ARTERIOSCLEROTIC HEART DISEASE (CORONARY ARTERY DISEASE)

Summary

The veteran served in the Army from August 1966 to December 1966, with additional Army National Guard service from 1965 to 1971. He sought service connection for arteriosclerotic heart disease, a skin condition (porphyria cutanea tarda/chloracne), hypertension, and left thumb carcinoma, contending these were caused by Agent Orange exposure at Fort Chaffee. The Board noted favorable findings for current diagnoses of arteriosclerotic heart disease, hypertension, and left thumb carcinoma from a prior rating decision. However, for the claimed conditions, the Board found the veteran's lay statements regarding symptom onset and continuity were not credible, as they contradicted medical records and his own service medical history. Specifically, heart symptoms and the thumb growth were first indicated in 2018, and his December 1966 separation examination reported no relevant issues. The Board also found no basis for presumptive herbicide exposure, as the record did not show service in qualifying locations or times for Agent Orange exposure at Fort Chaffee, and the veteran's personnel records contradicted his claimed presence during herbicide application periods. The Board also rejected claims of nuclear material exposure due to lack of evidence and the nature of training. A VA examiner opined it was less likely than not that the claimed conditions were caused by any applicable toxic exposure risk activities. A private medical opinion linking heart disease to Agent Orange was discounted due to its reliance on an inaccurate factual premise of exposure. Ultimately, the Board found the evidence failed to demonstrate an in-service incident, illness, or injury to which the claimed conditions could be linked, denying all claims.

Rationale

Persuasive weight of evidence against service connection; Lay statements not credible and contradicted by records; No nexus to service or TERA established

Full Decision Text

Citation Nr: A26033419
Decision Date: 04/10/26	Archive Date: 04/10/26

DOCKET NO. 250729-571047
DATE: April 10, 2026

ORDER

Entitlement to service connection for arteriosclerotic heart disease is denied.

Entitlement to service connection for a skin condition is denied.

Entitlement to service connection for hypertension is denied.

Entitlement to service connection for left thumb carcinoma is denied.

FINDINGS OF FACT

1. The persuasive weight of the evidence indicates that the Veteran's arteriosclerotic heart disease is not etiologically related to active service or to a Toxic Exposure Risk Activity. 

2. The persuasive weight of the evidence indicates that the Veteran's skin condition is not etiologically related to active service or to a Toxic Exposure Risk Activity. 

3. The persuasive weight of the evidence indicates that the Veteran's hypertension is not etiologically related to active service or to a Toxic Exposure Risk Activity. 

4. The persuasive weight of the evidence indicates that the Veteran's left thumb carcinoma is not etiologically related to active service or to a Toxic Exposure Risk Activity. 

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for arteriosclerotic heart disease have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309.

2. The criteria for entitlement to service connection for a skin condition have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309.

3. The criteria for entitlement to service connection for hypertension have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309.

4. The criteria for entitlement to service connection for left thumb carcinoma have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service in the Army from August 1966 to December 1966. He also had additional service in the with the Army National Guard with various periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) from 1965 to 1971.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2025 rating decision. In the July 2025 VA Form 10182, Notice of Disagreement, the Veteran elected the Hearing docket. A Board hearing was held on November 19, 2025, and a transcript is of record.

Therefore, the Board may only consider the evidence of record at the time of the July 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran [or 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 and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Generally, 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 (nexus).
 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Generally, 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 (nexus). Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995).

Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

In addition to the laws and regulations outlined above, active military, naval, or air service includes any period of ACDUTRA during which the individual concerned was disabled from a disease or injury incurred or aggravated in the line of duty, and any period of INACDUTRA during which the individual concerned was disabled from an injury incurred or aggravated in the line of duty. 38 U.S.C. § 101 (21) and (24); 38 C.F.R. § 3.6 (a). In order to establish status as a Veteran based upon a period of ACDUTRA, a claimant must establish that he was disabled or died from a disease or injury incurred or aggravated in the line of duty. 38 C.F.R. § 3.6 (a). 

