HALLUX VALGUS (BUNION) ACQUIRED

C. CRAWFORD · 2026 · Case ID: A26029822

DENIED

Summary

The Veteran, who served in the United States Marine Corps from November 1996 to August 2000, appeals the denial of service connection for bilateral hammer toe, lower back strain, acquired psychiatric disorder (including depression), and tooth loss. The Board found no current diagnoses for the hammer toe, lower back strain, or psychiatric disorder claims, and therefore denied them. The Veteran's own assertions and lay testimony were not considered probative for establishing these medical conditions or a nexus to service, as they lacked the necessary medical expertise. While private treatment records submitted after the AOJ decision showed diagnoses for these conditions, the Board could not consider this evidence as it was submitted after the AOJ's decision date. For the tooth loss claim, the Board acknowledged the in-service extraction of a tooth and multiple cavities repaired, but denied compensation. The Board found that the evidence did not demonstrate the tooth loss met the criteria for compensation under 38 C.F.R. § 4.150, specifically the loss of substance of the maxilla or mandible, and the Veteran was not competent to provide a dental nexus opinion. The Board noted that a claim for dental compensation can also be a claim for dental treatment, and advised the Veteran to pursue that separately with the VHA if desired. All claims were denied.

Rationale

No current diagnosis of right hammer toe found in the record.; Veteran's lay assertions lack probative weight for medical diagnosis.; Evidence persuasively weighs against service connection.

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250325-531482

Full Decision Text

Citation Nr: A26029822
Decision Date: 04/01/26 Archive Date: 04/01/26

DOCKET NO. 250325-531482
DATE: April 1, 2026

ORDER

Entitlement to service connection for right hammer toe is denied.

Entitlement to service connection for left hammer toe is denied.

Entitlement to service connection for lower back strain is denied.

Entitlement to service connection for an acquired psychiatric disorder, to include depression, is denied.

Entitlement to service connection for tooth loss is denied.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that the Veteran has a diagnosis of right hammer toe or has had such a diagnosis at any time during the pendency of the claim or approximate to the initiation of the claim.

2. The evidence of record persuasively weighs against finding that the Veteran has a diagnosis of left hammer toe or has had such a diagnosis at any time during the pendency of the claim or approximate to the initiation of the claim.

3. The evidence of record persuasively weighs against finding that the Veteran has a diagnosis of lower back strain or has had such a diagnosis at any time during the pendency of the claim or approximate to the initiation of the claim.

4. The evidence of record persuasively weighs against finding that the Veteran has a diagnosis of an acquired psychiatric disorder, to include depression, or has had such a diagnosis at any time during the pendency of the claim or approximate to the initiation of the claim.

5. The Veteran does not have a compensable dental disability under 38 C.F.R. § 4.150, as there is no evidence of tooth loss due to loss of substance of maxilla or mandible.

CONCLUSIONS OF LAW

1. The criteria for service connection for right hammer toe have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

2. The criteria for service connection for left hammer toe have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

3. The criteria for service connection for lower back strain have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

4. The criteria for service connection for an acquired psychiatric disorder, to include depression, have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

5. The criteria for entitlement to service connection for tooth loss, for compensation, have not been met. 38 U.S.C. §§ 1131, 1712(a)(2), 5107; 38 C.F.R. §§ 3.102, 3.303, 3.381, 4.150, 17.161.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Marine Corps from November 1996 to August 2000.

This matter comes before the Board of Veterans' Appeals (Board) on appeal of March 2025 rating decisions issued by a Department of Veterans Affairs (VA) regional office (RO), an agency of original jurisdiction (AOJ).

In the March 2025 rating decision, the AOJ favorably found that new and relevant evidence had been received to warrant readjudication of the claim of tooth loss. 38 C.F.R. § 3.104(c).

By way of background, the AOJ previously denied the Veteran's claim for depression in a rating decision issued in October 2024. In the March 2025 rating decision on appeal, the AOJ found that new and relevant evidence was not received to readjudicate the claim. However, in the body of the decision, the AOJ addressed the claim on the merits and confirmed and continued the denial. As such, the Board finds that the AOJ implicitly favorably found that new and relevant evidence had been received. 38 C.F.R. § 3.104(c). The Board is bound by the AOJ's favorable findings and will address the claim de novo. Id.

VA received the Veteran's VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) in March 2025. The Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the March 2025 AOJ decisions on
judicate the claim. However, in the body of the decision, the AOJ addressed the claim on the merits and confirmed and continued the denial. As such, the Board finds that the AOJ implicitly favorably found that new and relevant evidence had been received. 38 C.F.R. § 3.104(c). The Board is bound by the AOJ's favorable findings and will address the claim de novo. Id.

