MULTIPLE SCLEROSIS

S.C. KREMBS · 2026 · Case ID: 26005027

DENIED

Summary

The veteran, who served from January 1962 to January 1966, appeals the denial of service connection for multiple sclerosis (MS), Parkinson's disease, gastroesophageal reflux disease (GERD), and peripheral neuropathy of the left and right upper extremities. The Board acknowledged some evidence suggesting MS, including the veteran's report of a diagnosis and recent brain imaging showing potential lesions. However, subsequent imaging and multiple medical opinions questioned the MS diagnosis, noting it could be due to age-related changes and that the veteran had not received specific MS treatment or medications. The Board found the diagnosis questionable, with the veteran's reports of MS being inconsistent and lacking corroborating medical records. Even if MS were conceded, the Board found no nexus to service, as symptoms reported post-service were not continuous and service treatment records were silent on MS. For Parkinson's disease, GERD, and peripheral neuropathy, the Board denied claims due to a lack of confirmed current diagnoses in the record. While some symptoms were reported, they were attributed to other causes or remained undiagnosed. The Board noted a VA examiner's diagnosis of Parkinson's appeared to be based on another veteran's records or inaccurate premises, and the veteran denied ever being diagnosed with Parkinson's. Similarly, symptoms attributed to GERD or neuropathy were not diagnosed as such, with alternative explanations provided. The Board concluded that the evidence did not establish current disabilities or a nexus to service for any of the claimed conditions, thus denying all claims.

Rationale

Questionable diagnosis of MS; Lack of continuous symptoms post-service; No nexus to service established

Special Benefit

NO SPECIAL BENEFIT

Docket No.

19-26 392A

Full Decision Text

Citation Nr: 26005027
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 19-26 392A
DATE: April 29, 2026

ORDER

Service connection for multiple sclerosis (MS) is denied.

Service connection for a neurological disability claimed as Parkinson's disease is denied.

Service connection for gastroesophageal reflux disease (GERD) is denied.

Service connection for peripheral neuropathy of the left and right upper extremities is denied.

FINDINGS OF FACT

1. There is, at best, a questionable diagnosis of multiple sclerosis and the probative evidence fails to show that the condition manifested within seven years of the Veteran's separation from active service or was otherwise incurred as a result of active service.

2. There are no confirmed diagnoses of Parkinson's disease, GERD, or peripheral neuropathy of the left or right upper extremity.

CONCLUSIONS OF LAW

1. The criteria for service connection for multiple sclerosis have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for service connection for Parkinson's disease have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for GERD have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for peripheral neuropathy of the left upper extremity have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for service connection for peripheral neuropathy of the right upper extremity have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from January 1962 to January 1966. This matter is before the Board following is appeal of an April 2018 rating decision.

In July 2023, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is of record. The Board then remanded this appeal in October 2023 and July 2025.

Service Connection

Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F. 3d 604 (Fed. Cir. 1996) (table).

Following a review of the record, the Board finds that service connection is not warranted for multiple sclerosis (MS), Parkinson's disease, GERD, or peripheral neuropathy of the left and right upper extremities.

Turning first to MS, the Board acknowledges that there is some evidence of a diagnosis, including the Veteran's report of a receiving an MS diagnosis and brain imaging in October 2023 that revealed characteristic lesions noted to be "highly c/w stable MS." However, in conjunction with subsequent brain imaging in November 2024, it was noted that given the Veteran's age, the "abnormality is mostly due to microvascular ischemic type changes of long-standing chronicity. It was further noted that a component of demyelinating plaque could not be ruled out, but that there was no restricted diffusion or pathologic enhancement "to suggest active demyelinating plaque on this exam."

Other providers have questioned the reported MS diagnosis, noting that they had not seen documentation of the diagnosis and/or that various findings and symptoms could be explained by other conditions. In August 2023, the Veteran mentioned having MS, but the provider noted that "that was not indicated in the prior notes reviewed from outside neurologist..." The provider noted that the Veteran had not been seen by an outside neurologist in years. In June 2024, a VA provider again acknowledged the Veteran's report that he had MS that was diagnosed 30 years prior and affected mostly his right side. However, the provider again noted that outside records did not show that diagnosis and, instead, showed that a private neurologist explained to the Veteran "that at his age, issues such as these, rather than MS (which his father had), are likely to progress and gain in prominence." It was also noted that the Veteran had never been on medication, was unlikely to have active disease given his age, and that his right sided symptoms could also be caused by any type of myopathy, not just demyelinating/autoimmune. An assessment was made of possible MS. In November 2024, it was noted again that the Veteran had not been on disease modifying therapies or medications, nor had he been referred to neurology for MS in recent years.

