GLAUCOMA

R. BISIGNANI · 2026 · Case ID: A26028932

MIXED

Summary

The veteran, who served in the Army from May 1969 to July 1989, appeals the denial of service connection for bilateral open-angle glaucoma and the grant of service connection for bilateral great toes cold injury residual, decreased sensation. The Board found the current disability element established for glaucoma, noting the Veteran's service-connected left eye macular pucker. However, the Board found the service treatment records did not show in-service onset of glaucoma in either eye, and the Veteran affirmatively denied the condition at several examinations. Post-service records showed a diagnosis of primary open-angle glaucoma beginning in 2005. The Board found the Veteran's lay testimony regarding in-service diagnosis and treatment for glaucoma lacked probative weight due to inconsistencies with service records and the Veteran's own denials. A private medical report opining glaucoma was caused by service trauma was deemed inadequate due to lack of explanation and contradiction with other evidence. VA examinations yielded conflicting opinions, but the Board found the post-remand VA examinations adequate, assigning high probative weight to the finding that glaucoma is more likely due to age and heredity, and less likely due to service or the service-connected macular pucker. The benefit of the doubt doctrine was not applied as the evidence weighed against the claim. For the cold injury residuals, the Board found the current disability established. While service treatment records were silent, the Veteran's credible lay testimony regarding frostbite during Army Ranger School in 1969, corroborated by military personnel records showing attendance at Ranger School, established an in-service injury. The Board found the Veteran's statements regarding continuity of symptoms credible and assigned them high probative weight, overriding the VA examiner's negative opinion which was based solely on the lack of contemporaneous service treatment records. Applying the benefit of the doubt, service connection for the cold injury residuals was granted.

Rationale

No in-service diagnosis or treatment for glaucoma in either eye; Veteran's affirmative denials of glaucoma during service examinations; Post-service diagnosis of primary open-angle glaucoma in 2005; Lay testimony regarding in-service diagnosis lacked probative weight due to inconsistencies; Post-remand VA examinations found glaucoma more likely due to age/heredity; Less likely that glaucoma is due to service or service-connected macular pucker; Benefit of the doubt doctrine not applicable as evidence weighed against claim

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251205-622134

Full Decision Text

Citation Nr: A26028932
Decision Date: 03/31/26 Archive Date: 03/31/26

DOCKET NO. 251205-622134
DATE: March 31, 2026

ORDER

Entitlement to service connection for bilateral open angle glaucoma is denied.

Entitlement to service connection for bilateral great toes cold injury residual, decreased sensation (claimed as freezing cold injury residuals) is granted.

FINDINGS OF FACT

1. The probative evidence of record does not show that the Veteran's bilateral open angle glaucoma is related to his active-duty service or was caused or aggravated by a service-connected disability.

2. The probative evidence of record shows that the Veteran's bilateral great toes cold injury residual, decreased sensation is related to his active-duty service.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for bilateral open angle glaucoma have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310.

2. The criteria for entitlement to service connection for bilateral great toes cold injury residual decreased sensation (claimed as freezing cold injury residuals) have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the Army from May 1969 to July 1989.

In December 2025, the Board of Veterans' Appeals (Board) received a VA Form 10182, Decision Review Request: Board Appeal electing the Evidence Submission docket to review a May 2025 rating decision by an Agency of Original Jurisdiction (AOJ) of the Department of Veterans Affairs (VA). Therefore, the Board may only consider 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 with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303.

Service Connection

Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. 38 C.F.R. § 3.303; see Shedden v. Principi, 381 F. 3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F. 3d 604 (Fed. Cir. 1996) (table). Service connection may also be granted for any disease diagnosed after the military discharge, when all the evidence, including that pertinent to the period of military service, establishes that the disease was incurred during the active military service. 38 U.S.C. §§ 1113 (b); 38 C.F.R. §§ 3.303 (d).

