SHIN SPLINTS

Summary

The veteran served from May 1980 to September 1980. The veteran appeals the denial of service connection for hypertension and the grant of a 10 percent rating for bilateral shin splints. The Board found that the criteria for a 10 percent rating for shin splints in each leg were met, based on painful motion and the application of pre-February 7, 2021, rating criteria. The Board noted that while the veteran testified to pain and stiffness, the evidence did not support a higher rating under either the old or new criteria, as there was no evidence of malunion or treatment unresponsive to conservative measures for 12 consecutive months. For hypertension, the Board denied service connection, finding the evidence persuasively against a link to service. The VA examination in March 2025 provided a negative nexus opinion, as the veteran's blood pressure readings during service did not meet the definition for hypertension. The Board also considered and rejected the claim for hypertension secondary to a psychiatric condition, as the psychiatric claim was still pending and not service-connected. The Board also addressed and denied hypertension as secondary to Camp Lejeune water contamination, citing that hypertension is not a presumptive disease for that exposure. The Board found the benefit of the doubt doctrine inapplicable as the evidence favored denial.

Rationale

Painful motion of the ankle; No evidence of malunion; Treatment for less than 12 consecutive months

Full Decision Text

Citation Nr: A26034578
Decision Date: 04/14/26	Archive Date: 04/14/26

DOCKET NO. 250818-575295
DATE: April 14, 2026

ORDER

Entitlement to an initial 10 percent rating for right leg shin splints is granted, subject to the laws and regulations governing the award of monetary benefits.

Entitlement to an initial 10 percent rating for left leg shin splints is granted, subject to the laws and regulations governing the award of monetary benefits.

Entitlement to service connection for hypertension is denied.

FINDINGS OF FACT

1. The Veteran's right and left shin splint disabilities each manifested as painful motion of the ankle; there is no objective evidence of malunion of the tibia and/or fibula, ongoing treatment, or that the Veteran used orthotics or other conservative treatment.

2. The evidence of record is persuasively against finding that the Veteran's hypertension onset in service or within 1 year of separation from service or was otherwise the result of active military service.

CONCLUSIONS OF LAW

1. The criteria for a 10 percent rating, but no higher, for right leg shin splints have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.1, 4.3, 4.7, 4.20, 4.59, 4.71a, Diagnostic Code 5262.

2. The criteria for a 10 percent rating, but no higher, for left leg shin splints have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.1, 4.3, 4.7, 4.20, 4.59, 4.71a, Diagnostic Code 5262.

3. The criteria for entitlement to service connection for hypertension have not been met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307. 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active military service from May 1980 to September 1980.

In the August 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on January 5, 2026.

Therefore, the Board may only consider the evidence of record at the time of the April 2025 agency of original jurisdiction (AOJ) decision on appeal for shin splints and the May 2025 AOJ decision for hypertension, 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 claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Entitlement to an initial compensable rating for bilateral shin splints.

The Veteran is seeking a compensable rating for his shin splints. The Veteran has continuously pursued his claim for shin splints since submitting an intent to file in September 2020.

The Veteran's bilateral shin splints are rated under Diagnostic Code 5262 for musculoskeletal system disabilities involving the knee and leg. 38 C.F.R. § 4.71a.

Disability evaluations are determined by the application of the facts presented to VA's Schedule for Rating Disabilities at 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4
 intent to file in September 2020.

The Veteran's bilateral shin splints are rated under Diagnostic Code 5262 for musculoskeletal system disabilities involving the knee and leg. 38 C.F.R. § 4.71a.

Disability evaluations are determined by the application of the facts presented to VA's Schedule for Rating Disabilities at 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1.

Where the question for consideration is the propriety of the initial evaluation assigned, consideration of the medical evidence since the effective date of the award of service connection and consideration of the appropriateness of a "staged" rating is required. See Fenderson v. West, 12 Vet. App. 119, 125-26 (1999). VA adjudicators must consider whether to assign different ratings at different times during the rating period to compensate the Veteran for times when the disability may have been more severe than at others. This applies to established ratings as well as initial ratings. See Hart v. Mansfield, 21 Vet. App. 505, 509-10 (2007).

Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. Functional loss may be due to the absence or deformity of structures or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior in undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. 38 C.F.R. § 4.40. In Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011), the Court of Appeals for Veterans Claims (Court) held that, although pain may cause a functional loss, "pain itself does not rise to the level of functional loss as contemplated by VA regulations applicable to the musculoskeletal system."  Rather, pain may result in functional loss, but only if it limits the ability "to perform the normal working movements of the body with normal excursion, strength, speed, coordination, or endurance." Id., quoting 38 C.F.R. § 4.40.

