HYPERTENSION

S. B. MAYS · 2026 · Case ID: A26035515

MIXED

Summary

The veteran, who served in the U.S. Navy from May 1997 to September 2002, appeals the denial of service connection for hypertension, GERD, low back disability, neck/upper back disability, eye disability, and TDIU. The Board denied the claims for hypertension, GERD, low back, neck/upper back, and eye disability, finding that the veteran did not meet the threshold requirement of having a current diagnosis for these conditions. For the eye disability claim, the Board noted that refractive errors are not considered diseases or injuries for service connection purposes and that the veteran's vision was corrected to 20/20 with glasses. The Board denied TDIU, finding that the veteran was employed in substantially gainful occupations during the appeal period, including as a Mystery Shopper and ride-share driver, with income exceeding the federal poverty threshold. The claim for an acquired psychiatric disability, including PTSD and depression, was remanded. The Board found that while the veteran had diagnoses of PTSD and depression, the nexus opinion was based on an inaccurate factual premise, and the reported stressors, including witnessing a helicopter crash in December 1999, were not verified. The Board also noted a duty to assist error in failing to obtain a VA examination and opinion for the psychiatric claim. The matter was remanded for verification of stressors and a new VA examination to determine the etiology of the psychiatric disorders.

Rationale

No current diagnosis of hypertension found in the record.; No notation of elevated blood pressure readings post-service.; McLendon threshold not met as no current diagnosis or recurrent symptoms exist.

Service Branch

NAVY

Special Benefit

TDIU

Docket No.

210104-132100

Full Decision Text

Citation Nr: A26035515
Decision Date: 04/16/26 Archive Date: 04/16/26

DOCKET NO. 210104-132100
DATE: April 16, 2026

ORDER

Entitlement to service connection for hypertension is denied.

Entitlement to service connection for gastroesophageal reflux disease (GERD) is denied.

Entitlement to service connection for a low back disability is denied.

Entitlement to service connection for a neck (also claimed as an upper back) disability is denied.

Entitlement to service connection for blurry vision (hereafter referred to as an eye disability) is denied.

Entitlement to a total disability rating due to individual unemployability (TDIU) is denied.

REMANDED

Entitlement to service connection for an acquired psychiatric disability to include posttraumatic stress disorder (PTSD) and depression is remanded.

FINDINGS OF FACT

1. The Veteran is not diagnosed with hypertension during the pendency of, or proximate to, the pendency of the claim.

2. The Veteran is not diagnosed with GERD during the pendency of, or proximate to, the pendency of the claim.

3. Scoliosis, which was noted on the entrance examination, was not subjected to a superimposed disease or injury during service.

4. The Veteran is not diagnosed with a low back, neck, or upper back disability, during the pendency of, or proximate to, the pendency of the claim.

5. The Veteran's refractive error, which was noted on the entrance examination, was not subjected to a superimposed disease or injury during service.

6. The Veteran had blurry vision and irritated eyes during service but currently does not have an eye condition aside from the refractive error, and his vision is corrected to 20/20 in each eye with glasses.

7. During the period on appeal, the evidence reflects that the Veteran has been employed in a substantially gainful occupation which was not in a protected or sheltered work environment.

CONCLUSIONS OF LAW

1. 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.

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

3. The criteria for entitlement to service connection for a low back disability, including scoliosis, have not been met. 38 U.S.C. §§ 1110, 5107; 38?C.F.R. §§?3.102, 3.303, 4.9.

4. The criteria for service connection for a neck (also claimed as an upper back) disability have not been met. 38 U.S.C. §§1110, 5107; 38?C.F.R. §§?3.102, 3.303, 4.9.

5. The criteria for entitlement to service connection for claimed eye disability have not been met. 38 U.S.C. §§1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 4.9.

6. The criteria for an award of TDIU have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.16, 4.19.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in the United States Navy from May 1997 to September 2002, and thereafter in the Navy Reserve until 2005.

The rating decision on appeal was issued in February 2020 for the claims of entitlement to service connection for hypertension, GERD, low back disability, neck (also claimed as upper back) disability, eye disability, and TDIU, and in April 2020 for the claim of entitlement to service connection for an acquired psychiatric disability. The February 2020 and April 2020 rating decisions constitute initial decisions.

