PERIPHERAL NEUROPATHY

Summary

The veteran, who served in the United States Marine Corps from January 1994 to December 1997, appeals the denial of service connection for a right lower extremity shin splint and the initial denial of service connection for a right lower extremity condition, re-characterized from peripheral neuropathy, nerve damage, and numbness/tingling. The Board found that the evidence was in approximate balance regarding the right lower extremity condition, and resolving doubt in the veteran's favor, granted service connection. The veteran's service treatment records noted complaints of right leg pain after being kicked in the shin during boot camp, and post-service records documented continuous pain. Both a VA examiner and a private examiner opined that the right lower extremity condition, including peripheral neuropathy and varicose veins, was at least as likely as not related to service, citing the in-service injury and subsequent chronic symptoms. The Board found this evidence credible and granted service connection. For the right shin splint claim, the Board found no current diagnosis or compensable symptoms documented in the service treatment records, VA, or private treatment notes. A VA examiner specifically noted the veteran never had shin splints. The Board found the evidence persuasively against the claim, denying service connection for shin splints.

Rationale

Credible evidence of right lower extremity impairment during and since service; Resolving all reasonable doubt in the Veteran's favor; Onset of condition coincident with active-duty service

Full Decision Text

Citation Nr: A26018973
Decision Date: 03/03/26	Archive Date: 03/03/26

DOCKET NO. 201014-116234
DATE: March 3, 2026

ORDER

Entitlement to service connection for a right lower extremity condition (claimed as peripheral neuropathy, nerve damage, nerve paralysis, and numbness and tingling lower extremity) is granted.

Entitlement to service connection for a right lower extremity shin splint is denied.

FINDINGS OF FACT

1. The evidence is at least in approximate balance regarding whether the Veteran's right lower extremity condition is etiologically related to his active-duty service.

2. The weight of the evidence persuasively shows that there is no currently diagnosed right shin splint condition, that was incurred or caused by service and that any reported symptoms do not amount to functional impairment of earning capacity or are already compensated under other diagnostic codes.

CONCLUSIONS OF LAW

1. The criteria for establishing entitlement to service connection for a right lower extremity condition have been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303.

2. The criteria for establishing entitlement to service connection for a right extremity shin splint have not been met. 38 U.S.C. §§ 1110, 1116, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Marine Corps from January 1994 to December 1997.

These matters come before the Board of Veterans' Appeals (Board) on appeal from a September 2020 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). 

In October 2020, the Veteran disagreed with the abovementioned rating decision and filed a VA Form 10182 (Decision Review Request: Board Appeal (Notice of Disagreement)).  The Veteran selected the Hearing Lane by submitting notice of disagreement under the Appeals Modernization Act (AMA).  38 C.F.R. § 19.2(d).  In October 2024, the Veteran testified at a hearing before a Veterans Law Judge (VLJ).  Accordingly, the Board is limited to review of the evidence in the record at the time of the rating decision on appeal and the evidence submitted up to 90 days after the Veteran's hearing before the Board.  38 C.F.R. § 20.302. 

If evidence was associated with the claims file during a period of time when additional evidence was not allowed, the Board has not considered it in its decision on the above claim.  38 C.F.R. § 20.300.  If the Veteran would like VA to consider any evidence that was added to the claims file 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.

Regarding the right lower extremity condition claim, the Board notes that the Veteran filed his initial service connection claims for nerve damage, a right leg condition, and a right leg infection; and the RO denied the claim as entitlement to service connection for right lower extremity peripheral neuropathy (claimed as nerve damage, nerve paralysis, and numbness and tingling of the lower extremity).  However, in Clemons v. Shinseki, the United States Court of Appeals for Veteran's Claims (Court) held that, in determining the scope of a claim, the Board must consider the claimant's description of the claim; symptoms described; and the information submitted or developed in support of the claim.  Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009).  In light of the Court's decision in Clemons, the Board has re-characterized the issue on appeal as entitlement to service connection for a right lower extremity condition.  This will provide the most potentially favorable review of the Veteran's claim in keeping with the Court's holding in Clemons.  

Service Connection-Legal Criteria

Establishing service connection generally requires 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.  See Shedden
 of the claim.  Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009).  In light of the Court's decision in Clemons, the Board has re-characterized the issue on appeal as entitlement to service connection for a right lower extremity condition.  This will provide the most potentially favorable review of the Veteran's claim in keeping with the Court's holding in Clemons.  

Service Connection-Legal Criteria

Establishing service connection generally requires 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.  See Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). 

Service connection may be granted for any disease initially diagnosed after service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303(d).

In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the weight of the evidence is against the claim, in which case the claim is denied.  38 U.S.C. § 5107.  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 the claimant.  