The intent of the Rating Schedule is to recognize actually painful, unstable or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint, even in the absence of arthritis.  38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011).  38 C.F.R. § 4.59 is applicable to the evaluation of musculoskeletal disabilities involving actually painful, unstable or malaligned joints or periarticular regions, regardless of whether the Diagnostic Code under which the disability is evaluated is predicated on range of motion measurements. Southall-Norman v. McDonald, 28 Vet. App. 346 (2016).

Effective February 7, 2021, VA revised the criteria for evaluating musculoskeletal disorders. See Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries, 85 Fed. Reg. 76453, 76464 (Nov. 30, 2020); Correction, 86 Fed. Reg. 8142, 8143 (Feb. 4, 2021).

VA's General Counsel has held that where a law or regulation changes during the pendency of a claim for a higher rating, the Board must first determine whether the revised version is more favorable to the Veteran. In so doing, it may be necessary for the Board to apply both the old and new versions of the regulation. If the revised version of the regulation is more favorable, the retroactive reach of that regulation under 38 U.S.C. § 5110(g) can be no earlier than the effective date of that change. The Board must generally apply both the former and the revised versions of the regulation for the period prior and subsequent to the regulatory change, but an effective date based on the revised criteria may be no earlier than the date of the change.

VA thus must consider the claim for a higher rating pursuant to the former and revised regulations during the latter part of this appeal. See VAOPGCPREC 3-2000, 65 Fed. Reg. 33,422 (2000); DeSousa v. Gober, 10 Vet. App.
 the regulation is more favorable, the retroactive reach of that regulation under 38 U.S.C. § 5110(g) can be no earlier than the effective date of that change. The Board must generally apply both the former and the revised versions of the regulation for the period prior and subsequent to the regulatory change, but an effective date based on the revised criteria may be no earlier than the date of the change.

VA thus must consider the claim for a higher rating pursuant to the former and revised regulations during the latter part of this appeal. See VAOPGCPREC 3-2000, 65 Fed. Reg. 33,422 (2000); DeSousa v. Gober, 10 Vet. App. 461, 467 (1997). Therefore, the Board will consider the Veteran's claim under the old criteria prior to February 7, 2021, and both the old and new rating criteria from February 7, 2021, forward. The criteria that is more favorable to the Veteran will be applied.  

Pursuant to the musculoskeletal rating criteria prior to February 7, 2021, Diagnostic Code 5262 provides that impairment involving malunion of tibia and fibula with slight knee or ankle disability warrants a 10 percent rating. 38 C.F.R. § 4.71a. Impairment involving malunion of tibia and fibula with moderate knee or ankle disability warrants a 20 percent rating. Id. Impairment involving malunion of tibia and fibula with marked knee or ankle disability warrants a 30 percent rating. Id. Finally, impairment involving nonunion of tibia and fibula with loose motion requiring brace warrants a 40 percent rating. Id. 

Words such as "slight," "moderate," and "marked" are not defined in the Rating Schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to the end that its decision is "equitable and just." 38 C.F.R. § 4.6. Use of terminology such as "severe" by VA examiners and others, although evidence to be considered by the Board, is not dispositive of an issue. For reference and illustrative purposes, the Merriam-Webster dictionary defines "slight" as small of its kind or in amount; "moderate" as tending toward the mean or average amount or dimension; and "marked" as an adjective, is defined as "having a distinctive or emphasized character." See https://www. merriam-webster.com/dictionary/slight; www.merriam-webster.com/dictionary/moderate; www.merriam-webster.com/dictionary/marked.

Under the revised musculoskeletal rating criteria effective February 7, 2021, Diagnostic Code 5262 provides that impairment of tibia and fibula involving medial tibial stress syndrome (MTSS), or shin splints, and requiring treatment less than 12 consecutive months, one or both extremities, warrants a non-compensable rating. Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries, 85 Fed. Reg. 76453, 76463 (Nov. 30, 2020); 38 C.F.R. § 4.71a, Diagnostic Code 5262). Shin splints requiring treatment for no less than 12 consecutive months and unresponsive to either shoe orthotics or other conservative treatment, one or both lower extremities, warrants a 10 percent rating. Id. Shin splints requiring treatment for no less than 12 consecutive months and unresponsive to surgery and either shoe orthotics or other conservative treatment, one lower extremity, warrants a 20 percent rating. Id. Finally, shin splints requiring treatment for no less than 12 consecutive months and unresponsive to surgery and either shoe orthotics or other conservative treatment, both lower extremities, warrants a 30 percent rating. Id

At the June 2021 VA knee and lower leg VA examination, the Veteran reported that every now and then, he had stiffness in his posterior ankles and around his Achilles tendon, and "felt" his shins every once in a while. The Veteran did not report any issues with his knees. On examination, the examiner noted that the Veteran was diagnosed with shin splints in his left and right legs and his treatment was for less than 12 consecutive months. The Veteran did not use any assistive devices for his shin splints.