In the January 4, 2021, VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on September 11, 2024, where the Veteran limited his testimony to the service connection claim for an acquired psychiatric disability.

Here, the Board may only consider the evidence of record at the time of the February 2020 agency of original jurisdiction (AOJ) rating decision for entitlement to service connection for hypertension, GER
disability, and TDIU, and in April 2020 for the claim of entitlement to service connection for an acquired psychiatric disability. The February 2020 and April 2020 rating decisions constitute initial decisions.

Here, the Board may only consider the evidence of record at the time of the February 2020 agency of original jurisdiction (AOJ) rating decision for entitlement to service connection for hypertension, GERD, low back disability, neck (also claimed as upper back) disability, eye disability, and TDIU, and the April 2020 decision for entitlement to service connection for an acquired psychiatric disability, 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. The Veteran submitted a statement about events he witnessed while in service and his ongoing psychiatric symptoms within 90 days following the hearing.

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.

However, because the Board is remanding the claim of entitlement to service connection for an acquired psychiatric disability to include PTSD and depression, any evidence the Board could not consider will be considered by the AOJ in the adjudication of that claim. 38 C.F.R. § 3.103(c)(2)(ii).

The Board acknowledges that in May 2024, the authorized representative submitted a motion to withdraw. See May 2024 BVA Revocation of POA. However, in August 2024, the Board denied the motion to withdraw. See August 2024 BVA Ruling on Motion. The authorized representative then proceeded to represent the Veteran at the Board hearing in September 2024, and no other motion to withdraw was submitted. As such, the current representative remains the representative of record as evidenced by the header in this decision.

The record contains a September 2019 Privacy Act Request Acknowledgement Letter which acknowledged an August 2019 Privacy Act request. However, a review of the record shows there was no August 2019 Privacy Act Request. Rather, there was a March 2019 Privacy Act request that was fulfilled by the Board in July 2019. The Board considers the September 2019 Privacy Act Request Acknowledgement letter to be in error. Additionally, the Veteran's representative already has access to the Veteran's entire electronic claims file, including the requested records, via the Veterans Benefits Management System (VBMS). Therefore, the representative's request for access to the identified documents has already been fulfilled and no further action is required.

Service Connection - Laws and Regulations

Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d).

Establishing service connection generally requires three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009).

A veteran is presumed to have been in sound condition when examined, accepted, and enrolled for service except as to defects, infirmities, or disorders noted at the time of examination, acceptance, enrollment, or where clear and unmistakable evidence demonstrates that the injury or
§ 3.303(d).

A preexisting injury or disease will be considered to have been aggravated by active service where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease. 38?U.S.C. §?1153; 38?C.F.R. §?3.306; Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004). Clear and unmistakable evidence (obvious or manifest) is required to rebut the presumption of aggravation where the preservice disability underwent an increase in severity during service. 38?C.F.R. §?3.306. Aggravation may not be conceded where the disability underwent no increase in severity during service on the basis of all the evidence of record pertaining to the manifestations of the disability prior to, during, and subsequent to service. 38?C.F.R. §§?3.304, 3.306.

VA must provide a medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service, or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service, but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006).

A claimant bears the evidentiary burden to establish all elements of a service connection claim, including the nexus requirement. Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009).?

Lay statements may serve to support a claim for service connection by supporting the occurrence of lay-observable events, or the presence of disability, or symptoms of disability subject to lay observation. 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Although lay persons are considered competent to provide opinions on some medical issues, some medical issues fall outside of the realm of common knowledge of a lay person. Kahana v. Shinseki, 24 Vet. App. 428 (2011).

VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a claimant prevailing in either event. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The claimant is entitled to the benefit of the doubt when there is an "approximate" (meaning nearly equal) balance of positive and negative evidence regarding any material determination. See Lynch v. McDonough, 999 F.3d 1391 (2021); Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001).

Hypertension

Evidence and Analysis

The Veteran contends that his claimed hypertension is due to his military service. See December 2019 VA 21-526EZ.

On a May 1996 Report of Medical Examination, completed upon service entrance, the Veteran's heart and vascular system were found normal upon clinical evaluation. The Veteran did not report any issues with his heart or vascular system on the May 1996 Report of Medical History.

