PARALYSIS OF SCIATIC NERVE OR EXTERNAL POPLITEAL NERVE

MICHAEL A. HERMAN · 2026 · Case ID: A26030483

MIXED

Summary

The veteran, who served in the U.S. Navy from June 1973 to June 1976, appeals the denial of service connection for erectile dysfunction (ED) as secondary to his service-connected lower back problems, and for pseudofolliculitis barbae (PFB). The appeal for bilateral lower extremity radiculopathy was dismissed as moot because it was granted by the agency of original jurisdiction (AOJ) after the Board's review period began. For the ED claim, the Board found that while the veteran had current ED and was service-connected for thoracolumbar spine degenerative arthritis, there was no indication of an in-service event related to ED, nor was the thoracolumbar condition service-connected during the relevant review period. Consequently, no VA medical opinion was required, and the claim for secondary and direct service connection for ED was denied. For PFB, the Board found no competent evidence of a current diagnosis, as VA treatment records showed normal skin assessments without complaints or references to PFB. The claim was denied. The Board remanded the claim for bilateral knee osteoarthritis and osteophytes to the AOJ to verify all periods of the veteran's active duty, ADT, and IDT service, as this information was unclear and necessary for proper adjudication.

Rationale

Appeal dismissed as moot; Service connection for bilateral lower extremity radiculopathy granted by AOJ; No justiciable case or controversy before the Board

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210203-138583

Full Decision Text

Citation Nr: A26030483
Decision Date: 04/02/26 Archive Date: 04/02/26

DOCKET NO. 210203-138583
DATE: April 2, 2026

ORDER

The appeal seeking entitlement to service connection for bilateral lower extremity radiculopathy is dismissed.

Entitlement to service connection for erectile dysfunction (ED), to include as secondary to service-connected lower back problems is denied.

Entitlement to service connection for pseudofolliculitis barbae (PFB) is denied.

REMANDED

Entitlement to service connection for bilateral knee osteoarthritis and osteophytes is remanded.

FINDINGS OF FACT

1. While the appellant's appeal seeking entitlement to service connection for bilateral lower extremity radiculopathy was pending before the Board, an August 2025 rating decision granted the claim.

2. The appellant's ED is not secondary to service-connected lower back problems, and is not otherwise related to an in-service injury or disease.

3. PFB was not diagnosed at any time during or approximate the pendency of the claim.

CONCLUSIONS OF LAW

1. The criteria for dismissal of entitlement to service connection for bilateral lower extremity radiculopathy are met as the appeal is moot. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

2. The criteria for entitlement to service connection for ED, to include as secondary to service-connected lower back problems are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

3. The criteria for entitlement to service connection for PFB are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The appellant served on active duty in the United States Navy from June 1973 to June 1976. He is the recipient of the National Defense Service Medal.

Procedural History

These matters come before the Board of Veterans' Appeals (Board) on appeal from July 2020 and January 2021 rating decisions by the Department of Veterans Affairs' (VA) Veterans Benefits Administration, the agency of original jurisdiction (AOJ), under the modernized review system. See 38 C.F.R. § 3.2400. VA received a timely February 2021 notice of disagreement (NOD) to the July 2020 and January 2021 rating decisions, selecting the Hearing Docket. The appellant was sent April 2024 correspondence notifying him of his August 5, 2024, Board hearing. He did not attend the August 2024 Board hearing.

Of procedural note, an August 2025 rating decision granted service connection for bilateral lower extremity radiculopathy effective March 1, 2019, and service connection for thoracolumbar spine degenerative arthritis effective April 12, 2018. Additionally, the January 2021 rating decision did not address whether new and relevant evidence had been received sufficient to readjudicate the issue of entitlement to service connection for bilateral knee osteoarthritis and osteophytes but instead addressed the merits of the claim. The addressing of the merits of the claim is interpreted as a favorable finding as to the receipt of new and relevant evidence. The AOJ's finding that evidence submitted is new and relevant is a favorable finding binding on the Board. See 38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c).

