LYME DISEASE

J. PARKER · 2026 · Case ID: A26024681

DENIED

Summary

The veteran, who served in the Army National Guard and Army Reserve with periods of Active Duty for Training (ACDUTRA) from August 1972 to December 1972 and other ACDUTRA periods in 1988, appeals the denial of service connection for multiple conditions, including Lyme disease, anemia, chronic kidney disease, a cardiac disorder, bilateral hand and wrist degenerative arthritis, and bilateral hip osteoarthritis. The veteran claimed contracting Lyme disease in 1982 from a tick bite during ACDUTRA training at Fort McCoy, and that the other conditions developed secondary to the Lyme disease. The Board found the veteran had no active duty service for VA compensation purposes, only ACDUTRA and inactive duty training (INACDUTRA). For Lyme disease, the Board acknowledged a current diagnosis but found the evidence weighed against service connection, noting the appellant's testimony about a 1982 tick bite was contradicted by service records indicating a Lyme diagnosis in 1985, prior to his 1988 ACDUTRA training. The Board also found the veteran not competent to opine on the etiology of Lyme disease and not credible regarding the timing of the bite. As service connection for Lyme disease was denied, the secondary claims for anemia, CKD, cardiac disorder, hand/wrist/hip disorders were also denied as a matter of law due to the lack of a service-connected predicate condition. All claims were denied.

Rationale

No active duty service for VA purposes; ACDUTRA/INACDUTRA service only; No in-service complaints/treatment for bug bite; Lyme disease diagnosed prior to ACDUTRA service; Veteran not competent to opine on etiology; Veteran's testimony not credible

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250725-568427

Full Decision Text

Citation Nr: A26024681
Decision Date: 03/18/26 Archive Date: 03/18/26

DOCKET NO. 250725-568427
DATE: March 18, 2026

ORDER

Service connection for Lyme disease is denied.

Service connection for anemia is denied.

Service connection for chronic kidney disease is denied.

Service connection for supraventricular arrhythmia and severe concentric left ventricular hypertrophy with cardiac dilation is denied.

Service connection for right hand swan neck deformity with degenerative arthritis is denied.

Service connection for left hand swan neck deformity with degenerative arthritis is denied.

Service connection for right hip osteoarthritis is denied.

Service connection for left hip osteoarthritis is denied.

Service connection for right wrist degenerative arthritis is denied.

Service connection for left wrist degenerative arthritis is denied.

FINDINGS OF FACT

1. The appellant did not have active duty service for VA benefit purposes.

2. The appellant had active duty for training service (ACDUTRA) with additional periods of service in the Army National Guard and Army Reserve.

3. The evidence shows a current diagnosis for Lyme disease; the current Lyme disease was not due to a disease or injury incurred in the line of duty during any period of ACDUTRA service or due to an injury incurred in the line of duty during any period of inactive duty for training (INACDUTRA) service.

4. The evidence shows a current diagnosis for anemia; there is no primary service-connected disability upon which secondary service connection may be granted.

5. The evidence shows a current diagnosis for chronic kidney disease (CKD); there is no primary service-connected disability upon which secondary service connection may be granted.

6. The evidence shows a current diagnosis for supraventricular arrhythmia and severe concentric left ventricular hypertrophy with cardiac dilation (cardiac disorder); there is no primary service-connected disability upon which secondary service connection may be granted.

7. The evidence shows a current diagnosis for right hand swan neck deformity with degenerative arthritis (right hand disorder); there is no primary service-connected disability upon which secondary service connection may be granted.

8. The evidence shows a current diagnosis for left hand swan neck deformity with degenerative arthritis (left hand disorder); there is no primary service-connected disability upon which secondary service connection may be granted.

9. The evidence shows a current diagnosis for right hip osteoarthritis (right hip disorder); there is no primary service-connected disability upon which secondary service connection may be granted.

10. The evidence shows a current diagnosis for left hip osteoarthritis (left hip disorder); there is no primary service-connected disability upon which secondary service connection may be granted.

11. The evidence shows a current diagnosis for right wrist degenerative arthritis (right wrist disorder); there is no primary service-connected disability upon which secondary service connection may be granted.