According to a July 2002 Report of Medical Examination, completed in anticipation of separation from service, the Veteran's heart and vascular system were found normal upon clinical evaluation. On the corresponding Report of Medical History, the Veteran marked that he had experienced low blood pressure. Then, in the physician summery section, it was noted the Veteran had one abnormal blood
Veteran contends that his claimed hypertension is due to his military service. See December 2019 VA 21-526EZ.

According to a July 2002 Report of Medical Examination, completed in anticipation of separation from service, the Veteran's heart and vascular system were found normal upon clinical evaluation. On the corresponding Report of Medical History, the Veteran marked that he had experienced low blood pressure. Then, in the physician summery section, it was noted the Veteran had one abnormal blood pressure reading that was visibly high but nothing recently per a review of the medical record.

Post service, the Veteran's blood pressure has been taken periodically throughout the years. See July 2005 Emergency Dept Note, July 2010 Primary Care Note, April 2012 Immunization Note, August 2013 Primary Care Note, July 2015 Optometry Student Note, January 2016 Emergency Dept Note, July 2016 Primary Care Note, August 2017 Sleep Medicine Consult, August 2017 Nursing Note, November 2018 Endocrinology Note, May 2019 Primary Care Note, and March2020 Psychiatry Progress Note. The record contains no documentation of a diagnosis of hypertension or any notation about elevated blood pressure readings.

Based on all the available evidence, the Board finds that the criteria are not met to grant service connection for hypertension.

For VA purposes, "[h]ypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days," and "hypertension means that the diastolic blood pressure [the bottom number of the blood pressure ratio] is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure [the top number of the blood pressure ratio] is predominantly 160mm. or greater with a diastolic of less than 90mm." 38 C.F.R. § 4.104, Diagnostic Code 7101, Note (1).

The Board has reviewed the evidence of record, to include the VA and private medical records and examination reports and finds that the Veteran has not been diagnosed with hypertension during the pendency of the appeal.

As the Veteran does not have a current diagnosis of hypertension, he does not meet the threshold element of the claim, and as such it must be denied. There being no competent evidence that the Veteran has been diagnosed with the claimed disability of hypertension, an analysis of the remaining elements of a service connection claim under any theory is unnecessary.?

The Board acknowledges that the Veteran was not provided a VA examination for his hypertension claim. Here, there is no evidence of a current hypertension diagnosis or recurrent hypertensive symptoms. Therefore, the McLendon threshold was not satisfied, and VA was not required to provide an examination or nexus opinion.

In light of the above, the Board finds that the evidence is persuasively against the claim for hypertension, and as such the benefit of the doubt doctrine is not for application. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (only when the evidence persuasively favors one side, or another is the benefit of the doubt doctrine not for application).

The appeal is therefore denied.

GERD

Evidence and Analysis

The Veteran contends that his claimed GERD disability is due to his military service. See December 2019 VA 21-526EZ.

On the May 1996 Report of Medical Examination, his gastrointestinal system, mouth and throat, and abdomen and viscera were found normal upon clinical evaluation. The Veteran did not report any issues with his gastrointestinal system on the May 1996 Report of Medical History.

The July 2002 Report of Medical Examination, completed in anticipation of service separation, the Veteran's gastrointestinal system, mouth and throat, abdomen and viscera were found normal upon clinical evaluation. On the associated Report of Medical History, the Veteran marked "no" to the question of whether he had had any stomach, liver, or intestinal trouble, or frequent indigestion.

Post service, the record does not contain any diagnosis of GERD, nor does it contain any lay or medical documentation of symptoms such as acid reflux or substernal pain related to GERD.

As the Veteran does not have a current diagnosis of GERD, he does not meet the threshold element of the claim, and as such it must be denied. There being no competent evidence that the Veteran has been diagnosed with the claimed disability of GERD, an analysis of the remaining elements of a service connection claim under any theory is unnecessary.?

The Board acknowledges that the Veteran was not provided a VA examination for his GERD
no" to the question of whether he had had any stomach, liver, or intestinal trouble, or frequent indigestion.

Post service, the record does not contain any diagnosis of GERD, nor does it contain any lay or medical documentation of symptoms such as acid reflux or substernal pain related to GERD.