Even the Veteran's initial reports suggested that the diagnosis was not clear. The Veteran reported during December 2017 VA treatment that he was previously told that he had MS but that his private neurologist disagreed. In October 2019, he stated that "[t]hey think I have MS, but they aren't sure." Given the questionable diagnosis, attempts to obtain private treatment records were made by treating VA providers, including in December 2017 and April 2022. In fact, in March 2022, a VA provider sent a message to the Veteran noting that he had no records from outside providers, that the Veteran was responsible for ensuring that outside providers regularly faxed him records, that he had not done that, and that it was no longer safe for the VA provider to continue to prescribe medications. Though some records were apparently received in May 2022, limited records still appear in the claims file.

In any event, it is not clear to the Board whether the Veteran has a confirmed diagnosis of MS, as it appears that the diagnosis shown in the record was based on his self-reported history of a diagnosis and thereafter repeated. To the extent that a May 2025 VA reconciliation opinion appears to confirm a diagnosis of MS, the opinion is not probative as it relies on a finding that "medical records show diagnosis and treatment of MS," which, as discussed, is not accurate. The diagnosis has been questioned, the Veteran has denied receiving actual treatment for MS, and available VA and private records do not otherwise show any actual treatment, only discussion of the Veteran's reported history.

Regardless, even if the Board were to concede a diagnosis, service connection would still not be warranted. By his own reports, the Veteran stated that he was worked up for symptoms and diagnosed with MS in the 1990s, and he did not otherwise report that the symptoms in the 1990s had been ongoing for more than 20 years. Those reports place the onset of any MS symptoms more than seven years after the Veteran's separation from service in January 1966, such that presumptive service connection does not apply. 38 C.F.R. § 3.307(a)(3), (c). Traut v. Brown, 6 Vet. App. 495, 500 (1994). Additionally, VA examiners have declined to find that a nexus exists between the Veteran's claimed MS and his military service, noting that service treatment records (STRs) did not show any symptoms or episodes of MS during service or at separation. There is no other competent evidence that positively links or suggests an association between MS and service.

As for the other disabilities, the Board finds that service connection must be denied because the record does not establish current diagnoses. The available evidence is silent for diagnoses of Parkinson's disease, GERD, or peripheral neuropathy of the upper extremities. Specifically related to Parkinson's, as discussed in the Board's July 2025 remand, a May 2024 VA examiner's diagnosis of Parkinson's disease appears to have been based on another veteran's records or on an inaccurate factual premise as the examiner noted a diagnosis date of April 20, 2018
) did not show any symptoms or episodes of MS during service or at separation. There is no other competent evidence that positively links or suggests an association between MS and service.

As for the other disabilities, the Board finds that service connection must be denied because the record does not establish current diagnoses. The available evidence is silent for diagnoses of Parkinson's disease, GERD, or peripheral neuropathy of the upper extremities. Specifically related to Parkinson's, as discussed in the Board's July 2025 remand, a May 2024 VA examiner's diagnosis of Parkinson's disease appears to have been based on another veteran's records or on an inaccurate factual premise as the examiner noted a diagnosis date of April 20, 2018, and wrote "[the Veteran] has been diagnosed with Parkinson's disease as documented and service connected in 2018..." However, the Board was unable to locate a single medical record in the claims file dated April 20, 2018, to include one showing a diagnosis of Parkinson's disease, and service connection for Parkinson's disease was denied - not granted - in a rating decision that is, notably, dated April 20, 2018.

Clinical records are otherwise silent for a Parkinson's disease diagnosis other than one related to a different Veteran, and the Veteran denied to a May 2024 VA examiner ever having been diagnosed with Parkinson's disease. A May 2025 VA examiner found that there was a diagnosis of trigeminal cephalgia but no diagnosis of Parkinson's disease. In sum, the totality of the record supports that there is no diagnosis of Parkinson's disease for this Veteran and, although they were requested, no additional records or authorizations for the release of records were submitted on remand that show treatment or a diagnosis of Parkinson's disease.

