KIDNEY DISEASE OF

Summary

The veteran, who served from December 1968 to December 1972, appeals the denial of service connection for kidney disease. The veteran is service-connected for hypertension. The case involves a Toxic Risk Exposure Activity (TERA) memorandum confirming the veteran's participation in TERA. The primary issue is whether the veteran's chronic kidney disease is secondary to his service-connected hypertension. The Board reviewed several medical opinions: a VA treatment note from May 2024 suggested a link between kidney disease and hypertension; a June 2024 VA examination opined the kidney disease was less likely than not related to hypertension, speculating the treating clinician did not review the full history; an October 2024 opinion from the veteran's treating nephrologist linked the kidney disease to hypertension, supported by medical records; and an April 2025 VA examination reiterated the less likely than not opinion, again speculating about the treating physician's review. The Board found the evidence in approximate balance, ultimately giving the benefit of the doubt to the veteran. It placed more weight on the treating nephrologist's opinion due to the physician's experience and ongoing treatment relationship, while giving less weight to the VA examiner's opinions due to their speculative nature regarding the treating physician's assessment. Consequently, the Board found the kidney disease proximately due to hypertension and granted service connection.

Rationale

Current diagnosis of chronic kidney disease established.; Service-connected hypertension established.; Medical opinion from treating nephrologist links kidney disease to hypertension.; VA examiner opinions were less probative due to speculation.; Evidence found in approximate balance, benefit of doubt applied.

Full Decision Text

Citation Nr: A26034582
Decision Date: 04/14/26	Archive Date: 04/14/26

DOCKET NO. 260108-626232
DATE: April 14, 2026

ORDER

Service connection for kidney disease is granted.

FINDINGS OF FACT

1. The VA examination confirms a diagnosis of chronic kidney disease.

2. The Veteran is service-connected for hypertension.

3. The Toxic Risk Exposure Activity (TERA) memorandum dated December 24, 2024, confirms that the Veteran participated in TERA. 

4. The competent and probative evidence is in approximate balance as to whether the Veteran's current kidney disease is caused by to his service-connected hypertension.

CONCLUSION OF LAW

The criteria for service connection for kidney disease are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310(a). 

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The Veteran served on active duty from December 1968 to December 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May (notice on the 19th) 2025 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

Procedurally, the Board notes that a July 2024 rating decision initially denied service connection for kidney disease. The Veteran submitted a supplemental claim application in December 2024, and the Agency of Original Jurisdiction (AOJ) issued a rating decision in May 2025, which is the decision on appeal.

In a January 2026 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct Review docket. Based upon the selection of the Direct Review option, the Board may only consider the evidence of record as of May 16, 2025 - the date of the rating decision on appeal. See 38 C.F.R. § 20.301. If the Veteran submitted evidence that was added to the record after May 16, 2025, the Board did not consider it. If the Veteran wishes to have VA consider any evidence that was not considered, a supplemental claim should be submitted identifying such evidence. See 38 C.F.R. § 3.2501.

In the May 2025 rating decision, the AOJ determined that it had received new and relevant evidence to readjudicate the claim of service connection for kidney disease. The Board see no reason to disturb this favorable finding. 38 C.F.R. § 3.104(c). As such, the Board does not need to readjudicate the new and relevant evidence aspect of this issue and will proceed to the merits. 

Service Connection

Regulations provide that service connection is warranted for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Further, a disability which is aggravated by a service-connected disorder may be service connected to the degree that the aggravation is shown. Allen v. Brown, 7 Vet. App. 439, 449 (1995). In order to establish entitlement to secondary service connection, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; (3) medical evidence establishing a nexus between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

The Veteran is competent to report symptoms and experiences observable by his senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed Cir. 2009).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

Service connection for kidney disease.

After review of the record, the Board finds that the criteria for service connection for kidney disease, to include as secondary to service-connected disabilities, are met.

The Agency of Original Jurisdiction (AOJ) made a favorable finding that the Veteran is diagnosed with chronic kidney disease. The Board see no reason to disturb this favorable finding, and it establishes the first element of a service connection claim, a current diagnosis.

The VA treatment records show that, in May
 of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

Service connection for kidney disease.

After review of the record, the Board finds that the criteria for service connection for kidney disease, to include as secondary to service-connected disabilities, are met.

The Agency of Original Jurisdiction (AOJ) made a favorable finding that the Veteran is diagnosed with chronic kidney disease. The Board see no reason to disturb this favorable finding, and it establishes the first element of a service connection claim, a current diagnosis.

The VA treatment records show that, in May 2024, the Veteran's treating clinician indicated that the Veteran's chronic kidney disease is linked to hypertension. 05/29/2024, CAPRI, page 48. 

A June 2024 VA examiner opined that the Veteran's chronic kidney disease is less likely than not proximately due to or aggravated by his service-connected hypertension disability. The examiner acknowledged the May 2024 treatment note but speculates that this VA clinician did not review the medical history. 06/08/2024, C&P Exam.  

In October 2024, the Veteran's treating physician and chief of nephrology opined that the Veteran's chronic kidney disease is secondary to his hypertension. The VA physician indicated that a review of relevant medical records supports this opinion. 03/25/2025, CAPRI, page 244.

An April 2025 VA medical opinion was provided by the same VA examiner who conducted the June 2024 VA examination. The examiner opined that the Veteran's chronic kidney disease is less likely than not proximately due to or aggravated by his service-connected hypertension disability. The examiner also acknowledged the opinion of the Veteran's treating nephrologist but again speculates that the treating physician did not adequately review the medical history. Rather, the examiner indicates that the Veteran's kidney disease is likely related to aging. 04/12/2025, C&P Exam. 

After review of the relevant medical opinions, the Board finds the evidence is at least in approximate balance regarding whether the current kidney disease is proximately related to his service-connected hypertension. 38 U.S.C. § 5107(b). The Board places probative weight on the October 2024 medical opinion because VA physician's medical knowledge, training, and experience, as well as the history of treating the Veteran. On the other hand, the Board places less probative weight on the June 2024 and April 2025 VA medical opinions because the examiner did not adequately address the basis of speculation that the Veteran was incorrectly assessed by his treating nephrologist regarding the etiology of his kidney disease. 

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As such, the Board finds that the Veteran's kidney disease is proximately due to his service-connected hypertension, and that the Veteran's claim for service connection is granted. 38 C.F.R. § 3.310(a).

 

 

Paul Sorisio

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Han, David

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.