COLD INJURY RESIDUALS

M. C. WILSON · 2026 · Case ID: A26033104

GRANTED

Summary

The Veteran, an Army Veteran who served from March 1966 to March 1969, appeals the denial of service connection for frostbite residuals of the bilateral feet and onychomycosis. The Veteran also claimed a skin condition due to trichloroethylene exposure. The Board reviewed the evidence, including service records, VA treatment records, VA examinations, lay statements, and hearing testimony. The Veteran testified to experiencing frostbite during an overnight training exercise at Fort Dix, New Jersey, in 0° Celsius weather, noting his fingers and toes turned blue and his nails became brittle and discolored. While the VA examiner cited a lack of complaints in the record for a negative nexus opinion on frostbite, the Board found the Veteran's lay testimony credible and corroborated by the record, resolving doubt in his favor to grant service connection for frostbite residuals. For onychomycosis, the Veteran reported handling trichloroethylene drums during service and experiencing a persistent skin and nail condition since service. The VA examiner's opinion on this issue was deemed of limited probative value due to ambiguity and reliance on an absence of complaints. The Board found the Veteran's lay statements credible and generally corroborated, and given the AOJ's concession of the diagnosis, the Veteran's testimony about the condition's onset and persistence, and the examiner's failure to rule out a link to trichloroethylene or frostbite exposure, the Board resolved doubt in the Veteran's favor to grant service connection for onychomycosis. Service connection for both frostbite residuals and onychomycosis was granted.

Rationale

AOJ conceded frostbite diagnosis; Veteran credibly testified to frostbite onset and symptoms; VA examiner's negative opinion given little weight due to reliance on absence of complaints; Benefit of the doubt resolved in Veteran's favor

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250603-560351

Full Decision Text

Citation Nr: A26033104
Decision Date: 04/09/26 Archive Date: 04/09/26

DOCKET NO. 250603-560351
DATE: April 9, 2026

ORDER

Entitlement to service connection for residuals of cold injuries of the bilateral feet (frostbite) is granted.

Entitlement to service connection for onychomycosis (claimed as a skin and nail fungus condition) is granted.

FINDINGS OF FACT

1. Resolving all doubt in favor of the Veteran, the evidence of record supports a finding that the Veteran had frostbite during service.

2. Resolving all doubt in favor of the Veteran, the evidence of record supports a finding that the Veteran's frostbite residuals are related to service

3. Resolving all doubt in favor of the Veteran, the evidence of record supports a finding that the Veteran's onychomycosis is due to or the result of service.

CONCLUSIONS OF LAW

1. The criteria for service connection for residuals of cold injuries of the bilateral feet are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§3.102, 3.104, 3.303, 3.304.

2. The criteria for service connection for onychomycosis are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§3.102, 3.104, 3.303, 3.304.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in the United States Army from March 1966 to March 1969 with additional Reserve service.

The decision on appeal to the Board of Veterans' Appeals (Board) from the regional office (referred to as the Agency of Original Jurisdiction (AOJ)), was issued in April 2025. Therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In January 2023, the Veteran filed VA Form 21-526EZ (Claim) requesting service connection for frostbite with discolored nails, a skin condition due to exposure to trichloroethylene, and nail fungus on both hands and feet, among other issues. In April 2023, the AOJ denied service connection for all three issues.

In January 2024, the Veteran filed VA Form 20-0996 (Request for Higher-Level Review), requesting review of the April 2023 decision; and citing the frostbite, skin, and nail issues. In May 2024, the AOJ denied service connection for the Veteran's claimed frostbite and nail issues; however, the AOJ deferred deciding the skin condition issue for further development. In September 2024, the AOJ denied service connection for the Veteran's claimed skin condition.

In January 2025, the Veteran filed VA Form 20-0995 (Supplemental Claim), requesting service connection for the claimed frostbite, skin, and nail issues. In April 2025, the AOJ denied service connection for all three issues.

