INTERVERTEBRAL DISC SYNDROME

ERIC S. LEBOFF · 2026 · Case ID: A26027404

MIXED

Summary

The veteran, who served in the United States Marine Corps Reserves with active service from April 25, 1991, to October 4, 1991, and again from January 28, 2003, to August 18, 2003, appeals the denial of service connection for several conditions. The veteran sought service connection for a back disability, left leg disability, bilateral hearing loss, sinusitis, heart disability, irritable bowel syndrome (IBS), and an acquired psychiatric disability, to include adjustment disorder. The Board denied service connection for the back, left leg, hearing loss, sinusitis, heart, and IBS conditions, finding the weight of the evidence persuasively against a service connection or manifestation during service. The Board remanded the claim for an acquired psychiatric disability, including adjustment disorder, due to a pre-decisional error. The veteran's service treatment records did not reflect any mental health complaints or treatment, and post-service evaluations indicated normal psychiatric states. However, a private psychological evaluation in December 2024 noted anxiety and other symptoms, linking them to witnessing changes in fellow service members. The Board found the private evaluation's findings relevant but remanded the psychiatric claim for further development and correction of the pre-decisional error.

Rationale

Weight of evidence against service connection; No manifestation during service; No disease or injury during service

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250626-560525

Full Decision Text

Citation Nr: A26027404
Decision Date: 03/26/26 Archive Date: 03/26/26

DOCKET NO. 250626-560525
DATE: March 26, 2026

ORDER

Entitlement to service connection for a back disability is denied.

Entitlement to service connection for a left leg disability is denied.

Entitlement to service connection for bilateral hearing loss is denied.

Entitlement to service connection for sinusitis is denied.

Entitlement to service connection for a heart disability is denied.

Entitlement to service connection for irritable bowel syndrome (IBS) is denied.

REMANDED

Entitlement to service connection for an acquired psychiatric disability, to include adjustment disorder, is remanded.

FINDINGS OF FACT

1. The weight of the evidence is persuasively against a finding that a back disability manifested during the Veteran's period of active service, or that it is otherwise the result of a disease or injury during active service.

2. The weight of the evidence is persuasively against a finding of a left leg disability at any time during the appeal period.

3. The weight of the evidence is persuasively against a finding that a left leg disability manifested during the Veteran's period of active service, or that it is otherwise the result of a disease or injury during active service.

4. Hearing loss per 38 C.F.R. § 3.385 is not shown.

5. The weight of the evidence is persuasively against a finding that a sinus disability manifested during the Veteran's period of active service, or that it is otherwise the result of a disease or injury during active service.

6. The weight of the evidence is persuasively against a finding of a heart disability at any time during the appeal period.

7. The weight of the evidence is persuasively against a finding that IBS manifested during the Veteran's period of active service, or that it is otherwise the result of a disease or injury during active service.

CONCLUSIONS OF LAW

1. The criteria for service connection for a back disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.304.

2. The criteria for service connection for a left leg disability have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. § 3.303.

3. The criteria for service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310, 3.385.

4. The criteria for service connection for a sinus disability have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. § 3.303.

5. The criteria for service connection for a heart disability have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. § 3.303.

6. The criteria for service connection for IBS have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. § 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service in the United States Marine Corps Reserves with active service from April 25, 1991 to October 4, 1991, and from January 28, 2003 to August 18, 2003.

In a May 2025 rating decision, the Agency of Original Jurisdiction (AOJ) denied service connection for bilateral hearing loss, thoracolumbar strain, left sciatic radicular pain and paresthesia left lower leg, acute sinusitis, heart murmur, irritable bowel syndrome, and adjustment disorder. In the June 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the May 2025 AOJ decision on appeal, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date
ia left lower leg, acute sinusitis, heart murmur, irritable bowel syndrome, and adjustment disorder. In the June 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the May 2025 AOJ decision on appeal, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 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 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.

On December 9, 2025 VA issued correspondence to the Veteran informing him that he had a right to select a different Board review option by submitting a new VA Form 10182 within one year from the date of the AOJ decision. In January 2026, the Veteran submitted a document in which he waived his right to select a different Board review option and he requested that his appeal be reviewed as soon as possible.

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 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).

Under 38 C.F.R. § 3.303(b), an alternative method of establishing the second and third Shedden/Caluza element is through a demonstration of continuity of symptomatology. Barr v. Nicholson, 21 Vet. App. 303 (2007); see Savage v. Gober, 10 Vet. App. 488, 495-97 (1997). Continuity of symptomatology may be established if a claimant can demonstrate (1) that a condition was "noted" during service; (2) evidence of post-service continuity of the same symptomatology; and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. Savage, 10 Vet. App. at 495-96.

Initially, the Board notes that the Veteran's service personnel records do not reflect any foreign or sea service. His DD Form 214s reflect that his military occupational specialty (MOS) was Landing Support Specialist.

On his July 2003 Post-Deployment Health examination, the Veteran reported "asbestosis in living quarters for 3 weeks." 02/04/2019 STR at 6. In a February 2019 VA 21-526EZ, Fully Developed Claim (Compensation) the Veteran asserted that he was "exposed to asbestosis." A May 2025 Toxic Exposure Risk Activity (TERA) Memorandum reflects that the Veteran did not have any in-service exposures and did not participate in a TERA. As will be detailed below, there has been no showing of any disability due to claimed asbestos exposure.