Service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.310. In order to prevail on the theory of secondary service connection, there must be evidence of a current disability; evidence of a service-connected disability; and evidence establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for the evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. See Masors v. Derwinski, 2 Vet. App. 181 (1992). Equal weight is not accorded to each piece
. In order to prevail on the theory of secondary service connection, there must be evidence of a current disability; evidence of a service-connected disability; and evidence establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

VA must consider the competency of the lay evidence and cannot outright reject such evidence on the basis that such evidence can never establish a medical diagnosis or nexus. However, this does not mean that lay evidence is necessarily always sufficient to identify a medical diagnosis, but rather only that it is sufficient in those cases where the lay person is competent and does not otherwise require specialized medical training and expertise to do so; i.e., the Board must determine whether the claimed disability is a type of disability for which a layperson is competent to provide etiology or nexus evidence. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (b). This benefit-of-the-doubt rule applies if the competing evidence is nearly equal but does not apply when the evidence persuasively favors one side or the other. See Lynch v. McDonough, 999 F.3d 1391 (Fed. Cir. 2021).

1. Entitlement to service connection for bilateral open angle glaucoma.

The Veteran contends that his bilateral open angle glaucoma is related to his active-duty service. In the alternative, the Veteran contends that his bilateral open angle glaucoma was caused or aggravated by his service-connected macular pucker, left eye.

As an initial matter, the Board notes that the Veteran's claim for entitlement to service connection for glaucoma was denied in a September 2023 Higher-Level Review rating decision. See September 2023 Rating Decision - Narrative. In November 2024, the Veteran submitted a supplemental claim seeking readjudication of the issue of entitlement to service connection for glaucoma. See November 2024 VA Form 20-0995 Supplemental Claim Application. In the subsequent May 2025 AOJ rating decision currently on appeal, the AOJ found that new and relevant evidence had been received. See May 2025 Rating Decision - Narrative at 8. The Board is bound by this favorable finding and will proceed to the merits of the Veteran's claim without considering whether new and relevant evidence has been received. 38 C.F.R. 3.104 (c).

A. Facts

A March 2021 VA examination report shows that the Veteran was diagnosed with bilateral open-angle glaucoma. See March 2021 C&P Exam at 3, 7-8. As such, the Board finds the current disability element is established. See Shedden v. Principi, 381 F.3d 1163, 1167; Wallin v. West, 11 Vet. App. 509, 512 (1998).

The Board also notes that the Veteran has been granted service connection for macular pucker, left eye, with a 10 percent evaluation effective December 10, 2019. See October 2025 Rating Decision - Codesheet. Accordingly, with respect to secondary service connection, the Board finds that the Veteran has a primary service-connected disability to which a secondary service connection claim may attach. See Wallin, supra.

With respect to in-service injury and nexus, the Board begins with review of the Veteran's service treatment records. These records show that in June 1983, the Veteran sustained an injury to his left eye. See June December 2020 STR - Medical at 83. The Veteran was diagnosed with a retina injury but not with glaucoma. Id. The Veteran received follow-up care for his left eye injury with improvement noted through July 1983. Id at 83-88. A routine optometry examination in January 1984 did not reveal glaucoma. Id at 89. At a 1985 optometry examination the Veteran answered a patient questionnaire by checking box noting that he did not then have glaucoma. Id at 120. The Veteran reported
nexus, the Board begins with review of the Veteran's service treatment records. These records show that in June 1983, the Veteran sustained an injury to his left eye. See June December 2020 STR - Medical at 83. The Veteran was diagnosed with a retina injury but not with glaucoma. Id. The Veteran received follow-up care for his left eye injury with improvement noted through July 1983. Id at 83-88. A routine optometry examination in January 1984 did not reveal glaucoma. Id at 89. At a 1985 optometry examination the Veteran answered a patient questionnaire by checking box noting that he did not then have glaucoma. Id at 120. The Veteran reported taking no medications. Id. The Veteran's intraocular pressure was measured and no glaucoma was noted. Id at 119. The Veteran was afforded a physical examination at age 40, and while this examination is undated, the Board takes notice that for it to have been performed at or near age 40 it would need to have occurred no earlier than the 1987. Id at 123 (age 40 examination shows Veteran born in 1947). Block 69 shows that intraocular tension was measured at this examination and no diagnosis of glaucoma was noted. Id at 124. No glaucoma appears in a July 1988 optometry note. Id at 69. At the Veteran's retirement physical examination in May 1989, the Veteran reported a need for new glasses and reported the 1983 injury to his left eye but did not report glaucoma. Id at 67-68. The Veteran's intraocular pressure was again measured and no glaucoma was noted. Id at 66. The Board concludes that while these records show an in-service injury to the Veteran's left eye, they do not show an in-service injury to his right eye and do not show in-service onset of glaucoma in either eye. The Board notes that this conclusion is not based solely on the absence of a notation of glaucoma, but also on the presence of intraocular pressure tests and the Veteran's affirmative denial of the condition. Thus, these records satisfy the element of in-service injury with respect to left eye, but not right eye; and do not satisfy nexus with respect to either eye. See Shedden, supra.

