PERIPHERAL NERVE PARALYSIS

TIFFANY DAWSON · 2026 · Case ID: A26031333

MIXED

Summary

The Veteran served from February 1963 to December 1966. The Veteran appeals the denial of service connection for ischemic heart disease (IHD), diabetes mellitus type II, and fibromyalgia. The Veteran also appeals the severance of service connection for malignant neoplasm of the skin, right lower extremity peripheral neuropathy, and left lower extremity peripheral neuropathy, seeking restoration of service connection. Additionally, the Veteran appeals the remand of claims for hypertension, chronic obstructive pulmonary disorder (COPD), erectile dysfunction, acquired psychiatric conditions as secondary to service-connected disabilities, and entitlement to TDIU. The Board found the severance of service connection for the skin condition and peripheral neuropathies to be improper and granted restoration of service connection for these conditions, effective March 1, 2026. The Board denied service connection for IHD, diabetes mellitus type II, and fibromyalgia, finding the evidence persuasively weighed against these claims. The Board remanded the claims for hypertension and COPD. For hypertension, the Board found the November 2023 VA opinion inadequate as it did not specify the TERA and the Veteran's asbestos exposure had not yet been determined at that time. For COPD, the Board found the September 2024 VA opinion inadequate because it did not provide an opinion on the relationship to asbestos exposure, despite the AOJ conceding both COPD and asbestos exposure. The Board noted the January 2026 VA examiner's opinion that COPD and hypertension were at least as likely as not caused by asbestos exposure, but this opinion was not considered as it was submitted after the AOJ decision.

Rationale

Severance of service connection was improper.; Criteria for restoration of service connection met.

Special Benefit

TDIU

Docket No.

260211-624978

Full Decision Text

Citation Nr: A26031333
Decision Date: 04/07/26 Archive Date: 04/07/26

DOCKET NO. 260211-624978
DATE: April 7, 2026

ORDER

Severance being improper, restoration of service connection for right lower extremity peripheral neuropathy, effective March 1, 2026 is granted.

Severance being improper, restoration of service connection for left lower extremity peripheral neuropathy, effective March 1, 2026 is granted.

Severance being improper, restoration of service connection for malignant neoplasm of the skin, effective March 1, 2026 is granted.

Entitlement to service connection for ischemic heart disease (IHD) is denied.

Entitlement to service connection for diabetes mellitus type II (diabetes) is denied.

Entitlement to service connection for fibromyalgia is denied.

REMANDED

Entitlement to service connection for hypertension is remanded.

Entitlement to service connection for chronic obstructive pulmonary disorder (COPD) is remanded.

Entitlement to service connection for erectile dysfunction is remanded.

Entitlement to service connection for acquired psychiatric conditions as secondary to service connected disabilities is remanded.

Entitlement to a total disability rating based on individual unemployability due to service connected disabilities (TDIU) is remanded.

FINDINGS OF FACT

1. The Veteran was not provided proper due process prior to the severance of service connection for malignant neoplasm of the skin, left lower extremity peripheral neuropathy, and right lower extremity peripheral neuropathy.

2. The evidence is persuasively against finding that the Veeran was exposed to herbicide agents on a presumptive basis or on a facts found basis.

3. The evidence is persuasively against finding that the Veteran's IHD began during active service, manifested within one year of service discharge, or is otherwise etiologically related to his active service, to include as a result of the Veteran's conceded toxic exposure risk activity (TERA), namely asbestos.

4. The evidence is persuasively against finding that the Veteran's diabetes began during active service, manifested within one year of service discharged, or is otherwise etiologically related to his active service, to include as a result of the Veteran's conceded TERA, namely asbestos.

5. The evidence of record persuasively weighs against a finding that the Veteran has a current diagnosis of fibromyalgia proximate to the Veteran's claim, or during the appeal period.

CONCLUSIONS OF LAW

1. The severance of service connection for right lower extremity peripheral neuropathy is void ab initio; the criteria for restoration of service connection from March 1, 2026, have been met. 38 U.S.C. § 5109A; 38 C.F.R. §§ 3.103, 3.105.

2. The severance of service connection for left lower extremity peripheral neuropathy is void ab initio; the criteria for restoration of service connection from March 1, 2026, have been met. 38 U.S.C. § 5109A; 38 C.F.R. §§ 3.103, 3.105.

3. The severance of service connection for malignant neoplasm of the skin is void ab initio; the criteria for restoration of service connection from March 1, 2026, have been met. 38 U.S.C. § 5109A; 38 C.F.R. §§ 3.103, 3.105.

4. The criteria for entitlement to service connection for ischemic heart disease have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309.

5. The criteria for entitlement to service connection for diabetes mellitus type II have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309.

6. The criteria for entitlement to service connection for fibromyalgia have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from February 1963 to December
met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309.

6. The criteria for entitlement to service connection for fibromyalgia have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from February 1963 to December 1966.

The rating decisions on appeal were issued in August 2025 (IHD and diabetes), September 2025 (psychiatric disorder and TDIU), September 2025 (fibromyalgia), December 2025 (severance), January 2026 (erectile dysfunction), and February 2026 (COPD and hypertension) and constitute initial decisions; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

With regard to the Veteran's claims related to service connection for erectile dysfunction and hypertension, the Veteran initially requested Higher-Level Review when submitting a July 2025 VA Form 20-0996, Decision Review Request: Higher-Level Review. The Veteran also submitted a September 2025 VA Form 20-0996 regarding the issue of entitlement to service connection for COPD. In an October 2025 rating decision, the Higher-Level Reviewer determined that there had been duty to assist errors and transferred the claims to the Supplemental Claim decision review option for additional development.

In the February 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the August 2025 (IHD and diabetes), September 2025 (psychiatric disorder and TDIU), September 2025 (fibromyalgia), and December 2025 (severance) agency of original jurisdiction (AOJ) decisions on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

The Board may only consider the evidence of record at the time of the January 2026 (erectile dysfunction), and February 2026 (COPD and hypertension) AOJ supplemental claim decisions on appeal. 38 C.F.R. § 20.301. If evidence was submitted after the AOJ issued the supplemental claim decision on appeal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801.

The Board notes that the Veteran's February 2026 VA Form 10182 is timely to the February 2026 rating decision. The Veteran indicated appeal of entitlement to service connection for hypertension on his VA Form 10182. Additionally, the Veteran's representative submitted argument related to both the issues of entitlement to service connection for hypertension and COPD based on similar reasons. As such, the Board finds that the issues addressed in the February 2026 rating decision are properly before the Board.