Service connection may be granted for an injury or disease incurred or aggravated during a period of active duty for training (ACDUTRA). 38 U.S.C. § 101 (24)(B); 38 C.F.R. § 3.6 (a). ACDUTRA is, among other things, full-time duty in the Armed Forces performed by Reserves for training purposes or by members of the National Guard of any state. 38 U.S.C. § 101 (22); 38 C.F.R. § 3.6 (c)(1). Inactive duty training (IDT) is part-time duty in the Armed Forces performed by Reserves for training purposes or by members of the National Guard of any state. 38 U.S.C. § 101 (22); 38 C.F.R. § 3.6 (c)(1). Active duty also includes authorized travel to or from such duty or service. 38 C.F.R. § 3.6 (e). ACDUTRA is not defined as "active" service unless the individual concerned was disabled or died from a disease or injury incurred or aggravated in the line of duty while performing ACDUTRA. 38 U.S.C. § 101 (24); 38 C.F.R. § 3.6 (a). IDT is not defined at "active" service unless the individual concerned was disabled or died from an injury incurred or aggravated in line of duty or from an acute myocardial infarction, a cardiac arrest, or a cerebrovascular accident which occurred during such training. Id.

The Court has held that the Board must determine how much weight is to be attached to each medical opinion of record. See Guerrieri v. Brown, 4 Vet. App. 467 (1993). Greater weight may be placed on one medical professional's opinion over another, depending on factors such as reasoning employed by the medical professionals and whether or not, and the extent to which, they reviewed prior clinical records and other evidence. Gabrielson v. Brown, 7 Vet. App. 36 (1994).

Adequate reasons and bases, in short, must be presented if the Board adopts one medical opinion over another. In assessing evidence such as medical opinions, the failure of the physician to provide a basis for his opinion goes to the weight or credibility of the evidence in the adjudication of the merits. See Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). Other factors for assessing the probative value of a medical opinion are the physician's access to the claims file and the thoroughness and detail of the opinion. See Prejean v. West, 13 Vet. 444, 448-9 (2000). In some cases, the physician's special qualifications or expertise in the relevant medical specialty or lack thereof may be a factor. In every case, the Board must support its conclusion with an adequate statement of its reasoning of why it found one medical opinion more persuasive than the other.

In support of his claim, the Veteran submitted a December 2024 Report of Consultation and Examination from Dr. M. Traficante, D.C. Notably, the report indicates that the Veteran presented to her office "for assistance in organizing his material for claim submission." M. Traficante further explains that "It is the intent of this consultation, examination, and report to assist the Veteran with defining and explaining any applicable injuries or illnesses on which benefits will be applied for. Additionally, it was also her intent "to provide the VA reader with acceptable objective data supporting any illness or injury, as well as the basis on which service connection will be claimed by the Veteran." To be clear, the Veteran is unrepresented in this matter and M. Traficante is not included on the list of agents who are accredited to provide representation to Veterans before VA. The Board will discuss the substance of the report with regard to each claimed disability below.

Back disability

In February 2019, the Veteran filed an initial claim of service connection for back pain and a back condition.

The question for the Board is whether the Veteran has a current back disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

The Board concludes that, while the Veteran has a diagnosis related to the thoracolumbar spine, the evidence of record persuasively weighs against finding that any such diagnosis began during service or is otherwise related to an in-service
raficante is not included on the list of agents who are accredited to provide representation to Veterans before VA. The Board will discuss the substance of the report with regard to each claimed disability below.

Back disability

In February 2019, the Veteran filed an initial claim of service connection for back pain and a back condition.

The question for the Board is whether the Veteran has a current back 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 negative for any complaints or treatment for a back disability. May 1995 and June 2000 Reports of Medical Examination reflect that his 'spine, other musculoskeletal' was clinically evaluated as normal. On a May 1995 Report of Medical History, the Veteran checked the 'No' box for 'recurrent back pain.' On a June 2000 Report of Medical History, the Veteran checked the 'No' box for 'recurrent back pain or any back injury.' A July 2003 Post Deployment Health Care Assessment reflects that the Veteran checked the 'Yes During' box for 'back pain' and there is a handwritten note reflecting 'resolved.' 11/16/2004 STR-Medical at 28, 51-53, 55-57.

In April 2019, the Veteran underwent a C&P examination wherein the examiner diagnosed lumbosacral strain. The Veteran reported a date of onset in 1995, but the examiner noted that available records do not support this. He reported steady, relatively mild low back pain that was dull, aching and deep and that worsened with long workdays. The examiner proffered a negative etiological opinion, finding that a back disability is less likely as not due to service. The examiner acknowledged that the July 2003 post deployment evaluation indicates back pain and muscle aches on deployment, resolved since. The examiner stated that there are no further records found to indicate chronic low back pain or back injury during service.

In May 2019, the AOJ denied service connection for a thoracolumbar condition.

In January 2025, the Veteran filed a claim of service connection for "lumbar spine/back condition."

The December 2024 report from M. Traficante notes the following with regard to the lumbar spine:

[The Veteran] states he has suffered from low back pain during active duty military service. He was attended by military medical personnel. [The Veteran] has suffered from progressive low back pain which is daily in varying degrees and intensified with standing, sitting, bending, twisting, walking, and transitioning to and from a seated position. Also, he suffers from left sciatic pain and paresthesia. On examination his true lumbar ranges of motion to pain (hips immobilized) flexion 60 degrees, extension 15 degrees, right rotation 15 degrees, left rotation 15 degrees, right lateral flexion 15 degrees, and left lateral flexion 20 degrees. There is fixation at the lumbosacral joint with moderate hypertonicity of the superficial and deep musculature at that level. Straight leg raise on the left is positive at 60 degrees. Straight leg raise on the right is positive at 60 degrees. Valsalva is positive. Diagnosis: Pain of the lumbar spine. Onset of this condition which persists to the present during active duty military service should qualify said condition for service connection. It is as likely as not that the condition is directly and causally related to [the Veteran's] military service. This is a permanent condition.