At the June 2021 VA ankle examination, the Veteran was diagnosed with tendinopathy in his left and right ankles. The Veteran denied flare-ups to his ankles. The Veteran's initial range of motion (ROM) was normal (plantar flexion to 45 degrees and dorsiflexion to 20 degrees) in both ankles. The examiner estimated that after repeated
 Achilles tendon, and "felt" his shins every once in a while. The Veteran did not report any issues with his knees. On examination, the examiner noted that the Veteran was diagnosed with shin splints in his left and right legs and his treatment was for less than 12 consecutive months. The Veteran did not use any assistive devices for his shin splints.

At the June 2021 VA ankle examination, the Veteran was diagnosed with tendinopathy in his left and right ankles. The Veteran denied flare-ups to his ankles. The Veteran's initial range of motion (ROM) was normal (plantar flexion to 45 degrees and dorsiflexion to 20 degrees) in both ankles. The examiner estimated that after repeated use over time, there was plantar flexion to 30 degrees and dorsiflexion to 10 degrees in both ankles. There was no muscle atrophy, joint instability or ankylosis in either ankle. The Veteran did not use any assistive devices. The examiner noted that the functional impact of the Veteran's ankle disability is "if tries to do something all day long-where he has to climb ladders/lift would affect how well he could move his ankle."

The Veteran testified at his September 2024 Board hearing. However, the testimony was focused on the elements of service connection and did not address severity. 

Pursuant to the Board's December 2024 remand, the VA obtained a medical opinion that determined that the Veteran had a diagnosis of shin splints in both of his left and right legs. Following the medical opinion, the AOJ granted service connection for left and right leg shin splints in an April 2025 decision. The AOJ assigned a noncompensable rating effective September 24, 2020.

The Veteran testified at a January 2026 Board hearing. The Veteran testified that he has pain in his shins. He has not used orthotics due to financial constraints of obtaining a pair. He also testified that he did not have any other treatment. He reported that his legs feel stiff all the time, and if it starts to get too painful, he will stop walking and elevate his feet a little bit instead of continuing.

The Board finds that the credible, competent, and probative evidence warrants a 10 percent rating under 38 C.F.R. § 4.59 for painful motion for shin splints in each his left and right leg, with the ankles being the nearest joint showing painful motion. Using the criteria in effect prior to February 7, 2021, a higher rating under Diagnostic Code 5262 is not warranted because there is no evidence in the record, to include diagnostic imaging, that the Veteran's shin splits manifested in malunion. Malunion is a requirement for a compensable rating on a basis other than painful motion, and no such X-rays are noted in the record. Using the criteria in effect February 7, 2021, a rating higher than 10 percent disabling under Diagnostic Code 5262 is also not warranted because there is no evidence in the record that the Veteran had treatment for less than 12 months or used orthotics or other conservative treatment that was unresponsive. While the Board recognizes the Veteran's testimony that he was unable to afford treatment or orthotics, it would require speculation to determine that treatment and/or orthotic would or would not have relieved the Veteran's symptoms; moreover, the Board is prohibited from making its own medical determinations. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991) (VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions).

In deciding the Veteran's claims for increase, the Board has also considered the Veteran's lay statements that his service-connected bilateral shin splints are worse than evaluated by the 10 percent rating assigned by this decision. He is competent to report symptoms, such as pain. Layno v. Brown, 6?Vet. App.?465, 471 (1994). These statements, however, are not credible in identifying a specific level of disability of this disorder according to the appropriate diagnostic codes. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77?(Fed. Cir. 2007). The June 2021 VA examiner interviewed and examined the Veteran and directly addressed the criteria under which his disability is evaluated. As such, the Board finds the VA examination report, and the Veteran's Board hearing testimony as to his painful motion, to be the most probative evidence in determining whether a higher rating is warranted. 

For these reasons, the Board finds that a 10 percent rating for each the left and right shin splint disabilities, but no higher, is warranted. To that extent only, the appeal is granted. The Board
 disability of this disorder according to the appropriate diagnostic codes. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77?(Fed. Cir. 2007). The June 2021 VA examiner interviewed and examined the Veteran and directly addressed the criteria under which his disability is evaluated. As such, the Board finds the VA examination report, and the Veteran's Board hearing testimony as to his painful motion, to be the most probative evidence in determining whether a higher rating is warranted. 

