PSYCHOSIS

B.T. KNOPE · 2026 · Case ID: A26018637

DENIED

Summary

The veteran, who served in the United States Air Force from June 2020 until his honorable discharge in June 2024, appeals the denial of service connection for an acquired psychiatric disorder, bilateral knee instability, and bilateral foot metatarsalgia. The veteran claimed depression and anxiety related to service, but failed to attend a scheduled VA examination for this condition and provided no good cause for the absence. The Board found this demonstrated an unwillingness to cooperate with development and that remanding the claim would be futile. Furthermore, the veteran's service treatment records were silent regarding any psychiatric complaints, and no current diagnosis or post-service medical records were submitted. For the knee and foot conditions, the veteran's service treatment records also showed no complaints or diagnoses. While the veteran reported pain, the Board found no evidence of functional impairment to qualify these as disabilities. VA examinations for the feet and knees also yielded no current disabilities. The Board concluded that the evidence was persuasively against all claims, denying service connection for the psychiatric disorder, bilateral knee instability, and bilateral foot metatarsalgia due to lack of current diagnosis, failure to cooperate with development, and insufficient evidence of functional impairment or nexus to service.

Rationale

Failure to attend VA examination without good cause; No current diagnosis of acquired psychiatric disorder; Service treatment records silent for psychiatric complaints

Service Branch

AIR FORCE

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251024-601967

Full Decision Text

Citation Nr: A26018637
Decision Date: 03/03/26 Archive Date: 03/03/26

DOCKET NO. 251024-601967
DATE: March 3, 2026

ORDER

Entitlement to service connection for an acquired psychiatric disorder, to include depression and anxiety, is denied.

Entitlement to service connection for right knee instability is denied.

Entitlement to service connection for left knee instability is denied.

Entitlement to service connection for left foot metatarsalgia is denied.

Entitlement to service connection for right foot metatarsalgia is denied.

FINDINGS OF FACT

1. The Veteran failed to attend the scheduled VA examination for his claimed acquired psychiatric disorder and has not shown good cause for missing it or shown a willingness to reschedule.

2. The evidence of record is persuasively against finding that the Veteran has, or has had during the pendency of this appeal, an acquired psychiatric disorder, bilateral knee, and bilateral foot disabilities. To the extent that he claims pain for his foot and knee disabilities, he has not shown results in functional impairment such that it is considered a disability for VA purposes.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for an acquired psychiatric disorder have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for entitlement to service connection for right knee instability have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for entitlement to service connection for left knee instability have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for entitlement to service connection for left foot metatarsalgia have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. 4. The criteria for entitlement to service connection for right foot metatarsalgia have not been met. 38 U.S.C. §§ 1131, 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 Air Force from June 2020 until his honorable discharge in June 2024.

In September 2024, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a July 2024 decision regarding the issue of service connection for an acquired psychiatric disorder. He also submitted an HLR request in January 2025 of the January 2025 rating decision for the issues of service connection for bilateral knee instability and bilateral feet pain. In January 2025, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal for the acquired psychiatric issue, which considered the evidence of record at the time of the prior July 2024 decision. Regarding the issues of bilateral knee instability and bilateral feet pain, the AOJ found a duty to assist error and thus issued a rating decision with the new evidence in June 2025 (this decision is viewed as a Supplemental Claim decision now).

In the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the July 2024 decision for the issue of entitlement to service connection for an acquired psychiatric disorder and at the time of the June 2025 decision for the issues of entitlement to bilateral knee instability and bilateral feet pain. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

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.

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. §
.300, 20.301, 20.801.

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.304. Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d).

Generally, establishing service connection requires medical or, in certain circumstances, lay 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. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999).

1. Entitlement to service connection for an acquired psychiatric disorder

The Veteran contends, through the filing of this claim, that he has an acquired psychiatric disorder that is related to his military service.

The Veteran submitted a claim for service connection in March 2024 where he submitted a self-assessment explaining that he has been very depressed since joining the military. An examination request for his psychiatric disorder was issued in April 2024, but in May 2024, the record reflects that he failed to attend his scheduled appointment. Then the next day, the Veteran submitted a 38 U.S.C. § 5103 Notice Response where he requested that his claim be decided as soon as possible and that he has no other information or evidence to give VA to support his claim. The Board finds the Veteran has shown an unwillingness to attend future VA examinations regarding this claim.

When entitlement to a benefit cannot be established without a current VA examination or re-examination and a claimant, without good cause, fails to report for such examination or reexamination, an original claim for compensation is to be decided based on the evidence of record despite the failure to appear for the scheduled examination. 38 C.F.R. § 3.655(b); see also Turk v. Peake, 21 Vet. App. 565, 56970 (2008). Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, or death of an immediate family member. 38 C.F.R. § 3.655(a).

When evaluating a claim for benefits, the duty to assist is a two-way street. A claimant may not passively wait for assistance in building a claim but rather must actively assist VA in assessing his disabilities, for example, attending examinations as scheduled which may provide a better understanding of the disability claimed. See Wood v. Derwinski, 1 Vet. App 190, 193 (1991).

In short, the Veteran was given the opportunity to aid VA in developing his claim by attending a VA examination but failed to do so. Moreover, he has not provided good cause or requested to reschedule, and at this point, the Board finds it would be futile to remand the claim for similar development.