In adjudicating the Veteran's appeal, the Board acknowledges the recent United States Court of Appeals for Veterans Claims (Court) decision in Williams v. McDonough, 37 Vet. App. 305 (2024), which found that under 38 C.F.R. § 20.202(c)(2), the Board generally may not decide an appeal before the deadline for requesting an AMA docket switch has elapsed. 38 C.F.R. § 20.202(c) allows appellants to switch AMA dockets by completing and submitting a new VA Form 10182 within 60 days from when the Board receives the original VA Form 10182, or one year from the date the AOJ mails notice of the decision on appeal, whichever is later, unless: (1) an appellant has already submitted evidence or testimony as described in 38 C.F.R. §§ 20.302 and 20.303, or (2) the appellant or representative has requested a waiver of the ability to request to switch dockets during this timeframe. Williams, 37 Vet. App. 305. In this case, the Veteran submitted a Williams waiver in February 2026. As such, the Board will proceed with adjudication of the Veteran's appeal.

If
a new VA Form 10182 within 60 days from when the Board receives the original VA Form 10182, or one year from the date the AOJ mails notice of the decision on appeal, whichever is later, unless: (1) an appellant has already submitted evidence or testimony as described in 38 C.F.R. §§ 20.302 and 20.303, or (2) the appellant or representative has requested a waiver of the ability to request to switch dockets during this timeframe. Williams, 37 Vet. App. 305. In this case, the Veteran submitted a Williams waiver in February 2026. As such, the Board will proceed with adjudication of the Veteran's appeal.

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 the Board is denying or granting, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

However, because the Board is remanding the claims of entitlement to service connection for acquired psychiatric conditions as secondary to service connected disabilities, erectile dysfunction, hypertension, COPD, and TDIU, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

Whether the severance of service connection for right lower extremity peripheral neuropathy, effective March 1, 2026, was proper.

Whether the severance of service connection for left lower extremity peripheral neuropathy, effective March 1, 2026, was proper.

Whether the severance of service connection for malignant neoplasm of the skin, effective March 1, 2026, was proper.

Service connection will be severed only where evidence established that it is clearly and unmistakably erroneous (CUE), the burden of proof being on the Government. 38 C.F.R. § 3.105(d).

When severance of service connection is considered warranted, a rating proposing severance will be prepared setting forth all material facts and reasons. 38 C.F.R. § 3.105(d). The claimant will be notified at his or her latest address of record of the contemplated action and furnished detailed reasons therefor and will be given 60 days for the presentation of additional evidence to show that service connection should be maintained. Id. Unless otherwise provided in paragraph (i) of this section, if additional evidence is not received within that period, final rating action will be taken and the award will be reduced or discontinued, if in order, effective the last day of the month in which a 60-day period from the date of notice to the beneficiary of the final rating action expires. Id. The initial question before the Board is whether the AOJ followed the due process requirements of 38 C.F.R. § 3.105(d) for severing service connection.

A change in diagnosis may be accepted as a basis for severance action if the examining physician or physicians or other proper medical authority certifies that, in the light of all accumulated evidence, the diagnosis on which service connection was predicated is clearly erroneous. This certification must be accompanied by a summary of the facts, findings, and reasons supporting the conclusion. 38 C.F.R. § 3.105(d).

To establish that a grant of service connection was the product of CUE, VA must show that (1) either the correct facts as they were known at the time were not before the adjudicator, the adjudicator made an erroneous factual finding, or the statutory provisions were incorrectly applied; (2) the alleged error was undebatable, not merely a disagreement as to how the facts were weighed or evaluated; and (3) the error manifestly changed the outcome of the prior decision. Allen v. Nicholson, 21 Vet. App. 54, 58-59 (2007). A clear and unmistakable error is one about which reasonable minds could not differ. See 38 C.F.R. § 3.105(a)(1)(i).

In most respects, the CUE standard for severing service connection under 38 C.F.R. § 3.105(d) is equivalent to the CUE standard for reversing or revising a prior final decision under 38 C.F.R. § 3.105(a); Baughman v. Derwinski, 1 Vet. App. 563, 566 (1991). However, the determination is not limited
. Allen v. Nicholson, 21 Vet. App. 54, 58-59 (2007). A clear and unmistakable error is one about which reasonable minds could not differ. See 38 C.F.R. § 3.105(a)(1)(i).

In most respects, the CUE standard for severing service connection under 38 C.F.R. § 3.105(d) is equivalent to the CUE standard for reversing or revising a prior final decision under 38 C.F.R. § 3.105(a); Baughman v. Derwinski, 1 Vet. App. 563, 566 (1991). However, the determination is not limited to the law and the record that existed at the time of the original decision. VA may consider medical evidence and diagnoses that postdate the original award of service connection to demonstrate that the diagnosis on which service connection was predicated is clearly erroneous. Stallworth v. Nicholson, 20 Vet. App. 482, 488 (2006).

Due Process

In this case, the AOJ initially granted service connection for malignant neoplasm of the skin and bilateral lower extremity peripheral neuropathies in an August 2024 rating decision. In April 2025, July 2025, and October 2025, the AOJ proposed to sever the grants of service connection for malignant neoplasm of the skin, and bilateral lower extremity peripheral neuropathies. The AOJ informed the Veteran that he had 60 days to provide evidence refuting the determinations or request a personal hearing within 30 days of the notification. However, the Veteran did not respond.

In a December 2025 rating decision, the AOJ severed service connection for malignant neoplasm of the skin, and bilateral lower extremity peripheral neuropathies, effective March 1, 2026. However, the Veteran was not notified of the decision until January 2, 2026. As such, the effective date of the severance of service connection was earlier than the last day of the month in which a 60-day period from the date of notice to the beneficiary of the final rating action expired. As such, the procedural requirements to sever service connection under 38 C.F.R. § 3.105(d) were not appropriately followed by the AOJ in this case. Therefore, restoration of service connection for malignant neoplasm of the skin, and bilateral lower extremity peripheral neuropathies, effective March 1, 2026, is warranted.

Service Connection

Service connection may be granted if there is a disability resulting from personal injury or disease incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). To establish service connection, the evidence must show: (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

The requirement for a current disability is satisfied if the disability is present at any point proximate to the claim, or during the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). In the absence of proof of a current disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

Entitlement to service connection for IHD.

Entitlement to service connection for diabetes.