Such opinion does not provide any support for the conclusion that the Veteran had onset of this condition since service. The opinion is not supported by any rationale and lacks any consideration of the relevant medical records or documented past medical history. The report references the Veteran's report of low back pain during active service, but it does not appear that the examiner reviewed the service treatment records wherein the Veteran complained of back pain in July 2003 which was indicated to have resolved. Also, the report indicates that the Veteran was attended to by military medical personnel but the service treatment records do not reflect any treatment, thus it is not clear what this is referencing. M. Traficante's opinion is wholly conclusory because it does not support the findings reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record. See Stefl v. Nicholson, 21 Vet. App. 120, 124-24 (2007
. The report references the Veteran's report of low back pain during active service, but it does not appear that the examiner reviewed the service treatment records wherein the Veteran complained of back pain in July 2003 which was indicated to have resolved. Also, the report indicates that the Veteran was attended to by military medical personnel but the service treatment records do not reflect any treatment, thus it is not clear what this is referencing. M. Traficante's opinion is wholly conclusory because it does not support the findings reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record. See Stefl v. Nicholson, 21 Vet. App. 120, 124-24 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). Moreover, M. Traficante's opinion is largely based on the Veteran's self-reported history of onset and continuity of symptoms, which, as discussed in further detail below, is inconsistent with the evidence of record. Accordingly, M. Traficante's opinion is not afforded probative value and is not persuasive.

In February 2025, the Veteran underwent a C&P examination wherein the examiner diagnosed thoracolumbar strain. The Veteran reported an onset date of 1995.

In May 2025, a C&P examiner reviewed the claims folder. The examiner acknowledged the Veteran's report of onset in 1995, the 2003 report of back pain, and the opinion from Dr. Traficante. The examiner proffered a negative etiological opinion finding that his back condition is less likely as not due to service. While acknowledging his 2003 report of back pain, post service records show no back condition at all until diagnosis of thoracolumbar strain in February 2025. There is a nexus statement by M. Traficante opining low back issues. The Veteran's lay statement and nexus statements were considered. Although these statements report symptoms since the service, the statements do not address other potential causes of the Veteran's condition to include post service occupation, extra-curricular activities such as sports, aging and so forth that could have contributed to the Veteran's condition. Due to the lack of continuity of symptoms from what occurred during the service with also no evidence of other potential causes of the Veteran's back pain other than service, it is less likely than not that there is a current thoracolumbar strain condition incurred in or caused by the claimed in-service injury, event, or illness.

In light of the foregoing, the competent and probative evidence of record persuasively weighs against finding that the Veteran's back disability began during active service or that it is otherwise related to an in-service injury or disease.

While the Veteran has claimed a back disability due to service, he has not made any specific lay assertions as to the basis for this claim. He reported a date of onset in 1995, which is not during a period of active service, and has not described any injury or complaints pertaining to such onset. Again, as detailed above, he reported back pain in July 2003, but it was noted to be resolved. The medical evidence of record reflects an initial objective finding pertaining to the back to be when he underwent the April 2019 C&P examination. Thus, this constitutes an over 15-year period following his report of back pain. See Maxson v. Gober, 230 F.3d 1330 (Fed. Cir. 2000) (a significant lapse in time between service and post-service medical treatment may be considered as part of the analysis of a service connection claim).

Based on the in-service notation of back pain, the Veteran was afforded an examination in April 2019 in which the examiner proffered a negative etiological opinion. Such opinion was based on an examination of the Veteran, consideration of his lay assertions, and a review of the claims file and included an adequate rationale for the negative etiological opinion on a direct basis. He was afforded another examination in February 2025 and in May 2025 an examiner proffered a negative etiological opinion. The Board acknowledges that the examiner referenced an initial diagnosis in February 2025, rather than in April 2019. However, reference was made to the July 2003 complaint and lay assertions of the Veteran in formulating the negative etiological opinion. The Board finds that the collective opinions of the C&P examiners are entitled to great probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-04 (2008) (holding that it is the factually accurate, fully articulated, sound reasoning for the conclusion
He was afforded another examination in February 2025 and in May 2025 an examiner proffered a negative etiological opinion. The Board acknowledges that the examiner referenced an initial diagnosis in February 2025, rather than in April 2019. However, reference was made to the July 2003 complaint and lay assertions of the Veteran in formulating the negative etiological opinion. The Board finds that the collective opinions of the C&P examiners are entitled to great probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-04 (2008) (holding that it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion). As detailed, for the reasons discussed hereinabove, the Board assigns no probative value to the etiological opinion of Dr. Trificante.

The Board acknowledges that the Veteran is competent to describe symptoms related to the back during and subsequent to service and acknowledges his lay statements. However, the question of whether the symptoms the Veteran experienced in service or following service are related to a current disability or whether such disability is due to service are matters that require medical expertise to determine. See Clyburn v. West, 12 Vet. App. 296, 301 (1999) ("Although the veteran is competent to testify to the pain he has experienced since his tour in the Persian Gulf, he is not competent to testify to the fact that what he experienced in service and since service is the same condition he is currently diagnosed with."). While the Veteran believes he has a back disability due to active military service, the persuasive evidence of record weighs against finding a nexus relationship. The Veteran is not competent to provide a nexus opinion regarding this issue. The issue is medically complex and requires knowledge of pathology. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377; see Kahana v. Shinseki, 24. Vet. App. 428 (2011).

Left leg disability

In February 2019, the Veteran filed a claim of service connection for muscle aches.

A July 2003 Post Deployment Health Care Assessment reflects that the Veteran checked the 'Yes During' box for 'muscle aches' and there is a handwritten note reflecting 'resolved.' 11/16/2004 STR-Medical at 28.

In April 2019, the Veteran underwent a C&P Muscle Injuries examination wherein no diagnosis was rendered. The Veteran reported recurrent muscle aches since the 1990s, occurring at random, generally mild and occasionally moderate, with no particular focal pattern or relationship to activity or other factors. It is possible that this may represent pathology, however it is generally more likely in this case that this is a normal part of using muscles, with a likely unusually keen awareness of these sensations. There were no objective findings pertaining to his muscle groups. The examiner proffered a negative etiological opinion. The examiner stated that the July 2003 examination indicates muscle aches on deployment resolved since. The examiner stated that no further records were found to indicate chronic muscle problems during service. A current exam is negative for any objective muscle pathology, indicating that there is no condition with which to establish service connection.