Generally, no presumptions (including the presumptions of soundness, aggravation, or for presumptive diseases) attach to periods of ACDUTRA and INACDUTRA unless "veteran" status is attained during those periods. Paulson v. Brown, 7 Vet. App. 466, 470 (1995). For appellants who have achieved "veteran" status through a prior period of active service and now claim a disability incurred only during a later period of ACDUTRA, the presumption of soundness applies only when the veteran has been "examined, accepted, and enrolled for service" and where that examination revealed no "defects, infirmities, or disorders." Smith v. Shinseki, 24 Vet. App. 40, 45-46 (2010).

1. Entitlement to service connection for arteriosclerotic heart disease.

2. Entitlement to service connection for a skin condition.

3. Entitlement to service connection for hypertension.

4. Entitlement to service connection for left thumb carcinoma.

The Veteran seeks entitlement to service connection for arteriosclerotic heart disease, claimed as ischemic heart disease, a skin condition, claimed as porphyria cutanea tarda, hypertension, and left thumb carcinoma. He contends these conditions were caused by exposure to Agent Orange during his service at Fort Chaffee. 

As an initial matter, the Board observes the rating decision on appeal made favorable findings for a current diagnosis for arteriosclerotic heart disease, hypertension, and left thumb carcinoma. Under the AMA, the Board is bound by favorable findings made by the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c). 

Additionally, although a June 2025 examiner indicated there was no pathology to render a diagnosis for the claimed porphyria cutanea tarda, and medical records do not indicate a diagnosis for this condition, the Board has viewed the claim broadly to encompass any skin condition consistent with the Veteran's complaints. In this regard, the Veteran testified at his November 2025 hearing that his treating dermatologist had diagnosed chloracne due to irregular, irritated, moderate skin lesions located on the arms, face, and trunk. A review of the submitted medical records indicates a diagnosis for chlorac
 favorable findings made by the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c). 

Additionally, although a June 2025 examiner indicated there was no pathology to render a diagnosis for the claimed porphyria cutanea tarda, and medical records do not indicate a diagnosis for this condition, the Board has viewed the claim broadly to encompass any skin condition consistent with the Veteran's complaints. In this regard, the Veteran testified at his November 2025 hearing that his treating dermatologist had diagnosed chloracne due to irregular, irritated, moderate skin lesions located on the arms, face, and trunk. A review of the submitted medical records indicates a diagnosis for chloracne. Although additional diagnoses of tinea corporis, seborrheic keratosis, and mild actinic damage also appear in treatment records, these conditions are noted as related to current environmental causes including pets and warm or humid climates, or related to age or sun exposure. As such, the chloracne diagnosis is the only current diagnosis which appears reasonably encompassed by the Veteran's claims. 

Next, the Veteran contends that his conditions were present during or approximate to his active service. While the Veteran is not competent to diagnose disorders, he is nonetheless competent to testify about the presence of observable symptomatology, which may provide sufficient support for a claim of service connection, if credible, regardless of the lack of contemporaneous evidence to support service connection. Jandreau v. Nicholson, 492 F.3d 1372, 1376 (Fed. Cir. 2007). However, service connection cannot be warranted based purely on the assertions of continuous symptoms in this case.

Specifically, the Veteran reported at his June 2025 VA examination that he had heart symptoms since service, including that he had high blood pressure for as far back as the beginning of his service and symptoms including shortness of breath, loss of stamina, and mild chest pains. He reported his left thumb carcinoma began in 1967 or 1968 as an extra cuticle on the left inside thumb that became aggressive like a wart in 2016. However, the Board does not find these statements credible as they are contradicted by the other evidence of record. Notably, treatment records reflected heart symptoms were first indicated in 2018, and the carcinoma to the thumb was not indicated prior to 2018. Further, the Veteran did not indicate any related symptoms in his December 1966 report of medical history. 

