CHRONIC FATIGUE SYNDROME

Summary

The veteran, who served in the Army from March 1976 to February 1979, appeals the denial of service connection for multiple conditions including chronic fatigue syndrome (CFS), sleep disability, skin disability (chloracne), ALS, muscle disability, joint disabilities (ankles, knees, wrists, elbows, right shoulder), and a heart condition. The veteran contended these conditions originated during service due to military duties as a soil analyst and associated exposures to herbicide agents and toxic chemicals in Germany and the United States. The Board denied service connection for CFS, sleep disability, skin disability, ALS, muscle disability, joint disabilities, and the heart condition, finding no current diagnosis or evidence of functional impairment affecting earning capacity for the musculoskeletal claims, and no nexus to service for the heart condition. The Board noted the veteran's service was in Germany, not a presumptive herbicide exposure location, and that the TERA memorandum identified possible exposures to noise, engine exhaust, dust, industrial hazardous materials, and asbestos, but not herbicides. The VA examiner found no diagnosed CFS, sleep, skin, ALS, muscle, or joint disabilities, and opined unfavorably for the heart condition regarding TERA. The Board denied these claims due to lack of current diagnosis or functional impairment, and lack of nexus to service or TERA for the heart condition. The Board remanded claims for migraine headaches, chronic gastrointestinal conditions (GERD, esophageal ulcer), short-term memory loss, residuals of prostate cancer (erectile dysfunction), and bilateral hip strain for further development, including obtaining opinions on in-service onset and addressing lay statements and private treatment records.

Rationale

No current diagnosis of CFS during appeal period or proximate thereto.; No evidence of functional impairment affecting earning capacity.; Benefit of the doubt rule not applicable as evidence not in approximate balance.

Full Decision Text

Citation Nr: 26003000
Decision Date: 03/05/26	Archive Date: 03/05/26

DOCKET NO. 15-16 190
DATE: March 5, 2026

ORDER

Entitlement to service connection for chronic fatigue syndrome (CFS) is denied.

Entitlement to service connection for a recurrent sleep disability, to include insomnia, is denied.

Entitlement to service connection for a recurrent skin disability, to include chloracne, is denied.

Entitlement to service connection for amyotrophic lateral sclerosis (ALS) is denied.

Entitlement to service connection for a recurrent muscle disability is denied.

Entitlement to service connection for bilateral ankle, knee, wrist, elbow, and right shoulder disabilities (previously characterized as a recurrent joint disability) is denied.

Entitlement to service connection for a heart condition (previously characterized as a recurrent cardiovascular disability) is denied.

REMANDED

Entitlement to service connection for migraine headaches is remanded.

Entitlement to service connection for a chronic gastrointestinal condition, diagnosed as gastroesophageal reflux disease (GERD) and esophageal ulcer, is remanded.

Entitlement to a recurrent disability manifested by short-term memory loss claimed as the result of herbicide agent and toxic chemical exposure is remanded.

Entitlement to service connection for residuals of prostate cancer, to include erectile dysfunction (previously characterized as a recurrent prostate disability) is remanded.

Entitlement to service connection for bilateral hip strain (previously characterized as recurrent joint disability) is remanded.

FINDINGS OF FACT

1. Chronic fatigue has not been shown during the period on appeal or proximate thereto.

2. A sleep disability has not been shown during the period on appeal or proximate thereto.

3. A skin disability has not been shown during the period on appeal or proximate thereto.  

4. A diagnosis of ALS has not been shown during the period on appeal or proximate thereto.

5. A muscle disability has not been shown during the period on appeal or proximate thereto.

6. A bilateral ankle, knee, wrist, elbow, and/or right shoulder has not been shown during the period on appeal or proximate thereto.