Applicable Evidentiary Windows

The Board may only consider the evidence of record before the AOJ at the time of its decision on the issues on appeal, evidence submitted by the appellant or his or her representative at the Board hearing, to include testimony provided at the hearing; and evidence submitted within 90 days following the Board hearing. 38 C.F.R. § 20.300(a), 302(a). If an appellant does not appear for a scheduled hearing, and the hearing is not rescheduled subject to 38 C.F.R. § 20.704(d), the Board's decision will be based on a review of evidence of record at the time of the AOJ's decision on the issues on appeal, and the evidence submitted within 90 days following the date of the scheduled hearing. 38 C.F.R. § 20.302(c). If additional evidence was submitted between the dates of the AOJ decision and the date the appellant failed to appear for the hearing, the Board will not consider it unless it
following the Board hearing. 38 C.F.R. § 20.300(a), 302(a). If an appellant does not appear for a scheduled hearing, and the hearing is not rescheduled subject to 38 C.F.R. § 20.704(d), the Board's decision will be based on a review of evidence of record at the time of the AOJ's decision on the issues on appeal, and the evidence submitted within 90 days following the date of the scheduled hearing. 38 C.F.R. § 20.302(c). If additional evidence was submitted between the dates of the AOJ decision and the date the appellant failed to appear for the hearing, the Board will not consider it unless it is resubmitted during the 90 days following the date of the scheduled hearing. If the appellant would like VA to consider any evidence that was added to the claims file that the Board could not consider, the appellant 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 claim(s), considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a supplemental claim are included with this decision. See also Cook v. McDonough, 36 Vet. App. 175 (2023). With respect to the claim of entitlement to service connection for bilateral knee osteoarthritis and osteophytes, as it is remanded herein, any evidence the Board could not consider will be considered by the AOJ. 38 C.F.R. § 3.103(c)(2)(ii).

Service Connection, Generally

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. To establish entitlement to service connection, there must be (1) evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) a causal connection between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004).

VA must provide a medical examination and medical opinion 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. See McLendon v. Nicholson, 20 Vet. App. 79, 81-82 (2006).

1. Entitlement to service connection for bilateral lower extremity radiculopathy.

While the appellant's claim for entitlement to service connection for bilateral lower extremity radiculopathy, claimed as bilateral feet tingling and numbness and bilateral lower extremity nerve condition, an August 2025 rating decision granted the claim.

The Board has jurisdiction where there is a question of law or fact on appeal to the Secretary. 38 U.S.C. § 7104; 38 C.F.R. § 20.104. There is disagreement as to whether the Board should dismiss an appeal from the denial of service connection for a disability for which service connection has already been granted without consideration of the effective date consequences of such a determination. See Hepler v. McDonough, 2024 U.S. App. Vet. Claims LEXIS 1134 (nonprecedential per curiam order) (Bartley, J., dissenting from denial of reconsideration) (noting that appellant "convincingly argues that the issue before the Court is reasonably debatable and of continuing public interest" and describing the current state of the law on this question as a "nonprecedential house of cards"). However, the fact remains that Holland v. Gober, 10 Vet. App. 433, 436 (1997) and Grantham v. Brown, 114 F.3d 1156, 1158 (Fed. Cir 1997), which held that the grant of service connection is a full grant of the benefit sought on appeal from the denial of service connection for the same disability and disability ratings and effective dates are downstream elements of a claim that must be appealed separately, have not been
that appellant "convincingly argues that the issue before the Court is reasonably debatable and of continuing public interest" and describing the current state of the law on this question as a "nonprecedential house of cards"). However, the fact remains that Holland v. Gober, 10 Vet. App. 433, 436 (1997) and Grantham v. Brown, 114 F.3d 1156, 1158 (Fed. Cir 1997), which held that the grant of service connection is a full grant of the benefit sought on appeal from the denial of service connection for the same disability and disability ratings and effective dates are downstream elements of a claim that must be appealed separately, have not been overruled. See Hepler v. McDonough, 2024 U.S. App. Vet. Claims LEXIS 1134 (mem dec) (Laurer, J.) ("since the Board granted Mr. Hepler's hypertension claim, his appeal is moot. Appellant's primary concern here is with his effective date, but that's a challenge best suited for a decision that assigns one") (citing Aviles-Rivera v. McDonough, 35 Vet. App. 268 (2022), vacated, appeal dismissed as moot, No. 2022-2084, 2024 U.S. App. LEXIS 14234 (Fed. Cir. June 12, 2024) (nonprecedential per curiam order) and Yarbrough v. McDonough, 2025 U.S. App. Vet. Claims LEXIS 106 (Pietsch, J.) (affirming the Board's dismissal of a claim for service connection that had been granted by the AOJ and finding that even if the grant of service connection by the Board "would have resulted in an earlier effective date for the grant of service connection.....that is a challenge best suited for the decision that assigns the effective date for the service-granted disorder"). These decisions are not precedential, but the Board may rely upon them for any persuasiveness or reasoning they contain, especially in light of the fact the Board is still bound by Grantham and Holland. See Bethea v. Derwinski, 2 Vet. App. 252, 254 (1992).

