PERIPHERAL NERVE DISORDERS

L. HOWELL · 2026 · Case ID: A26026259

DENIED

Summary

The veteran served from December 1975 to March 1981. He appealed the denial of service connection for multiple conditions, including peripheral neuropathy (PN) in both lower and upper extremities, a right shoulder disorder, erectile dysfunction (ED), a kidney disorder, a respiratory disorder, a cardiovascular (CV) disorder, diabetes mellitus (DM), and hypertension. The Board dismissed the claims for bilateral lower extremity PN, noting that service connection had been granted by the agency of original jurisdiction (AOJ) for this condition, rendering the appeal moot. For the right shoulder disorder, the Board found that while a current diagnosis of rotator cuff tendonitis and AC joint separation existed, the service treatment records (STRs) were silent regarding any right shoulder complaints, only noting left shoulder issues. A private medical opinion linked the current right shoulder condition to an in-service injury, but the Board found this opinion conclusory and unsupported by contemporaneous records, noting the veteran's failure to report right shoulder symptoms during service or at separation, and his initial claim only for the left shoulder. The Board gave less probative weight to the veteran's current assertions, finding them contradicted by earlier evidence. For ED, the Board denied service connection, noting it was not incurred in service and not secondary to a service-connected disability, as DM was not yet service-connected. For kidney, respiratory, and bilateral upper extremity PN claims, the Board found no current diagnoses in the record and noted the STRs were silent for these conditions, with the veteran denying relevant symptoms at separation. The Board also found the veteran incompetent to diagnose these conditions. For CV disorder, DM, and hypertension, the Board acknowledged current diagnoses but found no in-service incurrence or presumptive basis for service connection, as STRs were silent and the veteran's claims of chest pain in service were not linked to these specific conditions, nor did he seek treatment until years after service. The Board found the medical evidence weighed against these claims.

Rationale

Bilateral upper extremity PN not shown in service; LUE PN not incurred in service

Special Benefit

NO SPECIAL BENEFIT

Docket No.

201112-121766

Full Decision Text

Citation Nr: A26026259
Decision Date: 03/24/26 Archive Date: 03/24/26

DOCKET NO. 201112-121766
DATE: March 24, 2026

ORDER

Service connection for left lower extremity (LLE) peripheral neuropathy (PN) is dismissed.

Service connection for right lower extremity (RLE) PN is dismissed.

Service connection for a right shoulder disorder is denied.

Service connection for erectile dysfunction (ED) is denied.

Service connection for right upper extremity (RUE) PN is denied.

Service connection for left upper extremity (LUE) PN is denied.

Service connection for a kidney disorder is denied.

Service connection for a respiratory disorder is denied.

Service connection for a cardiovascular (CV) disorder is denied.

Service connection for diabetes mellitus (DM) is denied.

Service connection for hypertension is denied.

FINDINGS OF FACT

1. The Veteran served on active duty from December 1975 to March 1981; he has been 100 percent disabled since October 2025.

2. During the pendency of the appeal and prior to this decision being issued, the agency or original jurisdiction (AOJ) granted service connection for bilateral upper extremity PN.

3. A right shoulder disorder, diagnosed as rotator cuff tendonitis and acromioclavicular joint separation, was not shown in service and is not etiologically related to service.

4. There is no service-connected primary disability upon which secondary service connection for ED may be granted.

5. Bilateral upper extremity PN, a chronic kidney disorder, and a chronic respiratory disorder have not been shown.

6. A CV disorder, diagnosed as hypertensive heart disease, DM, and hypertension were not shown in service, did not manifest to a compensable degree within a year of separation, were not continuous since separation, and are not casually or etiologically related to service.

CONCLUSIONS OF LAW

1. The criteria for dismissal of service connection for LLE PN have been met. 38 U.S.C. § 7105 (2012); 38 C.F.R. § 20.205 (2025).

2. The criteria for dismissal of service connection for RLE PN have been met. 38 U.S.C. § 7105 (2012); 38 C.F.R. § 20.205 (2025).