The Board acknowledges that the Veteran was not provided a VA examination for his GERD claim. There is no probative evidence of a GERD diagnosis or recurrent symptoms related to GERD. Therefore, the McLendon threshold has not been satisfied, and VA was not required to provide an examination or nexus opinion.

In light of the above, the Board finds that the evidence is persuasively against the claim for GERD, and as such the benefit of the doubt doctrine is not for application. Lynch v. McDonough, 21 F.4th 776.

The appeal is therefore denied.

Low Back, Neck/Upper Back

Evidence and Analysis

The Veteran contends that his claimed low back, neck/upper back disabilities are due to his military service. See December 2019 VA 21-526EZ.

On the May 1996 Report of Medical Examination, his spine was noted to have slight rotary scoliosis that was asymptomatic. No symptoms were noted, there was no weakness or atrophy, and he was found qualified to serve.

On the July 2002 Report of Medical Examination, conducted in anticipation of separation from active duty, the Veteran's spine was found normal upon clinical evaluation. On the associated Report of Medical History, the Veteran marked "no" indicating that he had not had recurrent back pain.

Post service, the record does not contain any diagnosis of a low back, neck or upper back disability, nor does it contain any lay or medical documentation of any related complaints or symptoms.

At the outset, the Veteran's entrance examination notes that he has rotary scoliosis. Scoliosis, by definition, is a congenital defect. See Dorland's Illustrated Medical Dictionary (32nd ed. 2012) (defining scoliosis as "an appreciable lateral deviation in the normally straight vertical line of the spine"). Service connection is generally precluded by regulation for "defects" because they are not "diseases" or "injuries" within the meaning of applicable legislation. 38 C.F.R. §§ 3.303(c), 4.9, 4.127; Terry v. Principi, 340 F.3d 1378, 1383-84 (Fed. Cir. 2003); Palczewski v. Nicholson, 21 Vet. App. 174, 179 (2007). To establish service connection for a congenital defect, the evidence must show superimposed disease or injury during service. See VAOPGCPREC 82-90 (service connection may not be granted for defects of congenital, developmental or familial origin, unless the defect was subject to a superimposed disease or injury).

Here, the Board finds that the Veteran's scoliosis was not subject to a superimposed disease or injury during service. The service treatment records show no spine complaints, treatment or diagnoses. Consequently, the Board finds that service connection is not warranted for scoliosis as VA regulations specifically prohibit service connection for congenital defects unless subjected to a superimposed disease or injury during service. See VAOGCPREC 82-90 ("It is clear that congenital or developmental defects may not be service-connected because they are not diseases or injuries under the law."); 55 Fed. Reg. 45,711 (Oct. 30, 1990) ("Service-connection may be granted for diseases (but not defects)").

Aside from scoliosis, there is no competent and credible evidence of a current low back, neck, or upper back disability. In other words, the Veteran is not currently diagnosed with a current low back, neck or upper back disability. The Veteran himself is not competent to diagnose a medical condition such as a back or neck disability.

Because the evidence does not show that he has a current low back, neck or upper back disability or any recurrent symptoms of same, the McLendon threshold has not been satisfied and VA was not required to provide an examination or nexus opinion.

In light of the above, the Board finds that the evidence is persuasively against the claim for low back, neck and upper back disabilities, and as such the benefit of the doubt doctrine is not for application. Lynch v
credible evidence of a current low back, neck, or upper back disability. In other words, the Veteran is not currently diagnosed with a current low back, neck or upper back disability. The Veteran himself is not competent to diagnose a medical condition such as a back or neck disability.

The appeal is denied.

Eye Disability

Evidence and Analysis

The Veteran contends that his claimed blurry vision disability is due to his military service. See December 2019 VA 21-526EZ.

In May 1996, during a prescreening evaluation, the Veteran reported he had been wearing glasses since age nine and had last seen an eye doctor in 1995. See May 1996 Applicant Medical Prescreening Form. In May 1996, the Veteran underwent an entrance examination where, upon clinical evaluation, his eyes were marked normal. He was noted to wear lenses when his distance vision, refraction, and near vision were examined. See May 1996 Report of Medical Examination. He was noted to wear glasses and have a refractive error. See May 1996 Report of Medical History.

