CHRONIC SINUSITIS

WENDY DAKNIS · 2025 · Case ID: A25111369

MIXED

Summary

The veteran, who served in the United States Army from April 1964 to April 1966, appeals the denial of service connection for multiple conditions, including sinusitis, elbows condition, cervical condition, erectile dysfunction, kidney condition, sleep apnea, wrists condition, asthma, shoulders condition, ankles condition, eye condition, peripheral vascular disease, and rhinitis. The Board denied service connection for sinusitis, elbows, cervical, erectile dysfunction, kidney, sleep apnea, wrists, asthma, shoulders, ankles, eye condition, peripheral vascular disease, and rhinitis, finding that the veteran did not have a current diagnosis for most of these conditions or that the evidence persuasively weighed against a service connection. For rhinitis, while a current diagnosis and in-service cold symptoms were acknowledged, the Board found the evidence did not support a service connection, relying on a VA examiner's opinion that the condition was not likely related to service and that the veteran's claimed symptoms began ten years prior to the examination. The Board also noted that the veteran's service in Germany did not qualify him for PACT Act presumptions for asthma or rhinitis. The Board remanded claims for an acquired psychiatric condition (recharacterized from PTSD) and special monthly compensation (SMC) aid and attendance. The remand for the psychiatric condition was due to a duty to assist error, as the VA failed to obtain private treatment records referenced in a 2018 medical review. The SMC claim was remanded because it was inextricably intertwined with the psychiatric condition claim.

Rationale

No current diagnosis found; Evidence persuasively against diagnosis; VA examiner found no evidence of sinusitis

Service Branch

ARMY

Special Benefit

SMC - AID & ATTENDANCE

Docket No.

250423-540331

Full Decision Text

Citation Nr: A25111369
Decision Date: 12/31/25 Archive Date: 12/31/25

DOCKET NO. 250423-540331
DATE: December 31, 2025

ORDER

Entitlement to service connection for sinusitis is denied.

Entitlement to service connection for elbows condition is denied.

Entitlement to service connection for a cervical condition is denied.

Entitlement to service connection for erectile dysfunction is denied.

Entitlement to service connection for a kidney condition is denied.

Entitlement to service connection for sleep apnea is denied.

Entitlement to service connection for wrists condition is denied.

Entitlement to service connection for asthma is denied.

Entitlement to service connection for shoulders condition is denied.

Entitlement to service connection for ankles condition is denied.

Entitlement to service connection for bilateral dry macular degeneration (eye condition) is denied.

Entitlement to service connection for peripheral vascular disease, claimed as heart condition, is denied.

Entitlement to service connection for rhinitis is denied.

REMANDED

Entitlement to service connection for an acquired psychiatric condition, claimed as posttraumatic stress disorder (PTSD), is remanded.

Entitlement to special monthly compensation based on aid and attendance (SMC aid and attendance) is remanded.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that the Veteran has had sinusitis at any time during or approximate to the pendency of the claim.

2. The evidence of record persuasively weighs against finding that the Veteran has had an elbows condition at any time during or approximate to the pendency of the claim.

3. The evidence of record persuasively weighs against finding that the Veteran has had a cervical condition at any time during or approximate to the pendency of the claim.

4. The evidence of record persuasively weighs against finding that the Veteran has had erectile dysfunction at any time during or approximate to the pendency of the claim.

5. The evidence of record persuasively weighs against finding that the Veteran has had a kidney condition at any time during or approximate to the pendency of the claim.

6. The evidence of record persuasively weighs against finding that the Veteran has had sleep apnea at any time during or approximate to the pendency of the claim.

7. The evidence of record persuasively weighs against finding that the Veteran has had a wrists condition at any time during or approximate to the pendency of the claim.

8. The evidence of record persuasively weighs against finding that the Veteran's asthma began during active service, or is otherwise related to an in-service injury or disease.

9. The evidence of record persuasively weighs against finding that the Veteran's shoulders condition began during active service, or is otherwise related to an in-service injury or disease.

10. The evidence of record persuasively weighs against finding that the Veteran's ankles condition began during active service, or is otherwise related to an in-service injury or disease.

11. The evidence of record persuasively weighs against finding that the Veteran's eye condition began during active service, or is otherwise related to an in-service injury or disease.

12. The evidence of record persuasively weighs against finding that the Veteran's peripheral vascular disease began during active service, or is otherwise related to an in-service injury or disease.

13. The evidence of record persuasively weighs against finding that the Veteran's rhinitis began during active service or is otherwise related to an in-service injury or disease.

