Case A26030293

KRISTI L. GUNN · 2026 · Case ID: A26030293

DENIED

Summary

The Veteran, an Air Force Veteran who served from January 1968 to September 1971, appeals decisions concerning the effective date for a right shoulder rating and service connection for vertigo and right lower extremity sciatica. The Board dismissed the appeal regarding the effective date for the right shoulder rating, finding it lacked jurisdiction as the issue was already decided by the Board and the subsequent rating decision was merely ministerial. For vertigo, the Veteran sought direct and secondary service connection. The Board denied direct service connection, noting the absence of in-service complaints or treatment, a decades-long gap before the first post-service diagnosis, and unfavorable VA medical opinions stating the condition (BPPV) was less likely than not related to service due to its idiopathic nature. Secondary service connection was also denied, as VA examiners opined that tinnitus and hearing loss do not cause or aggravate BPPV, citing distinct physiological mechanisms. For right lower extremity sciatica, the Board denied service connection. While the Veteran reported right thigh pulling at enlistment, no related condition was noted, and the presumption of soundness was not rebutted by clear and unmistakable evidence. Subsequent VA opinions concluded sciatica was less likely than not related to service, attributing it to age-related degenerative spine disease, not in-service trauma. The Veteran's lay assertions and inconsistent statements regarding onset were afforded no probative weight.

Service Branch

AIR FORCE

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251123-619112

Full Decision Text

Citation Nr: A26030293
Decision Date: 04/02/26 Archive Date: 04/02/26

DOCKET NO. 251123-619112
DATE: April 2, 2026

ORDER

Entitlement to an effective date prior to August 13, 2024, for the award of a 30 percent rating for the service-connected right shoulder disability is dismissed.

Entitlement to service connection for vertigo is denied.

Entitlement to service connection for right lower extremity sciatica is denied.

FINDINGS OF FACT

1. In November 2025, the Veteran submitted VA Form 10182 expressing disagreement with an October 2025 rating decision that solely implemented an October 15, 2025, Board decision.

2. The evidence of record persuasively weighs against a finding that the Veteran's vertigo had its onset during service or was caused or aggravated by a service-connected disability.

3. The evidence of record persuasively weighs against a finding that the Veteran's right lower extremity sciatica preexisted service or is otherwise related to service.

CONCLUSIONS OF LAW

1. The criteria for dismissal of the appeal as to the issue of entitlement to an effective date prior to August 13, 2024, for the assignment of a 30 percent rating for the service-connected right shoulder disability have been met. 38 U.S.C. §§ 511, 7104, 7105.

2. The criteria for service connection for vertigo have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

3. The criteria for service connection for right lower extremity sciatica have not been met. 38 U.S.C. §§ 1110, 1111, 1153, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.306.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in the United States Air Force from January 1968 to September 1971.

These matters come before the Board of Veterans' Appeals (Board) on appeal from an August 2025 rating decision issued following a June 2025 Board remand, and from an October 2025 rating decision implementing an October 15, 2025, Board decision that granted, inter alia, an earlier effective date of August 13, 2024, for the assignment of a 30 percent disability rating for the service-connected right shoulder disability. Both decisions were issued by the Department of Veterans Affairs (VA) Regional Office (RO).

On November 23, 2025, the Veteran submitted two VA Forms 10182, Decision Review Request: Board Appeal (Notice of Disagreement), and elected the Evidence Submission docket for both matters.

Therefore, for each appeal, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the corresponding 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.

This appeal has been advanced on the docket pursuant to 38 C.F.R. § 20.902(c).

Finally, the Board acknowledges that this decision is being issued prior to the expiration of the period in which the Veteran may elect to switch dockets pursuant to the holding in Williams v. McDonough, 37 Vet. App. 305 (2024). However, the Veteran has submitted evidence in accordance with his selected docket, including an article addressing the association between tinnitus and benign paroxysmal positional vertigo and a Report of Medical History dated August 2,
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.