In February 1997, the Veteran was seen due, in part, to experiencing two weeks of red eye. See February 1997 NEFF Inst. Corp Treatment.

In August 1999, the Veteran was seen for eye pain. The Veteran denied blurry vision, but his right eye lid was swollen with a small flat bump. He was prescribed medication. See August 1999 Acute Care and Treatment.

In May 2000, the Veteran was seen for a puffy and irritated left eye that had been ongoing for one day. He was diagnosed with a stye and prescribed a warm compress and medicated eye drops. See May 2000 Chronological Record of Medical Care. Later that month, he was seen again for irritation of the left eye. The Veteran reported his eye was itchy and had drainage. He was diagnosed with conjunctivitis and prescribed medication. See May 2000 Chronological Record of Medical Care.

In January 2001, the Veteran was diagnosed with viral conjunctivitis and prescribed medication. See January 2001 Chronological Record of Medical Care.

In May 2001, the Veteran underwent an eye examination. The Veteran was noted to have no complaints. See May 2001 Optometry Contact Lens Examination.

In September 2001, the Veteran elected to undergo excimer laser photorefractive keratectomy (PRK) surgery on both eyes. The Veteran had refractive error and met the FDA criteria for PRK. See September 2001 Informed Consent for PRK and September 2001 Chronological Record of Medical Care

In July 2002, the Veteran underwent an examination in preparation for separation from service. His eyes were marked normal upon clinical evaluation and his distant and near vision were both marked 20/20. There was no notation that the Veteran wore corrective lenses. See July 2002 Report of Medical Examination. On the Report of Medical History it was noted the Veteran had undergone PRK surgery on both eyes in September 2001 with no complications. See July 2002 Report of Medical History.

In September 2013, the Veteran was diagnosed with diabetes and, as part of his care, it was recommended he undergo an annual eye examination. See September 2013 Primary Care Telephone Note. In October 2013, the Veteran underwent diabetic teleretinal imaging of his eyes and no abnormalities were noted. See October 2013 Diabetology Consult.

In July 2015, the Veteran underwent an eye examination where his PRK was noted to be stable. He had symptomatic dry eye. See July 2015 Optometry Student Note. The Veteran reported artificial tears relieved the symptoms of his dry eye. See July 2015 Student Note.

In January 2020, the Veteran was afforded a VA examination with an optometrist. The Veteran did not currently have an eye condition. Upon examination, the Veteran's uncorrected distance vision for both eyes was 20/50, his corrected distance vision for both eyes was 20/20 or better, his uncorrected near vision for both eyes was 20/20 or better, and his corrected near vision for both eyes was 20/20 or better. The Veteran did not have an afferent pupillary
to be stable. He had symptomatic dry eye. See July 2015 Optometry Student Note. The Veteran reported artificial tears relieved the symptoms of his dry eye. See July 2015 Student Note.

In January 2020, the Veteran was afforded a VA examination with an optometrist. The Veteran did not currently have an eye condition. Upon examination, the Veteran's uncorrected distance vision for both eyes was 20/50, his corrected distance vision for both eyes was 20/20 or better, his uncorrected near vision for both eyes was 20/20 or better, and his corrected near vision for both eyes was 20/20 or better. The Veteran did not have an afferent pupillary defect, did not have anatomical loss, did not have light perception only, did not have extremely poor vision, and did not have blindness. The Veteran did not have corneal irregularity that resulted in severe irregular astigmatism or diplopia. See January 2020 VA Examination.

The VA examiner, after a review of the records and the examination, stated that at the current examination, the Veteran was not found to have any eye conditions. The Veteran's visual acuity was decreased due to myopia in both eyes, and his visual acuity was corrected to 20/20 in each eye with glasses. Therefore, the Veteran's claimed blurry vision is less likely than not incurred in or caused by the claimed blurry vision, irritated eye during service. Id.

Given the above, the Board finds that service connection for an eye disability to include blurry vision, an irritated eye, and refractive error is not warranted.