With respect to GERD and neuropathy of the upper extremities, the Board similarly finds that no current disabilities have been shown. Though cognizant that the record documents some symptoms, such as dysphagia and right arm sensory or motor symptoms, those symptoms were not attributed to GERD or peripheral neuropathy. Instead, symptoms and findings were attributed to other diagnoses or causes, or it was noted there were various possible causes. For example, in October and November 2024, the Veteran was noted to have significant oral dysphagia that was related to poor dentition, headaches, and/or right-sided temporal pain impacting mastication. Neither GERD nor other gastroesophageal symptoms were noted.

The Veteran also reported right-sided symptoms at different times, including electricity-like pain or weakness in his right hand and right upper extremity (in addition to his right lower extremity and the right side of his face), but those symptoms were not diagnosed as peripheral neuropathy. Instead, in June 2024, it was noted that the Veteran's right-sided symptoms could be caused by any type of myopathy, not just demyelinating or autoimmune, and that there were other causes for neuropathy including vitamin deficiency, thyroid issues, diabetes, and MGUS, among others. It was also noted that the Veteran had been advised to have an EMG but he declined and refused further assessment. To the extent that the record shows that the Veteran was prescribed pregabalin and he reported that the medication was for peripheral neuropathy, the record shows that pregabalin was prescribed for episodic paroxysmal hemicrania versus trigeminal autonomic cephalgia.

Accordingly, the Board finds that, with respect to Parkinson's disease, GERD, and neuropathy of the bilateral upper extremity, a current disability has not been shown. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Additionally, as noted, to the extent that a MS diagnosis does exist, a nexus to service has not been shown. Again, efforts were made to obtain outstanding treatment records that could support the Veteran's claims, but neither the Veteran nor his attorney representative responded.

To the extent that the Veteran has attributed symptoms to a diagnosis such as MS or GERD, or has reported symptoms since service, his reports are neither probative nor persuasive. As a lay person, and given the various potential causes for the symptoms or findings shown, the Veteran's opinion as to a diagnosis for or the cause of his symptoms is neither competent nor probative. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). Moreover, although the Veteran has reported symptoms since service, such as right-sided symptoms he attributes to MS or neuropathic symptoms in his arms, those reports are not consistent with the record, including the earliest post-service treatment of record. In that regard, the Veteran received private treatment in November 2012, at which time no
, or has reported symptoms since service, his reports are neither probative nor persuasive. As a lay person, and given the various potential causes for the symptoms or findings shown, the Veteran's opinion as to a diagnosis for or the cause of his symptoms is neither competent nor probative. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). Moreover, although the Veteran has reported symptoms since service, such as right-sided symptoms he attributes to MS or neuropathic symptoms in his arms, those reports are not consistent with the record, including the earliest post-service treatment of record. In that regard, the Veteran received private treatment in November 2012, at which time no neurological, musculoskeletal, gastrointestinal, or upper extremity symptoms were reported on review of systems or found on physical examination, and no medical history of any MS, GERD, Parkinson's disease, or other neurological disorder was noted in the Veteran's past medical history.

To the extent that a VA examiner in February 2025 and April 2025 opinions diagnosed peripheral neuropathy or found that peripheral neuropathy was related to service, that finding, as with the diagnosis of MS, is not otherwise supported by the record and there was no explanation or consideration of the other potential causes shown in the record. It appears that in making such findings, the VA examiner relied on the Veteran's self-reported subjective history of symptoms and diagnoses without any discussion of the medical evidence or prior statements that contradict those reports. For example, the examiner noted that the Veteran was diagnosed with GERD in 2017 and had been on medication for the condition. However, as discussed, neither the available treatment records nor the active medication lists support treatment for GERD. Similarly, the examiner relied on the Veteran's report that his neuropathy had existed since 2012 (but also since service). However, as discussed, November 2012 private treatment records are entirely silent for any such reports, findings, or diagnoses.

Thus, in the absence of positive evidence of a nexus or diagnoses, there cannot be equipoise and resolution of doubt. The Veteran still ultimately bears some burden of production. 38 U.S.C. § 5107(a); Cromer v. Nicholson, 455 F.3d 1346 (Fed. Cir. 2006). As the probative and persuasive evidence does not support a finding of a current disability and/or nexus to service, service connection is not warranted for MS, Parkinson's disease, GERD, or peripheral neuropathy of the bilateral upper extremity. See 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).

(signature on next page)

S. C. Krembs

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board A. Fagan

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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