As a matter of background, the Board denied the Veteran's claims for entitlement to service connection for IHD and diabetes mellitus type II in an August 2023 Board decision. In September 2023, the Veteran submitted a VA Form 20-0995, Supplemental Claim Application, seeking service connection for IHD and diabetes, to include as due to exposure to herbicide agents. The AOJ denied the Veteran's claims in a February 2024 rating decision. The Veteran appealed that decision to the Board. In June 2024, the Board remanded the issues for further development. In the August 2025 rating decision on appeal, the AOJ continued
.

Entitlement to service connection for diabetes.

As an initial matter, the AOJ found the Veteran had current diagnoses for IHD and diabetes. See August 2025 rating decision. The AOJ also conceded that the Veteran was exposed to asbestos based on his military occupational specialty as a radioman and therefore participated in a TERA. See October 2024 TERA Memorandum; August 2025 and February 2026 rating decisions. The Board is bound by these favorable findings. 38 C.F.R. § 3.104(c). As such, the first element of service connection has been established. Shedden, 381 F.3d at 1167.

In regard to the second element of service connection, the Veteran asserts he was exposed to herbicide agents onboard the USS Bennington during his service. In a June 2021 statement, the Veteran asserted he was onboard when the vessel entered Qui Nhon Bay harbor to pick up Bob Hope on December 26, 1966. The Veteran previously testified before the Board at a May 2023 hearing that he visited a U.S. military base or installation in Bangkok, Thailand, and visited Guam. He also testified that he visited other ships within the territorial waters of Vietnam by helicopter, including the USS Cunningham, USS O'Brien, USS Fechteler, and USS Eversole. See May 2023 hearing transcript. He testified that he flew in a helicopter over the landmass but did not touch down in Vietnam. Id. The Veteran submitted a lay statement from a fellow servicemember who reported they went to Bangkok, Thailand from May 22 to May 24, 1965. See September 2023 statement in support of claim. He reported the USS Bennington was anchored out in the harbor and they took a Marine boat back and forth to the city from the ship. Id.

For certain chronic diseases, including IHD and diabetes, service connection may be granted on a presumptive basis if the disease is manifested to a compensable degree within one year following service discharge. 38 C.F.R. §§ 3.307, 3.309(a).

Service connection can be established based on herbicide exposure for specific diseases, including Type II diabetes mellitus and coronary artery disease. 38 C.F.R. § 3.309(e). Herbicide agent exposure is presumed for those who served in the Republic of Vietnam between January 9, 1962, and May 7, 1975, in or near the Korean demilitarized zone between April 1, 1968 and August 31, 1971, in Thailand at any base between January 9, 1962 to June 30, 1976, Laos from December 1, 1965 to September 30, 1969, certain locations in Cambodia from April 16, 1969 to April 30, 1976, Guam or American Samoa (including the territorial waters) from January 9, 1962 to July 31, 1980, or Johnson Atoll or a ship that called there from January 1, 1972 to September 30, 1977, is presumed to have been exposed to herbicide. 38 U.S.C. §§ 1116 (d), (f), 116A, 1116B; 38 C.F.R. § 3.307. Herbicide exposure can also be shown on a facts-found basis.

Where the evidence does not warrant presumptive service connection, a veteran is not precluded from establishing service connection for disability due to exposure to herbicides with proof of direct causation. Combee v. Brown, 34 F.3d 1039, 1041 (Fed. Cir. 1994). In other words, a presumption of service connection provided by law is not the sole method for showing causation in establishing a claim for service connection for disability due to herbicide exposure.

The phrase "service in
1116 (d), (f), 116A, 1116B; 38 C.F.R. § 3.307. Herbicide exposure can also be shown on a facts-found basis.

The phrase "service in the Republic of Vietnam" in 38 U.S.C. § 1116 includes the territorial seas of the Republic of Vietnam extending 12 nautical miles from the shores of that nation. See Procopio v. Wilkie, 913 F.3d 1371 (Fed. Cir. 2019).

Congress has enacted the Blue Water Navy Vietnam Veterans Act of 2019 (Blue Water Navy Act). Pub. L. No. 116-23, 133 Stat. 966 (2019). The effective date of the Blue Water Navy Act is January 1, 2020. The stated main purpose of this Act was "to amend title 38, United States Code, to clarify presumptions relating to the exposure of certain veterans who served in the vicinity of the Republic of Vietnam, and for other purposes." See Blue Water Navy Vietnam Veterans Act of 2019, Pub. L. No. 116-23, 133 Stat. 966 (2019), Synopsis. The Blue Water Navy Act defines service "offshore of the Republic of Vietnam" as encompassing service in the territorial sea extending 12 nautical miles from the shores both of that nation and of Cambodia. See 38 U.S.C. § 1116A(d). It provides that the 12 miles are measured seaward of a line commencing on the southwestern demarcation line of the waters of Vietnam and Cambodia and intersecting at certain points (latitude North, longitude East); these are set out in a Points Geographic table included there. See 38 U.S.C. § 1116A(d). A veteran's service must take place during the period January 9, 1962, to May 7, 1975. 38 U.S.C. § 1116A(a).

On August 10, 2022, the PACT Act was signed into law, and pertinent to the present case, amended 38 U.S.C. § 1116 such that it expanded the presumption of herbicide agent exposure for veterans who served in the Republic of Vietnam; Thailand at any U.S. or Royal Thai base; Laos, certain provinces in Cambodia; Guam, or America Samoa or their territorial waters; or the Johnston Atoll or a ship that called there. Specific to this case, the PACT Act provided that any veteran who performed active-duty service in Guam or America Samoa, or in the territorial waters thereof from January 9, 1962, to July 31, 1980, and any veteran who performed active-duty service in Thailand at any United States or Royal Thai base during the period beginning on January 9, 1962, and ending on June 30, 1976, is presumed to have been exposed to herbicide agents during service. A notable element of the PACT Act is that it established a presumption for in-service exposure to herbicide agents "without regard to where on the base the veteran was located or what military job specialty the veteran performed." See PACT Act of 2022, Pub. L. No. 117-168, § 403(d)(2) (2022).

With regard to the Veteran's assertions of asbestos exposure, the Board recognizes that there are no statutes specifically addressing asbestos and service connection for asbestos related diseases and the Secretary of VA has not promulgated any specific regulations. An opinion by VA's Office of General Counsel discussed the development of asbestos claims. See VAOPGCPREC 4-2000.