The April 2019 C&P thoracolumbar spine exam reflects no signs or symptoms of radiculopathy. Straight leg raising test results were negative. A sensory exam was normal, a reflex exam was normal, and a strength exam was normal.

In a May 2019 rating decision, service connection for muscle aches was denied.

In January 2025, the Veteran submitted a supplemental claim for left sciatic radicular pain and paresthesia of the left lower leg (previously claimed as muscle ache).

In support of his claim, he submitted a December 2024 Report of Consultation and Examination from M. Traficante. The report notes the following with regard to the left sciatic radicular pain and paresthesia of the left leg:

See examination of the lumbar spine in the low back section. Diagnosis: Left sciatic radicular pain and paresthesia of the left lower extremity. It is as likely as not that the aforementioned is directly and causally related as a progression to [the Veteran's] low back condition as discussed in the low back pain section. It is accordingly more likely than not that same is directly and causally related to [the Veteran's] military service. This is a permanent and progressive condition.

In the lumbar spine section
2024 Report of Consultation and Examination from M. Traficante. The report notes the following with regard to the left sciatic radicular pain and paresthesia of the left leg:

In the lumbar spine section M. Traficante stated the following:

Also, he suffers from left sciatic pain and paresthesia. Straight leg raise on the left is positive at 60 degrees. Straight leg raise on the right is positive at 60 degrees. Valsalva is positive.

The February 2025 C&P thoracolumbar spine exam reflects no signs or symptoms of radiculopathy. Straight leg raising test results were negative. A sensory exam was normal, a reflex exam was normal, and a strength exam was normal.

A February 2025 C&P peripheral nerves conditions exam reflects the Veteran's report of a relatively mid low back dull aching and deep pain during long workdays and while wearing pack. The examiner determined that he did not have any symptoms attributable to any peripheral nerve conditions. Muscle strength testing was normal. Reflex exam was normal. A sensory exam was normal. He had no trophic changes. He had an antalgic gait due to his thoracolumbar strain. The examiner stated that there are no objective findings on review of medical records, today's evaluation and claims file to support a diagnosis for the claimed condition of left sciatic radicular pain and paresthesia of left lower limb. A diagnosis was deemed not warranted at that time.

Based on review of the record, the Board concludes that the evidence does not support a diagnosis as it pertains to the left lower extremity. As detailed, an April 2019 muscle exam was negative, and an April 2019 spine exam was also negative with regard to the lower extremities. Likewise, a February 2025 spine exam was negative with regard to the lower extremities, and a February 2025 peripheral nerves exam was negative with regard to the lower extremities. The Board acknowledges the December 2024 diagnosis of left sciatic radicular pain and paresthesia of the left leg but the basis for such diagnosis is unclear given the normal test results across multiple examinations. There is no indication that M. Traficante conducted sensory, reflex and strength examination of the lower extremities. The Veteran reported left sciatic pain and paresthesia, but such has not been shown via diagnostic testing. Thus, the Board finds that the diagnosis contained in the December 2024 report is entitled to limited probative weight and does not support a diagnosis of a left leg disability.

In the absence of proof of a current diagnosis of a chronic disability of the left leg there can be no valid claim. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Congress has specifically limited entitlement to service connection to cases where such incidents have resulted in a disability. Brammer, 3 Vet. App. at 225. As detailed, the probative medical evidence based on objective testing does not reflect a disability of the left lower extremity. Thus, the Board cannot conclude that the Veteran currently suffers from a disability of the left leg.

The Board concludes that the evidence of record does not support a finding that the Veteran has a current diagnosis related to the left leg. He has not had any such disability at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

Notwithstanding the above, even if the Board were to accept the diagnosis reflected in the December 2024 report, the opinion was that such is due to his lumbar spine disability. As detailed above, service connection has not been established for a back disability. Thus, service connection would not be warranted on a secondary basis.

The Board has considered the lay contentions of the Veteran, but his lay assertions are insufficient to establish a medical diagnosis. While
or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

The Board has considered the lay contentions of the Veteran, but his lay assertions are insufficient to establish a medical diagnosis. While he is capable of attesting to any symptoms in service and following service, his lay assertions alone are not competent evidence of the presence of a chronic disability.

Absent a showing of a disability of the left leg, service connection cannot be established for this disability.

Bilateral hearing loss

The Veteran has claimed service connection for bilateral hearing loss. As will be detailed below, the Board has determined that a diagnosis of bilateral hearing loss is not shown.

There are specific requirements regarding what constitutes a hearing loss disability under VA law. The threshold for normal hearing is from 0 to 20 decibels. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). For the purpose of applying the laws administered by VA, impaired hearing is considered to be a disability when the auditory threshold at any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater, or when speech recognition scores utilizing the Maryland CNC Tests are less than 94 percent. 38 C.F.R. § 3.385.

Service treatment records contain the results from an April 1991 reference audiogram from enlistment and a July 1993 current audiogram, which shows no hearing loss and no significant threshold shifts.

In April 2019, the Veteran underwent a C&P audiological evaluation that reflects normal hearing per 38 C.F.R. § 3.385 as none of the auditory thresholds were 40 decibels or greater; auditory thresholds for none of the frequencies were 26 or greater; and, the speech recognition scores were not less than 94 percent.

In February 2025, the Veteran underwent a C&P audiological evaluation that reflects normal hearing per 38 C.F.R. § 3.385 as none of the auditory thresholds were 40 decibels or greater; auditory thresholds for none of the frequencies were 26 or greater; and, the speech recognition scores were not less than 94 percent.