This appeal has been advanced on the docket pursuant to 38 C.F.R. § 20.902(c).

Finally, the Board acknowledges that this decision is being issued prior to the expiration of the period in which the Veteran may elect to switch dockets pursuant to the holding in Williams v. McDonough, 37 Vet. App. 305 (2024). However, the Veteran has submitted evidence in accordance with his selected docket, including an article addressing the association between tinnitus and benign paroxysmal positional vertigo and a Report of Medical History dated August 2, 1967. As such, he is precluded from switching to another review option. 38 C.F.R. § 20.202(c)(2). Therefore, the Board will proceed with adjudication of this appeal.

Service Connection

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. Establishing service connection requires evidence of: (1) a current disability; (2) an 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).

Service connection may also be granted on a secondary basis for a disability that is proximately due to, or the result of, or aggravated by a service-connected disability. Establishing secondary service connection requires evidence of: (1) a current disability for which secondary service connection is sought; (2) an already service-connected disability; and (3) an indication that the current disability was either (a) caused by or (b) aggravated by the service-connected disability. 38 C.F.R. § 3.310(a) and (b); Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc).

1. Entitlement to an earlier effective date prior to August 13, 2024, for the award of a 30 percent rating for the service-connected right shoulder disability is dismissed.

In November 2025, the Veteran submitted VA Form 10182 in response to an October 2025 rating decision issued by the AOJ that implemented the Board's October 15, 2025, decision, which granted an earlier effective date of August 13, 2024, for the assignment of a 30 percent disability rating for the service-connected right shoulder disability.

As a preliminary matter, the Board must address its jurisdiction. In Encarnacion v. McDonough, 36 Vet. App. 194 (2023), the Court of Appeals for Veterans Claims (CAVC) explained how the Board must address appeals from AOJ rating decisions issued solely to implement decisions of the Board. The Court observed that 38 U.S.C. § 7104 provides that the Board's jurisdiction is wholly derivative of the Secretary's and that it establishes that "'[a]ll questions in a matter under [38 U.S.C. §] 511(a) shall be subject to one review on appeal to the Secretary,' and '[f]inal decisions on such appeals shall be made by the Board.'" Id. at 200. The Court further explained that a Board decision constitutes the Secretary's final and conclusive determination as to any discrete issue decided therein. Id.

With these principles in mind, the Court held that when an AOJ decision merely implements a Board decision, the AOJ's action is ministerial rather than adjudicative, and there is no appealable decision. This is because the Board has already rendered the Secretary's final decision on the matter, leaving no remaining question for adjudication at the AOJ level. Encarnacion, 36 Vet. App. at 200.

Applying Encarnacion to the present case, the October 2025 rating decision merely implemented the Board's October 15, 2025, decision, which granted an earlier effective date of August 13, 2024, for the assignment of a 30 percent disability rating for the service-connected right shoulder disability. Thus, the Board had already rendered a final decision on the effective date assigned for that rating, and the AOJ's subsequent action did not involve any new adjudication of that issue.

Because the October 2025 AOJ action was purely ministerial and did not constitute a new decision on the merits, it is not an appealable decision within the meaning of 38 U.S.C. §§ 511 and 7104. Accordingly,
acion to the present case, the October 2025 rating decision merely implemented the Board's October 15, 2025, decision, which granted an earlier effective date of August 13, 2024, for the assignment of a 30 percent disability rating for the service-connected right shoulder disability. Thus, the Board had already rendered a final decision on the effective date assigned for that rating, and the AOJ's subsequent action did not involve any new adjudication of that issue.

Therefore, the appeal for entitlement to an effective date prior to August 13, 2024, for the assignment of a 30 percent disability rating for the service-connected right shoulder disability is dismissed.

To the extent the Veteran seeks further review of the October 15, 2025, Board decision, he is advised that Board decisions may be appealed to the United States Court of Appeals for Veterans Claims within the time period prescribed by law, or he may pursue any other post-decisional options available by law.