In this case, the Board finds the evidence of record persuasively weighs against finding the Veteran was exposed to herbicide agents during his service. Specifically, the Board finds that exposure to herbicide agents may not be presumed, as the evidence persuasively weighs against finding that the Veteran's active service included service or visitation to a U.S. or Royal Thai Air Force base or Guam, or in-country duty or visitation in the Republic of Vietnam, including on the landmass, inland waterways, or in the territorial sea extending 12 nautical miles seaward of a line commencing
An opinion by VA's Office of General Counsel discussed the development of asbestos claims. See VAOPGCPREC 4-2000.

In this case, the Board finds the evidence of record persuasively weighs against finding the Veteran was exposed to herbicide agents during his service. Specifically, the Board finds that exposure to herbicide agents may not be presumed, as the evidence persuasively weighs against finding that the Veteran's active service included service or visitation to a U.S. or Royal Thai Air Force base or Guam, or in-country duty or visitation in the Republic of Vietnam, including on the landmass, inland waterways, or in the territorial sea extending 12 nautical miles seaward of a line commencing on the southwestern demarcation line of the waters of Vietnam and Cambodia and intersecting at points specified in the Blue Water Navy Vietnam Veterans Act of 2019. Moreover, there is no probative evidence of actual exposure to an herbicide agent during the Veteran's service.

The Veteran has consistently asserted that his IHD and diabetes were associated with herbicide agent exposure based on his service onboard the USS Bennington. The Veteran's military personnel files show the Veteran reported to the USS Bennington on October 10, 1963, and that he was transferred off this ship on December 3, 1966 while it was stationed in a port in Japan. The Veteran's military personnel records, including a Transfers and Receipts form, document that he was assigned to the USS Kearsarge on December 8, 1966 while in Japan, and that this vessel traveled to the U.S. Naval Station in Long Beach, California, where the Veteran was transferred off the ship on December 20, 1966. The Veteran's service treatment records show that he was afforded a separation examination on December 23, 1966 in Long Beach, California. His DD Form 214 shows that the Veteran was discharged from active duty in Long Beach, California on December 28, 1966.

From January 2020 to December 2020, the AOJ obtained several logbooks for the USS Bennington. The logbooks, to include January 2020 map representations of the locations of this ship from December 10, 1963 to September 6, 1964, and from November 6, 1964 to December 8, 1966, show that the ship was not within the territorial sea extending 12 nautical miles of Vietnam. Furthermore, the June 2020 VA Form 21-6789 shows that there was no evidence that the USS Bennington had blue water or brown water service during the deployments in 1964, 1965, or 1966, while the Veteran was onboard this ship. Likewise, an April 2021 Military Records Research Center's reply shows that no evidence was located to support documentation of the Veteran's claimed exposure to herbicide agents while serving on the USS Bennington after requesting documents from the Naval History and Heritage Command and the National Archives and Records Administration, as well as researching the 1963, 1966, and 1967 command histories and the 1944 to 1968 ship history from the USS Bennington.

In October 2024, the AOJ received a response from the Records Research Center finding that the deck logs form March 26, 1964, April 23, 1965, and December 2, 1966 were not missing as they did not exist as the USS Bennington crossed the IDL on each of these dates. See October 2024 records research center response. It was also determined that the 1964 and 1965 command histories were not available; and that qualifying service was not shown. Id.; see October 2024 final attempt letter.

As noted, the Veteran asserted he was aboard the USS Bennington when the ship picked up Bob Hope in December 1966. See June 2021 statement. However, he stated he did not know the time frame, and that he recalled that while docked he never left the ship. Id. The Veteran also testified that he was aboard the USS Bennington when Bob Hope performed. See May 2023 Board hearing. However, the evidence shows that Veteran reported that the USS Bennington entered Qui Nhon Bay Harbor to pick up Bob Hope for onboard Christmas show on December 26, 1966, after the Veteran was already transferred off of the USS Bennington. See June 2021 correspondence. Therefore, the Veteran could not have been onboard the USS Bennington at that time as his military personnel records clearly demonstrate he was in Long Beach, California.

The Veteran also submitted correspondence indicating the USS Bennington went to Vietnam
recalled that while docked he never left the ship. Id. The Veteran also testified that he was aboard the USS Bennington when Bob Hope performed. See May 2023 Board hearing. However, the evidence shows that Veteran reported that the USS Bennington entered Qui Nhon Bay Harbor to pick up Bob Hope for onboard Christmas show on December 26, 1966, after the Veteran was already transferred off of the USS Bennington. See June 2021 correspondence. Therefore, the Veteran could not have been onboard the USS Bennington at that time as his military personnel records clearly demonstrate he was in Long Beach, California.

The Veteran also submitted correspondence indicating the USS Bennington went to Vietnam with coordinates in "December 1966." See March 2024 correspondence/email. However, the dates are not specific to the Veteran's dates and do not establish that the Veteran was onboard during any specific date that the USS Bennington visited Vietnam or was in the territorial waters of Vietnam.

The Veteran also asserted he spent a day in Bangkok, Thailand, and visited Guam. See May 2023 hearing transcript; March 2024 correspondence. He testified that he entered Bangkok through a U.S. entrance from the port where the USS Bennington was docked. Id. However, the claims file does not contain competent or credible evidence showing that the Veteran visited or was stationed at a U.S. or Royal Thai Air Force Base or Guam during his active duty. It was noted that the ship anchored in Bangkok from May 22, 1965 through May 24, 1965. See October 2024 records research center response. Additionally, the logbooks note that the Bangkok is not on the list of conceded herbicide nautical locations. See October 2024 logbooks. It was noted that Sattahip is the only herbicide nautical location in Thailand, but the USS Bennington did not anchor at Sattahip. Id. Moreover, the evidence, including military personnel records, does not demonstrate the Veteran visited or was stationed in Guam during his active duty service.

