PSYCHOSIS

Summary

The Veteran, who served in the United States Army from April 1951 to August 1953, appeals the denial of service connection for an acquired psychiatric disorder (claimed as PTSD, anxiety, and depression), hypertension, erectile dysfunction, and bilateral peripheral neuropathies in all extremities. The Veteran initially claimed presumptive service connection under the PACT Act for hypertension and secondary service connection for erectile dysfunction and peripheral neuropathies due to diabetes mellitus and hypertension. During the Board hearing, the Veteran also contended that his psychiatric condition was caused by maltreatment in service and was secondary to diabetes mellitus, and that all his claimed problems were secondary to diabetes mellitus. Crucially, the Veteran has never been service-connected for diabetes mellitus, precluding secondary claims based on it. The Agency of Original Jurisdiction (AOJ) denied PACT Act claims, finding no toxic exposure risk activity (TERA), and the Board found no evidence of chronic diseases manifesting within one year of service, precluding presumptive service connection. The Board found the evidence persuasively indicated that the claimed disabilities did not begin during service or relate to an in-service injury. The Veteran's lay contentions lacked probative value as they did not establish a medical nexus, and no private or VA medical opinions were submitted to support the claims. Consequently, service connection for all claimed conditions was denied.

Rationale

Probative evidence favors finding condition did not begin during service.; No competent indication of in-service nexus.; Veteran's lay contentions lack probative value without medical nexus.

Full Decision Text

Citation Nr: A26009459
Decision Date: 02/02/26	Archive Date: 02/02/26

DOCKET NO. 250609-546392
DATE: February 2, 2026

ORDER

Entitlement to service connection for an acquired psychiatric disorder (claimed as posttraumatic stress disorder [PTSD], anxiety, and depression) is denied.

Entitlement to service connection for hypertension is denied.

Entitlement to service connection for erectile dysfunction is denied.

Entitlement to service connection for left lower extremity (LLE) peripheral neuropathy is denied.

Entitlement to service connection for right lower extremity (RLE) peripheral neuropathy is denied.

Entitlement to service connection for left upper extremity (LUE) peripheral neuropathy is denied.

Entitlement to service connection for right upper extremity (RUE) peripheral neuropathy is denied.

FINDINGS OF FACT

1. The probative evidence of record during the evidentiary window persuasively favors finding that the Veteran's acquired psychiatric disorder did not begin during service and is not otherwise related to an in-service injury or disease.

2. The probative evidence of record during the evidentiary window persuasively favors finding that the Veteran's hypertension did not begin during service and is not otherwise related to an in-service injury or disease.

3. The probative evidence of record during the evidentiary window persuasively favors finding that the Veteran's erectile dysfunction did not begin during service and is not otherwise related to an in-service injury or disease.

4. The probative evidence of record during the evidentiary window persuasively favors finding that the Veteran's LLE peripheral neuropathy did not begin during service and is not otherwise related to an in-service injury or disease.

5. The probative evidence of record during the evidentiary window persuasively favors finding that the Veteran's RLE peripheral neuropathy did not begin during service and is not otherwise related to an in-service injury or disease.

6. The probative evidence of record during the evidentiary window persuasively favors finding that the Veteran's LUE peripheral neuropathy did not begin during service and is not otherwise related to an in-service injury or disease.

7. The probative evidence of record during the evidentiary window persuasively favors finding that the Veteran's RUE peripheral neuropathy did not begin during service and is not otherwise related to an in-service injury or disease.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for an acquired psychiatric disorder (claimed as PTSD, anxiety, and depression) have not been met.  38 U.S.C. §§ 1101, 1110, 1111, 1112, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

2. The criteria for entitlement to service connection for hypertension have not been met.  38?U.S.C. §§?1101, 1110, 1111, 1112, 1113, 5107; 38?C.F.R. §§?3.102, 3.303, 3.307, 3.309, 3.310.

3. The criteria for entitlement to service connection for erectile dysfunction have not been met.  38?U.S.C. §§?1101, 1110, 1111, 1112, 1113, 5107; 38?C.F.R. §§?3.102, 3.303, 3.307, 3.309, 3.310.

4. The criteria for entitlement to service connection for LLE peripheral neuropathy have not been met.  38?U.S.C. §§?1101, 1110, 1111, 1112, 1113, 5107; 38?C.F.R. §§?3.102, 3.303, 3.307, 3.309, 3.310.

5. The criteria for entitlement to service connection for RLE peripheral neuropathy have not been met.  38?U.S.C. §§?1101, 1110, 1111, 1112, 1113, 5107; 38?C.F.R. §§?3.102, 3.303, 3.307, 3.309, 3.310.