Importantly, a January 2019 private treatment record reflects the Veteran reported intermittent exertional chest discomfort and progressive exertional fatigue and dyspnea only over the past year. Treatment records indicate a growth near the left thumb nail in 2018, which was identified as carcinoma. Although the Veteran reported skin symptoms in his thumb prior to 2018 that he relates to his later carcinoma, his statements are not competent as he does not have the medical training or experience to identify the condition or whether earlier symptoms were related to his later diagnosed carcinoma. Further, his statements to treatment providers do not indicate longstanding symptoms of the heart or on his thumb. 

Similarly, the Veteran reported in a March 2025 statement that he has experienced skin symptoms since service. He stated he developed a rash in 1966 or 1967 diagnosed as jock itch in his groin, that never went away and always returned in the heat and sun. However, recent medical records do not indicate a fungal skin condition to the groin, and his diagnosed chloracne was first indicated in January 2025. Although the Veteran reported his jock itch spread to other parts of his body leading to his current symptoms, his statements are not competent to indicate a relationship as he does not have the medical training or experience to identify the condition or whether it was related to his later diagnosed chloracne. Treatment records approximate to his claim do not indicate jock itch, nor do they indicate a relationship between the Veteran's reported jock itch during active service and his current symptoms. 

Further, the Board notes that a separation examination was obtained at the completion of the Veteran's active service. A December 1966 examination noted no issues, marking all systems as normal and the Veteran's report of medical history marked "no" to any skin diseases, shortness of breath, pain or pressure in the chest, palpitation or pounding heart, high blood pressure, tumor, growth, cyst or cancer, and he reported no symptoms at that time. 

Therefore, the persuasive weight of the competent and credible evidence does not demonstrate the condition began in service or that he has experienced continuity of symptoms since service. 38 C.F.R. § 3.303.

Next, the Veteran contends that his symptoms are related to exposure to herbicides during service at Fort Chaffee. If a veteran meets certain requirements, they are entitled to a presumption of
 December 1966 examination noted no issues, marking all systems as normal and the Veteran's report of medical history marked "no" to any skin diseases, shortness of breath, pain or pressure in the chest, palpitation or pounding heart, high blood pressure, tumor, growth, cyst or cancer, and he reported no symptoms at that time. 

Therefore, the persuasive weight of the competent and credible evidence does not demonstrate the condition began in service or that he has experienced continuity of symptoms since service. 38 C.F.R. § 3.303.

Next, the Veteran contends that his symptoms are related to exposure to herbicides during service at Fort Chaffee. If a veteran meets certain requirements, they are entitled to a presumption of herbicide exposure, and need not prove actual exposure to herbicides. VA regulations state that a veteran who served in the Republic of Vietnam during the period from January 9, 1962, to May 7, 1975, shall be presumed to have been exposed during such service to certain toxic herbicide agents, with the most common being "Agent Orange," unless there is affirmative evidence to the contrary. 38 U.S.C. § 1116; 38 C.F.R. § 3.307(a)(6). VA has also presumed exposure to Agent Orange in offshore eligible waters as defined in the Blue Water Navy Vietnam Veterans Act of 2019, and in specific date ranges or locations with service in Thailand, Laos, Cambodia, Guam or American Samoa including the territorial waters, or Johnston Atoll including ships that called at Johnston Atoll, and in or near the Korean DMZ. Additionally, the presumption applies to limited active-duty service in certain regular Air Force units or Reservist assignments or with involvement in transporting, testing, storing, or other uses of Agent Orange during military service. If a veteran was exposed to an herbicide agent during active military, naval, or air service, service connection is presumed for certain disorders, including atherosclerotic cardiovascular disease, hypertension, porphyria cutanea tarda, and chloracne or other acneform disease consistent with chloracne. 38 C.F.R. § 3.309(e). 