Thus, the Board finds that the appeal should be dismissed, as the claim for service connection for bilateral lower extremity radiculopathy has already been granted, and there is no justiciable case or controversy before the Board at this time with respect to the claim. 38 U.S.C. § 7105(d)(5). As the instant appeal concerned only the question of entitlement to service connection, the Board does not have the jurisdiction to address the effective dates and/or ratings assigned.

2. Entitlement to service connection for ED, to include as secondary to service-connected lower back problems.

The appellant contends that he is entitled to service connection for ED, to include as secondary to service-connected lower back problems.

Applicable Law

Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. 38 C.F.R. § 3.310(a)-(b). Secondary causation exists when, but for the service-connected disability, the non-service-connected was caused by a service-connected disability either in a direct, etiological way or via multiple steps in a causal chain. Spicer v. McDonough, 61 F.4th 1360, 1365 (Fed. Cir. 2023) (citations omitted). Secondary aggravation exists when the non-service-connected disability not caused by a service-connected disability would be less severe were it not for a service-connected disability. Id. at 1364. The inability to prevail on a secondary basis does not foreclose the opportunity to prevail on a direct basis. Combee v. Brown, 34 F.3d 1039, 1043-33 (Fed. Cir. 1994).

Analysis

Prior to analyzing the claim, it is important to reiterate the limited relevant review period before the Board. The rating decision that denied entitlement to service connection for ED was issued in July 2020 and the appellant's Board hearing was scheduled for August 5, 2024. He did not attend the hearing. However, the relevant review period remains prior to the July 2020 rating decision and from August 4, 2024, to November 3, 2024. The appellant was granted service connection for thoracolumbar spine degenerative arthritis effective April 12, 2018, in an August 2025 rating decision.
1043-33 (Fed. Cir. 1994).

Analysis

Beginning with secondary service connection, the July 2020 rating decision made the favorable finding that the appellant had the current disability of ED. See 38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c). The appellant is service connected for thoracolumbar spine degenerative arthritis. The remaining question is whether his ED was caused or aggravated by his service-connected thoracolumbar spine degenerative arthritis.

There is no VA medical examination or opinion as to whether the appellant's ED was caused or aggravated by his thoracolumbar spine degenerative arthritis, triggering a McLendon analysis. The first element is met as the AOJ made the favorable finding that the appellant had the current disability of ED. The second and third elements, however, are not met. The appellant never alleges, and the record does not indicate, an in-service event, injury, or disease related to his ED. Additionally, during the period on review, there was no indication that the appellant's ED may be associated with another service-connected disability, as the appellant's thoracolumbar spine degenerative arthritis was not yet service-connected. As such, considering the period on review, the appellant was not entitled to a VA medical examination and opinion regarding his ED. No medical nexus opinion within the relevant review period addresses secondary service connection of the appellant's ED by his thoracolumbar spine degenerative arthritis. While the appellant believes that he has a nexus between his ED and his thoracolumbar spine degenerative arthritis, and he is competent to relate his lay observations, he is not competent to provide a nexus opinion in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4?(Fed. Cir. 2007); Kahana v. Shinseki, 24 Vet. App. 428 (2011).