For these reasons, the Board finds that a 10 percent rating for each the left and right shin splint disabilities, but no higher, is warranted. To that extent only, the appeal is granted. The Board has considered the doctrine of reasonable doubt but has determined that it is inapplicable, because the evidence is persuasively against the assignment of higher ratings beyond that awarded by this decision. 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 4.3, 4.7.

Entitlement to service connection for hypertension.

Service connection on a direct basis requires (1) competent and credible evidence confirming the Veteran has the claimed disability or at least has since filing the claim; (2) competent and credible evidence of in-service incurrence or aggravation of a relevant disease or injury; and (3) competent and credible evidence of a nexus or link between the in-service injury or disease and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when the evidence, including that pertinent to service, establishes that the disease was incurred in service. See 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d).    

Presumptive service connection can satisfy the requirements of an in-service event and a nexus to military service. Chronic diseases listed under 38 C.F.R. § 3.309(a)-(f) that manifest either during active service or subject to the requirements of 38 C.F.R. § 3.307 after discharge or release from military service are sufficient to establish in-service incurrence or aggravation. If a chronic disease enumerated in 38 C.F.R. § 3.309 does not manifest in-service or within the applicable time limits, the second and third elements of service connection may be granted based on continuity of symptomatology. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The United States Court of Appeals for the Federal Circuit (Federal Circuit) clarified that the law providing for awards of service connection on the basis of continuity of symptomatology is limited to those "chronic" diseases listed under 38 C.F.R. § 3.309(a). See Id. 

VA has acknowledged that persons residing or working at Camp Lejeune from August 1953 through December 1987 were potentially exposed to drinking water contaminated with volatile organic compounds (VOCs). See Veterans Benefits Administration (VBA) Fast Letter 11-03 (Revised) (January 28, 2013). In the early 1980s, it was discovered that two on-base water-supply systems were contaminated with the VOCs trichloroethylene (TCE), a metal degreaser, and perchloroethylene (PCE), a dry cleaning agent. Id. Benzene, vinyl chloride, and other VOCs were also found to be contaminating the water-supply systems. See VBA Training Letter 11-03 (Revised) (November 29, 2011). Accordingly, VA now essentially presumes that, absent evidence to the contrary, benefits claimants who served at Camp Lejeune between 1957 and 1987 were potentially exposed to the range of chemicals that contaminated the water there. Id. at 6.

Effective March 14, 2017, VA amended its adjudication regulations, 38 C.F.R. §§ 3.307 and 3.309, regarding presumptive service connection, adding certain diseases associated with contaminants present in the base water supply at Camp Lejeune. The final rule establishes that veterans who served at Camp Lejeune for no less than 30 days (either consecutive or nonconsecutive) during this period, and who have been diagnosed with any of eight associated diseases (adult leukemia, aplastic anemia and other myelodysplastic syndromes, bladder cancer, kidney cancer, liver cancer, multiple myeloma, Non-Hodgkin's lymphoma, and Parkinson's disease) are presumed to have incurred or aggravated the disease in service for purposes of entitlement to VA benefits. Thus, hypertension is not listed as a
.307 and 3.309, regarding presumptive service connection, adding certain diseases associated with contaminants present in the base water supply at Camp Lejeune. The final rule establishes that veterans who served at Camp Lejeune for no less than 30 days (either consecutive or nonconsecutive) during this period, and who have been diagnosed with any of eight associated diseases (adult leukemia, aplastic anemia and other myelodysplastic syndromes, bladder cancer, kidney cancer, liver cancer, multiple myeloma, Non-Hodgkin's lymphoma, and Parkinson's disease) are presumed to have incurred or aggravated the disease in service for purposes of entitlement to VA benefits. Thus, hypertension is not listed as a presumptive disease associated disease of exposure to contaminated water at Camp Lejeune. 

Service treatment records (STRs) are silent for any complaints, treatment or diagnosis for hypertension during service. In a May 1980 STR record, the Veteran's blood pressure was 110/70. An October 1981 examination report documented the Veteran's blood pressure as 128/92. 

In January 2025, VA received a November 2024 private consultant's opinion regarding hypertension, among other issues. The opinion provided a nexus between the Veteran's hypertension and his "psychiatric condition." The examiner explained that,

[The Veteran's] history indicates that he has multiple sources of chronic stress stemming from his service, including his gastrointestinal issues (discussed above) as well as his psychiatric condition. As such, it is at least as likely as not that [the Veteran's] hypertension is the result of chronic stress related to either or both of those aforementioned conditions, which have over the years afflicted enough acute bouts of hypertension to the degree that the condition has become chronic.