7. A heart disorder did not originate in service, and is not otherwise etiologically related to service, to include any toxic exposure risk activity.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for chronic fatigue syndrome have not been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for entitlement to service connection for a recurrent sleep disability, to include insomnia, have not been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for entitlement to service connection for a recurrent skin disability, to include chloracne, have not been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for entitlement to service connection for ALS have not been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for entitlement to service connection for a recurrent muscle disability have not been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

6. The criteria for entitlement to service connection for bilateral ankle, knee, wrist, elbow, and right shoulder disabilities (previously characterized as a recurrent joint disability) have not been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

7. The criteria for entitlement to service connection for a heart condition have not been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from March 1976 to February 1979.

These matters come before the Board of Veterans' Appeals (Board) on appeal of an April 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).  

In May 2023, the Board remanded these matters to obtain the Veteran's military personnel records (MPRS).  The AOJ obtained the Veteran's MPRs and they have been associated with the claims file. The Board finds
 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from March 1976 to February 1979.

These matters come before the Board of Veterans' Appeals (Board) on appeal of an April 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).  

In May 2023, the Board remanded these matters to obtain the Veteran's military personnel records (MPRS).  The AOJ obtained the Veteran's MPRs and they have been associated with the claims file. The Board finds that the RO substantially complied with the recent remand directives. See Stegall v. West, 11 Vet. App. 268 (1998); D'Aries v. Peake, 22 Vet. App. 97, 105 (2008).

The Veteran was scheduled for a hearing before a Veterans Law Judge on March 27, 2023.  However, in a February 2023 correspondence, the Veteran, through his then representative, waived his request for a hearing.  See February 15, 2023 Appellate Brief.  Accordingly, his request for a hearing is deemed withdrawn.  See 38 C.F.R. §§ 20.600(b); 20.704(d).

Pursuant to 38 C.F.R. § 20.6(a)(2), after an appeal has been certified to the Board, a representative may not withdraw services as a representative in the appeal unless good cause is shown on motion and motion must be in writing and must comply with the criteria set forth in 38 C.F.R. § 20.6(a)(2). In accordance with the regulatory provision, the Veteran's attorney filed a Motion to Withdraw Representation in September 2025. The Board finds that the Motion to Withdraw Representation is compliant with 38 C.F.R. § 20.6(a)(2) because it includes: (1) the attorney's explanation that the decision to withdraw representation was due the failure of the Veteran to cooperate with the proper preparation and presentation of the appeal, which make the continuation of representation impossible, impractical, or unethical; (2) the Veteran's name and VA file number, and (3) a signed statement certifying that a copy of the motion was sent to the Veteran. Therefore, good cause was shown, and the Motion to Withdraw Representation is granted. No new appointment of representation has been received. Accordingly, the Veteran is unrepresented.

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, service connection requires: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995).

With any claim for service connection, it is necessary for a current disability to be present. See Brammer v. Derwinski, 3 Vet. App. 223 (1992); McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). The requirement that a current disability exists is satisfied if the claimant had a disability at the time her claim for VA disability compensation was filed or during the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Without a current diagnosis, there may be no service connection for the claimed condition.

When all the evidence is assembled, VA is responsible for determining whether the weight of the evidence is in approximate balance. If the positive and negative evidence is evenly or approximately balanced, the claimant receives the benefit of the doubt. 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).

1. Entitlement to service connection for CFS is denied.

2. Entitlement to service connection for a recurrent sleep disability, to include insomnia, is denied.

3. Entitlement to service connection for a recurrent skin disability, to include chloracne, is denied.

4
 the evidence is assembled, VA is responsible for determining whether the weight of the evidence is in approximate balance. If the positive and negative evidence is evenly or approximately balanced, the claimant receives the benefit of the doubt. 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).

1. Entitlement to service connection for CFS is denied.

2. Entitlement to service connection for a recurrent sleep disability, to include insomnia, is denied.

3. Entitlement to service connection for a recurrent skin disability, to include chloracne, is denied.

4. Entitlement to service connection for ALS is denied.

5. Entitlement to service connection for a recurrent muscle disability is denied.

6. Entitlement to service connection for bilateral ankle, knee, wrist, elbow, and right shoulder disabilities (previously characterized as a recurrent joint disability) is denied.