Without a medical nexus opinion addressing secondary service connection, entitlement to service connection for ED as secondary to service-connected thoracolumbar spine degenerative arthritis is not warranted.

Moving to direct service connection, the appellant meets the first element of Shedden as the July 2020 rating decision made the favorable finding of a current disability of ED. The second element, however, is unmet, as the appellant does not allege, and the evidence does not show, an in-service incurrence or aggravation of a disease or injury. Additionally, the appellant was not provided a VA medical examination or direct service connection nexus opinion but, as addressed in the secondary service connection analysis, an exam was not required. As the second and third element of Shedden are unmet, entitlement to direct service connection for ED is not warranted.

In light of the above, the evidence persuasively weighs against the claim of entitlement to service connection for ED, and the benefit-of-the-doubt doctrine is not for application. The claim therefore must be denied. 38 U.S.C. § 5107(b); see also Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021) (en banc); 38 C.F.R. § 3.102.

The appellant is encouraged to file a supplemental claim to allow for the consideration of his service-connected thoracolumbar spine degenerative arthritis in causing or aggravating his ED.

3. Entitlement to service connection for PFB.

The appellant contends that he is entitled to service connection for PFB.

Analysis

3. Entitlement to service connection for PFB.

The appellant contends that he is entitled to service connection for PFB.

Analysis

The first element required for any theory of service connection is a current disability. After a thorough review of the record, the claims file does not show a current diagnosis of PFB, nor does it show a diagnosis of any such disability at any time during the pendency of the claim or recent to the filing of the claim. See Romanowsky v. Shinseki,?26?Vet. App.?289, 294?(2013); McClain v. Nicholson, 21 Vet. App.?319, 321?(2007). PFB is defined as "a condition resembling folliculitis, involving the bearded region... The primary lesion is a pinhead-sized pustule, pierced by a hair; if neglected this may lead to impetiginization and crust formation and may become chronic. Popularly known as razor bumps." DORLAND'S ILLUSTRATED MEDICAL DICTIONARY 1565 (31st ed. 2007). VA treatment records include November 2019, January 2020, and August 2020 skin assessments that were described as normal. There were no complaints, findings, or references to PFB or any other skin condition.

It is noted that no VA medical examination regarding the appellant's PFB was provided, triggering a McLendon analysis. However, the analysis fails the first element, as there is no competent evidence of a current disability or persistent or recurrent symptoms of a disability.

While the appellant believes that he has a diagnosis of PFB, and he is competent to relate his lay observations, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4?(Fed. Cir. 2007); Kahana v. Shinseki, 24 Vet. App. 428 (2011).

In light of the above, the evidence persuasively weighs against the claim of entitlement to service connection for PFB, and the benefit-of-the-doubt doctrine is not for application. The claim therefore must be denied. 38 U.S.C. § 5107(b); see also Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021) (en banc); 38 C.F.R. § 3.102.

REASONS FOR REMAND

1. Entitlement to service connection for bilateral knee osteoarthritis and osteophytes.

An appellant's claims must be remanded to the AOJ to correct pre-decisional duty to assist errors, including when the AOJ fails to make reasonable efforts to obtain VA treatment records, relevant federal or private treatment records; fails to obtain a VA examination; or provides an inadequate VA examination or opinion.? 38?C.F.R. §?20.802(a). An appeal may also be remanded for correction of any other error by the agency of original jurisdiction in satisfying a regulatory or statutory duty, if correction of the error would have a reasonable possibility of aiding in substantiating the appellant's claim. Id.

Upon review of the appellant's service record, it is not clear that the record contains a complete and accurate determination regarding the appellant's active duty, active duty for training (ADT), and inactive duty for training (IDT) service. Understanding the type of the appellant's service is necessary to properly address the appellant's claims. See 38 U.S.C. § 101. As such, a remand is warranted to verify the periods of the appellant's service.

The matter is REMANDED for the following action:

Verify all periods of active duty, ADT, and IDT, through all appropriate sources. A retirement points summary is not enough, the specific dates must be verified, and records obtained. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified, and this should be documented for the record. Required notice must be provided to the appellant and his representative.

MICHAEL A. HERMAN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Lee N. Feldman, Counsel

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