6. The criteria for entitlement to service connection for LUE peripheral neuropathy have not been met.  38?U.S.C. §§?1101, 1110, 1111, 1112, 1113, 5107; 38?C.F.R. §§?3.102, 3.303, 
 connection for RLE peripheral neuropathy have not been met.  38?U.S.C. §§?1101, 1110, 1111, 1112, 1113, 5107; 38?C.F.R. §§?3.102, 3.303, 3.307, 3.309, 3.310.

6. The criteria for entitlement to service connection for LUE peripheral neuropathy have not been met.  38?U.S.C. §§?1101, 1110, 1111, 1112, 1113, 5107; 38?C.F.R. §§?3.102, 3.303, 3.307, 3.309, 3.310.

7. The criteria for entitlement to service connection for RUE peripheral neuropathy have not been met.  38?U.S.C. §§?1101, 1110, 1111, 1112, 1113, 5107; 38?C.F.R. §§?3.102, 3.303, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from April 1951 to August 1953.  The Board thanks the Veteran for his service to our country. 

On March 10, 2025, VA received a VA Form 21-526EZ initiating the claims herein.  In an April 21, 2025, Rating Decision, the Agency of Original Jurisdiction (AOJ) denied the claims herein.  On June 9, 2025, VA received a VA Form 10182 in which the Veteran elected the Board's review of the claims herein under the Hearing Request Docket pursuant to the Appeals Modernization Act (AMA).  38 C.F.R. § 20.301.  On October 3, 2025, the Board held a virtual hearing and that hearing transcript is associated with the claims file.

Applicable Review Periods and Evidentiary Windows

The review period and the evidentiary window are distinct concepts in AMA that are not interchangeable (the review period is limited to the period considered by the AOJ [i.e., ends at the issuance of the AOJ decision on appeal]; the evidentiary window is the time which evidence may be submitted and considered for the issue on appeal).  The Hearing Request Docket only permits the Board to review the evidence of record at the time of the AOJ decision(s) on appeal as well as any evidence submitted at the hearing (including the testimony) and within 90 days after the hearing.  38 C.F.R. § 19.2(d).  If additional evidence was submitted between the dates of the AOJ decision(s) on appeal and the hearing, the Board will not consider it unless it is resubmitted during the 90 days following the hearing. ?Id; Cook v. McDonough, 36 Vet. App. 175 (2023). 

Regarding the appeal herein, the review periods span from the date of the claims (March 10, 2025) through the date the AOJ issued the decision on appeal (April 21, 2025); the evidentiary windows are limited to evidence of record at the time of the AOJ decision on appeal (April 21, 2025) as well as any evidence submitted at the October 3, 2025, Board hearing (including the testimony) and within 90 days following the hearing.  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 claim, considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a Supplemental Claim are included with this decision.  Cook, supra.

1. Entitlement to service connection for an acquired psychiatric disorder (claimed as PTSD, anxiety, and depression)

2. Entitlement to service connection for hypertension

3. Entitlement to service connection for erectile dysfunction

4. Entitlement to service connection for LLE peripheral neuropathy

5. Entitlement to service connection for RLE peripheral neuropathy  

6. Entitlement to service connection for LUE peripheral neuropathy 

7. Entitlement to service connection for RUE peripheral neuropathy 

Presumptive service connection may be warranted for certain chronic diseases listed at 38 C.F.R. § 3.309(a) if manifest to at least
 Specific instructions for filing a Supplemental Claim are included with this decision.  Cook, supra.

1. Entitlement to service connection for an acquired psychiatric disorder (claimed as PTSD, anxiety, and depression)

2. Entitlement to service connection for hypertension

3. Entitlement to service connection for erectile dysfunction

4. Entitlement to service connection for LLE peripheral neuropathy

5. Entitlement to service connection for RLE peripheral neuropathy  

6. Entitlement to service connection for LUE peripheral neuropathy 

7. Entitlement to service connection for RUE peripheral neuropathy 

Presumptive service connection may be warranted for certain chronic diseases listed at 38 C.F.R. § 3.309(a) if manifest to at least a compensable degree within one year from separation from service.  38 C.F.R. §§ 3.307(a)(3), 3.309(a).  The Veteran's inability to prevail on a presumptive basis does not foreclose his opportunity to prevail on a direct or secondary basis.  Combee v. Brown, 34 F.3d 1039, 1043-33 (Fed. Cir. 1994).  Direct service connection may be warranted if the evidence shows: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship ("nexus") between the present disability and the disease or injury incurred or aggravated during service.  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).  Although a competent medical opinion is generally required to establish etiology, competent and credible lay evidence of chronicity and continuity of symptomology may also establish etiology.  38 C.F.R. § 3.303(b); Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465 (1994).  Secondary service connection may be granted if a disability is due to or the result of a service-connected disease or injury or aggravated by a service-connected disease or injury.  38 C.F.R. § 3.310; Harvey v. Shulkin, 30 Vet. App. 10, 15 (2018); Ward v. Wilkie, 31 Vet. App. 233, 239 (2019); Spicer v. McDonough, 61 F.4th 1360, 1363 (Fed. Cir. 2023).