The Veteran also testified that he traveled from the USS Bennington to other ships as part of his duties as a radioman. Id. A July 2019 Navy and Coast Guard Ships Associated with Service in Vietnam and Exposure to Herbicide Agents document, which was associated with the claims file in June 2021, lists several of the ships the Veteran asserted he visited, or their crew, as being within inland or territorial waters of Vietnam during the Vietnam war era. For example, this document shows that the USS O'Brien sent a motorized whaleboat ashore while anchored in Da Nang Harbor on December 16, 1969. The USS Eversole sent a motorized whaleboat ashore to Chu Lai from offshore anchorage to transfer two crewmembers on July 25, 1972. The USS Fechteler operated in the Mekong River Delta on September 27, 1965 and Qui Nhon Bay on November 25-25, 1968, and sent a crew ashore for a beach party on September 25, 1965, and crewmembers went ashore for daytime liberty leave during October 1965 while conducting night patrols. The USS Edwards operated in the Mekong River Delta in Province of Kien Hoa from February 28, 1969 to March 1, 1969, and sent personnel ashore via small boat on November 5, 1967, and December 1, 1967. However, this evidence, as well as the record, does not show that the Veteran was located on these vessels during the specific dates in question when they were in the inland or territorial waters of Vietnam. In fact, many of the dates when the ships were documented within the territorial waters occurred after the Veteran had been assigned off of the USS Bennington on December 8, 1966 and/or was discharged from active duty while in California on December 28, 1966.

The Board has considered the Veteran's statements; however, it finds that such statements are contradicted by the other evidence of record, including the facts documented in the Veteran's service treatment records and military personnel records. The Board notes the AOJ has conducted a thorough search of the records showing the movements of the USS Bennington, including obtaining the deck logs, and replies from the appropriate records repositories. The Veteran, nor his representative, have provided any evidence showing that the Veteran was within the 12 nautical miles of Vietnam, visited or was stationed in Guam, or visited or was stationed at a U.S. or Royal Thai Air Force Base during his active duty service. The Veteran, nor his representative
, 1966.

With regard to direct service connection, the Veteran's service treatment records do not show a disease or injury indicative of IHD or diabetes. For example, the December 1966 Report of Medical Examination, as well as periodic examinations in August 1963 and January 1965, show normal clinical evaluations of the heart and vascular systems, and do not document symptoms indicative of diabetes. Furthermore, the December 1966 service separation evaluation shows that the Veteran certified that he had informed the medical office of all of his physical defects, illness, and injuries known to him. He also certified that he was "informed" and "understood the provides of BUMED Instruction 6120.6B." Thus, he indicated that he was informed he had been found to be fit, and if he had any serious medical problems, he should so inform the examining physician. See Real v. U.S., 906 F.2d 1557, 1559 (Fed. Cir. 1990). The evaluator further documented that the Veteran was examined that date, with no defects noted, and found to be physical qualified for release to inactive duty. Additionally, the Veteran denied a history of palpitation or pounding heart, high or low blood pressure, or pain or pressure in chest. Moreover, the Veteran, nor his representative, have asserted that his current heart and diabetes disabilities manifested in service or within one year he was diagnosed with coronary artery disease in 2001 following two heart attacks (myocardial infarctions), with pre-diabetes in 2009 or 2010, and diagnosed with type II diabetes mellitus in 2019.

The AOJ obtained a VA medical opinion in November 2024. The VA examiner opined that it was at least as likely as not that the Veteran's IHD was caused by exposure to herbicide agents. See November 2024 VA medical opinion. However, as discussed, the evidence does not demonstrate herbicide agent exposure, and the VA examiner relied on an inaccurate premise. Additionally, the VA examiner noted the Veteran did not qualify for a diagnosis of diabetes. As such, the Board finds the November 2024 medical opinions inadequate for decision making purposes. ?See Nieves-Rodriguez v. Peake, 22?Vet. App.?295, 302 (2008).

Given this evidence, the Board finds that the evidence persuasively weighs against finding that the Veteran's IHD and diabetes had their onset during active service or manifested within one year of service discharge in December 1966. The Board notes a negative inference may be drawn from the absence of complaints or treatment for an extended period, albeit only if the circumstances are such that it would be reasonable to expect a record to exist. Horn v. Shinseki, 25 Vet. App. 231, 239 (2012); Maxson v. West, 12 Vet. App. 453, 459 (1999), aff'd sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). The first evidence of a diagnosis of IHD is from 2001, which is more than 30 years after service separation. Likewise, the first instance of evidence of a diagnosis of diabetes in 2019, which is more than 50 years following separation from service. This is persuasive evidence that weighs against finding that the IHD and diabetes manifested within one year of separation from service and have been continuous since active duty. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006).

As noted, the AOJ conceded the Veteran was exposed to asbestos in service. The Veteran was
1333 (Fed. Cir. 2000). The first evidence of a diagnosis of IHD is from 2001, which is more than 30 years after service separation. Likewise, the first instance of evidence of a diagnosis of diabetes in 2019, which is more than 50 years following separation from service. This is persuasive evidence that weighs against finding that the IHD and diabetes manifested within one year of separation from service and have been continuous since active duty. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006).

As noted, the AOJ conceded the Veteran was exposed to asbestos in service. The Veteran was afforded a VA medical opinion in February 2025. The VA examiner opined that the Veteran's IHD was less likely than not caused by the indicated TERA, as the Veteran was not exposed to Agent Orange. See February 2025 VA medical opinion. However, the VA examiner did not address the Veteran's exposure to asbestos. As such, the February 2025 VA medical opinion is inadequate for decision making purposes. ?See Nieves-Rodriguez, 22?Vet. App. at 302.

In June 2025, the AOJ obtained a VA medical opinion addressing the Veteran's exposure to asbestos. The VA examiner opined that the Veteran's IHD was less likely that not caused by the indicated TERA, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. See June 2025 VA medical opinion. As rationale, the VA examiner noted that asbestos specifically did not lead to the Veteran's heart disease as there is no medical evidence to support this; the Veteran had a heart attack in 2001; CAD was the cause of the Veteran's heart attack; the Veteran did not have exposure to herbicide agents; and asbestos exposure has not been shown to lead to heart disease in any medical literature. Id.

In regard to the Veteran's diabetes, the June 2025 VA examiner opined that it is less likely than not that the Veteran's diabetes was caused by the indicated TERA, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. See June 2025 VA medical opinion. As rationale, the VA examiner noted the Veteran was not diagnosed with diabetes until 2019, well after his separation from service in December 1966; no research was found supporting a nexus between asbestos exposure and diabetes; although some environmental contaminants are suspected to increase the risk of diabetes in susceptible individuals, no research was found to support a nexus between diabetes and the synergistic combined effect of all TERAs of the Veteran; the Veterans statements indicated he may have had exposure to aircraft fuel fumes, although his job classification as operation of radio would not have exposed him directly to toxins; the medical literature does not support a nexus between diabetes and asbestos; and overall, the evidence is suggestive but not sufficient to infer a causal association between some environmental chemicals and diabetes outcomes. Id.