A December 2024 'Report of Consultation and Examination' from M. Traficante, D.C., reflects the following with regard to hearing loss and tinnitus:

During his military service, [the Veteran] states he was exposed to the acoustic trauma of ship engines, helicopters, and gunfire. He has suffered from progressive bilateral hearing loss and bilateral tinnitus. His hearing is tested in a room wherein normal day to day noise (air conditioner, computer, and soft background music) is introduced to test functional hearing under normal day to day conditions. 256 cps, 512 cps stimuli are employed along with spoken words at a distance of 5 feet. Testing reveals that [the Veteran] has an estimated bilateral hearing loss under normal conditions of 30% of the right ear and 30% of the left ear. It is as likely as not that [the Veteran's] bilateral hearing loss and tinnitus is directly and causally related to the acoustic trauma discussed herein; thus, it is as likely as not that same is directly and causally related to his military service. This is a permanent condition. [The Veteran] is asked to attend for a pure tone audiogram and have the results of same sent to this office. When received same will be filed in this case as an addendum.

This submission purports to establish a diagnosis of bilateral hearing loss; however, this statement is not accepted to establish a competent diagnosis of bilateral hearing loss, as the diagnosis was not based upon an audiogram. Instead, M. Traficante noted that the Veteran's hearing was tested in a room wherein normal day to day noise was introduced to test functional hearing under normal day to day conditions and that such testing revealed he had an estimated bilateral hearing loss under normal conditions of 30 percent of the right and left ear. While this evidence indicates that the Veteran's hearing was evaluated in some way, the December 2024 report does not indicate the method of testing performed. Notably, M. Traficante stated that she asked the Veteran to present for a pure tone audiogram and have results sent to her office. She is not an audiologist and thus any audiometric examination conducted by her would not be valid for VA adjudication and rating purposes. 38 C.F.R. § 4.85. As detailed, the Veteran underwent audiological testing in February 2025 which showed normal hearing in both ears. It is not known whether the Veteran provided M. Traficante with the results of this audiological testing and an addendum report has not been furnished. Thus, the December 2024 statement is not accepted as a competent diagnosis of right or left ear hearing loss.

No other evidence of record reveals hearing loss as defined under 38 C.F.R. § 3.385.

Thus, hearing loss is not shown for VA purposes per § 3.385. There is no other medical evidence of record that reflects a diagnosis of hearing loss per § 3.385, thus the claim of service connection for bilateral hearing loss is denied.

Sinusitis

In February 2019, the Veteran filed a claim for compensation for sinus problem.

Service treatment records do not reflect complaints or treatment referable to a sinus condition. On May 1995 and June 2000 Reports of Medical History the Veteran checked the 'No' boxes for 'sinusitis.' On May 1995 and June 2000 Reports of Medical Examinations his 'sinuses' were clinically evaluated as normal. A July 2003 Post Deployment Health Care Assessment reflects that the Veteran checked the 'Yes During' box for 'runny nose' and there is a handwritten note reflecting 'resolved.' 11/16/2004 STR-Medical at 28, 51-57. A Dental Health Questionnaire reflects he checked the 'Don't Know' box for 'Sinus problems.' 02/04/2019 STR at 9.

In a May 2019 rating decision, service connection for an unspecified sinus condition (claimed as sinus problems) was denied.

In January 2025, the Veteran submitted a supplemental claim for sinusitis.

In support of his claim, he submitted a December 2024 Report of Consultation and Examination from M. Traficante. The report notes the following with regard to "chronic sinusitis:"

[The Veteran] states he suffered from this condition during active duty. He was treated by military medical personnel. He followed up with a civilian doctor and an ENT. He suffers with respiratory deficiency to include congestion of the maxillary sinuses with difficulty breathing, pressure, and coughing. Diagnosis: Chronic sinusitis. Onset of this condition which persists to the present during active duty military service should qualify said condition for service connection. It is as likely as not that the condition is directly and causally related to [the Veteran's] military service. This is a permanent condition.

In February 2025, the Veteran underwent a C&P examination wherein the examiner diagnosed acute sinusitis. The Veteran reported experiencing sinusitis in service that has worsened over the years.

A May 2025 C&P examiner reviewed the claims folder noting his July 2003 complaint of a runny nose, the December 2024 diagnosis of chronic sinusitis, and the February 2025 diagnosis of acute sinusitis. The examiner acknowledged the 2003 post deployment exam which reflects a runny nose and the examiner noted that post service records are silent until the current exam notes acute sinusitis. Per sound medical principles, acute sinusitis would be a condition that develops suddenly and therefore cannot be something that occurs due to something that occurred more than 20 years prior. Due to the lack of continuity of symptoms from what occurred during the service it is less likely than not that there is a current acute sinusitis condition incurred in or cause by the claimed in-service injury, event or illness.

In light of the foregoing, the competent and
, the December 2024 diagnosis of chronic sinusitis, and the February 2025 diagnosis of acute sinusitis. The examiner acknowledged the 2003 post deployment exam which reflects a runny nose and the examiner noted that post service records are silent until the current exam notes acute sinusitis. Per sound medical principles, acute sinusitis would be a condition that develops suddenly and therefore cannot be something that occurs due to something that occurred more than 20 years prior. Due to the lack of continuity of symptoms from what occurred during the service it is less likely than not that there is a current acute sinusitis condition incurred in or cause by the claimed in-service injury, event or illness.

In light of the foregoing, the competent and probative evidence of record, persuasively weighs against finding that the Veteran has a chronic sinus disability that began during active service or that a chronic sinus disability is otherwise related to an in-service injury or disease.