At a VA examination in March 2025, the examiner noted high blood pressure readings from September 2007 of 159/99 and September 2023 of 189/119 and 185/119. Thus, the Veteran has a hypertension diagnosis. In the medical opinion, the examiner provided a negative opinion based on the Veteran not having elevated blood pressure readings during his military service that met the definition of systolic blood pressure is predominantly 160 millimeters (mm) or greater, with a diastolic blood pressure greater than 90mm. 

In April 2025, a medical opinion for hypertension due to contaminated water at Camp Lejeune was obtained. The examiner provided a negative opinion stating that "Based on the totality of the medical and scientific data and the lack of known or accepted causation there is no nexus between the Veteran's claimed [hypertension] and the synergistic, combined effect of all toxic exposure risk activities of the Veteran." The examiner further noted the Veteran had a history of alcoholism for which he was treated in 1988. The examiner further opined that "there is no medical or scientific evidence available that provides any indication of a relationship between [hypertension] and the toxic risk exposure activity (TERA) and the risk factors outside of the military service (Alcoholism, tobacco abuse, unhealthy diet, poor lifestyle, family history, stress) that outweigh the factors identified in the TERA." 

At his January 2026 Board hearing, the Veteran contended that his hypertension was secondary to his psychiatric disorder. The Veteran's attorney referenced a nexus opinion provided by a private consultant which concluded that there was a nexus between the Veteran's hypertension and his psychiatric condition. Further, the Veteran's attorney referenced that a prior Board decision regarding service connection for a psychiatric condition had been appealed to the Court.

After review of the record, the Board finds that competent and probative evidence of record is persuasively against finding that the Veteran is entitled to service connection for hypertension. The record does not show that the Veteran incurred hypertension during service. The March 2025 VA medical opinion provided a negative nexus opinion based on no incurrence of hypertension during service. The Board finds the March 27, 2025, opinion probative. Additionally, the evidence is persuasively against finding that the Veteran's hypertension was caused or is related to his presumptive exposure to contaminated water at Camp Lejeune. The April 2025 medical opinion explained that there was not an association between hypertension and exposure to contaminated water at Camp Lejeune. The Board finds the opinion probative.

Pertaining to the Veteran's contention that his hypertension is due to his psychiatric disorder, the Board acknowledges that the Veteran submitted a November 2024 private opinion providing a nexus between the Veteran's hypertension and his "psychiatric condition." However, at the present time, service connection is not currently in effect for a psychiatric disorder. In a separate docket, the Veteran's appeal for service connection for a psychiatric condition was remanded by the Court of Appeals for Veterans Claims (Court) in a February 2026 Joint Motion for Rem
 contaminated water at Camp Lejeune. The April 2025 medical opinion explained that there was not an association between hypertension and exposure to contaminated water at Camp Lejeune. The Board finds the opinion probative.

Pertaining to the Veteran's contention that his hypertension is due to his psychiatric disorder, the Board acknowledges that the Veteran submitted a November 2024 private opinion providing a nexus between the Veteran's hypertension and his "psychiatric condition." However, at the present time, service connection is not currently in effect for a psychiatric disorder. In a separate docket, the Veteran's appeal for service connection for a psychiatric condition was remanded by the Court of Appeals for Veterans Claims (Court) in a February 2026 Joint Motion for Remand (JMR). The Board has not adjudicated the psychiatric claim in accordance with the terms of the JMR, thus that issue remains pending. Therefore, at present, there is no basis to award service connection for hypertension as secondary to a service-connected disability, to include a psychiatric disorder. 

Although lay persons are competent to provide opinions on some medical issues, whether the hypertension was caused by service, to include as due to exposure to contaminated water at Camp Lejeune is outside the realm of common knowledge of a lay person because it involves complex medical issues that go beyond a simple and immediately observable cause-and-effect relationship. See Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007).

In summary, the evidence of record persuasively weighs against finding for service connection for hypertension, to include as due to exposure to contaminated water at Camp Lejeune, or as secondary to a service-connected disability. Service connection is not warranted, and the appeal is denied. In reaching the conclusions stated above, the Board has considered the applicability of the benefit of the doubt doctrine.  As the evidence persuasively favors one side or the other, the doctrine is not for application.  See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc); 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

 

 

J. Kirby

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	M. G. Perkins, Counsel

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.