for that period of ACDUTRA or INACDUTRA service alone. 38 U.S.C. § 101 (2), (24); see Acciola, 22 Vet. App. at 324.

Generally, no presumptions (including the presumptions of soundness, aggravation, or for presumptive diseases) attach to periods of ACDUTRA and INACDUTRA, unless "veteran" status is attained during those periods. Smith v. Shinseki, 24 Vet. App. 40, 45 (2010); Paulson v. Brown, 7 Vet. App. 466, 470 (1995).

Finally, as an initial matter, at the Board hearing, the Veteran's representative stated that the Veteran is a combat veteran and is requesting consideration under the combat presumption. To be considered a combat veteran, a veteran "must have personally participated in events constituting an actual fight or encounter with a military
presumptions (including the presumptions of soundness, aggravation, or for presumptive diseases) attach to periods of ACDUTRA and INACDUTRA, unless "veteran" status is attained during those periods. Smith v. Shinseki, 24 Vet. App. 40, 45 (2010); Paulson v. Brown, 7 Vet. App. 466, 470 (1995).

Finally, as an initial matter, at the Board hearing, the Veteran's representative stated that the Veteran is a combat veteran and is requesting consideration under the combat presumption. To be considered a combat veteran, a veteran "must have personally participated in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality," not just a showing of service in a general combat area. Moran v. Peake, 525 F.3d 1157, 1159 (Fed. Cir. 2008). Here, while the Veteran testified as to combat training, there is no indication he served in combat. In 2003 he served in support of Operation Enduring Freedom, but he was not deployed to a foreign country where combat was occurring. Therefore, he is not a combat veteran for VA purposes.

1. The issue of entitlement to service connection for hypertension.

The Veteran contends that he has hypertension that was incurred in service or due to service.

Under VA regulations hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. The term hypertension means that the diastolic blood pressure is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm. 38 C.F.R. § 4.104.

The AOJ noted as a favorable finding that the Veteran was diagnosed with hypertension in an August 2019 VA treatment record. Under the AMA, the Board is bound by favorable findings made by the AOJ unless rebutted by evidence that identifies clear and unmistakable error (CUE) with the favorable finding. 38 C.F.R. §§?3.104(c), 20.801(a). A finding means a conclusion either on a question of fact or on an application of law to facts made by an adjudicator concerning the issue(s) on review. 38?C.F.R. § 3.104(c). This favorable finding is binding on the Board as it is not clearly erroneous.

The issue for the Board is whether the Veteran's hypertension incurred in or is otherwise linked to the Veteran's service.

Service treatment records show that at enlistment in June 1984 and at periodic examinations in August 1991 and November 1996 the Veteran reported being in good health and denied having high blood pressure.

On January 6, 2001 the Veteran denied having high blood pressure at a periodic physical examination. The evaluating provider recommended that the Veteran have his blood pressure checked by his primary care physician. His blood pressure then was 138/102. The evidence does not show that the military physical of January 6, 2001 was during a recognized period of reserve service (two-week annual training). There is also no evidence that more than one blood pressure reading was taken.

In a May 2003 Report of Medical Assessment, which was prepared for purposes of separation from active duty, the Veteran indicated that since his last physical examination he had not been treated by a health care provider, had not had any injury or illness while on active duty for which he did not seek medical care, denied taking any medications, and had no conditions which currently limited his ability to work in his primary military specialty. He indicated that he had no questions or concerns about his health.

A January 2004 Reserve Unit Commander Memorandum indicates that the Veteran was physically fit for retention, and no physical or medical abnormalities were noted.

In a Reserve December 2004 medical certificate, the Veteran indicated that he was taking blood pressure medicine and allergy injections. In a Pre-Deployment Health Assessment, he indicated that his health in general was good and that he was not on a profile. A medical evaluator noted that he was deployable.