CONCLUSIONS OF LAW

1. The criteria for service connection for sinusitis are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for elbows are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for a cervical condition are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for erectile dysfunction are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for service connection for a kidney condition are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

6. The criteria for service connection for sleep apnea are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102,
C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for erectile dysfunction are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for service connection for a kidney condition are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

6. The criteria for service connection for sleep apnea are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

7. The criteria for service connection for wrists condition are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

8. The criteria for service connection for asthma are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

9. The criteria for service connection for shoulders condition are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

10. The criteria for service connection for ankles condition are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

11. The criteria for service connection for eye condition are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

12. The criteria for service connection for peripheral vascular disease are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

13. The criteria for service connection for rhinitis are not 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 in the United States Army from April 1964 to April 1966.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from February 2025 and April 2025 rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO), also known as the Agency of Original Jurisdiction (AOJ). In the April 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

For the issues of service connection for rhinitis and sinusitis, the Board may only consider the evidence of record at the time of the April 2025 AOJ decision on appeal. 38 C.F.R. § 20.301. For the rest of the issues on appeal, the Board may only consider the evidence of record at the time of the February 2025 AOJ decision on appeal. Id. Any evidence submitted after the AOJ decisions on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

For the claims being denied, 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.

However, because the Board is remanding the claims of service connection for an acquired psychiatric condition and SMC aid and attendance, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

Finally, the Board acknowledges that 38 C.F.R. § 20.202(c)(2) "creates a right for the claimant to modify his or her [notice of disagreement (NOD)] by submitting a new one and gives the claimant the later of a year from the AOJ decision or 60 days from when the Board receives the original NOD to do so." Williams v. McDonough, 37 Vet. App. 305, 309 (202
for an acquired psychiatric condition and SMC aid and attendance, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

Finally, the Board acknowledges that 38 C.F.R. § 20.202(c)(2) "creates a right for the claimant to modify his or her [notice of disagreement (NOD)] by submitting a new one and gives the claimant the later of a year from the AOJ decision or 60 days from when the Board receives the original NOD to do so." Williams v. McDonough, 37 Vet. App. 305, 309 (2024). The Board concludes that the Veteran has implicitly waived his right to change Board dockets under Williams. The present appeal has been advanced on the docket (AOD) based on the Veteran's age. The Board interprets this AOD status as reflecting an intent to have this matter reviewed in an expeditious manner, which the Board finds to be an implicit waiver of his right to change Board dockets under Williams.

Service Connection

Service connection will be granted for a disability resulting from an injury or disease contracted in the line of duty, or for aggravation of a pre-existing injury suffered or disease contracted in the line of duty, in the active military, naval, air, or space service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection requires evidence of (1) a current disability; (2) 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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

The Board is responsible for determining whether the evidence persuasively supports the claim or is in approximate balance, with the Veteran prevailing in either event, or whether the evidence is persuasively against the claim, in which case the claim is denied. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the claimant. 38 U.S.C. § 5107; see Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990).

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1. Entitlement to service connection for sinusitis.

2. Entitlement to service connection for elbows condition.

3. Entitlement to service connection for a cervical condition.

4. Entitlement to service connection for erectile dysfunction.

5. Entitlement to service connection for a kidney condition.

6. Entitlement to service connection for sleep apnea.

7. Entitlement to service connection for wrists.

The Veteran contends that he is entitled to service connection for sinusitis, elbows condition, cervical condition, erectile dysfunction, kidney condition, sleep apnea, and wrists condition. See February 2025 Application for Disability Compensation and Related Compensation Benefits.

As stated above, the first requirement for service connection is a current disability. In the February 2025 and April 2025 rating decisions, the Veteran was denied service connection for sinusitis, elbows condition, cervical condition, erectile dysfunction, kidney condition, sleep apnea, and wrists condition for not having a current disability. Therefore, the question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

The Board concludes that the Veteran does not have a current diagnosis for any of those disabilities and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

Regarding service connection for sinusitis, the Veteran was afforded the March 2025 VA examination. The examiner stated that there was no evidence of sinusitis during the examination. Additionally, the Board has thoroughly reviewed the Veteran's VA and private treatment records and that evidence is persuasively against a finding that the Veteran had a diagnosis or was treated for sinusitis, during or approximate to his claim.

Regarding service connection for elbows condition, cervical condition, erectile dysfunction, kidney condition, sleep apnea, and wrists condition, the Veteran was not afforded VA examinations for those conditions. However, after thorough review of the Veteran's medical records, the evidence is persuasively against a finding that the Veteran was diagnosed or treated for elbows condition,
2007).

While the Veteran believes there is a current diagnosis for these disabilities, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires medical education and knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).

As stated above, the Veteran was not afforded VA examinations for elbows condition, cervical condition, erectile dysfunction, kidney condition, sleep apnea, and/or wrists condition. A medical examination or opinion is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but: (1) contains competent evidence of a current diagnosed disability or persistent or recurrent symptoms of a disability; (2) establishes that an event, injury, or disease occurred in service or certain diseases manifested during an applicable presumptive period for which the claimant qualifies; and (3) indicates that the disability or symptoms may be associated with the established event, injury, or disease in service or with another service-connected disability. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 C.F.R. § 3.159(c)(4).