12. The evidence shows a current diagnosis for left wrist degenerative arthritis (left wrist disorder); there is no primary service-connected disability upon which secondary service connection may be granted.

CONCLUSIONS OF LAW

1. The criteria for service connection for Lyme disease have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303.

2. The criteria for service connection for anemia have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303, 3.310.

3. The criteria for service connection for chronic kidney disease have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303, 3.310.

4. The criteria for service connection for a cardiac disorder have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303, 3.310.

5. The criteria for service connection for a right hand disorder have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303
303, 3.310.

4. The criteria for service connection for a cardiac disorder have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303, 3.310.

5. The criteria for service connection for a right hand disorder have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303, 3.310.

6. The criteria for service connection for a left hand disorder have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303, 3.310.

7. The criteria for service connection for a right hip disorder have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303, 3.310.

8. The criteria for service connection for a left hip disorder have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303, 3.310.

9. The criteria for service connection for a right wrist disorder have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303, 3.310.

10. The criteria for service connection for a left wrist disorder have not been met. 38 U.S.C. §§ 101, 106, 1110, 1131, 5107; 38 C.F.R. §§ 3.1, 3.6, 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The appellant had ACDUTRA service from August 1972 to December 1972 with the Army National Guard with additional periods of service in the Army National Guard and Army Reserve.

This appeal is before the Board of Veterans' Appeals (Board) on appeal from a June 2025 Appeals Modernization Act (AMA) rating decision. In the July 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the appellant elected the Hearing docket. A Board hearing was held on December 4, 2025.

Therefore, the Board may only consider the evidence of record at the time of the June 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the appellant or representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

If the appellant would like VA to consider any evidence that was submitted that the Board could not consider, the appellant 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 LEGAL CRITERIA

To obtain veteran status, a claimant must show that he or she is "a person who served in the active military, naval, or air service." 38 U.S.C. § 101(2). "Active military, naval, or air service" includes any period of ACDUTRA during which the individual concerned was disabled or died from a disease or injury incurred in or aggravated in line of duty, or any period of INACDUTRA during which the individual concerned was disabled or died from injury incurred in or aggravated in line of duty. See 38 U.S.C. § 101(21), (24); 38 C.F.R. § 3.6(a), (d); Biggins v. Derwinski, 1 Vet. App. 474, 477 78 (1991). ACDUTRA is defined as full-time duty in the Armed Forces performed by Reserves for training purposes, and includes full-time duty performed by members of the National Guard of any State. 38 U.S.C. § 101(22); 38 C.F.R. § 3.6(c)(1). Service connection for INACDUTRA is permitted only for injuries, not diseases, incurred or aggravated in line of duty. See Brooks v. Brown, 5 Vet. App. 484, 485 (1993). VA's General Counsel has interpreted that it was the intention of Congress when it defined active service in 38 U.S.C. § 101(24) to exclude inactive duty training during which a member was disabled or died due to nontraumatic incurrence or aggravation of a disease process. See VAOPGCPREC 86-90.

A member of the National Guard serves in the federal military only when formally called into the military service of the United States. At all other times, a member of the National Guard serves solely as a member of the state militia under the command of a state governor. In this regard, to have basic eligibility based on a period of duty as a member of a state National Guard, a National Guardsman must have been ordered into Federal service under 38 U.S.C. §§ 316, 502, 503, 504, 505. See 38 C.F.R. §§ 3.6 (c), (d); Allen v. Nicholson, 21 Vet. App.?54, 57 (2007).

If the appellant's personnel records do not show his or her National Guard service in the relevant period was "federalized" (and where he or she has not contended that such service was federalized), periods of ACDUTRA or INACDUTRA in the National Guard are not qualifying service for VA compensation purposes. See 38 U.S.C. §§ 101 (22), (23); 38 C.F.R. §§ 3.6 (c), (d).

The U.S. Court of Appeals for Veterans Claims (Court) has held that when a claim is based only on a period of ACDUTRA there must be evidence that the claimant became disabled as a result of a disease or injury incurred or aggravated in the line of duty during the period of ACDUTRA (or as a result of an injury in the line of duty during a period of INACDUTRA). See Paulson v. Brown, 7 Vet. App. 466, 470 (1995); 38 U.S.C. § 101; 38 U.S.C. §§ 1110, 1131.