In March 2006 the Veteran indicated in a Report of Medical History that he did not have high blood pressure. His BP was 142/88. A March 2006 Reserve memorandum addressing the results of a retention physical examination indicated that the Veteran was physically fit for retention but was referred to a medical provider for his blood pressure and weight. It was noted that there were no physical abnormalities requiring profiling at that time. In a March 2006 dental health questionnaire, he did not indicate he had high blood pressure.

The Veteran submitted November 2020 correspondence to VA in support of his claim for hypertension. However, that letter was submitted outside of the applicable
that he was not on a profile. A medical evaluator noted that he was deployable.

The Veteran submitted November 2020 correspondence to VA in support of his claim for hypertension. However, that letter was submitted outside of the applicable evidentiary window and cannot be considered by the Board in this appeal. 38 C.F.R. §20.302(a).

The Veteran also submitted a November 2024 letter to the Board which the Board can consider as it was submitted during the applicable evidentiary window following the October 2024 Board hearing. In the letter the Veteran asserted that he had back, knee and shoulder injuries which caused chronic pain and stress on his body. He asserted that the physical and emotional stress were a contributing factor for his hypertension. He also asserted that taking medication for pain led to elevated blood pressure.

August 2019 private treatment records, received by VA in October 2019, show a history of essential hypertension with an onset date of June 2018.

August 2019 VA treatment records show that the Veteran was seen at a VA facility to establish care, that his blood pressure then was 138/90, and a medical assessment of essential hypertension was noted. A November 2019 VA podiatry treatment record states a history of hypertension. A January 2020 VA treatment note states that the Veteran reported that he was on medication to control blood pressure but stopped taking it because he was feeling better. He reported that certain foods containing sodium caused his blood pressure to increase.

At the October 2024 Board hearing, the Veteran testified that in the year 2000 he was in the field and was seen by a medic who told him that his blood pressure was a little high and that he was being put on restriction until his blood pressure went down. He stated that he saw a doctor in 2000 who told him that his blood pressure was a little high, and that after then he was placed on medication. He stated that in 2003 he was deployed and was not taking any blood pressure medication but was put on restricted duty. He stated that in 2004 his BP was 168/100 and he was not taking any medication.

The Board acknowledges and has considered Veteran's contentions and reported symptoms. Lay evidence is competent to establish the presence of observable symptomatology, where the determination is not medical in nature and is capable of lay observation. Barr v. Nicholson, 21 Vet. App. 303 (2007).

The Board finds that service connection for hypertension is not warranted.

The record shows that the Veteran denied having high blood pressure at physical examinations in 1984, 1991, 1996 and 2001. In the January 2001 physical examination, the evaluating provider recommended that he see his primary care physician as his BP then was noted to be 138/102. The record does not show that this was during active duty or active duty training. The Veteran thereafter served on active duty for a three-month period from February to May 2003. In a May 2003 medical assessment, he reported that he was not taking any medications and had no concerns for his health. In January 2004 no physical abnormalities were noted in a unit commander's memorandum. In December 2004 the Veteran reported that he was taking blood pressure medication and a medical evaluator then noted that he was deployable; the record does not show that this was during a period of active duty or active duty training. In March 2006 the Veteran reported that he did not have high blood pressure and his BP then was 142/88. Although he was referred to a medical provider because of his blood pressure and weight, it was noted that there were no physical abnormalities requiring profiling and he was found physically fit for retention. The record also does not show that this was during a period of active duty or active duty training.

The Veteran testified at the Board hearing that he was told by a provider in 2000 that his blood pressure was a little high and was placed on restricted duty. However, the record does not show that he was placed on a medical profile for hypertension or was seen by a provider for hypertension at that time. In November 2024, he submitted a private medical record dated in October 2006 which showed that he was seen for his hypertension and his medications were adjusted. This was not during a period of active duty or active duty training.

The record does
there were no physical abnormalities requiring profiling and he was found physically fit for retention. The record also does not show that this was during a period of active duty or active duty training.