3. A right shoulder disorder was not incurred in service. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2025).

4. ED was not incurred in service nor is it secondary to a service connected disability. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2025).

5. A kidney disorder was not incurred in service nor is it secondary to a service connected disability. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2025).

6. A respiratory disorder was not incurred in service. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2025).

7. RUE PN was not incurred in service. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2025).

8. LUE PN was not incurred in service. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2025).

9. A CV disorder was not incurred in service nor can it be presumed to have been incurred in service. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2025).

10. DM was not incurred in service nor can it be presumed to have been incurred in service. 38 U.S.C. §§ 1131, 5103(a), 510
5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2025).

10. DM was not incurred in service nor can it be presumed to have been incurred in service. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2025).

11. Hypertension was not incurred in service nor can it be presumed to have been incurred in service. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2025).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

This decision has been written under the guidelines of the Veterans Appeals Improvement and Modernization Act, also known as the Appeals Modernization Act (AMA). In September 2020, the agency of original jurisdiction (AOJ) denied the claims. In November 2020, the Veteran appealed to the Board via a Form 10182 and elected the Hearing docket. A hearing was held before the Board in May 2024. Therefore, the Board may consider only the evidence of record at the time of the AOJ decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a).

Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303 (a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009).

For a disorder to be service connected, it must be shown at the time a claim for VA disability compensation is filed or during or contemporary to the pendency of the appeal. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). That is, 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. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307.

Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

Bilateral Lower Extremity PN

The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An
38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

Bilateral Lower Extremity PN

The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.205.

Prior to the issuance of this decision, in November 2020, the AOJ granted service connection for bilateral lower extremity radiculopathy. Later that month, the Veteran was notified of the grant of the claims. As the November 2020 decision represents full grant of the issues on appeal, there is no longer a case or controversy as to these matters and the appeal as to the Veteran's claims for entitlement to service connection for RLE and LLE PN and the case must be dismissed. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

Right Shoulder

Turning to the medical evidence, an April and July 2020 VA examiner diagnosed rotator cuff tendonitis and acromioclavicular joint separation. As such, the first element of service connection has been met.

As to an in-service incurrence, the service treatment records (STRs) are silent for any right shoulder issues. Rather, STRs show complaints related to the left shoulder. The January 1981 separation examination noted normal clinical evaluations of the upper extremity. As such, a chronic right shoulder disorder was not noted in service.

To the extent that the Veteran asserts a medical nexus between the right shoulder disorder and service, private treatment records in July 2024 indicated that the Veteran had been receiving treatment with Dr.M.A.F. for the shoulders, among other conditions. The private clinician indicated that the conditions were sustained as a result of an injury in service. Based on current medical literature and research related to the conditions, the private physician concluded the right shoulder began during service.

The Board recognizes that while a VA examination for the shoulders was undertaken, a medical opinion was not provided; however, a remand for an opinion is not warranted. While the July 2024 private opinion related the right shoulder to service, the opinion is conclusory and unsupported by the contemporaneous records during service.

As indicated, the STRs are silent for a right shoulder condition, but rather evidence complaints related to the left shoulder. Therefore, the private opinion was based on an inaccurate factual basis of an in-service injury. Further, the Veteran has offered no contention or explanation as to why he feels that service connection is warranted. Rather, his only action was to file the claim itself without further competent information or evidence. As such, the low threshold is not met in this case because there is only the unsupported lay contention of a medical nexus (insofar as the Veteran filed the claim and made bare assertions).

If the Veteran had experienced right shoulder symptoms in service as he now contends, it is reasonable to expect that he would have reported such during service or at least at separation. However, the fact that he did not - despite having had ample opportunity to do so while noting multiple other medical issues - weighs against the credibility of his post-service assertion of an in-service etiology. See Fountain v. McDonald, 27?Vet. App.?258 (2015).

Here, the Board is not merely relying on the absence of evidence, but also on the contemporaneous medical records that specifically showed that the Veteran repeatedly denied right shoulder problems while in service and separation when it would be more likely for him to identify all medical problems.

