HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION

ERIC S. LEBOFF · 2026 · Case ID: 26003532

GRANTED

Summary

The Veteran served in the military from December 1992 to January 1995. This case involves an appeal of a May 2013 VA Regional Office decision that denied service connection for HIV/AIDS and legal blindness. The Veteran claims entitlement to service connection for HIV/AIDS, cryptococcal meningitis as secondary to HIV/AIDS, and optic atrophy and cortical blindness in both eyes as secondary to cryptococcal meningitis. The Board reviewed the evidence, including the Veteran's testimony and medical records. The Veteran reported testing positive for HIV shortly after service in January 1995, and has been consistent in reporting this timeline to VA treating providers. While VA examiners have generally opined negatively on service connection for HIV, citing a lack of in-service positive tests, the Board found these opinions inadequate due to a lack of medical rationale. The Board determined the evidence was in approximate balance regarding the timing of the HIV contraction, and applying the benefit of the doubt, granted service connection for HIV/AIDS. The Board also granted service connection for cryptococcal meningitis, right and left optic atrophy, and cortical blindness, finding them proximately due to the service-connected HIV/AIDS, based on opinions from VA examiners and a VA treating provider. All claims were granted.

Rationale

Veteran's report of positive HIV test in 1995 shortly after service is probative.; Veteran's statements to VA treating providers are consistent.; VA examiner opinions were inadequate due to lack of medical rationale.; Evidence in approximate balance; benefit of the doubt applied.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

15-43 094

Full Decision Text

Citation Nr: 26003532
Decision Date: 03/18/26 Archive Date: 03/18/26

DOCKET NO. 15-43 094
DATE: March 18, 2026

ORDER

Entitlement to service connection for human immunodeficiency virus/acquired immunodeficiency syndrome is granted.

Entitlement to service connection for cryptococcal meningitis as proximately due to service connected human immunodeficiency virus is granted.

Entitlement to service connection for right eye optic atrophy and cortical blindness as proximately due to service connected cryptococcal meningitis is granted.

Entitlement to service connection for left eye optic atrophy and cortical blindness as proximately due to service connected cryptococcal meningitis is granted.

FINDINGS OF FACT

1. The evidence is in at least approximate balance as to whether the Veteran first contracted human immunodeficiency virus during his period of active service.

2. The weight of the evidence supports a finding that the Veteran's cryptococcal meningitis is proximately due to his service connected human immunodeficiency virus/acquired immunodeficiency syndrome.

3. The weight of the evidence supports a finding that the Veteran's right and left optical atrophy and cortical blindness are proximately due to the Veteran's service connected cryptococcal meningitis.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for human immunodeficiency virus/acquired immunodeficiency syndrome are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for entitlement to service connection for cryptococcal meningitis as proximately due to his service connected human immunodeficiency virus/acquired immunodeficiency syndrome are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

3. The criteria for entitlement to service connection for right optical atrophy and cortical blindness as proximately due to service connected cryptococcal meningitis are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. The criteria for entitlement to service connection for left optical atrophy and cortical blindness as proximately due to service connected cryptococcal meningitis are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service in from December 1992 to January 1995. These claims originate from an appeal of a May 2013 Department of Veterans Affairs (VA) Regional Office (RO) rating decision that, in pertinent part, denied entitlement to service connection for disabilities claimed as "human immunodeficiency virus (HIV) related illness" and "legal blindness."

In direct appeals, all filings must be read in a liberal manner; where the claimant has raised an issue of service connection, the evidence in the record must be reviewed to determine the scope of that claim and the VA is obligated to determine all potential claims raised by the evidence. See Robinson v. Shinseki, 557 F.3d 1355, 1361 (Fed. Cir. 2009). VA will also consider all lay and medical evidence of record in order to adjudicate entitlement to benefits for the claimed condition as well as entitlement to any additional benefits for complications of the claimed condition. 38 C.F.R. § 3.155(d)(2). Consistent with these obligations, and as discussed further below, the Board finds that the following claims of service connection have been raised by the evidence of record: entitlement to service connection for human immunodeficiency virus manifesting as acquired immunodeficiency syndrome (HIV/AIDS); entitlement to service connection for cryptococcal meningitis as proximately due to service connected HIV/AIDS; and entitlement to service connection for right and left optical atrophy and cortical blindness.

These claims have previously been remanded by the Board. A remand by the Board confers on the Veteran, as a matter of law, the right to substantial compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). As the Board is here granting the instant claims in full, the matter of compliance with prior remand directives may be omitted without prejudice to the Veteran.

In adjudicating claims for VA benefits, the burden of proof only requires an "approximate balance" of the evidence for and against a claim. 38 U.S.C. § 5107
and entitlement to service connection for right and left optical atrophy and cortical blindness.

In adjudicating claims for VA benefits, the burden of proof only requires an "approximate balance" of the evidence for and against a claim. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1991). This low standard of proof is "unique" to the VA adjudicatory process, and "the nation, 'in recognition of our debt to our veterans,' has 'taken upon itself the risk of error' in awarding such benefits." Wise v. Shinseki, 26 Vet. App. 517, 531 (2014). In evaluating a claim for disability benefits, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107.

The Board has reviewed all of the evidence in the record, with an emphasis on the evidence relevant to this appeal. Although there is an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). Hence, the Board will summarize the relevant evidence as deemed appropriate and the analysis will focus specifically on what the evidence shows, or fails to show, as to the claim.

1. Entitlement to service connection for human immunodeficiency virus manifesting as acquired immunodeficiency syndrome is granted.

Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of 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 present disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); 38 C.F.R. § 3.303.