The Board has reviewed the Veteran's post-service treatment records and notes that the Veteran continued to receive care from military facilities after service. The First reference to glaucoma that the Board can locate occurs in February 2005. See March 2021 Medical Treatment Record - Government Facility at 601. The Veteran was prescribed Latanoprost solution. Id. These records show subsequent treatment for glaucoma. Id at 569 (Dr. [C] at Walter Reed medical center prescribing treatment for primary open-angle glaucoma in 2009).

The Board has also reviewed the Veteran's lay statements and testimony, including hearing testimony from a previous Board appeal concerning glaucoma. See September 2022 Hearing Transcript. At that time, the Veteran stated that he was diagnosed with glaucoma in the 1980's and began treatment for it during active duty-service. Id at 13-14. The Veteran and his representative discussed the Veteran's claim for entitlement to service connection for multiple vision conditions including glaucoma, cataracts, and pseudophakia. Id at 11. The Veteran acknowledged his left eye injury during service. Id at 12. The Veteran also acknowledged his diagnosis of left eye macular pucker associated with his in-service left eye injury and his compensable evaluation of 10 percent for left eye macular pucker. Id at 11. The Veteran and his attorney suggested that all of the Veteran's vision problems arose from the in-service left eye injury or, in the alternative, were diagnosed and treated during service with continuity of symptoms from that time. Id at 11-14. The Board assigns the Veteran's statement regarding in-service diagnosis and treatment for glaucoma no probative weight, noting that the Veteran underwent many eye examinations consisting of tests of intraocular pressure during service and at the time of his discharge and that these do not show a diagnosis of glaucoma or prescription for any medication to treat it. Additionally, the Board notes that the Veteran affirmatively denied glaucoma at several of these examinations, indicating that at the time, the Veteran denied outside treatment for the condition as well. See supra (discussing STR). Moreover, many of these records were associated with the Veteran's treatment for a significant eye injury. As such, they are entitled to high probative weight. See Madden v. Gober, 125 F.3d 1477, 1481 (1997) (finding Board entitled to discount the credibility of evidence in light of its own inherent
of intraocular pressure during service and at the time of his discharge and that these do not show a diagnosis of glaucoma or prescription for any medication to treat it. Additionally, the Board notes that the Veteran affirmatively denied glaucoma at several of these examinations, indicating that at the time, the Veteran denied outside treatment for the condition as well. See supra (discussing STR). Moreover, many of these records were associated with the Veteran's treatment for a significant eye injury. As such, they are entitled to high probative weight. See Madden v. Gober, 125 F.3d 1477, 1481 (1997) (finding Board entitled to discount the credibility of evidence in light of its own inherent characteristics and its relationship to other items of evidence); Pond v. West, 12 Vet. App. 341 (1999) (statements made for treatment purposes carry greater probative value than statements made for disability compensation purpose); Caluza v. Brown, 7 Vet. App. 498, 512 (1995), aff'd per curiam, 78 f.3d 604 (Fed. Cir. 1996) (upholding Board's finding that a Veteran was not credible because lay evidence about a wound in service was internally inconsistent with other lay statements that he had not received any wounds in service).

The Veteran submitted private treatment records for review. See February 2026 Medical Treatment Record - Non-Government Facility. These records contain a summary of findings dated December 22, 2025, and do not consist of records generated over a long period of time. Id at 1. These records note the Veteran's treatment by Dr. [C] at Walter Reed. Id. These records contain the following statement:

"The vision loss is caused by the trauma during his military service, which resulted in a retina detachment and damage to the internal drain causing severe stage glaucoma. The glaucoma has needed multiple ocular surgeries to maintain the remaining vision." Id at 2.