VA's duty to assist includes providing a medical examination when necessary to decide a claim.  38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4).  Such development is necessary if the evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or symptoms of disability, (2) establishes that the veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability.  38 C.F.R. § 3.159 (c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006) (noting that the third element establishes a low threshold and requires only that the evidence "indicates" that there "may" be a nexus between the current disability or symptoms and active service, including equivocal or non-specific medical evidence or credible lay evidence of continuity of symptomatology).

In the March 2025 VA Form 21-526EZ, the Veteran contended that: he had a psychiatric condition (claimed as PTSD, anxiety, and depression); his hypertension was presumptively related to his service through the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act) and/or secondary to his diabetes mellitus; his erectile dysfunction was secondary to his hypertension and/or secondary to his diabetes mellitus; and his bilateral upper and lower extremity peripheral neuropathies were directly caused by in-service cold exposure and/or were secondary to his diabetes mellitus.  In the June 2025 VA Form 10182, the Veteran contended that: his psychiatric condition was caused by maltreatment in service; and his erectile dysfunction was secondary to his hypertension.  During the October 2025 Board hearing, the Veteran contended that: his psychiatric condition was directly caused by the circumstances surrounding his separation from service and/or was secondary to his diabetes mellitus; and that all
ics Act of 2022 (PACT Act) and/or secondary to his diabetes mellitus; his erectile dysfunction was secondary to his hypertension and/or secondary to his diabetes mellitus; and his bilateral upper and lower extremity peripheral neuropathies were directly caused by in-service cold exposure and/or were secondary to his diabetes mellitus.  In the June 2025 VA Form 10182, the Veteran contended that: his psychiatric condition was caused by maltreatment in service; and his erectile dysfunction was secondary to his hypertension.  During the October 2025 Board hearing, the Veteran contended that: his psychiatric condition was directly caused by the circumstances surrounding his separation from service and/or was secondary to his diabetes mellitus; and that all of his claimed medical problems were secondary to his diabetes mellitus.  Notably, all mental health diagnoses are collectively construed as a single claim for entitlement to service connection for an acquired psychiatric disorder.? Clemons v. Shinseki, 23?Vet. App.?1 (2009) (the scope of a mental health disability claim includes any mental disability that may be reasonably encompassed by the claimant's description of the disability, reported symptoms, and other information of record).

Crucially, to date: the Veteran has never been service connected for diabetes mellitus, which forecloses the avenue for secondary service connection on that ground (see December 2025 Codesheet); the AOJ determined that the Veteran did not participate in toxic exposure risk activity (TERA) during his service, which forecloses the avenue for presumptive service connection pursuant to the PACT Act (see July 2024 TERA Memorandum); and the probative evidence of record during the evidentiary window does not document pertinent manifestations or diagnoses within one year from separation from service, which forecloses the avenue for presumptive service connection pursuant to 38 C.F.R. § 3.309(a) (see service treatment records; VA treatment records).  As such, the remaining question before the Board is whether service connection is warranted on a direct basis.  Shedden, supra.  In that regard, the probative evidence of record during the evidentiary window persuasively favors finding that the Veteran's claimed disabilities did not begin during service and are not otherwise related to an in-service injury or disease.  Specifically, the medical treatment records currently associated with the claims file lack any competent indication that the Veteran's claimed disabilities began during qualifying service or were otherwise related to an in-service injury or disease.  See service treatment records; VA treatment records.  Further, although the Veteran is competent to report lay-observable symptoms and functional loss related to his conditions, the evidence currently associated with the claims file fails to show that the Veteran has the necessary medical background to competently diagnose his manifestations or opine regarding their etiology; as such, the Veteran's uncorroborated contentions that his conditions began during or shortly after service are of no probative value.  Jandreau, supra; Layno, supra.  Further, the Veteran did not submit any etiological opinions from private or VA providers regarding these claimed disabilities; accordingly, although VA has never afforded the Veteran pertinent examinations to address etiology, VA is not required to provide examinations because there are simply no competent indications that there may be nexuses.  McLendon, supra; Jandreau, supra; Kahana v. Shinseki, 24 Vet. App. 428, 438 (2011) (standing alone, lay contentions as support for new theories of entitlement are not competent evidence).  Thus, the claims must be denied.

 

 

T. Raymond

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	H. Daus, Counsel

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.