The Board notes that evidence was added to the claims file during a period of time when new evidence was not allowed. Specifically, in October 2025, the Veteran submitted VA Form 21-0781, Statement in Support of Claim for PTSD. In November 2025, private treatment records were also added to the file. However, because this evidence was submitted during the period after the AOJ issued the decision, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the 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.

To more accurately reflect the scope of the Veteran's claim, the issue of entitlement to service connection of depression has been recharacterized to encompass all diagnosed psychiatric disorders. Clemons v. Shinseki, 23 Vet. App. 1 (2009).

Entitlement to service connection for right hammer toe.

Entitlement to service connection for left hammer toe.

Entitlement to service connection for lower back strain.

Entitlement to service connection for an acquired psychiatric disorder, to include depression.

The Veteran asserts that his claimed bilateral hammer toe, lower back strain, and acquired psychiatric disorder, to include depression, are related to his active duty service. See June 2024 VA Form 21-526EZ, Fully Developed Claim; see also November 2024 VA Form 21-526, Veterans Application for Compensation. For the reasons that follow, the Board finds that the claim must be denied.

Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. In general, service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).

At the outset, the Board points out that pivotal to any claim is the presence of a current disability. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (absent proof of a current disability, there is no valid claim). This is true regardless of whether the claim is based on a direct, secondary, or presumptive service connection theory of entitlement. Thus, the Board must first address whether the current disability element of the claim has been met.

Here, aside from the Veteran's general assertions that he has diagnoses of bilateral hammer toe, lower back strain, and acquired psychiatric disorder, to include depression, which are related to his military service, there is no evidence in the record showing that he currently has diagnoses of any of these conditions. The Board acknowledges that the AOJ favorably found that the Veteran participated in a toxic risk exposure activity (TERA) based on his military occupational specialty (MOS) of field artillery batteryman. See November 2024 VA Memorandum. However, a review of the record shows no diagnoses of bilateral hammer toe, lower back strain, and acquired psychiatric disorder, to include depression, at any time during the pendency of the claim or approximate to the initiation of the claim. See Saunders v. Wilkie, 886 F.3d 1356, 1364-66 (Fed. Cir. 2018); McClain v. Nicholson, 21 Vet
the record showing that he currently has diagnoses of any of these conditions. The Board acknowledges that the AOJ favorably found that the Veteran participated in a toxic risk exposure activity (TERA) based on his military occupational specialty (MOS) of field artillery batteryman. See November 2024 VA Memorandum. However, a review of the record shows no diagnoses of bilateral hammer toe, lower back strain, and acquired psychiatric disorder, to include depression, at any time during the pendency of the claim or approximate to the initiation of the claim. See Saunders v. Wilkie, 886 F.3d 1356, 1364-66 (Fed. Cir. 2018); McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). In addition, TERA Examination and Medical Opinion Requirement exception includes musculoskeletal disorders. See VBA Letter 20-22-10, Exception to TERA Examination and Medical Opinion Requirement at pages 10-13 (December 22, 2022). Thus, TERA examination is not required. See 38 U.S.C. § 1168(b).

While the Veteran believes that he may have current diagnoses of bilateral hammer toe, lower back strain, and acquired psychiatric disorder, to include depression, he is not competent to provide an opinion in this regard. Establishing the presence of these conditions is medically complex, as it requires specialized medical education to diagnose. Jandreau v. Nicholson, 492 F.3d 1372, 1377, n.4 (Fed. Cir. 2007). The Veteran does not have such expertise. Further, to the extent that the Veteran asserts that he has current diagnoses of bilateral hammer toe, lower back strain, and acquired psychiatric disorder, to include depression, and that these conditions are attributable to his military service, he is also not competent to provide a nexus opinion in this regard. Id. Accordingly, his statements are afforded no probative weight.

The Board acknowledges that private treatment records added to the file in November 2025 indicate diagnoses of low back pain, bilateral toe pain, and adjustment disorder with mixed anxiety and depressed mood. However, as this evidence was added to the file during the period after the AOJ issued the decision, the Board cannot consider it in this decision. 38 C.F.R. §§ 20.300, 20.301, 20.801.

Based on the foregoing, the Board finds that the persuasive evidence is against finding that service connection for bilateral hammer toe, lower back strain, and acquired psychiatric disorder, to include depression, is warranted. As there is not an approximate balance of positive and negative evidence regarding the merits of the issues, the benefit of the doubt doctrine is not applicable. 38?U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776, 781 (Fed. Cir. 2021). The claims are denied.