In June 2025, the Veteran filed VA Form 10182 (Notice of Disagreement), requesting review of the April 2025 decision; citing the frostbite, skin, and nail issues; and selecting the Hearing Docket. The hearing was docketed in July 2025; and a virtual hearing was held on September 24, 2025, with the Veteran's representative present.

Therefore, the Board may only consider the evidence of record at the time of the April 2025 decision, identified as the decision being appealed, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it 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 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 claim, considering the new evidence in addition to the evidence previously considered. 38 C.F.R. § 3.2501. Specific instructions for filing a Supplemental Claim are included with this decision.

The Board notes
, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

The Board notes that although the AOJ stated that relevant evidence was not received with the January 2025 Supplemental Claim, the AOJ then readjudicated the issues on the merits, thereby implicitly finding new and relevant evidence had been submitted. The Board is bound by this implicit finding; thus, the issues are ripe for adjudication on the merits. See April 2025 Rating Decision; 38 C.F.R. §§ 3.2501(a)(1); 20.801(a).

Service Connection

The Veteran asserts that his frostbite residuals and onychomycosis are related to service. See January 2023 Claim; September 2025 Hearing Transcript.

Relevant Legal Criteria

To establish service connection, a Veteran must show: (1) the existence of 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).

Additionally, service connection is granted for a disability resulting from disease or injury incurred in or aggravated by active duty. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.304. Service connection may be granted for any disease initially diagnosed after service when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d).

The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act), effective August 10, 2022, requires a disability examination and medical opinion be requested for certain non-presumptive conditions involving toxic exposure risk activity (TERA). For such claims, VA is required to provide a disability examination and medical opinion when (1) the Veteran submits a claim for compensation, (2) has evidence of a disability, (3) has evidence of participation in a TERA, and (4) such evidence is not sufficient to establish service connection for the disability. 38 U.S.C. § 1168.

However, if the Secretary determines that there is no indication of an association between the disability claimed by the Veteran and the TERA for which the Veteran submitted evidence, then no TERA examination or opinion is required. Id.

A Veteran can claim participation in a TERA explicitly or implicitly through service in a location presumed associated with toxic exposure, or records showing participation in a TERA; or, if VA has conceded exposure in a prior claim, or the file has a claim attributable to toxic exposure. Other ways to claim or establish participation in a TERA include, when a Veteran's military occupational specialty (MOS) is associated with toxic exposure; when medical records suggest exposure to a toxic substance, chemical, or airborne hazard such as VHA exposure screening; or, with any other relevant evidence of record, to include garrison exposures. Id.

When VA provides an examination, it must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 310-11 (2007). For a medical opinion to be adequate, the opinion must support its conclusion with an analysis that the Board can weigh, and a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision. Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007). A VA examiner must consider the Veteran's lay statements in rendering an opinion. Dalton v. Nicholson, 21 Vet. App. 23, 39 (2007). Moreover, before the Board can rely on an absence of documentation in the record to draw inferences disproving service connection, a proper foundation must first be established. See Fountain v. McDonald, 27 Vet. App. 258, 272 (2015).

Lay statements made by a Veteran can be competent and credible when they relate to evidence derived from the witness's own personal knowledge and limited to what the witness has observed through the senses
informed decision. Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007). A VA examiner must consider the Veteran's lay statements in rendering an opinion. Dalton v. Nicholson, 21 Vet. App. 23, 39 (2007). Moreover, before the Board can rely on an absence of documentation in the record to draw inferences disproving service connection, a proper foundation must first be established. See Fountain v. McDonald, 27 Vet. App. 258, 272 (2015).

Lay statements made by a Veteran can be competent and credible when they relate to evidence derived from the witness's own personal knowledge and limited to what the witness has observed through the senses. Layno v. Brown, 6 Vet. App. 465, 470 (1994). Additionally, the Board is bound by favorable findings by the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c).

In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. Gabrielson v. Brown, 7 Vet. App. 36, 39 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Layno, 6 Vet. App. at 469; see also Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) ("although interest may affect the credibility of testimony, it does not affect competency to testify").