The Veteran seeks service connection for CFS, a recurrent sleep disability, a skin disability, ALS, a recurrent muscle disability, and joint disabilities, to include of the bilateral ankles, knees, wrist, elbows, and the right shoulder, all of which he contends originated during active service due to his military duties as a soil analyst and associated exposure to herbicide agents and other toxic chemicals in Germany and the United States.

While in remand status, the AOJ obtained a toxic exposure risk activity (TERA) memorandum which found that the Veteran had possible exposures to heavy equipment/machinery noise, engine exhaust, dust, industrial hazardous materials, and asbestos, due to his military occupational specialty (MOS) of Army Materials Quality Specialist.

The AOJ then obtained CFS, skin, ALS, muscle injuries, and ankle, knee, wrist, elbow, and shoulder examinations and opinions.  The examiner determined that the Veteran had no diagnosed CFS, sleep, skin, ALS, muscle injuries, ankle, knee wrist, elbow, or right shoulder disabilities. Regarding a sleep disability, the examiner noted the Veteran's reported subjective history of insomnia, but found no diagnosis.

After a thorough review of the evidence of record, the Board finds that the Veteran has not been diagnosed with CFS, sleep, skin, ALS, muscle injuries, and ankle, knee, wrist, elbow, and/or right shoulder disabilities at any time during the appeal period to support his claims for service connection.  The Board acknowledges that the Veteran was diagnosed with fracture, left clavicle with acromioclavicular separation.  However, service connection for the left shoulder has been in effect since 1997 and is not on appeal before the Board.

Proof of a current disability is a threshold to establishing service-connection. In the absence of proof of a present disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

No underlying CFS, sleep, skin, ALS, muscle injuries, and ankle, knee, wrist, elbow, and/or right shoulder disability has been clinically diagnosed during the appeal period or proximate thereto. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013).

In making these findings, the Board acknowledges that the Veteran has reported bilateral knee and wrist pain. See May 2024 VA Examinations. In Saunders v. Wilkie, 886 Fed. Cir. 1356 (2018), the United States Court of Appeals for the Federal Circuit (Federal Circuit) held that pain can constitute a disability under 38 U.S.C. § 1110. However, the Federal Circuit did not hold that the veteran could demonstrate service connection simply by asserting subjective pain. Rather, to establish a disability, the veteran's pain must amount to a functional impairment. The Federal Circuit held that to establish the presence of a disability, the veteran will need to show that his or her pain reaches the level of a functional impairment of earning capacity. Id. at 28. In Wait v. Wilkie, 33 Vet. App. 8 (2020), the Court of Appeals for Veterans Claims (Court) clarified that under Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), there must be competent evidence demonstrating that the claimed symptoms result in functional impairment that in fact affects the veteran's earning capacity. In determining whether a veteran's impairment rises to a level affecting earning capacity, VA can consider manifestations of similar severity, frequency, and duration as those VA has determined by regulation would cause impaired earning capacity in an average person.

In this case, the Board acknowledges the Veteran's assertion that he has bilateral knee and wrist pain. However, the Board
28. In Wait v. Wilkie, 33 Vet. App. 8 (2020), the Court of Appeals for Veterans Claims (Court) clarified that under Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), there must be competent evidence demonstrating that the claimed symptoms result in functional impairment that in fact affects the veteran's earning capacity. In determining whether a veteran's impairment rises to a level affecting earning capacity, VA can consider manifestations of similar severity, frequency, and duration as those VA has determined by regulation would cause impaired earning capacity in an average person.

In this case, the Board acknowledges the Veteran's assertion that he has bilateral knee and wrist pain. However, the Board finds that the Veteran has not presented any competent evidence that his bilateral knee and wrist pain results in functional impairment that in fact affects his earning capacity.

The Veteran is certainly competent to report his history of bilateral knee and wrist pain, and any treatment that he may have undergone. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the Veteran has not presented any competent and credible evidence of a current diagnosis for a bilateral knee or wrist disability, and the available evidence does not support that the Veteran has any persistent symptomatology that would suggest that he has an underlying chronic disability.