To the extent that the Veteran now asserts that the right shoulder disorder is related to service, the current assertions made for VA compensation purposes are given less probative weight, because they are contradicted and outweighed by the more contemporaneous lay and medical evidence. See Harvey v. Brown, 6?Vet. App.?390, 394 (1994) (Board decision properly assigned more probative value to a private hospital record that included lay history that was made for treatment purposes than to subsequent statements made for compensation purposes).

Additionally, the Veteran first filed a VA disability compensation claim for service connection for a left shoulder disorder in March 1981, shortly following separation from active duty but did not claim service connection for the right shoulder or make any mention
the extent that the Veteran now asserts that the right shoulder disorder is related to service, the current assertions made for VA compensation purposes are given less probative weight, because they are contradicted and outweighed by the more contemporaneous lay and medical evidence. See Harvey v. Brown, 6?Vet. App.?390, 394 (1994) (Board decision properly assigned more probative value to a private hospital record that included lay history that was made for treatment purposes than to subsequent statements made for compensation purposes).

The Board acknowledges that symptoms, not treatment, are the essence of any evidence of continuity of symptomatology (Savage v. Gober, 10 Vet. App. 488, 496 (1997); however, here, he initially filed a claim for service connection but did not mention right shoulder symptoms at that time. This suggests to the Board that there was no pertinent right shoulder symptomatology at that time. He did not file a claim for the right shoulder until 2020, some 39 years following separation from service.

While inaction regarding filing a claim is not necessarily indicative of the absence of symptomatology, where, as here, a veteran takes action regarding other claims, it becomes reasonable to expect that they are presenting all issues for which they are experiencing symptoms that they believe are related to service.

In other words, the Veteran demonstrated that he understood the procedure for filing a claim for VA disability compensation, and he followed that procedure in other instances where he believed he was entitled to those benefits. In such circumstances, it is more reasonable to expect a complete reporting than for certain symptomatology to be omitted.

Thus, his inaction regarding a claim for a right shoulder disorder, when viewed in the context of his action regarding the left shoulder for compensation, may reasonably be interpreted as indicative of his belief that he did not sustain a right shoulder injury in service, or the lack of a right shoulder symptomatology at the time he filed the claim, or both.

The Board has considered the Veteran's assertion that his right shoulder condition began during active duty. While he is competent to report symptoms as this requires only personal knowledge as it comes to him through his senses, he is not competent to offer an opinion as to the etiology of the current disorder due to the medical complexity of the matter involved. In sum, the medical evidence weighs against the appeal.

The Veteran contends that ED is related to DM. This is the only service connection theory he has advanced in this appeal and the STRs are negative for ED during active duty. Of note, as of this decision, DM is not service connected. Therefore, as there is no primary service-connected disability upon which secondary service connection for ED may be granted, the appeal is not supported by the evidence.

Kidney, Respiratory, Bilateral Upper Extremity PN

The Veteran asserts that his kidney, respiratory, and bilateral upper extremity disorders are related to service, or in the alternative secondary to DM. As to current diagnoses, the weight of the medical evidence does not show diagnoses of a kidney disorder, respiratory disorder, or bilateral upper extremity PN.

Private clinical records are silent for diagnoses of the disorders. Further, while clinical records reflect a diagnosis of diabetic polyneuropathy, it is not clear whether they are of the upper extremities. VA clinical records are also silent for the same.

In addition, the STRs do not reflect complaints of, treatment for, or diagnosis related to the kidneys, a respiratory condition, or upper extremity nerve condition. In the January 1981 Report of Medical History at separation, the Veteran denied shortness of breath, kidney trouble, or paralysis. While he complained of chest pain in that report, there is no current diagnosis reasonably related to a respiratory disorder to relate to that complaint of chest pain in service.

To date, the Veteran has failed to provide or allege any documentation supporting current diagnoses for the kidneys, a respiratory disorder, or bilateral upper extremity PN. Moreover, the competent medical evidence of record fails to show a diagnosis of, or symptoms related to the claimed conditions.