The Board assigns these records no probative weight with respect to the onset of the Veteran's glaucoma, noting that they are contradicted by the Veteran's service treatment records, the Veteran's in-service statements denying glaucoma, and also by the Veteran's post-service treatment records which do not show a diagnosis of traumatic glaucoma or continuous treatment from discharge; but, rather, show a diagnosis of primary open-angle glaucoma beginning in 2005. See Reonal v. Brown, 5 Vet. App. 458, 460-61 (1993) (medical opinion based on inaccurate factual premise may properly be rejected as non-probative); see also Coburn v. Nicholson, 19 Vet. App. 427, 432-33 (2006) (Board may reject probative value of medical opinion if based on discredited statements made by veteran).

The overall evidence record in this case contains several VA examination reports with conflicting opinions, associated with the Veteran's original claim for service connection. The matter came before the Board in November 2022 on appeal of a prior, original denial of the Veteran's claim, and the Board discussed these early conflicting opinions as follows:

"The first examiner's positive opinion obtained in March 2021 acknowledges the in-service eye injury and provides that it at least as likely as not predisposed him to the macular hole that required surgical repair. A second negative opinion provided that his eye injury would less likely than not predispose him to cataract nor glaucoma, instead, it is likely age related. Two addendum opinions were obtained in July 2021. The first opinion provided that the cataracts are due to natural age-related progression and the glaucoma is hereditary or due to age. The second opinion provided that the cataracts and glaucoma are less likely than not due to service and are at least as likely related to natural age-related progression." See November 2022 BVA Decision at 14-15.

The Board remanded the matter for further development consisting of clarifying opinions. Id at 15-16. In its analysis of the instant appeal, the Board has reviewed the March 2021 and July 2021 VA examinations and opinions and finds them inadequate for rating purposes because they are confusing and do not adequately explain their conclusions. Horn v. Shinseki, 25 Vet. App. 231, 240-42 (2012) (stating that under caselaw "an unexplained conclusory opinion is entitled to no weight in a service-connection context"). Additionally, the Board notes that in the March 2021 examination, the examiner checked a box indicating that the Veteran's claimed condition was at least as likely as not incurred in or caused by the claimed injury, event, or illness and explained that "the claimant had an injury in 198
instant appeal, the Board has reviewed the March 2021 and July 2021 VA examinations and opinions and finds them inadequate for rating purposes because they are confusing and do not adequately explain their conclusions. Horn v. Shinseki, 25 Vet. App. 231, 240-42 (2012) (stating that under caselaw "an unexplained conclusory opinion is entitled to no weight in a service-connection context"). Additionally, the Board notes that in the March 2021 examination, the examiner checked a box indicating that the Veteran's claimed condition was at least as likely as not incurred in or caused by the claimed injury, event, or illness and explained that "the claimant had an injury in 1983 to his left eye that would less likely than not predispose him to cataracts (more likely age related) nor glaucoma of the right eye." Id at 3. As noted above, the Board finds that its prior analysis of this examination is appropriate because it is unclear. However, the Board notes that the examiner opined that the Veteran's injury to his left eye would not cause problems in his right eye. Id. The Board finds this portion of the examiner's rationale probative. Monzingo v. Shinseki, 26 Vet. App. 97, 107 (2012) ("Furthermore, even if a medical opinion is inadequate to decide a claim, it does not necessarily follow that the opinion is entitled to absolutely no probative weight). To the extent the same examiner noted that the Veteran had been diagnosed with and treated for glaucoma "since the 1980's," the Board assigns the examiner's opinion no probative weight, noting that this conclusion is contradicted by the Veteran's statements in the 1980's that were made for treatment purposes and that this conclusion is also unsupported by medical evidence. See Reonal, supra.

After the Board's November 2022 remand, the Veteran was afforded new VA examinations and opinions. Because the examiner provided many separate reports, the factual record is convoluted. However, the Board does not find that the actual facts are not at all unclear. The examiner reported that the Veteran's left eye macular pucker, for which he is service-connected with a 10 percent evaluation (and which condition is not currently on appeal) is a chronic condition related to service. See, e.g., November 2022 C&P Exam at 2; November 2022 C&P Exam at 3. The examiner noted that macular pucker is not a risk factor for the development of open-angle glaucoma, and that because of this, it is less likely than not that the Veteran's left eye macular pucker caused or aggravated his glaucoma. See, e.g., November 2022 C&P Exam; November 2022 C&P Exam.