To deny a claim on its merits, the weight of the evidence must persuasively stand against a finding that the evidence is in "approximate balance" or "nearly equal" to the evidence that supports the claim.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

Right Lower Extremity-Analysis 

The Veteran seeks service connection for a right lower extremity condition which he contends is etiologically related to his active-duty service.  The medical evidence confirms the Veteran has current diagnoses of chronic right leg pain, right leg peripheral neuropathy, and right lower extremity varicose veins status post-surgery.  See August 2018 VA Artery and Vein Conditions examination; see also October 2024 private Disability Benefits Questionnaire (DBQ).  Therefore, the central issues to be resolved are whether the Veteran's current disabilities originated in service or are otherwise etiologically related to service.  

Initially, the Board notes that the Veteran's service treatment records (STRs) do contain complaints of, and treatment for his right lower extremity.  The Board notes a May 1994 treatment record where the Veteran complained of right leg pain for three days after being kicked in the shin.  Additionally, the Board notes an August 1997 treatment record wherein the Veteran reported swelling, bruising, and pain in his right lower extremity after climbing Mt. Fuji.  The Veteran's post-service VA and private treatment records document continuous complaints of right lower extremity pain which onset in 1994 after the Veteran was kicked in the shin during basic training, and that the symptoms have been continuing from that time to present day.

In August 2018, the Veteran was provided with a VA Artery and Veins Conditions examination.  Here, the Veteran reported swelling and dull aching pain in his right lower extremity that began in service and has continued to present day.  After a review and discussion of the Veteran's medical records and history, the examiner opined that it is at least as likely as not that the Veteran's right lower extremity varicose veins status post-surgery was incurred during service.  The rationale provided was that the Veteran's STRs contain treatment for his lower extremity condition and the Veteran experienced post-service treatment for his varicose veins.

During his October 2024 Board hearing, the Veteran testified regarding the onset of his symptoms.  The Veteran noted that in 1994 he was kicked in the shin during boot camp, and that he has had continuous symptoms of pain and swelling since that day.  The Veteran also discussed his treatment from service to present day for his right lower extremity.

During the 90-day evidentiary window following his Board hearing, the Veteran submitted an October 2024 private DBQ.  Here, the private examiner diagnosed the Veteran with chronic right leg pain, and right lower extremity peripheral neuropathy.  The examiner opined that it is at least as likely as not that the Veteran's right lower extremity peripheral neuropathy was etiologically related to service.  The rationale provided was that the Veteran had an in-service injury when he was kicked in the shin, that the condition has been chronic since that time, and that the Veteran experiences functional limitation due to his
 pain and swelling since that day.  The Veteran also discussed his treatment from service to present day for his right lower extremity.

During the 90-day evidentiary window following his Board hearing, the Veteran submitted an October 2024 private DBQ.  Here, the private examiner diagnosed the Veteran with chronic right leg pain, and right lower extremity peripheral neuropathy.  The examiner opined that it is at least as likely as not that the Veteran's right lower extremity peripheral neuropathy was etiologically related to service.  The rationale provided was that the Veteran had an in-service injury when he was kicked in the shin, that the condition has been chronic since that time, and that the Veteran experiences functional limitation due to his claimed condition.  The examiner noted that the Veteran's unilateral altered sensorium, abnormal knee reflex, and varicose veins are attributable to his initial in-service injury.

The Veteran also submitted an October 2024 lay statement.  Here, the Veteran noted that when he injured his leg in service it became swollen for several days and that he has experienced ongoing symptoms of pain, numbness, and tingling to his right lower extremity since that initial injury.  The Veteran noted that he has been prescribed gabapentin, pregabalin, Aleve, and compression stockings for treatment of his condition.

In this case, the Board must determine the value of all evidence submitted, including lay and medical evidence.  Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006).  The evaluation of evidence generally involves a 3-step inquiry.  First, the Board must determine whether the evidence comes from a "competent" source.  The Board must then determine if the evidence is credible, or worthy of belief.  Barr v. Nicholson, 21 Vet. App. 303 (2007).  The third step of this inquiry requires the Board to weigh the probative value of the proffered evidence in light of the entirety of the record.  The Board also notes that under certain circumstances, lay evidence may be sufficient to establish a nexus.  See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); see also Layno v. Brown, 6 Vet. App. 465 (1994).  

The Board has considered the medical evidence of record.  As noted above, the Veteran's STRs show complaints of and treatment for his right lower extremity.  Further, the Board notes that the VA and private examiners are medical professionals, competent to determine physical characteristics and deformities, and opine as to the etiology of the Veteran's right lower extremity condition.  There is no evidence that the examiners are not credible.  Moreover, the examiners provided an analysis based upon both subjective and objective information to form an opinion based upon medical expertise.