The record does not show that the Veteran was diagnosed with hypertension or that he had hypertension that was aggravated during a period of active service or active duty training. When a claim for service connection is based on a period of ACDUTRA or INACDUTRA, there must be evidence that the claimant became disabled as a result of a disease or injury incurred or aggravated in the line of duty. See 38 U.S.C. §§ 101 (2), (22), (24); 38 C.F.R. § 3.6 (a). Here, the record does not show that he had hypertension during a period of ACDUTRA or INACDUTRA. As hypertension is a disease, for service connection to be warranted, it must be due to a period of active duty or active duty training; only injuries during a period of inactive duty can be service-connected. If the Veteran had symptoms of hypertension or even diagnosis of such while he was in Reserve status (inactive duty), this does not mean service connection can be awarded for this disease.

In addition, in November 2024 correspondence to the Board, the Veteran asserted that he had pain and emotional stress due to his back, knee and shoulder conditions which contributed to his hypertension and that taking medication for pain led to elevated blood pressure. The Board notes that the Veteran has service-connected low back, left shoulder and left knee conditions, effective from July 2019. However, the Veteran is not competent to render a medical opinion and no treating or examining medical provider had opined that these conditions or medication for these conditions contributed to or aggravated his hypertension. Further, this is a new contention and remand for an addendum medical opinion addressing this issue is not warranted under the AMA as there is no indication that a duty to assist error occurred prior to the date of the AOJ decision on appeal. See 38?C.F.R. §?20.802(a).

The claim for service connection for hypertension is denied. The evidence is not in approximate balance and not 'nearly equal'; therefore, the benefit of the doubt rule has no application. Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

2. The issue of entitlement to service connection for erectile dysfunction.

The Veteran contends that he has erectile dysfunction that was incurred in service or due to service.

The AOJ noted as a favorable finding that the Veteran was diagnosed with erectile dysfunction in an August 2019 VA treatment record. This favorable finding is binding on the Board as it is not clearly erroneous. 38 C.F.R. § 3.104(c).

The issue for the Board is whether the Veteran's erectile dysfunction incurred in or is otherwise linked to the Veteran's service. In his VA Form 21-526EZ the Veteran asserted that he had erectile dysfunction and that he was treated in service for this condition. However, he did not indicate an approximate date of treatment in the claims form.

At the October 2024 Board hearing the Veteran testified that after his back and shoulder injuries and after Anthrax injections in service he noticed a difference in his erection. He testified that he also felt that his diagnosed major depressive disorder had something to do with it. He stated that no doctor ever told him his erectile dysfunction was due to his service-connected back injury or Anthrax injections in service.

In November 2024 correspondence to the Board, the Veteran stated that he had chronic back pain and that medications for this condition directly contributed to his erectile function. He further stated that his medical provider has linked his erectile dysfunction to the physical and psychological impact of his injuries. He submitted a private medical record with a list of reviewed problems that showed diagnosis of impotence with onset in February 2009.

Service treatment records are silent for any complaints, treatment of diagnosis for erectile dysfunction. Service treatment records show that at enlistment in June 1984 and at periodic examinations in August 1991, November 1996 and January 2001 the Veteran reported being in good health. In a May 2003 Report of Medical Assessment, which was prepared for purposes of separation from active duty, he indicated that he had no questions or concerns about his health. In a December 2004 Pre-Deployment Health Assessment, he indicated that his health in general was good and that he was not on a medical profile.

Having reviewed the medical and lay evidence, the Board finds that service connection for erectile dysfunction is not warranted.

Service treatment records are silent for any complaints, treatment or diagnosis for erectile dysfunction. Although VA treatment records indicate a diagnosis of erectile dysfunction in 2019, no treating or examining medical provider has opined that the Veteran's erectile dysfunction incurred in, is due to, or linked to service.

Although the Veteran indicated in his VA form 21-526-EZ that he had erectile dysfunction which was treated in service, this is not shown in the record. In addition, at the October 2024 Board hearing, he testified that no medical provider has opined that his erectile dysfunction is the result of his back condition or Anthrax injections that he had in service. In his November 2024 correspondence he stated that his medical provider had linked his erectile dysfunction to the physical and psychological impact of his injuries. He submitted a private medical record that showed diagnosis of "psychosexual dysfunction associated with inhibited libido." At best, this diagnosis relates psychological issues to libido issues, not the opposite. There is no persuasive medical evidence linking this condition to his service-connected injuries. Although the Veteran testified that he believed his erectile dysfunction was the result of his back injury, Anthrax injections during service, and psychological injury, he is not competent to render such a medical opinion. See Barr, supra.