While the Veteran has claimed a sinus disability due to service, the service treatment records do not reflect any specific complaints or treatment for a chronic sinus condition. Again, as detailed, he reported a runny nose in 2003, but it was noted to be resolved. A diagnosis of a sinus disability is not reflected based on his report of a runny nose. He reported that he did not know whether he had a sinus disability but no diagnosis is reflected. The Veteran told M. Traficante that he has followed up with a civilian doctor and ENT, but the Veteran has not identified such medical providers nor indicated when he sought such treatment. He has not submitted medical evidence from an ENT pertaining to a diagnosis of sinusitis. Per the above, chronic sinusitis was diagnosed by M. Traficante in December 2024, and acute sinusitis was diagnosed via C&P examination in February 2025. Thus, this constitutes an over 20-year period following his report of any in-service symptomatology. See Maxson v. Gober, 230 F.3d 1330 (Fed. Cir. 2000) (a significant lapse in time between service and post-service medical treatment may be considered as part of the analysis of a service connection claim).

Based on the in-service notation of a runny nose, the Veteran was afforded an examination wherein acute sinusitis was diagnosed. However, the May 2025 C&P examiner proffered a negative etiological opinion on a direct basis. The Board finds that the May 2025 opinion of the C&P examiner is entitled to probative weight as it was based on review of the C&P examination, review of the service treatment records, and consideration of the Veteran's lay assertions, and such opinion contains an appropriate rationale. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-04 (2008) (holding that it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion).

While acknowledging the etiological opinion of M. Traficante the Board assigns such opinion limited probative weight. M. Traficante noted the Veteran's report that he was treated by military medical personnel. However, the circumstances of such treatment was not further detailed by the Veteran and service treatment records are negative for any complaints or treatment other than the runny nose in July 2003. The opinion does not provide support for the conclusion that sinusitis manifested during service and due to service. The opinion is not supported by any rationale and lacks any consideration of the relevant medical records or documented past medical history. M. Traficante's opinion is wholly conclusory because it does not support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record. See Stefl v. Nicholson, 21 Vet. App. 120, 124-24 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). Moreover, Dr. Traficante's opinion is largely based on the Veteran's self-reported history of onset and continuity of symptoms, which, as discussed in further detail below, is inconsistent with the evidence of record. Accordingly, M. Traficante's opinion is afforded limited probative value and is not persuasive.

The Board acknowledges that the Veteran is competent to describe symptoms related to his claimed sinus disability during and subsequent to service and acknowledges his lay statements. But whether any symptoms documented in service or following service are related to a current disability or whether such disability is due to service are matters that require medical expertise to determine. See Clyburn v. West, 12 Vet. App. 296, 301 (1999) ("Although the veteran is competent to testify to the pain he has experienced since his tour in the Persian Gulf, he is not competent to testify to the fact that what he experienced in service and since service is the same condition he is currently diagnosed with."). While the Veteran believes he has a sinus disability due to active military service, the persuasive evidence of record weighs against finding a nexus relationship. He is not competent to provide a nexus opinion regarding this issue. The issue is medically complex and requires knowledge of pathology. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377; see Kahana v. Shinseki, 24. Vet. App. 428 (2011).

Heart disability

In February 2019, the Veteran filed a claim of service connection for heart condition/ systolic murmur.

An April 1991 Report of Medical History reflects that the Veteran checked the 'Don't Know' box for 'heart trouble or murmur' but there is no specific finding of a heart murmur. The April 1991 Report of Medical Examination reflects that his heart was clinically evaluated as normal. A June 19, 2000 EKG reflects sinus bradycardia, possible early repolarization. A June 19, 2000 Report of Medical Examination reflects a finding of left II/VI systolic murmur at left USB without clicks, gallops or rub. The Veteran denied any history of shortness of breath, constrictive pericarditis (CP), palpitations or syncopal episodes. There were no significant findings on EKG. The assessment was systolic heart murmur, most likely physiologic. On the July 2003 post-deployment exam the Veteran checked the 'No' box for 'chest pain or pressure.' 11/16/2004 STR-Medical at 28, 51-52, 61-63, 91.

In April 2019, the Veteran underwent a C&P heart conditions exam. He reported being told he had a heart murmur, and both his entrance and five-year exams indicate a murmur with the exact same description. However, the current exam indicates a split S1 which is physiologic, with no murmur noted on exam. This did not rule out cardiac pathology, but there was not enough information to make a current objective diagnosis. The examiner noted that the June 2000 EKG showed possible early repolarization, a nonspecific finding. An April 2019 EKG showed normal left ventricular size and ejection fraction and trivial mitral regurgitation.

In May 2019, the AOJ denied service connection for an unspecified heart condition.

In January 2025, the Veteran submitted a supplemental claim of service connection for heart murmur.

In support of his claim he submitted a December 2024 Report of Consultation and Examination from M. Traficante. The report notes the following with regard to "heart murmur:"

[The Veteran] states he was diagnosed with this condition during active duty. He states he follows up with a cardiologist for further evaluation. He states he also suffers from dyspnea. Diagnosis: heart murmur. Onset of this condition which persists to the present during active duty military service should qualify same as service connected. It is as likely as not that the condition is directly and causally related to the [Veteran's] military service. This is a permanent condition.

In February 2025, the Veteran underwent a C&P examination wherein the Veteran reported that while in service he was told that he had a heart condition. He reported intermittent palpitations and "my heart beats fast." The examiner determined that the Veteran does not have a current diagnosis with regard to the heart, noting that there are no objective findings on review of medical records. An ECG was normal.

Based on review of the prob
nea. Diagnosis: heart murmur. Onset of this condition which persists to the present during active duty military service should qualify same as service connected. It is as likely as not that the condition is directly and causally related to the [Veteran's] military service. This is a permanent condition.