The record reflects that the Veteran has a current diagnosis of HIV/AIDS. See e.g., 04/10/2013, CAPRI at 71.

The Veteran contends that he contracted HIV during his period of active service. See e.g., 02/06/2012, Correspondence; 03/06/2019, Hearing Transcript at 6 - 7. The Veteran has testified to engaging in HIV risk factor behavior during his period of active service. 03/06/2019, Hearing Transcript at 6 - 7. The Veteran further reports that he tested positive for HIV in 1995, less than one month after his separation from active duty in January of that year. 02/06/2012, Correspondence.

The Board finds the Veteran's report of the timing of his HIV diagnosis to be probative. While the Veteran is not competent to render independent medical diagnoses, he is competent to relay information presented to him. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). The Veteran is not purporting to diagnose himself with either HIV or AIDS on the basis of clinical presentation or symptoms; rather, the Veteran is relaying information as he contends it was presented to him. Additionally, the Veteran has been consistent in his reports to VA treating providers of the time frame he first tested positive for HIV. See e.g., 04/10/2013, CAPRI AT 118, 136. Statements made for the purpose of medical diagnosis or treatment are exceptionally credible because the declarant has a strong motive to tell the truth in order to receive proper medical care. See White v. Illinois, 502 U.S. 346, 356 (1992). The Board acknowledges that
3.159(a). The Veteran is not purporting to diagnose himself with either HIV or AIDS on the basis of clinical presentation or symptoms; rather, the Veteran is relaying information as he contends it was presented to him. Additionally, the Veteran has been consistent in his reports to VA treating providers of the time frame he first tested positive for HIV. See e.g., 04/10/2013, CAPRI AT 118, 136. Statements made for the purpose of medical diagnosis or treatment are exceptionally credible because the declarant has a strong motive to tell the truth in order to receive proper medical care. See White v. Illinois, 502 U.S. 346, 356 (1992). The Board acknowledges that treating providers' documentation of a lay statement regarding the existence of a disability is not competent medical evidence of the existence of that disability. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). However, here, the existence of a diagnosis of HIV or AIDS is not in dispute; rather, at issue is the timing of such diagnoses.

In addition, VA has received multiple statements from one of the Veteran's VA treating providers, Dr. V.M., who has documented the Veteran's report of a positive HIV test in 1995, and opined that this report is not inconsistent with the Veteran's in-service negative HIV tests. 10/06/2015, Third Party Correspondence; 03/10/2019, Medical Treatment Record - Government Facility. Dr. V.M.'s written statements reflect their independent medical judgment that the Veteran's report is not inconsistent with the medical evidence of record.

Multiple VA examiners throughout the period on appeal have opined that it is less likely than not that the Veteran contracted HIV during his period of active service. However, as discussed by the Board in prior decisions, these opinions have been found to be inadequate due to various deficiencies. The most recent opinion, obtained in November 2025, is similarly negative. However, the examiner relies entirely on the absence of any in-service positive HIV tests and the absence of any documented positive HIV tests until 2001. It is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes probative value to a medical opinion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). As the November 2025 VA examiner offers no medical rationale for why the lack of documentation is, itself, probative of the question of the timing of HIV contraction, the probative value of the opinion is limited.

The Board finds that the evidence is in at least approximate balance as to whether the Veteran first contracted human immunodeficiency virus during his period of active service. The criteria for entitlement to service connection human immunodeficiency virus/acquired immunodeficiency syndrome are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

2. Entitlement to service connection for cryptococcal meningitis as proximately due to service connected human immunodeficiency virus/acquired immunodeficiency syndrome is granted.

3. Entitlement to service connection for right eye optic atrophy and cortical blindness as proximately due to service connected human immunodeficiency virus/acquired immunodeficiency syndrome is granted.

4. Entitlement to service connection for left eye optic atrophy and cortical blindness as proximately due to service connected human immunodeficiency virus/acquired immunodeficiency syndrome is granted.

Entitlement to service connection may be established on a secondary basis where there is evidence of (1) a current, non-service-connected disability, (2) a current service-connected disability, and (3) evidence that the non-service-connected disability is either (i) proximately due to or the result of a service-connected disability or (ii) aggravated (increased in severity) beyond its natural progression by a service-connected disability. 38 U.S.C. § 1110; Allen v. Brown, 7 Vet. App. 439, 446 (1995); 38 C.F.R. § 3.310.

The record reflects that the Veteran has current diagnoses of cryptococcal meningitis, optical atrophy, and cortical blindness. See e.g., 04/28/2025, C&P Exam.

Dr. V.M., in their April 2019 written statement to the Board, and VA examiners in October 2023 and April 2025 have characterized the Veteran's cryptococcal meningitis as proximately due to his service connected HIV/AIDS. The weight of the evidence supports a finding that the Veteran's cryptococcal meningitis is proximately due to his service connected human immunodeficiency virus/acquired immunodeficiency syndrome. The criteria for entitlement to service connection for cryptococcal meningitis as proximately due to his service connected human immunodeficiency virus/acquired immunodeficiency syndrome are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

A July 2024 V examiner has opined that the Veteran's right and left optical atrophy and cortical blindness are proximately due to the Veteran's service connected cryptococcal meningitis. The weight of the evidence supports a finding that the Veteran's right and left optical atrophy and cortical blindness are proximately due to the Veteran's service connected cryptococcal meningitis. The criteria for entitlement to service connection for right optical atrophy and cortical blindness as proximately due to service connected cryptococcal meningitis are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310. The criteria for entitlement to service connection for left optical atrophy and cortical blindness as proximately due to service connected cryptococcal meningitis are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Sametshaw, Eric C.

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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