To the extent that the Veteran believes he has a kidney disorder, respiratory disorder, and bilateral upper extremity PN, he is not competent to provide a diagnosis as the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007).

Consequently, the Board gives more probative weight to the medical evidence of record which does not demonstrate any complaints, treatment, or diagnosis for the
kidneys, a respiratory disorder, or bilateral upper extremity PN. Moreover, the competent medical evidence of record fails to show a diagnosis of, or symptoms related to the claimed conditions.

Consequently, the Board gives more probative weight to the medical evidence of record which does not demonstrate any complaints, treatment, or diagnosis for the kidneys, a respiratory disorder, or bilateral upper extremities. In sum, the medical evidence does not support the appeals.

CV, DM, Hypertension

Turning to the medical evidence, private clinical records reflect diagnoses for hypertensive heart disorder, DM, and hypertension. As such, the first element of service connection has been met.

As to an in-service occurrence, the Veteran claims to have been exposed to Agent Orange during service but this is not supported by the record. Additionally, he does not have service in the Republic of Vietnam, or any other location presumptively associated with herbicide exposure. Based on the above, herbicide agent exposure cannot be presumed.

Similarly, the STRs are silent for any complaints, treatments, or diagnoses related to the CV, DM, or hypertension. While the Veteran complained of chest pain at the separation examination and accompanying Report of Medical History, he specifically denied heart trouble or high or low blood pressure and the blood pressure reading was 108/64. Rather, the STRs reflect complaints related to sinus, abdominal pain, left shoulder, bilateral knee, constipation, and rash in the thighs, to name a few. As such, the second element of service connection is not met.

Private clinical records note the Veteran's assessments and treatments for hypertensive heart disorder, DM, and hypertension. In addition, no medical professional has provided an opinion linking a CV disorder, DM, or hypertension to service. The Board recognizes that no examination was undertaken in conjunction with the claims.

For service connection claims, VA is obliged to provide an examination or obtain a medical opinion in a claim when (1) the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, (2) the record indicates that the disability or signs and symptoms of disability may be associated with active service, and (3) the record does not contain sufficient information to make a decision on the claim. 38 U.S.C. § 5103A (d); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The threshold for finding a link between a current disability and service is low.

However, a remand for an examination is not warranted. In this regard, there is no lay or medical evidence of any nexus to service. Further, the Veteran has offered no contention or explanation as to why he feels that service connection is warranted. Rather, his only action was to file the claim itself without further competent information or evidence.

While the Veteran testified at the March 2024 Board hearing that he began to experience chest pain in Hawaii and reported to sick call and was placed on medications, STRs do not reflect any treatments specifically related to his heart or to hypertension, and these conditions were specifically denied upon separation.

The Veteran also reported that he did not seek treatment for hypertension or heart problems until the 1990s, some 10 years following separation, and was unsure whether these conditions are directly related to service or not. This weighs against the claims. As such, the low threshold is not met in this case because there is only the unsupported lay contention of a medical nexus (insofar as the Veteran filed the claims and made bare assertions).

With regard to DM, the Veteran contended that Agent Orange was sprayed in foliage at Fort Polk and that he routinely performed training exercises on the ground; however, as indicated above, Agent Orange exposure has not been shown.

The Board has considered the Veteran's contention that the CV, DM, and hypertension were related to service. While he is competent to report symptoms as this requires only personal knowledge as it comes to him through his senses, he is not competent to offer an opinion as to the etiology of the current disorders due to the medical complexity of the matter involved.

In sum, after a careful review of the record, the medical evidence weighs persuasively against the claims for service connection.

Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017
Board has considered the Veteran's contention that the CV, DM, and hypertension were related to service. While he is competent to report symptoms as this requires only personal knowledge as it comes to him through his senses, he is not competent to offer an opinion as to the etiology of the current disorders due to the medical complexity of the matter involved.

In sum, after a careful review of the record, the medical evidence weighs persuasively against the claims for service connection.

Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).

L. HOWELL

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Y. Asfaw, 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.

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