The Board notes that service connection may not be granted for refractive errors of the eyes even if visual acuity decreased in service, as this is not a disease or injury within the meaning of applicable legislation relating to service connection. 38 C.F.R. §§ 3.303(c), 4.9. Refractive errors of the eyes are congenital or developmental defects and not disease or injury within the meaning of applicable legislation. 38 C.F.R. §§ 3.303(c), 4.9. VA regulations specifically prohibit service connection for refractory errors of the eyes unless such defect was subjected to a superimposed disease or injury which created additional disability. See VAOPGCPREC 82-90 (July 18, 1990) (cited at 55 Fed. Reg. 45,711) (Oct. 30, 1990) (service connection may not be granted for defects of congenital, developmental, or familial origin, unless the defect was subject to a superimposed disease or injury); see also O'Bryan v. McDonald, 771 F.3d 1376, 1380-81 (Fed. Cir. 2014) (refractive error of the eye is not a compensable disease because it is specifically excluded from the regulation even though refractive errors of the eye can progress) (citing Terry v. Principi, 340 F.3d 1378, 1383-84 (Fed. Cir. 2003)).

Under 38 C.F.R. § 3.303(c), refractive error of the eye is not considered a disease or injury within the meaning of applicable legislation governing the awards of compensation benefits. As myopia and astigmatism are shown to be refractive errors, these conditions are not "diseases" or "injuries" for purposes of service connection. See McNeely v. Principi, 3 Vet. App. 357, 364 (1992); Parker v. Derwinski, 1 Vet. App. 522 (1991). Service connection is thus not warranted for these conditions. The Veteran's eye disability, claimed as blurry vision, does not warrant service connection.

In this case, the Veteran's refractive error that was noted upon entry into service, was corrected in service through a successful PKR surgery for both eyes. There were no complications from the procedure and over a decade after service the results of his PKR surgery were noted to be stable. There is no evidence of a current eye condition and his eyesight has been corrected by glasses.

Additionally, the Board assigns high probative weight to the negative January 2020 VA opinion because it was rendered by a medical professional whose specialty is optometry, contains sound reasoning and aligns with the remaining medical evidence of the record. See?Nieves-Rodriguez,?22?Vet. App.?295; see also Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012) [finding medical reports must be read as a whole and in the context of the evidence of record].

There is no favorable medical opinion of record.

The Board recognizes
surgery were noted to be stable. There is no evidence of a current eye condition and his eyesight has been corrected by glasses.

There is no favorable medical opinion of record.

The Board recognizes that the Veteran is competent to report visual problems. The Veteran is not, however, competent to diagnose an eye condition or provide a nexus opinion as he does not have the medical expertise to offer an opinion as it is beyond the knowledge of a lay person. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).

In light of the above, the Board finds that the evidence is persuasively against the claim, and as such the benefit of the doubt doctrine is not for application. Lynch v. McDonough.

The appeal is therefore denied.

TDIU

Laws and Regulations

Total disability will be considered to exist where there is present any impairment of mind and body that is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340. Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is unable to secure or follow a substantially gainful occupation because of service-connected disabilities, provided that the Veteran meets the schedular requirements.

Specifically, if there is only one such disability, this disability shall be ratable at 60 percent or more; if there are two or more disabilities, there shall be at least one disability that is ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a). For the stated purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable; and (2) disabilities resulting from common etiology or a single accident. 38 C.F.R. § 4.16(a).

"Substantially gainful employment" is that employment "which is ordinarily followed by the nondisabled to earn their livelihood with earnings common to the particular occupation in the community where the Veteran resides." Moore v. Derwinski, 1 Vet. App. 356, 358 (1991). "Marginal employment shall not be considered substantially gainful employment." 38 C.F.R. § 4.16(a).

In determining whether unemployability exists, consideration may be given to the Veteran's level of education, special training, and previous work experience, but not to his age or to any impairment caused by nonservice-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19.

Based on the foregoing, the Veteran's total combined disability rating during this appeal was 10 percent effective November 19, 2025, and the Veteran did not meet the schedular criteria during this period. Nevertheless, VA's policy is to assign a total rating for all veterans who are unemployable due to their service-connected disabilities. Currently, "the VA appeals system allows the Board to adjudicate extraschedular TDIU in the first instance. Without Bowling [Bowling v. Principi, 15 Vet. App. 1, 10 (2001)], it is now free to do so." Witkowski v. Collins, 2025 U.S. App. Vet. Claims LEXIS 1423, at *33 (October 21, 2025). Therefore, the Board may now address the issue on the merits in the first instance. Id; Browder v. Brown, 5 Vet. App. 268, 270 (1993) ("A body subject to the decision of a federal appellate court is without power to do anything which is contrary to either the letter or the spirit of the mandate construed in light of the opinion of the court[.]").