The only evidence indicating the Veteran's diabetes and IHD are the result of his active duty service was the Veteran's own statements. However, he is not shown to have the medical training necessary to do so. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).

In sum, while there are current diagnoses for IHD and diabetes, the evidence of record fails to demonstrate the Veteran's conditions are etiologically related to his active duty service. Therefore, the benefit of the doubt rule is not applicable. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Accordingly, service connection for IHD and diabetes is not warranted.

Entitlement to service connection for fibromyalgia.

In September 2025, the Veteran sought service connection for fibromyalgia due to asbestos exposure during service. See September 2025 VA Form 21-526.

As noted, the requirement for a current disability is satisfied if the disability is present at any point proximate to the claim, or during the claim. Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321. In the absence of proof of a current disability, there can be no valid claim
Vet. App. 49, 53 (1990). Accordingly, service connection for IHD and diabetes is not warranted.

Entitlement to service connection for fibromyalgia.

In September 2025, the Veteran sought service connection for fibromyalgia due to asbestos exposure during service. See September 2025 VA Form 21-526.

In regard to the first element of service connection, the evidence of record does not show that the Veteran has a current diagnosis of fibromyalgia proximate to the claim (received in September 2025) or during the appeal period.

The Veteran's service treatment records are silent for any complaints, symptoms, or diagnosis related to fibromyalgia. VA treatment records are also silent for any complaints, symptoms, or diagnoses related to fibromyalgia. The Veteran, nor his representative, provided any evidence demonstrating the Veteran has a current diagnosis of fibromyalgia proximate to the claim or during the appeal period.

The Board acknowledges the Veteran has not been provided with a VA examination or medical opinion; however, VA does not have a duty to provide one in this case. See McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006) (VA's duty to provide an examination only triggered if the evidence of record "indicates" that the claimed disability or symptoms "may be" associated with the established event). While the Veteran alleged an in-service event, asbestos exposure, he did not provide any evidence concerning persistent or recurrent symptoms of a disability related to fibromyalgia. As noted, post-service treatment records in the claims file prior to the September 2025 rating decision are silent for any complaints, symptoms, or diagnoses related to the Veteran's claim to service connection for fibromyalgia proximate to the claim or during the appeal period. The only evidence indicating that the Veteran has a current disability is the Veteran's limited statement on the claims form seeking service connection. However, the Board notes he has not been shown to have the medical training necessary to do so. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Accordingly, there is no duty to provide the Veteran with an examination to evaluate the etiology of the Veteran's claim to entitlement to service connection for fibromyalgia.

Based on the foregoing, the Board finds that there is no competent evidence of a current disability, and there is no valid claim. Brammer, 3 Vet. App. at 225. As such, the Board need not address the other elements of service connection without evidence of a current diagnosis of a disability. As the evidence is persuasively against the claim, the benefit of the doubt doctrine does not apply, and the claim must be denied. 38 U.S.C. § 5107 (b); see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990).

Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Yancy v. McDonald, 27 Vet. App. 484, 495 (2016); Doucette v. Shulkin, 38 Vet. App. 366, 369-70 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).

REASONS FOR REMAND

Under the AMA, the Board may only remand an issue for the correction of (1) duty to assist errors occurring prior to the date of the AOJ decision on appeal (i.e., pre-decisional duty to assist errors) and (2)?AOJ errors in satisfying a regulatory or statutory duty, if correction of such error would have a reasonable possibility of aiding in substantiating the appellant's claim.? See?38?C.F.R. §?20.802(a).

Entitlement to service connection for hypertension is remanded.

Entitlement to service connection for COPD is remanded.

In April 2022, the Veteran initially sought service connection for hypertension. See April 2022 VA Form
FOR REMAND

Entitlement to service connection for hypertension is remanded.

Entitlement to service connection for COPD is remanded.

In April 2022, the Veteran initially sought service connection for hypertension. See April 2022 VA Form 21-526, that was denied in a July 2022 rating decision. In July 2023, the Veteran sought a higher level review of that decision. In July 2023, the AOJ determined there was duty to assist error that was subsequently denied by the AOJ in an August 2024 rating decision. In July 2025, the Veteran sought a higher level review that was ultimately denied in the February 2026 rating decision on appeal.

In August 2024, the Veteran sought service connection for COPD secondary to a TERA. See August 2024 VA Form 21-526. The AOJ denied the Veteran's claim in a September 2024 rating decision. In September 2025, the Veteran sought a higher level review that was ultimately denied in the February 2026 rating decision on appeal.

As an initial matter, the AOJ conceded the Veteran is currently diagnosed with hypertension and COPD. The AOJ also conceded the Veteran's exposure to asbestos during service. The Board is bound by these favorable findings. 38 C.F.R. § 3.104(c).

The Veteran was initially afforded a VA examination for hypertension in November 2023. The VA examiner opined that it was less likely than not that the Veteran's hypertension was caused by the indicated TERA. See November 2023 VA medical opinion. However, the VA examiner did not indicate the specific TERA, and at that time it had not yet been determined that the Veteran had exposure to asbestos. As such, the Board finds that the November 2023 VA medical opinion is inadequate for decision making purposes. ?See Nieves-Rodriguez, 22?Vet. App. at 302.

The Veteran was afforded a VA examination in September 2024 for his COPD. The VA examiner opined that the Veteran's COPD was less likely than not incurred in or caused by his service. See September 2024 VA medical opinion. As rationale, the VA examiner determined the Veteran was not diagnosed with COPD in service; that he was a former smoker with a 54 year history; and had a family history of COPD. Id. However, the VA examiner did not provide an opinion regarding whether the Veteran's COPD was related to his asbestos exposure in service. ?See Nieves-Rodriguez, 22?Vet. App. at 302.