2. Service connection for vertigo is denied.

The Veteran seeks service connection for vertigo on a direct basis or as secondary to his service-connected tinnitus and/or left ear hearing loss.

Direct Service Connection

The Veteran's service treatment records (STRs) are silent for complaints, treatment, or diagnoses related to vertigo, dizziness, or balance problems. At separation in September 1971, the Veteran denied dizziness or fainting spells, and upon clinical evaluation, including equilibrium testing, his neurological system was evaluated as normal.

Post-service treatment records likewise do not reflect complaints or treatment for vertigo or related symptoms until decades following separation from service. In this regard, the Veteran denied vertigo in June 2011, June 2012, and October 2014, and denied dizziness in November 2010 and October 2013. Notably, the first documented complaint of vertigo appears in March 2024, when the Veteran reported vertigo episodes associated with head movement and was diagnosed with benign paroxysmal positional vertigo (BPPV).

At a September 2024 VA examination, the Veteran reported a six-month history of positional vertigo, described as a sensation of the room spinning when turning his head from left to right, often awakening him at night. The examiner opined that the condition was less likely than not related to service, explaining that there was no evidence of chronic symptoms during service or for many years thereafter, and that the condition instead reflected post-service onset with an intervening event, illness, or injury as a more likely etiology.

In June 2025, VA obtained an additional VA opinion. The VA examiner again concluded that the Veteran's BPPV was less likely than not incurred in or otherwise related to service. The examiner explained that BPPV is not a latent or progressive condition that remains dormant for decades, but rather typically has a sudden onset and is unrelated to remote events absent precipitating head trauma, which is not shown here. The examiner concluded that the Veteran's symptoms-positional, room-spinning vertigo particularly while laying down-are consistent with idiopathic BPPV caused by displacement of otoliths in the inner ear, a condition commonly seen in older adults without a history of head trauma or otologic disease. Given the absence of in-service symptoms or complaints, the decades-long gap in onset, and the known pathophysiology of BPPV, the examiner concluded that the condition cannot be reasonably linked to any event, illness, or injury incurred during service.

The Board assigns significant probative weight to the September 2024 and June 2025 medical opinions, as they are based on review of the record, consideration of the Veteran's lay reports, and supported by clear, well-reasoned rationales grounded in medical principles. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Importantly, there are no competent medical opinions to the contrary.

Accordingly, the weight of the evidence is against a finding that vertigo was incurred in or is otherwise related to service. As the evidence is not in approximate balance, 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 (Fed. Cir. 2021).

Secondary Service Connection

The Veteran also contends that his vertigo is caused or aggravated by his service-connected tinnitus and/or left ear hearing loss.

Secondary Service
22 Vet. App. 295 (2008). Importantly, there are no competent medical opinions to the contrary.

Secondary Service Connection

The Veteran also contends that his vertigo is caused or aggravated by his service-connected tinnitus and/or left ear hearing loss.

Secondary Service Connection Based on Causation

In June 2025, a VA examiner explained that the Veteran's symptoms are consistent with BPPV, a mechanical condition caused by displacement of otoliths (calcium carbonate crystals) within the semicircular canals of the inner ear. The examiner stated that there is no pathophysiologic basis that tinnitus or hearing loss causes the dislodgement of otoliths or otherwise alters vestibular function in a manner that would result in BPPV. Rather, tinnitus and hearing loss both involve cochlear (sensorineural) dysfunction, which is anatomically and physiologically distinct from the vestibular system implicated in BPPV. The examiner further noted that current medical literature does not support a causal relationship between tinnitus or hearing loss and the development of BPPV.

The examiner also found that the Veteran's symptom pattern-late-onset, positional vertigo decades after service-is inconsistent with vestibular disorders typically associated with an auditory pathology, such as Meniere's disease or labyrinthitis, which generally present with symptoms in closer temporal proximity to hearing impairment.