Unfortunately, the Board determines that the appeal must be denied for the lack of a current disability for an acquired psychiatric disorder. Service connection may only be granted for a current disability; when a claimed condition is not shown, there may be no grant of service connection. 38 U.S.C. § 1110; Rabideau v. Derwinski, 2 Vet. App. 141 (1992); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

Specifically, the Veteran's service treatment records are silent for complaints of, treatment for, or diagnosis of a psychiatric disorder up until the Veteran submitted the claim in March 2024. Prior to this, the service treatment records do not reflect that the Veteran had any problems with his mental health. In fact throughout the years, the Veteran kept reporting no when asked if he had any nervous trouble, PTSD, and ADHD. Moreover, when the Veteran complained of having depression in the March 2024 Disability Benefits Questionnaire that he filled
Rabideau v. Derwinski, 2 Vet. App. 141 (1992); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

Specifically, the Veteran's service treatment records are silent for complaints of, treatment for, or diagnosis of a psychiatric disorder up until the Veteran submitted the claim in March 2024. Prior to this, the service treatment records do not reflect that the Veteran had any problems with his mental health. In fact throughout the years, the Veteran kept reporting no when asked if he had any nervous trouble, PTSD, and ADHD. Moreover, when the Veteran complained of having depression in the March 2024 Disability Benefits Questionnaire that he filled out himself, there was no clinical diagnosis for an acquired psychiatric disorder.

Moreover, the evidence of record does not include a current diagnosis for any acquired psychiatric disorder. Indeed, there are no post-service medical records, to include VA treatment records, associated with the claims file. Moreover, the Veteran has not submitted lay statements describing his disorders or whether they cause any functional impairment.

As such, the evidence of record is persuasive in showing that the Veteran does not have a current diagnosis for his claimed acquired psychiatric disorder.

As part of this claim, the Board recognizes statements from the Veteran that his claimed disorder is related to active service. While he is competent to provide testimony regarding observable symptomatology, he is not competent to provide a diagnosis or nexus opinions in this case. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Therefore, any statements regarding a diagnosis and etiology of the Veteran's claimed acquired psychiatric disorder is found to lack competency.

Moreover, the Board observes that the Veteran has not provided sufficient evidence, including private opinions and/or medical evidence to establish a relationship between his claimed disorder and active service.

In light of the above, the Board concludes that the evidence is persuasively against the claim of service connection for the Veteran's claimed acquired psychiatric disorder, and there is no doubt to be otherwise resolved. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Therefore, the appeal is denied.

2. Entitlement to service connection for right knee instability

3. Entitlement to service connection for left knee instability

4. Entitlement to service connection for left foot metatarsalgia

5. Entitlement to service connection for right foot metatarsalgia

The Veteran contends, through the filing of this claim, that he has bilateral knee instability and bilateral foot pain that are all related to service.

Unfortunately, the Board determines that these claims must be denied for the lack of a current disability for bilateral knee and bilateral foot disabilities. Specifically, the Veteran's service treatment records are silent for complaints of, treatment for, or diagnosis of a foot or knee disability. The only reference to any knee or feet pain is from the March 2024 Disability Benefits Questionnaire that the Veteran filled out himself. Prior to this, there is no record in the service treatment records that the Veteran was experiencing any pain or problems with his feet or knees. In fact, there are many instances where the Veteran responded no when asked if he had any foot or knee trouble.

Regardless, the evidence of record does not include a current diagnosis of either disabilities. Indeed, there are no post-service medical records, to include VA treatment records associated with the claims file. Moreover, the Veteran has not submitted lay statements describing his current disabilities or whether they cause any functional impairment.

The Veteran was afforded VA examinations for both the feet and knee and in both examinations, the VA examiner found that he did not have any feet or knee disabilities. Even upon physical examination, there was no indication that the Veteran experienced any functional impairment.

The Board recognizes that pain, on its own, may constitute a disability under 38 U.S.C. § 1110. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). However, for pain to constitute a disability, it must "reach the level of a functional impairment of earning capacity." Id. To the extent that the Veteran reports bilateral foot pain and bilateral knee instability, there is no evidence that they result in functional impairment as of this decision.

As such, the evidence of record is persuasive in showing that the Veteran does not have current diagnoses regarding his claimed knee and feet disabilities. Nor does any reported pain result in functional impairment so as to qualify as a disability for VA purposes.

As part of this claim, the Board recognizes statements from the Veteran that his claimed disorders are related to active service. While he is competent to provide testimony regarding observable symptomatology, such as bilateral foot pain and bilateral knee instability, he
). However, for pain to constitute a disability, it must "reach the level of a functional impairment of earning capacity." Id. To the extent that the Veteran reports bilateral foot pain and bilateral knee instability, there is no evidence that they result in functional impairment as of this decision.

As part of this claim, the Board recognizes statements from the Veteran that his claimed disorders are related to active service. While he is competent to provide testimony regarding observable symptomatology, such as bilateral foot pain and bilateral knee instability, he is not competent to provide diagnoses or nexus opinions in this case. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Therefore, any statements regarding diagnoses and etiologies of the Veteran's claimed disorders are found to lack competency.

In light of the above, the Board concludes that the evidence is persuasively against claims of service connection for the Veteran's claimed disorders, and there is no doubt to be otherwise resolved. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Therefore, the appeal is denied. 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.

B.T. KNOPE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Imam, S.

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