The Court also held in Smith v. Shinseki, 24 Vet. App. 40, 47 (2010) that a claim based on a period of active duty for training can never be entitled to a presumption of service connection, where, by definition, the presumption of service connection applies when there is no evidence that a condition began in or was aggravated during service, and, by contrast, a claim based on a period of ACDUTRA or INACDUTRA requires there to be some evidence that the claimed disability (or cause of death) was "incurred or aggravated" in the line of duty, during the relevant period of service.

For claimants with active duty service, generally, service connection may be granted for disabilities resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131
based on a period of active duty for training can never be entitled to a presumption of service connection, where, by definition, the presumption of service connection applies when there is no evidence that a condition began in or was aggravated during service, and, by contrast, a claim based on a period of ACDUTRA or INACDUTRA requires there to be some evidence that the claimed disability (or cause of death) was "incurred or aggravated" in the line of duty, during the relevant period of service.

For claimants with active duty service, generally, service connection may be granted for disabilities 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).

Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. 38 C.F.R. § 3.310(a)-(b). Secondary causation exists when, but for the service-connected disability, the non-service-connected was caused by a service-connected disability either in a direct, etiological way or via multiple steps in a causal chain. Spicer v. McDonough, 61 F.4th 1360, 1365 (Fed. Cir. 2023) (citations omitted). Secondary aggravation exists when the non-service-connected disability not caused by a service-connected disability would be less severe were it not for a service-connected disability. Id. at 1364. For example, secondary aggravation may be established where the natural progression of the non-service-connected disability could have been arrested or improved but for the service-connected disability. Id.

When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 999 F. 3rd 1391 (2021).

1. Service connection for Lyme disease

The appellant contends that he contracted Lyme disease around 1982 during a two-week summer camp training at Fort McCoy. During the December 2025 Board hearing, the appellant testified that he was in the field for 10 days without access to a shower, and by the end of the training he emerged with a sore on his back. The appellant testified that a medic examined the sore and thought it was just a bug bite, and that he fell ill after coming home from the training. Subsequently, the appellant was tested and diagnosed with Lyme disease in 1989. The appellant testified to his belief that the bug bite he sustained during training at Fort McCoy was actually a tick bite that caused him to contract Lyme disease. In the June 2025 decision on appeal, the AOJ found a current diagnosis of Lyme disease. The Board is bound by this favorable finding.

Initially, the Board finds that the appellant has no active duty period of service as defined by law governing entitlement to VA disability benefits. Military personnel records reflect the appellant had various periods of ACDUTRA and INACDUTRA service with the Army National Guard and the Army Reserve, including a period of ACDUTRA service occurring from August 1972 to December 1972 with the Army National Guard. See DD Form 214. Military personnel records include orders for the August 1972 period of service which explicitly reflects the appellant was ordered to ACDUTRA service and not active duty service. The appellant also served various periods of ACDUTRA service with the Army Reserve, including several periods of ACDUTRA service during the summer of 1988 at Fort McCoy. Military personnel records do not reflect the appellant was ordered into Federal service under 38 U.S.C. §§ 316, 502, 503, 504, 505 at any time during service with the Army National Guard or the Army Reserve. See 38 C.F.R. §§ 3.6(c), (d). Therefore, without active duty service as defined by law for VA compensation purposes, the appellant's claims for service
of service which explicitly reflects the appellant was ordered to ACDUTRA service and not active duty service. The appellant also served various periods of ACDUTRA service with the Army Reserve, including several periods of ACDUTRA service during the summer of 1988 at Fort McCoy. Military personnel records do not reflect the appellant was ordered into Federal service under 38 U.S.C. §§ 316, 502, 503, 504, 505 at any time during service with the Army National Guard or the Army Reserve. See 38 C.F.R. §§ 3.6(c), (d). Therefore, without active duty service as defined by law for VA compensation purposes, the appellant's claims for service connection may only be based on a disease or injury incurred during a period of ACDUTRA service, or an injury incurred during a period of INACDUTRA service.