Accordingly, the Board finds that the benefit-of-the-doubt rule is not applicable as the evidence is not in approximate balance, and entitlement to service connection for CFS, sleep, skin, ALS, muscle injuries, and ankle, knee, wrist, elbow, and/or right shoulder disabilities, is denied. 38 U.S.C. § 5107 (b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

7. Entitlement to service connection for a heart condition, diagnosed as acute, subacute, or old myocardial infarction (MI), stable angina, coronary artery disease (CAD), percutaneous coronary intervention (PCI) status post (s/p) MI, is denied.

The Veteran seeks service connection for a heart condition which he contends originated during active service due to his military duties as a soil analyst and associated exposure to herbicide agents and other toxic chemicals in Germany and the United States.

As discussed above, the Veteran's probable exposures are limited to heavy equipment/machinery noise, engine exhaust, dust, industrial hazardous materials, and asbestos.  See January 2, 2024 VA TERA Memorandum 

The Veteran's service treatment records (STRs) are silent as to treatment or diagnosis for a heart condition.

The Veteran reported that his heart condition onset in 2009/2010, noting that he had a heart attack some time between 2009/2010.  See August 2024 VA Heart Conditions Examination

The Veteran does not contend, and the record does not show, that he had active service in the Republic of Vietnam or any other location where there is currently a presumption for exposure to herbicides. 38 C.F.R. § 3.307; Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxins Act of 2022 (PACT Act), 117 P.L. 168 (enacted Aug. 10, 2022). The Veteran's service personnel records only show that his foreign service was performed in Germany. Therefore, in-service exposure to herbicide agents is not presumed, as Germany is not included in service locations where exposure to herbicides is presumed.

Without a presumption of exposure, there would need to be credible and competent evidence factually showing the Veteran was exposed to herbicides, on a facts-found basis.

The Veteran asserts that he was exposed to herbicides at Fort Dix, Fort Belvoir, and in Germany.  The Department of Defense (DOD) has not identified any of these as locations that tested, stored, and/or disposed of herbicide agents. See https://www.publichealth.va.gov/exposures/agentorange/locations/tests-storage/outside-vietnam.asp; https://www.publichealth.va.gov/PUBLICHEALTH/exposures/agentorange/locations/tests-storage/usa.asp.

In January 2024, the AOJ attempted to verify the Veteran's claimed exposures.  A toxic exposure risk activity (TERA) memorandum determined that the Veteran had possible exposure to heavy equipment/machinery noise, engine exhaust, dust, industrial hazardous materials, and asbestos, in his MOS of army materials quality specialist.  The memo did not indicate any exposure to herbicides further supporting a finding that he was not exposed to Agent Orange during service. See January 2024 TERA Memorandum

Consequently, the Board finds that the evidence does not demonstrate that the Veteran was exposed to herbicide agents during military service.

In August 2024, the AOJ obtained
ALTH/exposures/agentorange/locations/tests-storage/usa.asp.

In January 2024, the AOJ attempted to verify the Veteran's claimed exposures.  A toxic exposure risk activity (TERA) memorandum determined that the Veteran had possible exposure to heavy equipment/machinery noise, engine exhaust, dust, industrial hazardous materials, and asbestos, in his MOS of army materials quality specialist.  The memo did not indicate any exposure to herbicides further supporting a finding that he was not exposed to Agent Orange during service. See January 2024 TERA Memorandum

Consequently, the Board finds that the evidence does not demonstrate that the Veteran was exposed to herbicide agents during military service.

In August 2024, the AOJ obtained a VA examination and opinion concerning the Veteran's TERA.  After reviewing the claims file, interviewing the Veteran, and conducting an examination, the examiner opined that the Veteran's heart disorder was less likely than not due to any TERA, to include any related exposure as a soil analyst, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERA by the Veteran. The examiner found that there are no clear and specific or confirmed exposures which would lead to development of coronary artery disease, heart attack (MI) necessitating PCI, or stable angina identified in the TERA memorandum or medical history and literature.