In January 2026, a VA examiner initially opined that the Veteran's COPD and hypertension were at least as likely as not caused by the indicated TERA, namely asbestos exposure. See January 2026 VA medical opinion. As rationale, with regard to COPD, the VA examiner noted asbestosis damages the lungs that can lead to various lung diseases, including COPD. Id. With regard to hypertension, the VA examiner noted asbestos exposure causes chronic pulmonary conditions that can contribute to the worsening of hypertension; and asbestos-induced pulmonary disease increases workload on the heart and contributes. Id. However, the VA examiner did not address the Veteran's history of smoking. The AOJ requested an addendum medical opinion, and in a January 2026 VA addendum medical opinion, the same VA examiner opined that the Veteran's COPD and hypertension were less likely than not caused by his in service asbestos exposure. See January 2026 VA addendum medical opinion. As rationale, the VA examiner noted long-term smoking is a well-established cause of both COPD and hypertension. Id. However, the VA examiner did not address the Veteran's in-service asbestos exposure. As such, the Board finds that January 2026 VA medical opinion and the January 2026 VA addendum medical opinions inadequate for decision making purposes. The VA examiner appears to provide contradicting medical opinions: one that it is less likely than not that the Veteran's COPD and hypertension are related to in-service asbestos exposure and one that it is less likely than not. Both opinions fail to fully address the Veteran's medical treatment
his in service asbestos exposure. See January 2026 VA addendum medical opinion. As rationale, the VA examiner noted long-term smoking is a well-established cause of both COPD and hypertension. Id. However, the VA examiner did not address the Veteran's in-service asbestos exposure. As such, the Board finds that January 2026 VA medical opinion and the January 2026 VA addendum medical opinions inadequate for decision making purposes. The VA examiner appears to provide contradicting medical opinions: one that it is less likely than not that the Veteran's COPD and hypertension are related to in-service asbestos exposure and one that it is less likely than not. Both opinions fail to fully address the Veteran's medical treatment records and TERA exposure. The AOJ's failure to provide an adequate medical opinion is a pre-decisional duty to assist error, and remand is necessary to obtain an addendum medical opinion. See?38?C.F.R. §?20.802(a).

The Board notes that the Veteran submitted a letter from D.M., FNP-C, in January 2026 who noted that although most cardiac diseases can be related to genetics, poor diet, and smoking, recent studies have linked exposure to asbestos. D.M. stated it was possible that any occupational exposure to asbestos could have been a precursor to the Veteran's current medical history of coronary artery disease and hypertension. The Board finds D.M.'s opinion speculative and conclusory and therefore inadequate to favorably resolve the Veteran's claim for service connection for hypertension.

In addition, the Board acknowledges that the Veteran submitted treatment notes from a pulmonary office visit dated in December 2025 with C.P., FNP, who noted that the Veteran reports exposure to agent orange and asbestos while in the military. C.P. then concluded "it is just as likely as not that patient's asbestos exposure and agent orange exposure are contributing factors to patient's COPD." However, as explained above, the evidence is persuasively against finding the Veteran was exposed to an herbicide agent, to include Agent Orange, during his military service. While the Veteran's exposure to asbestos has been conceded, the Board finds C.P.'s opinion is conclusory as it contains no supporting rationale and is based on an inaccurate factual premise; thus the Board finds this opinion inadequate to favorably resolve the Veteran's claim for service connection for COPD.

Entitlement to service connection for erectile dysfunction is remanded.

In April 2022, the Veteran initially sought service connection for erectile dysfunction. See April 2022 VA Form 21-526. In July 2022, the AOJ denied the Veteran's claim. In July 2023, the Veteran sought a higher level review of that decision. In July 2023, the AOJ determined that a duty to assist error had occurred and readjudicated the Veteran's claim. In August 2024, the AOJ denied the Veteran's claim, and the Veteran sought a higher level review in July 2025. In the January 2026 rating decision on appeal, the AOJ denied the Veteran's claim.

The Veteran was afforded a VA examination in November 2023. The VA examiner opined that the Veteran's claimed condition was less likely than not caused by the indicated TERA. See November 2023 VA medical opinion. However, the VA examiner did not indicate the specific TERA, and at that time it had not yet been determined that the Veteran had exposure to asbestos. As such, the Board finds that the November 2023 VA medical opinion is inadequate for decision making purposes. ?See Nieves-Rodriguez, 22?Vet. App. at 302.

The Veteran was afforded a second VA examination in January 2026. The VA examiner opined that it was less likely than not that the Veteran's erectile dysfunction was caused by the indicated TERA, including asbestos exposure. See January 2026 VA medical opinion. As rationale, the VA examiner noted several factors that cause erectile dysfunction, including underlying psychological causes or organic etiologies. Id. However, the VA examiner merely listed the risk factors and causes, and did not explain how the risk factors applied to the Veteran. Additionally, the VA examiner did not address the Veteran's exposure to asbestos. Therefore, the Board finds the January 2026 VA medical opinion inadequate for decision making purposes. ?See Nieves-Rodriguez, 22?Vet. App. at 302. The AOJ's failure to provide an adequate medical opinion is a pre-decisional duty to assist error, and remand is necessary to obtain an addendum medical opinion. See?38?C.F.R. §?20.802(a).

Entitlement to
or organic etiologies. Id. However, the VA examiner merely listed the risk factors and causes, and did not explain how the risk factors applied to the Veteran. Additionally, the VA examiner did not address the Veteran's exposure to asbestos. Therefore, the Board finds the January 2026 VA medical opinion inadequate for decision making purposes. ?See Nieves-Rodriguez, 22?Vet. App. at 302. The AOJ's failure to provide an adequate medical opinion is a pre-decisional duty to assist error, and remand is necessary to obtain an addendum medical opinion. See?38?C.F.R. §?20.802(a).

Entitlement to service connection for acquired psychiatric conditions as secondary to service connected disabilities is remanded.

In April 2022, the Veteran initially sought service connection for an acquired psychiatric disorder secondary to his service connected conditions. See April 2022 VA Form 21-526. In July 2022, the AOJ denied the Veteran's claim. In July 2023, the Veteran submitted a VA Form 20-0996, seeking a higher level review that was subsequently denied in a July 2023 rating decision. In March 2024, the Veteran appealed the issue to the Board. In a June 2024 Board decision, the Board remanded the issue as inextricably intertwined with other issues that were remanded. In the September 2025 rating decision on appeal, the AOJ denied the Veteran's claim for service connection to an acquired psychiatric condition as secondary to service connected malignant neoplasm of the skin.

As an initial matter, the AOJ conceded the Veteran has current diagnoses for depression with anxiety. The Board is bound by this favorable finding. 38 C.F.R. 3.104(c).

The Veteran was afforded a VA examination in June 2025. The VA examiner noted that heart disease, type II diabetes, COPD, and neuropathy are relevant to the understanding or management of the Veteran's mental health disorder. See June 2025 VA examination. The Veteran reported he began struggling with anxiety and depression related to medical issues in 2001. Id. The VA examiner initially opined that the Veteran's claimed condition was at least as likely as not proximately due to or the result of his service connected condition. See June 2025 VA medical opinion. As rationale, the VA examiner noted the Veteran did not suffer from mental health issues prior to military service; he indicated he began struggling with anxiety and depression related to medical issues in 2001; he had his first heart attack in 2001; and that there is a well-known connection between chronic medical issues and anxiety/depression. Id. However, the AOJ obtained an addendum medical opinion since the examiner did not specify which service connected condition the mental health condition was secondary to, and noted the Veteran was not service connected for a heart condition.

