Back to BVA DecisionsDENIEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 250506-540595
MULTIPLE SCLEROSIS
M. MILLS · 2026 · Case ID: A26024235
Summary
The veteran, who served from July 1981 to March 1984, appeals the denial of service connection for primary lateral sclerosis (PLS). The Board reviewed the evidence of record at the time of the initial rating decision in October 2024, as the veteran elected the Direct Review docket under the Appeals Modernization Act. Service treatment records were silent regarding complaints, diagnosis, or treatment for PLS, and a separation examination showed normal neurologic findings. While VA treatment notes confirmed a diagnosis of PLS, the Board found the evidence persuasively weighed against a service connection. The Board noted the absence of a VA examination, but concluded it was not warranted as there was no competent evidence linking the PLS to service beyond the veteran's bare assertion, which does not trigger the duty to assist. The Board also addressed the veteran's representative's argument that PLS is a subset of ALS, which has a presumption of service connection. However, a medical treatise submitted with the appeal could not be considered as it was received outside the open evidentiary period. The Board reiterated that laypersons are not competent to opine on the etiology of a disability. Ultimately, the Board found the evidence persuasively against the claim, and as the evidence was not in approximate balance, the benefit-of-the-doubt doctrine was not applicable. Service connection for PLS was denied.
Rationale
Service treatment records silent for PLS; No competent evidence linking PLS to service; Veteran's bare assertion of nexus insufficient
Full Decision Text
Citation Nr: A26024235 Decision Date: 03/18/26 Archive Date: 03/18/26 DOCKET NO. 250506-540595 DATE: March 18, 2026 ORDER Service connection for primary lateral sclerosis (PLS) is denied. FINDING OF FACT The evidence of record persuasively weighs against finding that PLS began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for PLS are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served from July 1981 to March 1984. The rating decision on appeal was issued in October 2024 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the May 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 October 2024 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. 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 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. 1. Service connection for primary lateral sclerosis (PLS) The Veteran seeks service connection for primary lateral sclerosis (PLS). Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). 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. Service treatment records are silent for complaints, diagnosis, or treatment for PLS. A January 1984 separation examination reflected normal neurologic findings. A January 1984 report of medical history showed the Veteran denied history of neuritis or paralysis. VA treatment notes reflect diagnosis and treatment for PLS. At a September 2024 visit, the Veteran reported that he had been diagnosed with PLS about 3 years before the visit, and related that he was steadily losing muscle mass. The Board concludes that, while the Veteran has a diagnosis of PLS, the evidence of record persuasively weighs against finding that it began during active service, or is otherwise related to an in-service injury, event, or disease. The Board notes that the Veteran has not been afforded a VA examination in relation to this claim. VA's duty to assist includes providing a medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service, or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) there is insufficient competent medical evidence on file to make a decision on the claim. 38 U.S.C. § 5103A, 38 C.F.R. § 3.159; McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this case, there is no competent evidence of record indicating that the Veteran's PLS is related to active service. Other than the Veteran's or disease occurred in service, or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) there is insufficient competent medical evidence on file to make a decision on the claim. 38 U.S.C. § 5103A, 38 C.F.R. § 3.159; McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this case, there is no competent evidence of record indicating that the Veteran's PLS is related to active service. Other than the Veteran's bare assertion, inherent in making the claim, no theory of entitlement or basis for finding a link to service was put forth to the RO. Notably, a bare assertion of a nexus by the Veteran, alone, does not suffice to trigger the duty to assist. See Waters v. Shinseki, 601 F.3d 1274, 1278 (Fed. Cir. 2010). Therefore, the Board finds that no VA examination or medical opinion was warranted. While the Veteran believes the claimed PLS is related to service, the Board reiterates that the evidence of record persuasively weighs against findings that in-service toxic exposure or injury occurred. While laypersons are competent to report the presence of observable symptoms, the Veteran is not competent to provide an opinion regarding the etiology of his claimed disability. A medical opinion of that nature requires medical testing and expertise that is outside the common knowledge of a layperson. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Therefore, the Veteran is not competent to provide an opinion with regard to these claims, and his belief in and assertion of a nexus bears no probative weight. The Veteran's representative argues that PLS is a subset of amyotrophic lateral sclerosis (ALS). They argue that service connection should be granted for PLS, because there is a presumption of service connection for veterans who develop ALS at any time after service connection. 38 C.F.R. § 3.318. Included in the February 2026 brief is a medical article on the issue of ALS. The Veteran's contention relies upon this submitted treatise evidence. However, under VA's evidentiary rules only the evidence in his file at the time of the October 2024 AOJ decision on appeal can be considered. Thus, the medical treatise evidence submitted by the Veteran could not be considered because it was submitted outside an open evidentiary period. 38 C.F.R. §§ 20.300, 20.301, 20.303, 20.801. Moreover, the implications of the article to the assessment of service connection is a matter requiring medical knowledge and expertise. Jandreau 492 F.3d at 1376-77. Thus, while the Board may consider medical treatises, Harvey v. Shulkin, 30 Vet. App. 10, 20 (2018) (holding that the Board may weigh and evaluate medical treatise evidence), the Board is prohibited from independently making determinations as to nexus as it would require the Board to make a medical determination. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991) (VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions). The Board encourages the Veteran to file a Supplemental Claim if he would like VA to consider any evidence that was submitted that the Board could not consider. 38 C.F.R. § 3.2501. (Continued on the next page) ? 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 PLS is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. M. MILLS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Lauritzen 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. -the-doubt doctrine is not applicable and service connection for PLS is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. M. MILLS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Lauritzen 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.