The examiner opined that it is less likely than not that any of the Veteran's right eye conditions are related to active-duty service or to the Veteran's left eye macular pucker. See November 2022 C&P Exam. The examiner noted that primary open-angle glaucoma is more likely due to heredity and age. See November 2022 C&P Exam. The examiner also noted that while the glaucoma presents in both eyes, only the Veteran's left eye was injured during service. See March 2025 C&P Exam. The examiner also noted that the Veteran's glaucoma is of the open-angle type and not the traumatic type. See November 2022 C&P Exam. This is consistent with treatment records, which show diagnosis of open-angle glaucoma and not traumatic glaucoma, even near in time to the Veteran's 1983 eye injury. See supra (discussing treatment records).

Taken together, the Board finds the November 2022 examiner's reports adequate for rating purposes and assigns them high probative weight, noting that they together suggest that the Veteran's in-service left eye injury caused his service-connected left- eye macular pucker, for which the Veteran has been granted service connection and which is not on appeal; and that the Veteran's glaucoma of both eyes is more likely due to unrelated risk factors such as age and heredity, and less likely either directly due to the Veteran's service or to his service-connected left eye macular pucker. See Nieves-Rodriguez v. Peake, 22 Vet. App. At 304 (2008) ("It is the factually accurate, fully articulated, sound reasoning for the conclusion ... that contributes probative value to a medical opinion.") In making this finding, the Board acknowledges that the manner in which the examiner reported (i.e., many separate statements) is complex and that a more consolidated report would have been easier to read. However, the Board finds that the separate reports issued by the
Veteran's glaucoma of both eyes is more likely due to unrelated risk factors such as age and heredity, and less likely either directly due to the Veteran's service or to his service-connected left eye macular pucker. See Nieves-Rodriguez v. Peake, 22 Vet. App. At 304 (2008) ("It is the factually accurate, fully articulated, sound reasoning for the conclusion ... that contributes probative value to a medical opinion.") In making this finding, the Board acknowledges that the manner in which the examiner reported (i.e., many separate statements) is complex and that a more consolidated report would have been easier to read. However, the Board finds that the separate reports issued by the examiner together make a whole that is both understandable and consistent with the Veteran's treatment records and other probative evidence. See Parrish v. Shinseki, 24 Vet. App. 391, 401 (2011) (recognizing that poorly drafted medical opinion not necessarily inadequate if it can otherwise be understood); McClaim v. Nicholson, 21 Vet. App. 321 (2007) (noting that although clarity is preferred, it "is not and cannot be demanded in every instance or finality would forever be delayed pending perfection in draftsmanship").

Based on the foregoing, the Board finds that the element of in-service injury is not satisfied with respect to the Veteran's right eye with respect to his claim for service connection for glaucoma on a direct basis. See Shedden, supra. The Board further finds that the element of nexus is not satisfied for either the Veteran's left or right eye on either a direct or secondary basis. See Shedden, supra; Wallin, supra.

The Board acknowledges the private Report of Consultation and Examination submitted by the Veteran, dated August 2024. See November 2024 Medical Treatment Record - Non-Government Facility. This report opines, in relevant part as follows:

"As a result of [the Veteran's service-connected left eye macular pucker, [the Veteran] has also developed glaucoma and cataracts." Id at 2.

The Board finds this report inadequate for rating purposes, noting that it contains no explanation at all for its conclusion. See Horn, supra. The Board further notes that unlike the post-remand VA examination, this report also does not account for other risk factors present in the Veteran's case, nor does it reconcile the Veteran's bilateral condition with his traumatic injury to only one eye. As such, the Board finds the VA examination more probative. See Owens v. Brown, 7 Vet. App. 429, 433 (1995) (Board may properly favor one medical opinion over another).

The Board also acknowledges the Veteran's opinion that his glaucoma is related to his active-duty service or to his service-connected left eye macular pucker. The Board finds that the issue is medically complex because it involves the interpretation of imaging and medical tests, and that lay testimony is not sufficient to establish nexus. See Davidson, supra. As there is no evidence of record that the Veteran possesses sufficient medical training and experience to offer a competent medical opinion, the Board assigns his opinion no probative weight. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir 2006).

Thus, the weight of the competent and probative evidence does not support entitlement to service connection for bilateral open angle glaucoma either on a direct or secondary basis. Accordingly, the Veteran's claim is denied. In reaching these conclusions, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the weight of the evidence is against the Veteran's claim, that doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107 (b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990).