However, the record does not reflect service in any of these locations where exposure to toxic herbicide agents has been presumed. As such, there is no basis for presumptive service connection. 38 C.F.R. § 3.307. Although the Veteran is not entitled to presumptive service connection, he is not precluded from demonstrating that his conditions were otherwise related to service, to include as due to herbicide exposure. See Combee v. Brown, 43 F.3d 1039, 1041-42 (Fed. Cir. 1994).

In this regard, VA has published a list of herbicide tests and storage sites in the United States, a copy of which is included in the claims file in a June 2025 document. The information provided is obtained from the Department of Defense on projects to test, dispose of or store herbicides in the United States, and indicates herbicide application at Fort Chaffee in 1967, from May 16 to 18, from July 22 to 23, and from August 23 to 25, at a site identified only as FTCH-041, from a Bell G-2 helicopter or cherry picker. There is no other verification of testing or use of herbicides at Fort Chaffee. 

The Veteran's personnel records indicate assignment to Fort Chaffee in June 1966, June 1968, May 1969, and July 1970. Although an April 2025 statement in support of claim and March 2025 correspondence reflects the Veteran reported assignment at Fort Chaffee in 1967, the Board cannot find these statements credible as they are contradicted by the record of assignments contained in his personnel record. As such, the persuasive weight of the evidence indicates the Veteran was not present at Fort Chaffee at the time of herbicide applications or for several months after. 

The Veteran's representative argued at the November 2025 hearing that the Blue Water Navy Act conceded herbicide exposure 12 miles from the shores of Vietnam, and thus if the Veteran was within 12 miles of the herbicide application at Fort Chaffee, the spray could have traveled 12 miles with winds, and the Veteran should likewise be presumed exposed. However, the Board does not find this argument persuasive. Notably, VA has made no presumptions of exposure supportive of the representative's argument. Further, the evidence does not indicate the Veteran was present at Fort Chaffee at the time of the herbicide application.  

Moreover, the Veteran's statements do not indicate he observed defoliated areas or was otherwise in close proximity to where herbicide agents were utilized, nor do they indicate he was involved
 the Blue Water Navy Act conceded herbicide exposure 12 miles from the shores of Vietnam, and thus if the Veteran was within 12 miles of the herbicide application at Fort Chaffee, the spray could have traveled 12 miles with winds, and the Veteran should likewise be presumed exposed. However, the Board does not find this argument persuasive. Notably, VA has made no presumptions of exposure supportive of the representative's argument. Further, the evidence does not indicate the Veteran was present at Fort Chaffee at the time of the herbicide application.  

Moreover, the Veteran's statements do not indicate he observed defoliated areas or was otherwise in close proximity to where herbicide agents were utilized, nor do they indicate he was involved with transporting, testing, storing, or otherwise using herbicide agents, such as loading them on to the aircraft responsible for spraying at Fort Chaffee. 

In support of his claim, the Veteran submitted several articles and documents in November 2025, however, the Board finds this material does not assist in substantiating the Veteran's claim. Notably, many documents indicate herbicide testing at Fort Chaffee, which has been established by VA as indicated herein.  Although a post from Colonel Gene McVay was included, which discussed additional herbicide use at Fort Chaffee, the Board finds this evidence unpersuasive. Importantly, the post is based on an unverified story which is contradicted by service department records that document use of Agent Orange at Fort Chaffee on only three occasions in 1967. 

The Board acknowledges the Veteran's lay statements that he believes he was exposed to Agent Orange while at Fort Chaffee. However, a layperson's assertions indicating exposure to chemicals during service are not sufficient evidence alone to establish that such an event actually occurred during service. See Bardwell v. Shinseki, 24 Vet. App. 36 (2010). In this case, the record is negative for any evidence that the Veteran was exposed to tactical herbicides other than his own assertions. He did not describe any activities that involved any direct contact or use of Agent Orange or other herbicides, nor does his military occupational specialty indicate any such activity. Thus, there is no indication the circumstances of his service would involve transporting, testing, storing, or other uses of Agent Orange during his military service. Additionally, a June 2025 toxic exposure risk activity (TERA) memorandum did not indicate any exposure to herbicides. As such, the Board finds the service records are more probative and persuasive than the Veteran's lay assertions. The weight of the competent and credible evidence is against a finding that the Veteran was exposed to herbicide agents, as defined by VA, during his military service.