Entitlement to service connection for tooth loss.

Under the general laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, to establish service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).

VA regulations provide that a veteran may apply for both compensation and for dental treatment only. See 38 C.F.R. §§ 3.303, 3.381, 17.161; see also Mays v. Brown, 5 Vet. App. 302 (1993) (A claim for service connection is also considered to be a claim for VA outpatient dental treatment). Service connection for compensation purposes can only be established for certain types of dental and oral conditions listed under 38 C.F.R. § 4.150, such as impairment of the mandible, loss of a portion of the ramus, and loss of a portion of the maxilla. Compensation is available for loss of teeth only if such is due to loss of substance of body of maxilla or mandible. See Simmington v. West, 11 Vet. App. 41 (1998). For loss of teeth, bone loss through trauma or disease such as osteomyelitis must be shown for purposes of compensation. The loss of the
A claim for service connection is also considered to be a claim for VA outpatient dental treatment). Service connection for compensation purposes can only be established for certain types of dental and oral conditions listed under 38 C.F.R. § 4.150, such as impairment of the mandible, loss of a portion of the ramus, and loss of a portion of the maxilla. Compensation is available for loss of teeth only if such is due to loss of substance of body of maxilla or mandible. See Simmington v. West, 11 Vet. App. 41 (1998). For loss of teeth, bone loss through trauma or disease such as osteomyelitis must be shown for purposes of compensation. The loss of the alveolar process as a result of periodontal disease is not considered disabling. See 38 C.F.R. § 4.150, DC 9913, Note.

On June 2024 VA Form 21-526EZ, Fully Developed Claim, the Veteran requested service connection for loss of tooth. He reported that he had his tooth removed in boot camp and it was never fixed due to his MOS.

A review of the Veteran's service treatment records (STRs) shows that in December 1996, the Veteran complained of loose C tooth. His tooth was extracted at that time. The STRs also show extraction of two wisdom teeth. The Veteran had multiple cavities repaired during his military career. The Veteran was cleared for separation in July 2000. See Report of Medical Examination.

The Veteran underwent a VA examination for oral and dental conditions in February 2025. At that time, loss of tooth due to extraction was noted. The examiner noted that the Veteran has an edentulous space where the tooth used to be. No other oral or dental diagnosis was noted. The examiner concluded that the Veteran's tooth loss was at least as likely as not incurred in or caused by in-service event.

The Board finds that the evidence of record does not show a current dental disability for which service connection for compensation purposes can be granted. It is undisputed that the Veteran's current dental condition, tooth loss, is due to the contemporaneously documented, in-service injury. However, the evidence does not show that this condition manifested as or more nearly approximated loss of teeth due to the loss of substance of the body of the maxilla or mandible. See 38 C.F.R. § 4.150, Diagnostic Code 9913.

The Board acknowledges the Veteran's contention that he has a current dental disorder that is or should be subject to VA disability compensation. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, as a lay person, he is not competent to say that his current dental condition manifested as or more nearly approximated loss of teeth due to the loss of substance of the body of the maxilla or mandible. Jandreau v. Nicholson, 492 F.3d 1372, 1377, n.4 (Fed. Cir. 2007). Such diagnostic findings require specialized dental knowledge, training, and expertise. The Veteran has not cited specific medical or dental evidence competently showing that his current dental disorder constitutes loss of teeth due to the loss of substance of the body of the maxilla or mandible, or any other specific dental disability for which VA disability compensation benefits are available.

Based on the foregoing, service connection for tooth loss for compensation purposes must be denied. As there is not an approximate balance of positive and negative evidence regarding the merits of the issue, the benefit of the doubt shall not be given to the Veteran. See?38?U.S.C. §?5107(b);?38 C.F.R. § 3.102; Lynch, 21 F.4th at 781-82.

The Board notes that a claim for service connection for dental compensation purposes can also constitute a claim for service connection for VA dental treatment purposes. See e.g., Mays v. Brown, 5 Vet. App. 302 (1993). If the Veteran wishes to pursue a claim for service connection for dental treatment purposes, he may do so by filing an appropriate claim with the Veterans Health Administration (VHA). See https://www.va.gov/health-care/about-va-health-benefits/dental-care/ (last accessed March 19, 2026); 38 C.F.R. § 17.161.

C. CRAWFORD

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board A. Kuzniar, Associate Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.130

Analyze in VA Law Explorer