Finally, the Board must determine whether the evidence persuasively favors the claim or if there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, with the Veteran prevailing in either event, or whether the evidence persuasively weighs against the claim in which case it must be denied. See Lynch v. McDonough, 21 F.4th 776, 778 (Fed. Cir. 2021). The Veteran is entitled to the benefit of the doubt when there is an "approximate balance" of the evidence regarding any material determination; or, in other words, the evidence is nearly equal. Id.; 38 U.S.C. 5107; 38 C.F.R. § 3.102.

Facts and Analysis

To begin, the AOJ conceded that the Veteran was diagnosed with cold injuries on both his feet (frostbite) and onychomycosis. See April 2025 Rating Decision. Additionally, the AOJ conceded that the Veteran participated in a toxic exposure risk activity (TERA), including exposure to trichloroethylene during service. See May 2024 Higher-Level Review Rating Decision. As such, the question then becomes whether there was an in-service incurrence of disease or injury and a link between the Veteran's two diagnoses and any in-service diseases or injuries. Shedden, 381 F.3d. at 1166-67; 38 C.F.R. § 3.104(c).

The Board notes that the AOJ also conceded that the Veteran was diagnosed with tinea versicolor. See September 2024 Rating Decision. However, at the hearing, the Veteran's representative stated that the most recent examination showed that the Veteran's "skin condition, the onychomycosis, [caused the Veteran's] nail and . . . skin issue," clarifying that the onychomycosis is the skin condition being claimed. See September 2025 Hearing Transcript.

The relevant record on review includes service records, VA treatment records, April 2023 articles regarding chemicals and solvents, VA examinations from August 2024 and January 2025 (received April 2025), lay statements, and the September 2025 hearing transcript.

The Veteran's service treatment records are silent for skin, foot, and nail injuries. See March 1966 Report of Medical Examination; January 1969 Reports of Medical History and Examination; February 1976 Army Reserve Reports of Medical History and Examination.

Frostbite

The record demonstrates that the Veteran was stationed at Fort Dix, New Jersey, for basic training from at least March 1966 to April 1966. See Record of Assignments.

At the hearing, the Veteran testified that the only time that he was exposed to cold weather was when he was stationed at Fort
, VA examinations from August 2024 and January 2025 (received April 2025), lay statements, and the September 2025 hearing transcript.

Frostbite

The record demonstrates that the Veteran was stationed at Fort Dix, New Jersey, for basic training from at least March 1966 to April 1966. See Record of Assignments.

At the hearing, the Veteran testified that the only time that he was exposed to cold weather was when he was stationed at Fort Dix during basic training. See September 2025 Hearing Transcript (testifying that the Veteran lived in Florida, he was in Texas, and he was stationed on the island of Tokashiki). The Veteran testified that he participated in an outdoor overnight training exercise at Fort Dix when it was 0° celsius. During this training exercise, he developed frostbite. The Veteran noticed that his fingers and toes turned blue; and later his nails were more brittle, were darker, and stopped growing correctly. Although he did mention the issue, he did not make an official complaint because "when you're in basic training, you do what you're told to do." Id.

Turning to the January 2025 VA examination for cold injury residuals, the examiner diagnosed the Veteran with cold injuries to both feet. See January 2025 VA Examination - Frostbite DBQ. However, in explaining the negative nexus opinion, the examiner cited an absence of complaints of frostbite in the record. See January 2025 VA Examination - Frostbite Opinion. Insofar as the January 2025 examiner relied on an absence of complaints in the record in offering the negative nexus opinion, the examination is of little probative value. See Fountain, 27 Vet. App. at 272. The Board awards it little weight.

The Board finds that the Veteran's lay statements regarding his symptoms of frostbite and the onset of the same to be competent and credible as they are generally corroborated by the record. Layno, 6 Vet. App. at 470; Record of Assignments; September 2025 Hearing Transcript.