Additionally, the examiner observed that a Dix-Hallpike test performed in August 2024 was negative, suggesting either resolution of symptoms or some uncertainty regarding diagnostic consistency.

Based on the foregoing, the examiner concluded that the Veteran's vertigo is less likely than not proximately due to or the result of his service-connected tinnitus or left ear hearing loss.

Secondary Service Connection Based on Aggravation

The June 2025 examiner also opined that the Veteran's vertigo was not aggravated beyond its natural progression by his service-connected tinnitus or left ear hearing loss. The examiner specifically noted that he reviewed the claims file, including the June 2025 remand and the Veteran's lay statements.

The examiner explained that BPPV follows a mechanical pathophysiology that is distinct from auditory conditions. Specifically, BPPV involves the vestibular system, whereas tinnitus and hearing loss affects the cochlea. The examiner noted that there is no medical evidence or peer-reviewed literature supporting that tinnitus or hearing loss worsens or aggravates the course of BPPV.

The examiner further found that the record does not demonstrate any worsening of vertigo associated with hearing loss, tinnitus, or treatment thereof. Notably, the evidence does not reflect that the Veteran uses hearing aids, takes medication, or otherwise receives treatment for his service-connected tinnitus or hearing loss. There is no indication that any form of treatment-or lack thereof-has resulted in an increase in severity of the Veteran's vertigo. Likewise, tinnitus while distressing, is not shown to have worsened or to be temporally associated with vertigo symptoms. No clinical or audiological evidence suggests that tinnitus or hearing loss has affected vestibular function in a manner that would aggravate BPPV.

Additionally, although the examiner considered the Veteran's lay reports, the Veteran's symptom pattern-late-onset, positional vertigo developing decades after service-is more consistent with idiopathic (spontaneous) BPPV than with a condition aggravated by an auditory pathology.

Based on the foregoing, the examiner concluded that it is less likely than not that the Veteran's vertigo was aggravated by his service-connected tinnitus or left ear hearing loss, including as a result of any treatment thereof.

Conclusion

The Board finds the VA medical opinions of record highly probative, as they reflect consideration of the Veteran's contentions, review of the claims file, and are supported by clear medical explanations distinguishing the anatomical and physiological systems involved. See Nieves-Rodriguez, 22 Vet. App. at 295.

The Board acknowledges the Veteran's belief that his vertigo is related to service or his service-connected tinnitus or left ear hearing loss. While the Veteran is competent to report observable symptoms such as dizziness, he is not competent to provide a nexus opinion regarding the etiology of a complex vestibular disorder such as BPPV as he does not have the requisite training and experience necessary to address such complex medical matters. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed.
of the Veteran's contentions, review of the claims file, and are supported by clear medical explanations distinguishing the anatomical and physiological systems involved. See Nieves-Rodriguez, 22 Vet. App. at 295.

The Board acknowledges the Veteran's belief that his vertigo is related to service or his service-connected tinnitus or left ear hearing loss. While the Veteran is competent to report observable symptoms such as dizziness, he is not competent to provide a nexus opinion regarding the etiology of a complex vestibular disorder such as BPPV as he does not have the requisite training and experience necessary to address such complex medical matters. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Accordingly, his lay assertions as to the etiology of his vertigo are afforded no probative weight.

Further, the Board acknowledges that the Veteran also submitted an article in November 2025 from a 2025 Journal of Clinical Medicine suggesting a possible link between tinnitus and BPPV. While the article indicates that there may be an association between these conditions, it does not establish that the Veteran's vertigo or BPPV is as least as likely as not caused or aggravated by his service-connected tinnitus. Medical treatise evidence that is general in nature, and not specific to the facts of a particular case, is typically insufficient to establish a nexus. Sacks v. West, 11 Vet. App. 314, 316-17 (1998). Although such evidence may support a claim when it discusses relationships with a degree of certainty, the article submitted here expressly notes that "[w]hile this study suggests a potential link between BPPV and tinnitus, further investigation is required to establish a definitive pathophysiological connection." Accordingly, it does not provide the level of specificity necessary to establish causation in this case. The Board may not substitute its own medical judgment for that of a medical practitioner. Colvin v. Derwinski, 1 Vet. App. 171, 174 (1991).