After a review of all the lay and medical evidence, the Board finds the persuasive weight of the competent and credible evidence is against service connection for Lyme disease. The persuasive weight of the evidence is against finding that the current Lyme disease is the result of an injury or disease incurred in the line of duty during a period of ACDUTRA service or an injury sustained during a period of INACDUTRA service. Service treatment records do not reflect any disease or injury sustained during a period of ACDUTRA service or an injury sustained during a period of INACDUTRA service, including any complaints, treatment, or reports of sustaining a bug bite.

Instead, the evidence establishes Lyme disease was incurred outside of the appellant's periods of ACDUTRA and INACDUTRA service. As noted above, the appellant testified to his belief that he sustained a tick bite in the summer of 1982 during summer camp training at Fort McCoy. Service personnel records reveal that the only ACDUTRA periods of service that spanned approximately two-weeks in duration, occurring during the summer at Fort McCoy, took place in 1988 with the Army Reserve. Contemporaneous service treatment records also show that the appellant reported he was diagnosed with Lyme disease in 1985, but was not treated until 1989, presumably when the appellant also reported being hospitalized for Lyme disease in July 1989. See March 1991 Report of Medical History; July 1991 service treatment record. This evidence indicates the appellant was diagnosed with Lyme disease prior to the periods of ACDUTRA service ordered during the summer of 1988 at Fort McCoy.

Additionally, while the appellant is competent to testify to sustaining a bug bite, the Board finds the appellant is not competent to draw a conclusion that the bug bite he sustained during summer training was from a tick or that the current Lyme disease is etiologically related to the bug bite sustained during ACDUTRA training. The question of the etiology of the appellant's Lyme disease involves complex medical questions involving internal and mostly unseen system processes unobservable by the appellant, and without the requisite medical training and knowledge, he is not competent to opine on.

Moreover, the appellant's Board testimony that he sustained Lyme disease during summer training at Fort McCoy is contradicted by his own contemporaneous reports contained in the service personnel records, discussed above, which establish he a diagnosis of Lyme disease years before undergoing summer training. For these reasons, the Board finds the appellant's Board testimony is not credible.

As the foregoing evidence demonstrates no disease or injury sustained during a period of ACDUTRA service and no injury sustained during a period of INACDUTRA service that resulted in the current Lyme disease, and that the current Lyme disease was diagnosed outside of the appellant's periods of ACDUTRA and INACDUTRA service, the Board finds the persuasive weight of the evidence is against service connection for Lyme disease, and the appeal must be denied.

2. Service connection for anemia

3. Service connection for chronic kidney disease

4. Service connection for a cardiac disorder

5. Service connection for a right hand disorder

6. Service connection for a left hand disorder

7. Service connection for a right hip disorder

8. Service connection for a left hip disorder

9. Service connection for a right wrist disorder

10. Service connection for a left wrist disorder

The appellant explicitly contends that the claimed anemia, CKD, a cardiac disorder, right and left hand disorders, right and left hip disorders, and right and left wrist disorders developed as a result of the non-service-connected Lyme disease. This is the appellant's sole contention. See March 2025 VA Form 20-0995 Supplemental Claim Application; December 2025 Board hearing transcript.

In the June 2025 decision on appeal, the AOJ found current diagnoses for anemia, CKD, a cardiac disorder, right and left hand sw
a right hip disorder

8. Service connection for a left hip disorder

9. Service connection for a right wrist disorder

10. Service connection for a left wrist disorder

In the June 2025 decision on appeal, the AOJ found current diagnoses for anemia, CKD, a cardiac disorder, right and left hand swan neck deformity with degenerative arthritis, right and left hip osteoarthritis, and right and left wrist degenerative arthritis. The Board is bound by these favorable findings.

As the Board's instant decision above denies service connection for Lyme disease, the claims for secondary service connection for anemia, CKD, a cardiac disorder, right and left hand disorders, right and left hip disorders, and right and left wrist disorders must be denied as a matter of law because there is no primary service-connected disability upon which secondary service connection may be granted. See 38 C.F.R. § 3.310(a); Reiber v. Brown, 7 Vet. App. 513, 516-17 (1995); Sabonis v. Brown, 6 Vet. App. 426, 430 (1994).

J. PARKER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board E. Choi, 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.

Analyze in VA Law Explorer