Because the AOJ conceded the Veteran's frostbite diagnosis, the Veteran credibly testified that the only place where he was ever exposed to cold weather was during basic training at Fort Dix, and that during the training exercise he noticed his fingers and toes turned blue-the Board resolves all doubt in favor of the Veteran and finds that he had frostbite during service and that his frostbite residuals are related to service. Shedden, 381 F.3d. at 1166-67; 38 C.F.R. § 3.104(c); September 2025 Hearing Transcript. As such, the appeal is granted. 38 U.S.C. 5107; 38 C.F.R. § 3.102.

Onychomycosis

The Veteran reported that he was assigned to the motor pool during service and that he unloaded and handled drums of trichloroethylene. He knew that the barrels contained the solvent "because the barrels were marked and then [he] had to use [trichloroethylene] to clean the equipment on base." See January 2024 Lay Statement.

Additionally, the Veteran also submitted evidence stating that when skin comes into contact with concentrated solutions of trichloroethylene (a solvent), it can cause skin rashes; and that solvents can cause skin dryness, irritation, rashes and/or chemical burns. See February 2023 Trichloroethylene - ToxFAQs; April 2023 VA Public Health Industrial Solvents Publication.

At the hearing, the Veteran testified that the onychomycosis (a fungal infection), affecting his skin and nails, began in service. Additionally, he testified that he was treated for his skin and nail condition during service but that the condition persisted following service. See September 2025 Hearing Transcript; October-November 2024 VA Treatment Records (noting that the Veteran reported getting a cream for his skin and nails during service).

Turning to the VA examinations, in discussing the Veteran's tinea versicolor and tinea pedis diagnoses, the August 2024 VA examiner noted that trichloroethylene exposure "can lead to a range of health effects, primarily affecting the nervous system, liver, and kidneys. It does not directly impact the skin's susceptibility to fungal infections." See August 2024 VA Examination - TERA Opinion (emphasis added).

However, as noted above, the August 2024 examiner was discussing the Veteran's tinea versicolor and tinea pedis diagnoses and not onychomycosis. Additionally, the examiner did not explain what was meant by the phrase "directly impact," and whether trichloroethylene exposure could leave the Veteran more susceptible to fungal infections. As such, the August 2024 VA examination is of limited probative value. Stefl, 21 Vet. App. at 124-25.

On the other hand, the January 2025 VA examiner diagnosed the Veteran with onychomycosis on the left hand and both feet. See January 2025 VA Examination - Skin DBQ. However, the examiner also offered a negative nexus opinion based on an absence of complaints for a fungal infection in the record. See January 2025 VA Examination - Skin and Nail Opinion. Insofar as the January 2025 examiner relied on an absence of complaints in the record in offering the negative nexus opinion, the examination is of little probative value. See Fountain, 27 Vet. App. at 272. The Board awards it little weight.

The Board finds that the Veteran's lay statements regarding his skin and nail symptoms of onychomycosis and the onset of the same to be competent and credible as they are generally corroborated by the record. Layno, 6 Vet. App. at 470; September 2025 Hearing Transcript.

Because the AOJ conceded the Veteran's onychomycosis diagnosis; the Veteran credibly testified that during service his nails became more brittle, were darker, and stopped growing correctly; the Veteran credibly testified that this condition persisted following service; and the VA examiner did not rule out that the Veteran's exposure to trichloroethylene or frostbite exposure could have played a role in the development of the disease-the Board resolves all doubt in favor of the Veteran and finds that his onychomycosis is related to service. Shedden, 381 F.3d. at 1166-67; 38 C.F.R. § 3.104(c); September 2025 Hearing Transcript; January 2024 Lay Statement; February 2023 Trichloroethylene - ToxFAQs; April 2023 VA Public Health Industrial Solvents Publication; August 2024 VA Examination - TERA Opinion (emphasis added). As such, the appeal is granted. 38 U.S.C. 5107; 38 C.F.R. § 3.102.

M. C. WILSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board L. Davidson

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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