2. Entitlement to service connection for bilateral great toes cold injury residual, decreased sensation (claimed as freezing cold injury residuals)

The Veteran contends that his cold injury residual condition is related to his active-duty service. Specifically, the Veteran contends that his cold injury residual condition began during service and has been continuous ever since.

As an initial matter, a December 2025 VA examination report shows that the Veteran has been diagnosed with residuals of cold injury, decreased sensation of bilateral great toes. See April 2025 C&P Exam at 2. As such, the Board finds the current disability element is established. See Shedden v. Principi, 381 F.3d 1163, 1167.

With respect to in-service injury, the Board first notes
to service connection for bilateral great toes cold injury residual, decreased sensation (claimed as freezing cold injury residuals)

With respect to in-service injury, the Board first notes that the Veteran's STR are silent for any reference to a cold injury. However, during his most recent VA examination for this condition, the Veteran reported that during Army Ranger School, the Veteran's feet were submerged in water after rappelling and he subsequently suffered frostbite. See April 2025 C&P Exam at 2. Review of the Veteran's military personnel file shows that he attended Army Ranger School in 1969. See January 2025 Military Personnel Record at 62. The Board takes notice of the fact that Ranger School is conducted in remote areas where immediate medical care is frequently difficult to obtain and finds the Veteran's statement that he was exposed to harsh elements during ranger school and suffered a cold injury to his toes there credible. 38 C.F.R. § 3.159 (a)(2). Noting no contrary evidence in the record, the Board is satisfied that the Veteran experienced an in-service injury or event consisting of frostbite on his bilateral great toes. See Shedden, supra,

Turning to nexus, the Board observes that there is no evidence of a subsequent cold injury to the Veteran's bilateral great toes anywhere in the record. The Board notes that at his VA examination, the Veteran reported that he has experienced residual numbness of his great toes ever since experiencing frostbite during Ranger School See April 2025 C&P Exam at 2. Noting that these residual symptoms are symptoms that can be entirely perceived and diagnosed with the Veteran's senses, the Board finds that the Veteran's frostbite residuals are a type of disability for which lay evidence is acceptable to establish nexus. See Davidson, supra. The Board finds the Veteran's statements credible and assigns them high probative weight. Id. Thus, the Board is satisfied as to the element of nexus. See Shedden, supra.

So finding, the Board acknowledges the conclusion of the December 2024 VA examiner. See April 2025 C&P Exam at 2. Specifically, the examiner opined that the Veteran's frostbite residuals are less likely than not incurred in or caused by the Veteran's claimed injury, explaining that "HE DID NOT SEEK CARE AND THERE ARE NO IDENTIFIABLE STRS THUS THE ABOVE DIAGNOSIS, WITHOUT OBJECTIVE EVIDENCE FOR NEXUS, IS LESS LIKELY RELATED TO ACTIVE DUTY." Id. The Board finds this examination inadequate for rating purposes, noting that it is entirely based on the lack of contemporaneous service treatment records. See Dalton v. Nicholson, 21 Vet. App. 23 (2007) (noting that an examination was found inadequate where the examiner did not comment on the Veteran's report of in-service injury and relied on the lack of evidence in the service treatment records to provide a negative opinion); Buchanan v. Nicholson, 451 F. 3d 1331, 1336-37 (2006) (holding that the lack of contemporaneous medical records does not, in and of itself, render lay evidence not credible). The Board assigns the conclusion of this report no probative weight. Id. However, as noted above, the Board finds the portion of the report that contains competent lay reporting of the onset and continuity of the Veteran's symptoms probative. See Monzingo, supra.

The Board has reviewed the Veteran's VA and private treatment records and notes that they contain no evidence which could either support or contradict either the Veteran's lay reporting of his symptoms or the VA examiner's report. Accordingly, these records are not probative to the issue.

Thus, accounting for and assigning weight to the evidence and resolving any remaining reasonable doubt in favor of the Veteran, the Board finds that it is at least as likely as not that the Veteran's currently-diagnosed bilateral great toes cold injury residual, decreased sensation, was directly incurred during service. Accordingly, the Veteran's claim for entitlement to service connection is granted. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

R. Bisignani

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Divis, Robert A.

's report. Accordingly, these records are not probative to the issue.

R. Bisignani

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Divis, Robert A.

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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