The Board has considered the Veteran's lay statements in support of his claim.  The Veteran is competent to report symptoms, such as pain because this requires only personal knowledge as it comes to him through his senses.  Layno v. Brown, 6 Vet. App. 465, 469 (1994).  In this case, the Veteran has competently and credibly reported that he experienced right lower extremity pain, numbness, and tingling from service which has continued into present day.  The Board finds the lay statements of record credible in this regard.  

In light of the foregoing, because of the credible evidence of right lower extremity impairment during and since service, and resolving all reasonable doubt in the Veteran's favor, the Board finds that service connection for the claimed condition is warranted because the onset of this condition was coincident with the Veteran's active-duty service.  See Flynn v. Brown, 6 Vet. App. 500, 503 (1994); see also 38 C.F.R. § 3.303(a).  As such, the Veteran's claim is granted.

Right Extremity Shin Splints-Analysis 

The Veteran seeks service connection for a right lower extremity shin splints disability.  However, for the reasons addressed below, the Board finds that the Veteran is not entitled to service connection for a shin splints condition.  As such, the Veteran's claim for service connection is denied.

Initially, the Board notes that pain alone, even without an underlying pathology or diagnosis, can constitute a disability under VA law where such pain results in functional impairment.  Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018).  The Court has additionally held that Saunders is not limited to pain, such that a disability for VA purposes includes any condition that results in functional impairment of earning capacity.  Martinez-Bodon v. Wilkie, 32 Vet. App
 splints disability.  However, for the reasons addressed below, the Board finds that the Veteran is not entitled to service connection for a shin splints condition.  As such, the Veteran's claim for service connection is denied.

Initially, the Board notes that pain alone, even without an underlying pathology or diagnosis, can constitute a disability under VA law where such pain results in functional impairment.  Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018).  The Court has additionally held that Saunders is not limited to pain, such that a disability for VA purposes includes any condition that results in functional impairment of earning capacity.  Martinez-Bodon v. Wilkie, 32 Vet. App. 393 (2020).  

The Board finds that the probative evidence of record does not document that the Veteran has any current diagnoses of any right shin splint disabilities.  Further any symptoms experienced do not rise to compensable levels, result in impairment of functional capacity, or are compensated under other diagnostic codes.  As such, service connection is not warranted on direct, secondary, or presumptive bases for the claimed disabilities.  Martinez-Bodon, supra.

The Board has thoroughly reviewed the Veteran's medical records.  The Veteran's STRs do not contain any complaints, treatment, or diagnoses for any right shin splint conditions.  Further, the Veteran's VA and private treatment notes of record do not document any right shin splint conditions.  The Board notes that the Veteran reported right lower extremity pain, however, the right lower extremity pain is not reported as being associated with any shin splint disability.  Additionally, the Veteran's right lower extremity pain has been service-connected above.

The Veteran was provided with an August 2018 VA Knee and Lower Leg Conditions examination.  Here, the examiner noted that the Veteran did not now, nor has he ever had, shin splints.

The Board has carefully considered the lay and medical evidence of record.  Based on the above, the Board does not find evidence of any current right shin splints condition at any time during the pendency of the appeal.  Additionally, the Board does not find that the Veteran experiences any compensable symptoms, or functional impairment, thereof, or that these symptoms are otherwise compensated under other diagnostic codes.  The Board notes that the VA examiners of record are medical professionals, competent to opine as to the Veteran's claimed shin splints.  There is no evidence that the examiners are not credible. Moreover, the examiners provided their analyses based upon both subjective and objective information to form an opinion based upon medical expertise.

The Board has considered the Veteran's lay contentions and finds the lay statements are competent insofar as they report observable symptoms.  See Layno v. Brown, 6 Vet. App. 465, 469 (1994).  However, to the extent that the Veteran asserts that his claimed disability is related to his active service such statements are of no probative value, as the Veteran lacks the medical expertise to diagnose complex conditions or to render medical nexus opinions.  See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007).  Moreover, to the extent the Veteran asserts that he has any current conditions, such statements are inconsistent with the medical evidence of record that does not document any relevant diagnoses at any time during the pendency of the appeal.  See Caluza v. Brown, 7 Vet. App. 498, 506 (1995); see also Martinez-Bodon, supra. 

The evidence of record persuasively is against finding that the Veteran has any right shin splints condition, or any functional impairment that is not already being compensated by other diagnostic codes.  Accordingly, the evidence is persuasively against the claim.  As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable and service connection for a right shin splints condition is not warranted.  See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

 

 

T. REYNOLDS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Gresham, Trevor

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.