Based on review of the probative medical evidence, the Board concludes that the evidence of record persuasively weights against a diagnosis of a heart disability. While acknowledging the in-service finding of a heart murmur, the post-service medical evidence does not reflect a heart disability. As detailed, both the April 2019 and February 2025 examinations were negative for a heart disability. The Veteran told M. Traficante that he follows up with a cardiologist and that he has dyspnea but he did not submit any treatment records nor medical evidence reflecting a heart disability. M. Traficante diagnosed heart murmur but did not identify any post-service heart disability. The basis for the diagnosis is unclear, as it does not appear that any testing was conducted by this examiner. It is also noted that a cardiac work-up would be beyond the scope of a chiropractor, which is M. Traficante's credential. It appears that the diagnosis was rendered based strictly on the Veteran's report of being diagnosed with a heart murmur, rather than review of the service treatment records and diagnostic testing.

Notably, heart murmurs can be present at birth (congenital) or develop later in life. A heart murmur is not a disease, but murmurs may indicate an underlying heart problem. Often, heart murmurs are harmless and do not need treatment. Heart murmurs are typically diagnosed by echocardiogram (ECG). See https://www.mayoclinic.org/diseases-conditions/heart-murmurs/symptoms-causes/

Thus, in the absence of proof of a current diagnosis of a chronic disability of the heart associated with the detection of the in-service heart murmur there can be no valid claim. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Congress has specifically limited entitlement to service connection to cases where such incidents have resulted in a disability. Brammer, 3 Vet. App. at 225. As detailed, the probative medical evidence based on objective testing does not reflect a disability of the heart. Thus, the Board cannot conclude that the Veteran currently suffers from a disability of the heart.

The Board concludes that the evidence of record does not support a finding that the Veteran has a current diagnosis related to the heart. He has not had any such disability at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

Absent a showing of a disability of the heart, service connection cannot be established for this disability.

Irritable bowel syndrome

In February 2019, the Veteran filed a claim of service connection for "diarrhea issues."

On the July 2003 post-deployment exam the Veteran checked the 'Yes during' box for diarrhea and a handwritten note reflects that it had resolved. 11/16/2004 STR-Medical at 28.

In a May 2019 rating decision, the AOJ denied service connection for an unspecified digestive condition (claimed as diarrhea issues).

In January 2025, the Veteran filed a supplemental claim of service connection for IBS.

In support of his claim, he submitted a December 2024 Report of Consultation and Examination from M. Traficante. The report notes the following with regard to "irritable bowel syndrome:"

[The Veteran] states he suffered with this condition during active duty. He was treated by military medical personnel. The
the Veteran checked the 'Yes during' box for diarrhea and a handwritten note reflects that it had resolved. 11/16/2004 STR-Medical at 28.

In a May 2019 rating decision, the AOJ denied service connection for an unspecified digestive condition (claimed as diarrhea issues).

In January 2025, the Veteran filed a supplemental claim of service connection for IBS.

In support of his claim, he submitted a December 2024 Report of Consultation and Examination from M. Traficante. The report notes the following with regard to "irritable bowel syndrome:"

[The Veteran] states he suffered with this condition during active duty. He was treated by military medical personnel. The condition via intermittent constipation and diarrhea has been present since active duty without hiatus. Diagnosis: IBS. Onset of this condition which persists to the present during active duty military service should qualify said condition for service connection. It is as likely as not that the condition is directly and causally related to [the Veteran's] military service. This is a permanent condition. Further evaluation by a gastroenterologist is recommended at this time.

In February 2025, the Veteran underwent a C&P intestinal conditions examination. The Veteran reported experiencing abdominal pain with an unknown date of onset. The examiner determined that the Veteran did not have a current diagnosis. Based on review of the Veteran's records and clinical judgement, there are no findings to support a current diagnosis for the claimed IBS. Review of records indicate that this claim is subjective and symptoms are subjective as there is no evidence for IBS in the records.

While the Veteran has claimed IBS due to service, the service treatment records do not reflect any specific complaints or treatment for IBS other than a report of diarrhea in July 2003 that had resolved. A diagnosis of IBS or any other gastrointestinal disability is not reflected based on his report of diarrhea. The Veteran told M. Traficante that he was treated by medical personnel, but service treatment records do not reflect any such treatment other than the complaint of diarrhea in July 2003 that was resolved. The Veteran told M. Traficante that he has experienced intermittent constipation and diarrhea since service without hiatus but in the over 20 years since separation he did not submit any medical evidence in support of this assertion to include findings of a diagnosis related to such complaints. M. Traficante diagnosed IBS based on the Veteran's reported symptoms but the basis for the positive etiological opinion contains no rationale.

Again, M. Traficante noted the Veteran's report that he was treated by military medical personnel, but no details as to the circumstances of such treatment were reported by the Veteran and service treatment records are negative for any complaints or treatment other than resolved diarrhea in July 2003. The opinion does not provide support for the conclusion that IBS manifested during service and due to service. The opinion is not supported by any rationale as to the basis for a finding of IBS due to service due to a report of diarrhea. The opinion lacks any consideration of the relevant medical records or documented past medical history. M. Traficante's opinion is wholly conclusory because it does not support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record. See Stefl v. Nicholson, 21 Vet. App. 120, 124-24 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). Moreover, M Traficante's opinion is largely based on the Veteran's self-reported history of onset and continuity of symptoms, which, as discussed in further detail below, is inconsistent with the evidence of record. Accordingly, M. Traficante's opinion is afforded limited probative value and is not persuasive. Thus, such opinion cannot provide the basis for a grant of service connection.

There is otherwise no other opinion of record, as the February 2025 C&P examiner found no diagnosis based on his subjective complaints.

The Board acknowledges that the Veteran is competent to describe symptoms related to his claimed IBS during and subsequent to service and acknowledges his lay statements. While the Veteran believes he has IBS due to active military service, the persuasive evidence of record weighs against finding a nexus relationship. The Veteran is not competent to provide a nexus opinion regarding this issue. It is outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377; see Kahana v. Shinseki, 24. Vet. App. 428 (2011).

subjective complaints.