In contrast, the June 2025 VA examiner considered the Veteran's specific medical history, reviewed relevant medical literature regarding potential associations between tinnitus and hearing loss with BPPV and provided a reasoned opinion tailored to the facts of this case. As such, the examiner's opinion is afforded significantly greater probative weight than the general medical article submitted by the Veteran. Accordingly, the most probative evidence of record establishes that the Veteran's vertigo is not related to service and is not caused or aggravated by his service-connected tinnitus or hearing loss. As the evidence is against the claim, the benefit-of-the-doubt doctrine is not applicable. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch, 21 F.4th at 776.

Service connection for vertigo, on both a direct and secondary basis, is denied.

Other Considerations

To the extent the Veteran's representative asserts that medications the Veteran uses to treat other service-connected disabilities caused or aggravated his vertigo, this theory of entitlement was not raised prior to the AOJ decision on appeal. Accordingly, there is no pre-decisional duty-to-assist error, and remand for development of this theory is not warranted. 38 C.F.R. § 20.802(a).

Similarly, the article submitted in November 2025, titled Association of Tinnitus with BPPV, was received after the AOJ decision on appeal. Because this evidence was not before the AOJ at the time of the decision, the Board may not remand for further development, to include obtaining an addendum medical opinion for AOJ consideration, in the absence of a pre-decisional duty-to-assist error. 38 C.F.R. § 20.802(a).

The Board has also considered the representative's argument challenging the competency of the June 2025 VA examiner, a physician assistant. Specifically, the representative asserts that the examiner lacked the knowledge, skill, or training to render an opinion regarding the etiology of the Veteran's vertigo. Instead, the representative states that VA should have obtained an opinion from an examiner with more specialized knowledge, such as an otolaryngologist.

However, VA examiners are presumed competent, and there is no evidence demonstrating that the examiner lacked requisite qualifications or experience to render the opinion. Here, the representative has not identified any specific deficiency in the examiner's qualifications beyond a general assertion that the examiner was not a specialist. There is no evidence of record demonstrating that the examiner lacked the requisite education, training, or experience to provide the requested opinion. Accordingly, the Board finds the June 2025 VA opinion to be adequate and probative for adjudication purposes.

Consistent with the foregoing, and for the reasons discussed above, the Board assigns significant
Instead, the representative states that VA should have obtained an opinion from an examiner with more specialized knowledge, such as an otolaryngologist.

Consistent with the foregoing, and for the reasons discussed above, the Board assigns significant probative weight to the June 2025 VA medical opinion, which weighs against the claim.

3. Service connection for right lower extremity sciatica is denied.

The Veteran seeks service connection for right lower extremity sciatica. The record raises multiple theories of entitlement, including direct service connection and aggravation of a pre-existing condition.

The Veteran asserts that his sciatic pain began during service and has progressively worsened since that time. See August 2024 VA Examination.

In June 2025, the Board remanded the claim for additional development. Specifically, the Board noted that, at enlistment, the Veteran reported right leg symptoms, thereby raising the question of whether right lower extremity sciatica preexisted service and, if so, whether it was aggravated beyond its natural progression by service.

Presumption of Soundness/Aggravation

A veteran is presumed to be in sound condition except for defects, infirmities, or disorders noted when the veteran is examined, accepted, and enrolled in service. 38 U.S.C. § 1111; 38 C.F.R. § 3.304(b). Only those conditions recorded in examination reports are considered as "noted." 38 C.F.R. § 3.304(b)(1).

Here, although the Veteran reported pulling in the right thigh with walking on his report of medical history at enlistment, no musculoskeletal or neurological abnormalities, diagnoses, or defects were noted on the entrance examination. Accordingly, right lower extremity sciatica or a related condition was not "noted" at entry, and the presumption of soundness attaches.