Based on the evidence of record, including service department records, the known facts and circumstances of the Veteran's service, and the Veteran's lay statements, the Board finds the evidence persuasively indicates that the Veteran was not exposed to herbicide agents on a presumptive or facts found basis. 

Additionally, the Board notes that a March 2025 correspondence reflects a statement from the Veteran that he attended an 8-inch Nuclear Assembly course in 1968, and handled the nuclear cones in his left hand which he attributes to his later left thumb carcinoma. While the Veteran may have attended a training course, it is highly unlikely a training environment would expose trainees to hazardous nuclear material. Indeed, military specification document MIL-P-63188 (AR) for the 8-inch training course for projectile assembly, nuclear, indicates that training projectiles were used for the course, which would not be expected to contain live warhead sections. Moreover, if the training involved such exposure, it is expected this would be recorded in the Veteran's personnel record. However, there is no indication in the Veteran's records he was exposed to any nuclear material. Notably, a June 2025 toxic exposure risk activity (TERA) memorandum did not indicate any exposure to nuclear materials. As such, the Board does not find the Veteran's statements regarding exposure to nuclear material credible.

Next, the Board has considered whether the Veteran's conditions are otherwise related to service. In this regard, a June 2025 VA examiner opined it was less likely than not the Veteran's claimed conditions were caused by the indicated TERAs, after considering the total potential exposure through all applicable military deployments and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. In support, the examiner noted there was no medical or scientific evidence available that noted a relationship between the development of the claimed conditions and established asbestos or noise exposure. Although a detailed explanation for the opinion is not provided, the examiner considered the relevant medical history, including detailing the medical history for the thumb carcinoma, the Veteran's reported skin symptoms and skin diagnoses, and heart symptoms. The examiner performed an in-person examination, considered the Veteran's lay statements and
 In this regard, a June 2025 VA examiner opined it was less likely than not the Veteran's claimed conditions were caused by the indicated TERAs, after considering the total potential exposure through all applicable military deployments and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. In support, the examiner noted there was no medical or scientific evidence available that noted a relationship between the development of the claimed conditions and established asbestos or noise exposure. Although a detailed explanation for the opinion is not provided, the examiner considered the relevant medical history, including detailing the medical history for the thumb carcinoma, the Veteran's reported skin symptoms and skin diagnoses, and heart symptoms. The examiner performed an in-person examination, considered the Veteran's lay statements and service information, and provided clear conclusions and supporting evidence. Thus, the examiner's conclusion and basis for reaching it are clearly indicated. See Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012). As such, the examiner's opinion is found adequate and accordingly given probative weight. 

The Board acknowledges that the Veteran provided a private medical opinion which attributed his heart disease to active service. However, the opinion is based solely on an inaccurate factual premise, that the Veteran was exposed to Agent Orange. As addressed herein, the Board has determined that the Veteran was not exposed to Agent Orange on a presumptive or facts found basis. Therefore, the medical opinion can be afforded no probative weight. Unfortunately, there are no probative opinions which would relate any of the Veteran's claimed conditions to his active service. 

In review of all the competent and credible evidence, the Board finds the evidence fails to demonstrate in-service incident, illness, or injury to which the Veteran's claimed conditions may be presently linked. Accordingly, the persuasive weight of the evidence indicates that service connection for arteriosclerotic heart disease, a skin condition, hypertension, and left thumb carcinoma is not warranted, and the claims must be denied. 

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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.

 

B.T. KNOPE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Patterson, Associate Counsel