NONTUBERCULOUS LUNG DISEASE

Summary

The Veteran, a Veteran who served from July 2022 to April 2024, appeals the denial of service connection for a pleural based cyst on his left lower lung. The denial stemmed from the Veteran's inability to attend a VA examination due to hospitalization for paranoid delusions and possible ingestion of wood cleaner. The Veteran's service treatment records did not indicate a lung lesion diagnosis. However, private treatment records from December 2023 revealed a 7cm masslike lesion in the left lower posterior lung, later confirmed as a neurofibroma requiring surgical resection. A medical officer noted the incidental cystic pleural mass during the Veteran's psychiatric hospitalization. The Board found that the lung cyst was first discovered during service, entitling the Veteran to the presumption of soundness. Despite the lack of in-service treatment records for the specific condition, the Board determined that the medical notation suggesting the need for surgical resection, coupled with the presumption of soundness, was sufficient to grant service connection. The Board granted service connection for the pleural left lower lung cyst.

Rationale

Presumption of soundness applicable as condition first diagnosed in service; Private treatment records and medical notation confirmed cyst; Evidence sufficient for service connection despite lack of in-service treatment records

Full Decision Text

Citation Nr: A26019017
Decision Date: 03/03/26	Archive Date: 03/03/26

DOCKET NO. 251119-611984
DATE: March 3, 2026

ORDER

Service connection for a pleural left lower lung cyst is granted.

FINDING OF FACT

The evidence of record persuasively favors the conclusion that left lower lung cyst in the Veteran's lung was first diagnosed in service. 

CONCLUSION OF LAW

The criteria for service connection for a left lower lung cyst have been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.304.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service from July 2022 to April 2024. 

This matter stems from a January 2025 rating decision that denied service connection for a pleural based cyst on his left lower lung. 

The Veteran timely appealed the January 2025 rating decision by filing a VA Form 10182, wherein he selected the direct review docket within the Veterans Appeals Improvement Modernization Act (AMA) review system. Therefore, the Board is only able to consider the evidence at the time of the January 2025 rating decision.  By operation of law, the Board is precluded from considering evidence submitted during a period after the AOJ issued the decision on appeal. 38?C.F.R. §?20.303.

SERVICE CONNECTION

Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service relationship between the present disability and the disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service (nexus). Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

The Veteran's service treatment records (STRs) do not show any diagnoses of a left lung lesion. However, his private treatment records show that in December 2023, an x-ray revealed a 7cm masslike lesion in the Veteran's left lower posterior lung. In April 2024, a medical officer sent the Veteran a letter noting that he had a pleural based cyst in his left lower lung that needed further evaluation/treatment. At the time, the Veteran was admitted to an inpatient psychiatry ward for paranoid delusions and possible ingestion of wood cleaner. An incidental cystic pleural mass was found, and it was recommended he follow up. The Veteran did not have any symptoms at the time. Treatment notes from October 2024 show that the Veteran's mass was confirmed to be consistent with a neurofibroma (noncancerous) and would need surgical resection. 

In January 2025, a social worker called VA noting that the Veteran had been hospitalized since June 2024, and that he would be unable to attend any VA examinations. 

His claim was denied as he was unable to attend a VA examination to specifically diagnose the condition; however, the type of cyst is more of a rating issue, not a service connection issue.  The fact of the matter is that the lung cyst was first discovered in service, the Veteran was entitled to the presumption of soundness for it, and a medical notation suggested that it would need to be excised.  

This is sufficient for service connection to be granted. 

 

MATTHEW W. BLACKWELDER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Elizabeth Gadson, 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.