To rebut the presumption of soundness, VA must show by clear and unmistakable evidence both that the condition preexisted service and was not aggravated by service. Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004); Horn v. Shinseki, 25 Vet. App. 231, 234 (2012). Clear and unmistakable evidence is evidence that is obvious or manifest and "cannot be misinterpreted and misunderstood, i.e., it is undebatable." Quirin v. Shinseki, 22 Vet. App. 390, 396 (2009).

The Board finds that this high evidentiary standard has not been met. The June 2025 VA examiner opined that right lower extremity sciatica did not clearly and unmistakably pre-exist service. The examiner explained that sciatica is an acquired condition typically associated with degenerative spine pathology and is not congenital or developmental in nature and found no evidence of sciatica or related neurological impairment prior to service. The examiner further noted that sciatica was first documented decades after service.

Based on the foregoing, the Board finds that the evidence of record does not clearly and unmistakably establish that right lower extremity sciatica preexisted service, and the presumption of soundness is not rebutted.

Therefore, the claim is analyzed as one for direct service connection.

Direct Service Connection

The evidence does not establish that right lower extremity sciatica had its onset during service or is otherwise related to service.

STRs are silent for complaints, treatment, or diagnoses of sciatica or related neurological symptoms. The record further reflects no documented complaints or treatment for sciatica until many years after separation from service, which weighs against a finding of in-service onset.

Following remand, a June 2025 VA addendum medical opinion was obtained. The examiner reviewed the claims file, considered the Veteran's statements, and concluded that the Veteran's sciatica was less likely than not related to service. The examiner explained that the Veteran's symptoms are consistent with age-related degenerative spine disease rather than an in-service event or injury. In support thereof, the examiner noted that imaging studies demonstrated age-related degenerative changes, including anterolisthesis, retrolisthesis, disc space narrowing, and facet arthropathy. The examiner explained that these findings are consistent with natural aging rather than trauma or service-related pathology.

The Board assigns significant probative weight to this opinion, as it reflects
onset.

The Board assigns significant probative weight to this opinion, as it reflects a review of the record, consideration of the Veteran's statements, and is supported by clear and well-reasoned rationale consistent with the medical evidence of record. Nieves-Rodriguez, 22 Vet. App. at 295.

The Board has also considered the Veteran's lay assertions that his symptoms began in service. See September 2024 VA examination. While he is competent to report observable symptoms such as pain, he is not competent to provide a nexus opinion regarding the etiology of his sciatica as he does not have the requisite training and experience necessary to address such complex medical matters. See Jandreau, 492 F.3d at 1372. Accordingly, his lay assertions as to the etiology of his sciatica are afforded no probative weight.

Additionally, the Veteran has provided inconsistent statements regarding the onset of his sciatica. Notably, on his April 2024 VA Form 21-526EZ, he reported that his sciatica began in 2011, which weighs against a finding of in-service onset or continuity of symptomatology.

Conclusion

In sum, the most probative evidence establishes that right lower extremity sciatica did not preexist service, did not have its onset during service, and is not otherwise related to service. As the evidence is not in approximate balance, the benefit-of-the-doubt doctrine is not applicable. 38 U.S.C. § 5107(b); Lynch, 21 F.4th at 776.

Other Considerations

The Board has also considered the representative's argument challenging the competency of the June 2025 VA examiner, a physician assistant. Specifically, the representative asserts that the examiner lacked the knowledge, skill, or training to render an opinion regarding the etiology of the Veteran's sciatica. Instead, the representative states that VA should have obtained an opinion from an examiner with more specialized knowledge, such as a neurologist.

Consistent with the foregoing, and for the reasons discussed above, the Board assigns significant probative weight to the June 2025 VA medical opinion, which weighs against the claim.

KRISTI L. GUNN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Hatcher, Valerie

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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