The Veteran solely contends that his heart condition is related to in-service chemical and herbicide agent exposure in Germany and in the U.S. However, the Board still considered whether entitlement to service connection is warranted on other bases but finds that it is not.

The Veteran's January 1979 separation examination, apart from a left shoulder scar, was normal.  Moreover, the Veteran reported during his August 2024 VA examination that his heart condition began in 2009/2010 when he had a heart attack.  Thus, the evidence does not show a heart condition began in service, shortly after service, nor was there a continuity of symptoms from service to diagnosis. See 38 C.F.R. § 3.303, 3.307, 3.309.

Based on the foregoing, the Board finds that service connection for a heart condition is not warranted. 

REASONS FOR REMAND

Unfortunately, the remaining claims must be remanded for further development to enable the Board to make a fully informed decision.

1. Entitlement to service connection for migraine headaches, claimed as the result of herbicide agent and toxic chemical exposure, is remanded.

The Veteran asserts that he has had migraine headaches since 1976.  See May 2024 VA Headaches Examination

The May 2024 VA examiner diagnosed the Veteran with migraine headaches, including migraine variants.  The examiner provided a negative TERA opinion.  Addressing service connection as directly related to the Veteran's active service, the examiner concluded that it is less likely than not that the Veteran's migraines are due to service as there is a lack of substantiating evidence supporting a nexus between the current diagnosis of migraine, including migraine variants, and military service. Without chronicity during service or after service, a post-service event, illness, or injury is considered to be a more likely etiology.

The Board finds the May 2024 VA opinion to be inadequate as the examiner failed to address the Veteran's lay statements concerning an in-service onset of symptoms that have persisted since.

Therefore, remand is required to obtain an opinion that addresses the Veteran's report of an in-service onset of migraines that have persisted since.

2. Entitlement to service connection for a chronic gastrointestinal condition, diagnosed as gastroesophageal reflux disease (GERD) and esophageal ulcer, is remanded.

During the Veteran's August 2024 VA intestinal conditions examination, he reported that his symptoms onset in 1979 in the Army.  The August 2024 VA examiner provided a negative TERA opinion but failed to opine as to whether the Veteran's GERD and/or esophageal ulcer, could be related to his active service, to include the Veteran's report of an in-service onset.

Remand is required to obtain an opinion that considers the Veteran's lay reports of an in-service onset.

3. Entitlement to a recurrent disability manifested by short-term memory loss claimed as the result of herbicide agent and toxic chemical exposure is remanded.

In the January 2025 supplemental statement of the case (SSOC), the AOJ referenced a May 9, 2024, examination and opinion concerning the Veteran's claimed disability manifested by short-term memory loss.  On thorough review of the claims file, neither appear to have been associated with the claims file.

Remand is required to associate the outstanding May 2024 VA examination and opinion with the claims file.

4. Entitlement to service connection for residuals of prostate cancer, to include erectile dysfunction (pre
 obtain an opinion that considers the Veteran's lay reports of an in-service onset.

3. Entitlement to a recurrent disability manifested by short-term memory loss claimed as the result of herbicide agent and toxic chemical exposure is remanded.

In the January 2025 supplemental statement of the case (SSOC), the AOJ referenced a May 9, 2024, examination and opinion concerning the Veteran's claimed disability manifested by short-term memory loss.  On thorough review of the claims file, neither appear to have been associated with the claims file.

Remand is required to associate the outstanding May 2024 VA examination and opinion with the claims file.

4. Entitlement to service connection for residuals of prostate cancer, to include erectile dysfunction (previously characterized as a recurrent prostate disability), is remanded.

The Veteran underwent a VA male reproductive conditions examination in May 2024.

During the examination, the Veteran reported treatment at Banner Hospital. These private records are not in the claims file and there is no indication that the AOJ made any attempts to obtain them.  Therefore, remand is required to attempt to obtain these private records which may contain pertinent evidence.