Here, the first and second prongs of the McLendon criteria have not been met. There is no competent evidence of a current diagnosed disability, nor is there evidence that establishes an event, injury, or disease during service. The Veteran's service treatment records do not contain any indication of an elbows condition, cervical condition, erectile dysfunction, kidney condition, sleep apnea, and/or wrists condition. Additionally, in the February 2025 claim, the Veteran did not provide an explanation as to how those conditions were related to service. Therefore, the Board finds that remanding for examinations and opinions under McLendon is not warranted.

Accordingly, since there is no current disability, service connection for sinusitis, elbows condition, cervical condition, erectile dysfunction, kidney condition, sleep apnea, and wrists condition is denied.

8. Entitlement to service connection for asthma.

9. Entitlement to service connection for shoulders condition.

10. Entitlement to service connection for ankles condition.

11. Entitlement to service connection for eye condition.

12. Entitlement to service connection for peripheral vascular disease.

The Veteran contends that he is entitled to service connection for asthma, shoulders condition, ankles condition, eye condition, and peripheral vascular disease. See February 2025 Application for Disability Compensation and Related Compensation Benefits.

The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran had diagnoses for asthma, shoulders condition, ankles condition, eye condition, and peripheral vascular disease. In the February 2025 rating decision on appeal, the AOJ made favorable findings that the Veteran had current disabilities for asthma, ankles condition, eye condition, and peripheral vascular disease. See 38 C.F.R. § 3.104(c). Additionally, the January 2011 VA treatment record shows that the Veteran complained of right shoulder pain and the June 2013 VA treatment record shows that he was diagnosed with left shoulder degenerative joint disease. However, the evidence of record persuasively weighs against finding that the current disabilities are related to an in-service event, injury, or disease.

The Board has thoroughly reviewed the Veteran's service treatment records and military personnel record, and there is no indication of any event, injury, or disease that may be related to asthma, shoulders condition, ankles condition, eye condition, and/or peripheral vascular disease. Furthermore, in the February 2025 claim, the Veteran did not provide an explanation of an in-service event, injury, or disease for shoulders condition, ankles condition, eye condition, and/or peripheral vascular disease. Moreover, the Veteran did not provide any lay statements as to how those conditions are related to service. However, the Board notes that the Veteran claimed service connection for asthma under the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act). See February 2025 Application for Disability Compensation and Related Compensation Benefits. Indeed, the PACT Act added asthma as a presumptive condition for Gulf War veterans. See 38 U.S.C. §§ 1119, 1120. However, the Veteran's active service was from April 1964 to April 1966 and his foreign service was in Germany, thus he is not considered a Gulf War veteran. See DD Form 214, service record, February 2025 rating decision codesheet. Therefore, the PACT Act presumption for asthma does not apply to the Veteran. Finally, the Veteran did not participate in a toxic exposure risk activity (TERA), so there is no basis to remand for a TERA examination and opinion. See February 2025 TERA memorandum.

Additionally, the Board acknowledges that the Veteran has not been afforded VA examinations for asthma, shoulders condition, ankles condition, eye condition, and/or peripheral vascular disease. The Board finds that examinations and opinions were not required under McLendon. As stated above, there is no evidence which establishes that the Veteran had issues with these conditions during service, nor evidence that indicates the condition may be associated with an in-service event, injury, or disease. Thus, a remand for an examination is not warranted.

Therefore, since there is no evidence of an in-service event, injury, or disease that may be related to asthma, shoulders condition, ankles condition, eye condition, and/or peripheral vascular disease, service connection for those conditions is denied.

13. Entitlement to service connection for rhinitis.

The Veteran contends that he is entitled to service connection for rhinitis. See February 2025 Application for Disability Compensation and Related Compensation Benefits. In the April 2025 rating decision, the AOJ made a favorable finding that the Veteran had a rhinitis diagnosis. See 38 C.F.R. § 3.104(c). Additionally, the Veteran was treated for cold symptoms during service. See September 1964 service treatment record. As such, the in-service event element of service connection is met.

Therefore, the question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

The Board concludes that, while the Veteran has a current diagnosis of rhinitis, and evidence shows that in-service event occurred, the evidence of record persuasively weighs against finding that the rhinitis began during service or is otherwise related to an in-service injury, event, or disease.

The March 2025 VA examiner opined that the Veteran's rhinitis is not at least as likely as not related to an in-service injury, event, or disease. The rationale was that based on the Veteran's assertions during the examination and medical data in the service treatment records, his rhinitis symptoms began ten years prior to the examination. Additionally, the examiner explained that the Veteran's service treatment records did not show signs, symptoms, complaints, treatment, or any chronic disability pattern related to rhinitis. Finally, the examiner explained that the September 1964 cold symptoms experienced by the Veteran were an active transitory illness, likely due to a virus infection. See September 1964 service treatment record. The examiner's opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).