The Board also notes that the assertion that his erectile dysfunction is secondary to his service-connected disabilities, or related to Anthrax injections, are new contentions, as they were not asserted at any time by the Veteran prior to the rating decision on appeal. As they are new contentions, a remand for a medical opinion addressing these issues is not warranted under the AMA as there is no indication that a duty to assist error occurred prior to the date of the AOJ decision on appeal. See 38?C.F.R. §?20.802(a).

The claim for service connection for erectile dysfunction is denied. The evidence is not in approximate balance and not 'nearly equal'; therefore, the benefit of the doubt rule has no application. Ortiz, supra.; Lynch, supra.

3. The issue of entitlement to service connection for a foot condition.

The Veteran contends that he has a foot condition that was incurred in or is due to service.

The AOJ noted as a favorable finding that the Veteran was diagnosed with and treated for foot pain at a VA Medical Center from November 2019 to February 2020. This favorable finding is binding on the Board. 38 C.F.R. § 3.104(c).

The issue for the Board is whether a foot condition was incurred in or is otherwise linked to the Veteran's service.

Service treatment records show that the Veteran reported at an August 1991 periodic medical examination that his feet were treated for foot fungus and that toenails were removed as part of that treatment. He reported again at November 1996 and January 2001 physical examinations that he had been treated for foot fungus. At the 2001 physical examination the evaluating provider noted normal findings for the feet. Following his February to May 2003 period of active duty, the Veteran reported in a May 2003 medical assessment that he was not taking any medications and had no concerns for his health. The Veteran also completed a March 2006 Report of Medical History for an examination and denied at that time having foot trouble including pain, corns or bunions.

VA treatment records in November 2019 show that he was treated for foot pain. He was seen at a VA podiatry clinic where he reported that he had a history of athlete's foot in 1995 with 8 toenails removed. He reported that he had bilateral heel pain and lateral left foot pain. The provider's diagnoses were left peroneus longus tendonitis, bilateral plantar fasciitis, neuritis/neuroma of
Veteran reported in a May 2003 medical assessment that he was not taking any medications and had no concerns for his health. The Veteran also completed a March 2006 Report of Medical History for an examination and denied at that time having foot trouble including pain, corns or bunions.

VA treatment records in November 2019 show that he was treated for foot pain. He was seen at a VA podiatry clinic where he reported that he had a history of athlete's foot in 1995 with 8 toenails removed. He reported that he had bilateral heel pain and lateral left foot pain. The provider's diagnoses were left peroneus longus tendonitis, bilateral plantar fasciitis, neuritis/neuroma of the left 3rd interspace, bilateral foot pain, equinus, and radiculopathy. No diagnosis for athlete's feet was noted. Also, a February 2020 VA podiatry record shows that the Veteran had a normal gait bilaterally.

The Veteran submitted correspondence dated in November 2020. As this letter was not received by VA during an applicable evidentiary window for this appeal, the Board cannot consider it in this appeal.

At the October 2024 Board hearing, the Veteran testified that he developed foot fungus as a result of training in wet boots. He stated that he went on sick call and saw a podiatrist who removed eight toenails. He stated that his toes are still tender. He also stated that he was diagnosed with plantar fasciitis, heel spurs and flat feet in 1995, and that a doctor said that military service contributed to the conditions. He stated that he did not want a medical profile in service and just kept moving, indicating that he did not then seek medical treatment. He confirmed that the treatment he received for his feet took place during weekend drills or periods of inactive duty. He stated that he had the surgery to remove his toenails in October 1995. He stated that he continues to have issues with foot problems. He also stated that in 1991 his left foot was injured when a device slipped and a rail struck his foot. He also stated that a VA podiatrist stated that he had feet like he had seen with other veterans.

