UNDIAGNOSED ILLNESSES

Summary

The Veteran served in the Southwest Asia theater of operations from August 1989 to January 1993. This Legacy appeal concerns the denial of service connection for an autoimmune disorder and the dismissal of a claim for colon cancer. The Veteran contended that his autoimmune disorder was due to toxic exposure risk activity (TERA) during service, a fact conceded by the VA. The Board found that while the Veteran has a current autoimmune disorder and conceded in-service TERA exposure, the nexus requirement was not met. A May 2025 VA examination opined that the autoimmune condition was less likely than not related to service, citing a lack of objective evidence and no consistent reports in service treatment records. The Board found this opinion highly probative. Private medical records suggested the disorder was cyclical and potentially linked to post-service chemical exposure, but the Board found them less probative than the VA opinion due to a lack of clear rationale connecting the condition to military service. The Board concluded the evidence weighed against a service connection for the autoimmune disorder. The claim for colon cancer was dismissed as moot because the AOJ granted service connection for it in a subsequent May 2025 rating decision.

Rationale

VA examiner opined less likely than not related to service; Lack of objective evidence/diagnosis in service treatment records; Private medical evidence found less probative than VA opinion

Full Decision Text

Citation Nr: 25010075
Decision Date: 08/04/25	Archive Date: 08/04/25

DOCKET NO. 19-26 326A
DATE: August 4, 2025

ORDER

Entitlement to service connection for an autoimmune disorder, including as due to in-service participation in a toxic exposure risk activity (TERA), is denied.

Entitlement to service connection for colon cancer, to include gastrointestinal issues, is dismissed.

FINDINGS OF FACT

1.  The record evidence shows that the Veteran served in the Southwest Asia theater of operations during active service; thus, his in-service participation in a TERA is conceded.

2.  The record evidence shows that the Veteran currently experiences an autoimmune disorder.

3.  The record evidence shows that the Veteran's autoimmune disorder was not incurred in or caused by active service or any incident of service, including as due to in-service participation in a TERA.

4.  The record evidence shows that, in a May 20, 2025, rating decision, the Agency of Original Jurisdiction (AOJ) granted the Veteran's claim of entitlement to service connection for colon cancer, to include gastrointestinal issues; therefore, there is no longer a case or controversy with respect to this service connection claim. 

CONCLUSIONS OF LAW

1.  The criteria for service connection for an autoimmune disorder have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.159, 3.303.

2.  The claim of service connection for colon cancer, to include gastrointestinal issues, is dismissed as moot. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from August 1989 to January 1993.

This Legacy appeal has a long procedural history.  It comes before the Board of Veterans' Appeals (Board) on appeal from a November 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO).

In January 2025, the Board remanded the currently appealed claims to the AOJ for additional development.  A review of the claims file shows that there has been substantial compliance with the Board's remand directives.  See Stegall v. West, 11 Vet. App. 268 (1998); see also Dyment v. West, 13 Vet. App. 141 (1999) (holding that another remand is not required under Stegall where the Board's remand instructions were substantially complied with), aff'd, Dyment v. Principi, 287 F.3d 1377 (2002).

Having reviewed the record evidence, the Board finds that the issues on appeal should be characterized as stated above.  Neither the Veteran nor his attorney has raised any other issues nor have any other issues been reasonably raised by the record, to include entitlement to an additional disability rating, an extraschedular rating for a service-connected disability, service connection for another disability as secondary to a service-connected disability, or to a total disability rating based on individual unemployability (TDIU).  See Doucette v. Shulkin, 28 Vet. App. 366, 369 370 (2017).

1. Entitlement to service connection for an autoimmune disorder

The Veteran contends that his autoimmune disorder is due to his service in Southwest Asia. It is undisputed that the Veteran served in the southwest Asia theater of operations during the presumptive period. The AOJ conceded that the Veteran's autoimmune condition exists and is documented in the record. As such, the first element of a claim of service connection (a current disability) is established. As to in-service incurrence, the Veteran's participation in a toxic exposure risk activity (TERA) is conceded by VA due to his service in the southwest Asia theater of operations. Thus, the second element of a claim of service connection (in-service incurrence) is established. See Shedden v. Principi, 381 F. 3d 1163, 1167 (Fed. Cir. 2004).

This appeal centers on whether the Veteran's current autoimmune disorder can be attributed to active service (the nexus requirement). Id. Regarding the nexus requirement, the Veteran was afforded a VA examination in May 2025 and VA opinions were obtained at that time for direct service connection and for service connection as due to participation in a TERA. As to direct service connection, the May 2025 VA examiner opined that the Veteran's autoimmune condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In the examination, the Veteran
urrence) is established. See Shedden v. Principi, 381 F. 3d 1163, 1167 (Fed. Cir. 2004).