In an August 2025 VA addendum medical opinion, the VA examiner noted the Veteran's heart condition seems to be the main source of the mental health difficulty. See August 2025 VA addendum medical opinion. In a September 2025 VA medical opinion, the VA examiner opined that it was less likely than not that the Veteran's mental health condition was proximately due to or the result of the Veteran's service connected condition, including malignant neoplasm of the skin, and bilateral lower extremity peripheral neuropathies. See September 2025 VA medical opinion. As rationale, the VA examiner noted while the Veteran does cite medical issues as relevant to mental health issues, the Veteran talked about heart issues and related fatigue/brain fog as being more connected to these issues, as opposed to neuropathy/neoplasm of the skin. Id. However, the VA examiner did not address whether the Veteran's mental health condition is aggravated by a service connected condition. The AOJ's failure to provide an adequate medical opinion, including a clear secondary aggravation medical opinion, is a pre-decisional duty to assist error, and remand is necessary to obtain an addendum medical opinion. See 38 C.F.R. § 20.802; see also El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013); Atencio v. O'Rourke, 30 Vet. App. 74, 90-91 (2018). Additionally, the Board finds that the Veteran's claim to service connection for an acquired psychiatric disability is inextricably intertwined with the claims of entitlement to service connection for hypertension, COPD, and erectile dysfunction. See Harris v. Derwinski, 1 Vet. App. 180, 183
-decisional duty to assist error, and remand is necessary to obtain an addendum medical opinion. See 38 C.F.R. § 20.802; see also El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013); Atencio v. O'Rourke, 30 Vet. App. 74, 90-91 (2018). Additionally, the Board finds that the Veteran's claim to service connection for an acquired psychiatric disability is inextricably intertwined with the claims of entitlement to service connection for hypertension, COPD, and erectile dysfunction. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991).

Entitlement to a total disability rating based on individual unemployability due to service connected disabilities (TDIU) is remanded.

In April 2022, the Veteran submitted a claim for TDIU. See April 2022 VA Form 21-526. The Veteran's April 2022 VA Form 21-8940 indicates his report that all of his service related conditions prevent him from working. Therefore, the Board finds that entitlement to a TDIU is inextricably intertwined with the claims being remanded herein. See Harris v. Derwinski, 1 Vet. App. at 183.

The matters are REMANDED for the following action:

1. Forward the record and a copy of this Remand to a clinician for completion of an addendum medical opinion regarding the Veteran's claim for entitlement to service connection for hypertension. Schedule the Veteran for an examination only if one is required by the clinician. After reviewing the Veteran's claims file, the clinician must address whether it is at least as likely as not (i.e., likelihood is at least approximately balanced or nearly equal, if not higher) that his hypertension was incurred in or caused by an in-service injury, event, or disease, to include in-service asbestos exposure.

A complete rationale should be given for all opinions and conclusions expressed. The clinician must address the Veteran's post-service medical records, smoking history, and conceded in-service asbestos exposure.

The clinician must consider a) the total potential exposure through all applicable deployments; and b) the synergistic, combined effect of all TERAs of the Veteran. The examiner must provide an opinion as to whether it is at least as likely as not that there is a nexus between the Veteran's claimed disability and the TERA.

The clinician should address the January 2026 opinion from D.M., FNP-C, who noted that although most cardiac diseases can be related to genetics, poor diet, and smoking, recent studies have linked exposure to asbestos and it was possible that any occupational exposure to asbestos could have been a precursor to the Veteran's current medical history of coronary artery disease and hypertension.

If the examiner cannot provide an opinion without resorting to speculation, he/she should explain why an opinion cannot be provided.

2. Forward the record and a copy of this Remand to a clinician for completion of an addendum medical opinion regarding the Veteran's claim for entitlement to service connection for COPD. Schedule the Veteran for an examination only if one is required by the clinician. After reviewing the Veteran's claims file, the clinician must address whether it is at least as likely as not (i.e., likelihood is at least approximately balanced or nearly equal, if not higher) that his COPD was incurred in or caused by an in-service injury, event, or disease, to include in-service asbestos exposure.

The clinician should address the December 2025 pulmonary office treatment note from C.P., FNP, who noted that the Veteran's asbestos exposure is as likely as not that patient's asbestos exposure is a contributing factor to his COPD.

If the examiner cannot provide an opinion without resorting to speculation, he/she should explain why an opinion cannot be provided.

3. Forward the record and a copy of this Remand to a clinician for completion of an addendum medical opinion regarding the Veteran's claim for entitlement to service connection for erectile dysfunction. Schedule the Veteran for an examination only if one is required by the clinician. After reviewing the Veteran's claims file, the clinician must address whether it is at least as likely as not (i.e., likelihood is at least approximately balanced or nearly equal, if not higher) that his erectile dysfunction was incurred in or caused by an in-service injury, event, or disease, to include in-service asbestos exposure.

If the examiner cannot provide an opinion without resorting to speculation, he/she should explain why an opinion cannot be provided.

4. Forward the record and a copy of this Remand to a clinician for completion of an addendum medical opinion regarding the Veteran's claim for entitlement to service connection for an acquired psychiatric disability as secondary to service connected disabilities. Schedule the Veteran for an examination only if one is required by the clinician. After reviewing the Veteran's claims file, the clinician should address the following:

(a.) Whether it is at least as likely as not (i.e., likelihood is at least approximately balanced or nearly equal, if not higher) that his acquired psychiatric disability is proximately due to, or the result of, his service-connected skin and/or bilateral lower extremity peripheral neuropathy disabilities.

(b.) Whether it is at least as likely as not (i.e., likelihood is at least approximately balanced or nearly equal, if not higher) that his acquired psychiatric disability was aggravated (worsened) by his service-connected skin and/or bilateral lower extremity peripheral neuropathy disabilities.

A complete rationale should be given for all opinions and conclusions expressed. If the examiner cannot provide an opinion without resorting to speculation, he/she should explain why an opinion cannot be provided.

Tiffany Dawson

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Moore, Carlin

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.

Analyze in VA Law Explorer