The Board also received correspondence from the Veteran in November 2024 during the evidentiary window following the Board hearing which the Board has considered in this appeal. In this correspondence the Veteran stated that due to his back and knee injuries, he developed an altered gait placing additional strain on his feet. He also stated that he had foot fungus due to field showers during active-duty training which resulted in the surgical removal of a toenails. He submitted a November 2019 VA x-ray report showing calcaneal spurs and hallux valgus. He also submitted a November 2019 VA MRI report showing tenosynovitis and a plantar fibroma.

The record shows that in February 2020 VA examinations for knee and back conditions, no altered gait was recorded, and the examiner noted that the Veteran did not have functional loss due to either the knee or back condition. The Board notes that in a February 2020 podiatry VA treatment record it was noted that the Veteran had a normal gait bilaterally.

The Board acknowledges and has considered the Veteran's contentions and reported symptoms. Upon review of the evidence of record, the Board finds that the evidence persuasively weighs against a finding of service connection for a foot condition. The record shows that the Veteran reported at periodic examinations in 1991, 1996 and 2001 that he had had foot trouble during Reserve service, described as foot fungus. However, in the 2001 medical examination the examining provider noted that he had no foot abnormalities. The Veteran had active service from February to May 2003 and following that period of active duty he completed a medical assessment and specifically denied having a foot condition then. There is no record of complaints or treatment for a foot condition in medical or personnel records for the 2003 period of active duty or for his subsequent Reserve service. The Veteran was seen for complaints of foot pain in 2019, and diagnoses for foot conditions were made, but they did not include athlete's foot, the foot condition that he had reported while in the Reserve. There is no probative evidence that the Veteran has a current athlete's foot condition. Service connection requires a finding of a current disability. See Caluza v. Brown, 7 Vet. App. 498, 506 (1995) (holding that service connection cannot be awarded in the absence of 'competent evidence of current disability'); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (stating that "Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a
2019, and diagnoses for foot conditions were made, but they did not include athlete's foot, the foot condition that he had reported while in the Reserve. There is no probative evidence that the Veteran has a current athlete's foot condition. Service connection requires a finding of a current disability. See Caluza v. Brown, 7 Vet. App. 498, 506 (1995) (holding that service connection cannot be awarded in the absence of 'competent evidence of current disability'); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (stating that "Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability"). For his other diagnosed foot conditions noted by the VA treating podiatrist and on x-ray/MRI in 2019, no provider has linked these conditions to service.

The Board acknowledges that the Veteran raised the issue of secondary service connection in his November 2024 correspondence wherein he asserted that he had a foot condition due to alleged altered gait as a result of his service-connected back and knee conditions. However, the record shows that the Veteran had a VA examination for the knees and back where there was no indication of altered gait due to these service-connected conditions. In addition, a February 2020 podiatry VA treatment record states that the Veteran had a normal gait bilaterally. Further this is a new contention not previously raised by the Veteran, and a remand for a medical opinion addressing this issue is not warranted under the AMA. There is no indication that a duty to assist error occurred prior to the date of the AOJ decision on appeal. See 38?C.F.R. §?20.802(a).

In sum, the record does not show that the Veteran had a foot condition during a period of active service or a period of ACDUTRA or INACDUTRA, and no medical provider has opined that the Veteran had any foot condition due to or as a result of active duty. Although he alleges his foot condition is also due to wearing certain boots or wet socks during training, to include inactive duty periods, this is not the equivalent of an injury during inactive duty. An "injury" denotes harm from external trauma, and the term "trauma" commonly refers to the application of external force or violence. VAOPGCPREC 4-2002; VAOPGCPREC 8-2001.

The claim for service connection for a foot condition is denied. The evidence is not in approximate balance and not 'nearly equal'; therefore, the benefit of the doubt rule has no application. Ortiz, supra.; Lynch, supra.

MICHELLE L. KANE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Lawrence Hubert

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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