This appeal centers on whether the Veteran's current autoimmune disorder can be attributed to active service (the nexus requirement). Id. Regarding the nexus requirement, the Veteran was afforded a VA examination in May 2025 and VA opinions were obtained at that time for direct service connection and for service connection as due to participation in a TERA. As to direct service connection, the May 2025 VA examiner opined that the Veteran's autoimmune condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In the examination, the Veteran reported symptoms of fatigue. However, this examiner noted no diagnosis of an autoimmune disease stating that there is no objective evidence of the claimed condition at this time. As rationale, the examiner stated that medical records were reviewed and that they fail to reveal a specific diagnosis that will explain or link to the claimed autoimmune disorder. Additionally, the examiner noted the Veteran's report of fatigue and had the ability to consider that symptom in formation of the opinion. Ultimately, the examiner did not conclude that the reported fatigue was due to an autoimmune disorder or due to service. The conclusion of the opinion for direct service connection is adequately supported by its rationale, and the Board finds it highly probative. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007).

The May 2025 VA examiner also opined that the autoimmune condition was less likely than not caused by the indicated TERA after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. As rationale, the examiner opined that the medical records were reviewed and there were no consistent or ongoing reports of autoimmune disorder noted in service treatment records (STRs) or immediately following discharge, which weakens the likelihood of a direct connection between the current diagnosis and military service. In forming this opinion, the examiner clearly considered each of the types of exposures the Veteran was noted to have had in service. The conclusion of the opinion for service connection as due to TERA participation is adequately supported by its rationale. As such, the Board finds the May 2025 VA examiner's opinion for service connection as due to TERA to be highly probative. Id.

The Board acknowledges private treatment records received by VA in support of this appeal which indicate that the nature of the Veteran's autoimmune disorder was cyclical which may explain the lack of a current diagnosis by the May 2025 VA examiner. Additionally, the private physician indicated a reactivation of an autoimmune disorder in 2010 as secondary to chemical exposure to a genotoxin at the Veteran's post-service employment. The physician also considered this condition to be a Desert Storm overlay autoimmune condition. 

The Court has held that the Board is free to assess medical evidence and is not compelled to accept a physician's opinion. Wilson v. Derwinski, 2 Vet. App. 614 (1992). The Court also has held that the value of a physician's statement is dependent, in part, upon the extent to which it reflects "clinical data or other rationale to support his opinion." Bloom v. West, 12 Vet. App. 185, 187 (1999). Thus, a medical opinion is inadequate when it is unsupported by clinical evidence. Black v. Brown, 5 Vet. App. 177, 180 (1995). The Board notes here that the private physician whose records were submitted in support of this appeal provided no explanation as to how a clearly articulated, work-related autoimmune disorder attributed to a worker's compensation claim could be connected to or arise from the Veteran's military service. In fact, this private physician attributed the Veteran's cyclic autoimmune disorder due to recurrent chemical exposure to the genotoxins at the Veteran's post-service job. Thus, the Board finds this private medical evidence to be less probative than the May 2025 VA examiner's medical opinion on the issue of whether the Veteran's current autoimmune disorder is attributable to active service.  

Based on the foregoing, the most probative evidence (VA examiner's opinions dated in May 2025) is against finding a nexus between the Veteran's current autoimmune disorder and active service, including his conceded in-service participation in a TERA while in the southwest Asia theater of operations. The evidence persuasively weighs against the claim. Therefore, the benefit of the doubt rule does not apply. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). In summary, the Board finds that service connection for an autoimmune disorder, including as due to in-service participation in a TERA, is not warranted.  

2. Entitlement to service connection for colon cancer,
.  

Based on the foregoing, the most probative evidence (VA examiner's opinions dated in May 2025) is against finding a nexus between the Veteran's current autoimmune disorder and active service, including his conceded in-service participation in a TERA while in the southwest Asia theater of operations. The evidence persuasively weighs against the claim. Therefore, the benefit of the doubt rule does not apply. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). In summary, the Board finds that service connection for an autoimmune disorder, including as due to in-service participation in a TERA, is not warranted.  

2. Entitlement to service connection for colon cancer, to include gastrointestinal issues

As noted in the Introduction, the AOJ granted service connection for colon cancer, to include gastrointestinal issues, in a May 2025 rating decision. Although this claim returned to the Board following its January 2025 remand, the May 2025 award of service connection represents a full grant of the benefits sought by the Veteran. See Grantham v. Brown, 114 F.3d. 1156 (Fed. Cir. 1997); see also 38 U.S.C. §§ 7104(a), 7105(d)(5). Accordingly, this appeal for service connection for colon cancer, to include gastrointestinal issues, is moot and the claim is dismissed.

 

 

MICHAEL T. OSBORNE

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Jeffreys, J.

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.