The Board acknowledges the Veteran's belief that the claimed rhinitis is related to an in-service injury, event, or disease. The Veteran in this case is not competent to provide a nexus opinion regarding this issue because of the medical complexity of the matters involved. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau
1964 service treatment record. The examiner's opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).

The Board acknowledges the Veteran's belief that the claimed rhinitis is related to an in-service injury, event, or disease. The Veteran in this case is not competent to provide a nexus opinion regarding this issue because of the medical complexity of the matters involved. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the March 2025 VA examiner than the Veteran's contentions regarding the nexus between rhinitis and service. Therefore, the nexus element of service connection is not met.

Finally, the Board notes that the Veteran claimed service connection for rhinitis under the PACT Act. See February 2025 Application for Disability Compensation and Related Compensation Benefits. Indeed, the PACT Act added chronic rhinitis as a presumptive condition for Gulf War veterans. See 38 U.S.C. §§ 1119, 1120. However, the Veteran's active service was from April 1964 to April 1966 and his foreign service was in Germany, thus he is not considered a Gulf War veteran. See DD Form 214, service record, February 2025 rating decision codesheet. Therefore, the PACT Act presumption for chronic rhinitis does not apply to the Veteran. Finally, the Veteran did not participate in a toxic exposure risk activity (TERA), so there is no basis to remand for a TERA opinion. See February 2025 TERA memorandum.

Accordingly, service connection for rhinitis is denied.

REASONS FOR REMAND

Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159.

1. Entitlement to service connection for an acquired psychiatric condition.

2. Entitlement to SMC aid and attendance.

The Veteran contends that he is entitled to service connection for PTSD. The Veteran was denied service connection for PTSD in the February 2025 rating decision in part because the AOJ found no evidence of a current diagnosed disability. However, in an April 2018 private medical data review, the examiner stated that the Veteran had diagnoses for generalized anxiety disorder and major depressive disorder. When a Veteran makes a claim, they are seeking service connection for symptoms, regardless of how those symptoms are diagnosed or labeled. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). Accordingly, the Board finds it appropriate to recharacterize the Veteran's claim as one for entitlement to service connection for an acquired psychiatric condition.

The Board finds that the AOJ committed a pre-decisional duty to assist error by not obtaining relevant private treatment records. In the April 2018 private medical data review, the examiner stated that the Veteran was in comprehensive psychiatric and psychological therapy with poor improvement. The claims file does not contain any indication that the AOJ attempted to obtain the treatment records for psychiatric and psychological therapy. Thus, the Board must remand to correct this duty to assist error. See 38 C.F.R. § 20.802(a).

The Veteran also contends that he is entitled to SMC aid and attendance. SMC under 38 U.S.C. § 1114(l) and 38 C.F.R. § 3.350(b) is payable as the result of service-connected disability if a veteran has an anatomical loss or loss of use of both feet, or of one hand and one foot; has blindness in both eyes with visual acuity of 5/200 or less (or concentric contraction of the field of vision beyond 5 degrees in both eyes); is permanently bedridden; or is so helpless as to be in need of regular aid and attendance.

Currently, the Veteran does not have a service-connected disability. See April 2025 rating decision codesheet. Therefore, the question of whether the Veteran is entitled to SMC aid and attendance is inextricably intertwined with the outcome of the remand of service connection for an acquired psychiatric condition. Therefore, the
is payable as the result of service-connected disability if a veteran has an anatomical loss or loss of use of both feet, or of one hand and one foot; has blindness in both eyes with visual acuity of 5/200 or less (or concentric contraction of the field of vision beyond 5 degrees in both eyes); is permanently bedridden; or is so helpless as to be in need of regular aid and attendance.

Currently, the Veteran does not have a service-connected disability. See April 2025 rating decision codesheet. Therefore, the question of whether the Veteran is entitled to SMC aid and attendance is inextricably intertwined with the outcome of the remand of service connection for an acquired psychiatric condition. Therefore, the Board must also remand the issue of SMC aid and attendance. See Tyrues v. Shinseki, 23 Vet. App. 166, 177 (2009) (en banc) (explaining that claims are inextricably intertwined where the adjudication of one claim could have a significant impact on the adjudication of another claim); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991).

The matters are REMANDED for the following action:

Ask the Veteran to complete a VA Form 21-4142 for medical providers and/or facilities that provided psychiatric and psychological treatment, which were referenced in the April 2018 medical data review. Make two requests for the authorized records from the identified medical providers and/or facilities, unless it is clear after the first request that a second request would be futile.

W. Daknis

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board D. Brodbeck

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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