MULTIPLE SCLEROSIS

Summary

The Veteran, who served from January 1994 to March 2003, appeals the denial of service connection for Multiple Sclerosis (MS). The Veteran contends that her MS symptoms, specifically extremity sensory changes, began during active duty in 1995. She asserts that medical personnel during service misattributed or ignored these symptoms. The Veteran's treating VA physician, Dr. L., stated in January 2020 that the initial symptom onset was in 1995. The Board found this opinion credible and consistent with other evidence, including a VA neuropsychological evaluation, the Veteran's hearing testimony, lay statements from family and a fellow service member, and service treatment records documenting extremity sensory disturbances. The Board noted the absence of any medical opinion weighing against service connection. Applying the benefit of the doubt doctrine, the Board found that the evidence persuasively demonstrated the Veteran's MS arose in service. Service connection for MS was granted.

Rationale

Current disability established; In-service onset of symptoms in 1995; Credible treating physician opinion linking symptoms to service; No medical opinion weighing against service connection

Full Decision Text

Citation Nr: A26030685
Decision Date: 04/03/26	Archive Date: 04/03/26

DOCKET NO. 210201-137051
DATE: April 3, 2026

ORDER

Service connection for multiple sclerosis (MS) is granted.

FINDING OF FACT

The Veteran's MS began during active service.

CONCLUSION OF LAW

The criteria for service connection for MS are met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from January 1994 to March 2003.

In the February 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket.  A Board hearing was held on August 12, 2024.

Therefore, the Board may only consider the evidence of record at the time of the March 2020 AOJ decision on appeal, as well as any evidence submitted by the Veteran or her attorney at the hearing or within 90 days following the hearing.  38 C.F.R. § 20.302(a).  Evidence was associated with the file both (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, and (2) more than 90 days following the hearing.  The Board did not consider this evidence in its decision.  38 C.F.R. §§ 20.300, 20.302(a), 20.801.  

If the Veteran would like VA to consider any evidence that the Board could not consider, she 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, considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a Supplemental Claim are included with this decision. 

Neither the Veteran nor her attorney have raised any issues with the duty to notify or duty to assist that occurred prior to the rating decision on appeal.  See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument).

Service connection for MS is granted.

The Veteran and her attorney assert that her conceded MS disability had its onset on active duty, as demonstrated by sensory disturbances in her extremities beginning in approximately 1995.  See August 2024 hearing transcript.  They further assert that, while she repeatedly sought medical treatment for sensory disturbances in her extremities on active duty, she was ignored or misdiagnosed, with medical personnel attributing her symptoms to childbearing.  See id.; November 2024 lay statements.

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303.  The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

The benefit of the doubt rule provides that an appellant will prevail in a case where the positive evidence is in approximate balance with the negative evidence.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.  It is only when the weight of the evidence is persuasively against the claim that the claim must be denied.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

The Board concludes that the Veteran has a current disability that began during active service.  38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009
 positive evidence is in approximate balance with the negative evidence.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.  It is only when the weight of the evidence is persuasively against the claim that the claim must be denied.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

The Board concludes that the Veteran has a current disability that began during active service.  38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a).

Because the issue of direct service connection is dispositive, the Board need not address other theories of service connection.

As an initial matter, the Board is bound by the favorable findings reached by the AOJ in its rating decision.  See 38 U.S.C. § 5104(b)(4); 5104A; 38 C.F.R. § 20.801(a).  Here, the AOJ favorably found that the Veteran has a current MS disability.

Thus, the question becomes whether the current disability is related to service. 

While the Veteran was not afforded a VA examination or opinion in connection with this claim, her treating VA physician stated in January 2020 that the first symptom of her MS, extremity sensory changes, occurred in 1995.  The Veteran testified that she receives all of her MS treatment through VA.  See August 2024 hearing transcript.  Her physician, Dr. L., is charged with accurately evaluating the Veteran in order to provide appropriate care for the claimed disability.  The January 2020 opinion of Dr. L. is credible and consistent with other evidence of record, including a neuropsychological evaluation performed by a VA psychologist in February 2020; the Veteran's credible August 2024 hearing testimony; the lay statements of the Veteran's mother, cousin, and fellow service member; and multiple service treatment records demonstrating sensory disturbances in the extremities.  See February 2020 VA treatment records; November 2024 lay statements; February 1998, May 1998, March 2000, April 2001, and May 2001 service treatment records.  The Board therefore affords the January 2020 opinion of the Veteran's treating VA physician great probative weight.

There is no medical opinion of record weighing against direct service connection.

Upon review of the record, the Board finds the evidence persuasively demonstrates that the Veteran's current MS arose in service.  Accordingly, the Board finds that service connection for MS is warranted.

 

 

D. Martz Ames

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A.C.

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.