5. Entitlement to service connection for bilateral hip strain (previously characterized as recurrent joint disability) is remanded.

As discussed above, the AOJ obtained a number of examinations and opinions concerning the Veteran's claim for a recurrent joint disability.  The May 2024 VA examiner diagnosed the Veteran with bilateral hip strain. During the exam, the Veteran reported left hip pain since his left shoulder injury in 1978 and right hip pain for the past 4 years.  The examiner provided negative opinions for bilateral hip strain, to include as due to the Veteran's TERA.  However, in providing the negative opinions, the examiner noted that the Veteran's bilateral hip strain is a musculoskeletal condition and that such conditions are due to wear, tear and stress on the body, often due to physical demands of service.

As the examiner seemed to indicate a relationship between the Veteran's bilateral hip strain and his active service, remand is required to obtain addendum opinion.

Accordingly, the matters are REMANDED for the following actions:

1. Obtain a medical opinion concerning the nature and etiology of the Veteran's migraine headaches.

The examiner should answer the following:

(a)	Opine whether the Veteran's migraines onset during his active-duty service, to include the Veteran's report of an in-service onset in 1976?

The examiner must specifically consider and address the following evidence:

"	Service treatment records (STRs) documenting the Veteran's report of nausea, vomiting, and headaches, since that morning.  See September 8, 1977 STR

"	The Veteran's assertion that he has had migraine headaches since 1976.  See May 2024 VA Headaches Examination

2. Then, obtain a medical opinion concerning the nature and etiology of the Veteran's GERD and ulcer of the esophagus.

(a)	Opine whether the Veteran's GERD onset during his active-duty service, to include the Veteran's report of an in-service onset in 1979?

The examiner must specifically consider and address the following evidence:

"	Service treatment records (STRs) documenting treatment for gastroenteritis.  See August 5, September 8, 1977, September 28 and October 31, 1978 STRs

"	The Veteran's assertion that his GERD and esophageal varices onset in the Army in 1979.  See August 2024 VA Intestinal Conditions Examination

3. Contact the Veteran and request that he provide information as to any outstanding private treatment record, to include at Banner Hospital, relevant to his claim for service connection for residuals of prostate cancer. After obtaining the necessary authorization from the Veteran, the AOJ must make reasonable efforts to obtain any identified records.

4. Then, obtain a medical opinion concerning the nature and etiology of the Veteran's bilateral hip strain.

The examiner should answer the following:

(a)	Opine whether the Veteran's bilateral hip strain onset during his active-duty service?

The examiner must specifically consider and address the following evidence:

"	The Veteran's report of left hip pain since his in-service left shoulder injury in 1978 and his report of right shoulder pain that onset in the prior 4 years.  See May 2024 VA Hip Examination

"	The May 2024 VA examiner's negative TERA opinion noting that the Veteran's bilateral hip strain is a musculoskeletal condition and that such conditions are due to wear, tear and stress on the body, often due to physical demands of service.  See May 2024 VA Opinion

A complete rationale must be provided for any opinion(s) offered.

The Board emphasizes that it is not determining whether or not the Veteran's statements in support of his claims are credible at this time, as the additional development set forth
	The Veteran's report of left hip pain since his in-service left shoulder injury in 1978 and his report of right shoulder pain that onset in the prior 4 years.  See May 2024 VA Hip Examination

"	The May 2024 VA examiner's negative TERA opinion noting that the Veteran's bilateral hip strain is a musculoskeletal condition and that such conditions are due to wear, tear and stress on the body, often due to physical demands of service.  See May 2024 VA Opinion

A complete rationale must be provided for any opinion(s) offered.

The Board emphasizes that it is not determining whether or not the Veteran's statements in support of his claims are credible at this time, as the additional development set forth in the remand directives could impact that determination. Although the Board is requesting medical opinion regarding the claims, this is for thoroughness and not based on a finding as to credibility.

 

 

LESLEY A. REIN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board                                                                    C. Gates	

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.