REASONS FOR REMAND

The Veteran's claim of service connection for an acquired psychiatric disability, to include adjustment disorder, is remanded to correct a pre-decisional error.

In January 2019, the Veteran filed a claim of service connection for adjustment disorder.

Service treatment records do not reflect any complaints or treatment for a mental health disability. The May 1995 and June 2000 Reports of Medical Examination reflect that his psychiatric state was clinically evaluated as normal. The May 1995 and June 2000 Reports of Medical History reflect that he checked the 'No' boxes for 'depression or excessive worry' and 'nervous trouble of any sort.' The July 2003 Post Deployment Health Care Assessment reflects that he checked the 'No' boxes with regard to whether he has had any nightmares about it or thought about it when you did not want to; tried hard not to think about it or went out or your way to avoid situations that remind you of it; were constantly on guard, watchful, or easily startled; felt numb or detached from others, activities or your surroundings; you may have serious conflicts with your spouse, family members, or close friends; and you might hurt or lose control with someone. 11/16/2004 STR-Medical at 29, 51-57.

In support of his claim, the Veteran submitted a December 2024 Psychological Disability Evaluation. The examiner noted the Veteran's reserve and active duty service. The examiner summarized his family history, education and post-military employment as a law enforcement officer. The Veteran reported that his most difficult experiences during service were to witness the changes, physical and emotional, of my men who deployed to Afghanistan and my attempts to help them carry on. He denied needing or seeking mental health treatment during service. On mental status evaluation/behavioral observations, he was casually dressed and well groomed. He was polite, cooperative and willing to disclose his military experiences and the emotional difficulties he experienced witnessing the return of his men who left to serve in Afghanistan. Rapport was established and he was oriented to person, time, place, and situation. His speech was clear and thought content was linear and goal directed, insight and judgment appeared normal. Although to a lower degree his mood continued to be anxious throughout the valuation and affect was congruent to mood. At the end of the assessment, the Veteran was evaluated for suicidality or homicidally. He denied suicidal/homicidal ideation. He reported difficulty sleeping, withdrawing from other people, rapid mood changes, oud outbursts of anger, avoidance of crowds, occasional worries, racing thoughts, occasional muscle tension, occasionally feeling jumpy, decreased energy, occasional nightmares related to his post service career with the police department and difficulties expressing emotions.

The examiner noted that the Veteran reported multiple anxiety-related experiences, including generalized anxiety and reexperiencing and/or panic. He indeed likely experiences significant anxiety and anxiety-related problems, PTSD features including intrusive ideation, nightmares, and dissociative experiences, and panic. He also reports engaging in compulsive behavior. He reports a large number of unusual thoughts and perceptions and problematic impulsive behavior. After review of the Veteran's history, the results of the MMPI-3, and his account of anxiety symptoms experienced during service which was related to witnessing his men's emotional and physical changes when returning from Afghanistan, the examiner opined that the Veteran's symptoms of anxiety began to occur as a result of the stressful and demanding environment while serving and were exacerbated by working as a civilian police officer post military service. Since separation, the Veteran has progressively developed chronic symptomatology that currently meets DSM-5 criteria for a diagnosis of adjustment disorder unspecified. As a result of the progression and current mild to moderate symptoms of adjustment disorder unspecified, the examiner opined that the symptoms experienced by the Veteran are at least as likely as not to be service-connected.

In the May 2025 rating decision, the AOJ made a favorable finding that he had been diagnosed with adjustment disorder but denied service connection on a direct basis.

McLendon v
returning from Afghanistan, the examiner opined that the Veteran's symptoms of anxiety began to occur as a result of the stressful and demanding environment while serving and were exacerbated by working as a civilian police officer post military service. Since separation, the Veteran has progressively developed chronic symptomatology that currently meets DSM-5 criteria for a diagnosis of adjustment disorder unspecified. As a result of the progression and current mild to moderate symptoms of adjustment disorder unspecified, the examiner opined that the symptoms experienced by the Veteran are at least as likely as not to be service-connected.

In the May 2025 rating decision, the AOJ made a favorable finding that he had been diagnosed with adjustment disorder but denied service connection on a direct basis.

McLendon v. Nicholson, 20 Vet. App. 79 (2006), holds that in disability compensation (service connection) claims, VA must provide a medical examination [for a nexus opinion, as applicable] when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (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) insufficient competent medical evidence on file for the VA to make a decision on the claim.

As detailed, the AOJ determined that there was competent evidence of a current psychiatric disability. The December 2024 Psychological Disability Evaluation reflects a positive etiological opinion to service. The Board has determined that such opinion cannot provide the basis for a grant of service connection as there is no indication that the examiner reviewed the claims folder, to include service treatment records. Such opinion, however, contains the Veteran's lay assertions as to the basis for his belief that his adjustment disorder is due to service, and contains a positive etiological opinion. As the report details "an event, injury or disease in service," the Board finds that this triggers the need to obtain a VA medical opinion with regard to etiology. 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4).

The matter is REMANDED for the following action:

1. Schedule the Veteran for an examination with a psychologist/psychiatrist with regard to his claim of service connection for an acquired psychiatric disability. The claims folder should be reviewed in conjunction with the examination. The examiner should respond to the following:

a) Please state all diagnoses of record. Consideration should be given to the diagnoses of record, specifically the December 2024 diagnosis of adjustment disorder.

b) Is an acquired psychiatric disability, to include adjustment disorder, at least as likely as not (approaching approximate balance or better) due to active service or any incident therein, to include the Veteran's in-service experience of witnessing "the changes, physical and emotional, of my men who deployed to Afghanistan and my attempts to help them carry on."

A comprehensive rationale for the opinion expressed must be provided. If any opinion cannot be rendered without resorting to speculation, the examiner must explain in detail why an opinion cannot be offered.

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Kreindler, Marcy W.

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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