Evidence and Analysis

The Veteran asserts that he is entitled to TDIU. See December 2019 VA 21-526EZ.

Service connection for tinnitus is currently in effect at 10 percent from November
. Vet. Claims LEXIS 1423, at *33 (October 21, 2025). Therefore, the Board may now address the issue on the merits in the first instance. Id; Browder v. Brown, 5 Vet. App. 268, 270 (1993) ("A body subject to the decision of a federal appellate court is without power to do anything which is contrary to either the letter or the spirit of the mandate construed in light of the opinion of the court[.]").

Evidence and Analysis

The Veteran asserts that he is entitled to TDIU. See December 2019 VA 21-526EZ.

Service connection for tinnitus is currently in effect at 10 percent from November 19, 2015. See March 2017 Rating Decision.

The narrow issue before the Board is whether the Veteran has been unable to secure or follow a substantially gainful occupation because of his service-connected disability. In determining whether a veteran can secure, follow, and maintain a substantially gainful occupation, the Board will consider the following factors: (1) the Veteran's occupational history, education, skill, and training; (2) whether the Veteran has the physical ability (both exertional and non-exertional) to perform the type of activities required by the occupation at issue; and (3) whether the Veteran has the mental ability to perform the activities required by the occupation at issue. Ray v. Wilkie, 31 Vet. App. 58, 73 (2019).

Based on the evidence discussed below, the Board finds that TDIU based on the Veteran's service-connected disability is not warranted.

The Veteran has a bachelor's degree from California State LA in business administration with a major in marketing and a minor in economics. See January 2018 Mental Health Initial Assessment-Consult.

Here, the Board finds that entitlement to a TDIU is not warranted because during the appeal period, he was employed. Specifically, during the appeal period, the Veteran was employed as a Mystery Shopper and ride share driver, in addition to working in marketing. See January 2018 Mental Health Initial Assessment-Consult, October 2019 Sleep Medicine Consult, January 2020 Homeless Program Note.

The Board further finds that there is no evidence showing that his current work environment was considered sheltered or protected work. Moreover, although some of his jobs appeared to be home based, working from home does not necessarily equate to working in a "sheltered" (also referred to as "protected") work environment, as the term is used in 4.16(a). A veteran can establish marginal employment either by demonstrating an income less than the poverty threshold established by the U.S. Census Bureau or by the facts of his particular case. Ortiz-Valles v. McDonald, 28 Vet. App. 65, 71 (2016).

In this regard, work that is less than on a full-time basis is not necessarily considered marginal. In Faust v. West, 13 Vet. App. 342 (2000), the Court affirmed the Board's denial of TDIU when the claimant had engaged in part-time work which, nevertheless, brought him earnings which exceeded the poverty threshold for one person. Id. at 356 (stating, "[T]he Court holds that where, as in this case, the veteran became employed, as shown by clear and convincing evidence, at a substantially gainful occupation i.e., one that provides annual income that exceeds the poverty threshold for one person, irrespective of the number of hours or days that the veteran actually works and without regard to the veteran's earned annual income prior to his having been awarded a 100 percent rating based on individual unemployability, such employment constitutes, as a matter of law, a substantially gainful occupation....").

Here, according to the Veteran, his income fluctuated but in January 2020, he reported that it was between $1000 and $1250 with an additional $140 in disability benefit payment. See January 2020 Homeless Program Note. Even considering the lowest amount of income he reported ($1000 plus $140), it is slightly higher than the federal poverty threshold for one person. The federal poverty threshold for a family size of one, under 65 years old was $13,465 in 2020. See, Poverty Thresholds, U.S. Census Bureau, http://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-thresholds.html (last visited March 20, 2026).

Given the evidence, the Board finds that the probative evidence of record does not show that employment by the Veteran was precluded on account of the service-connected tinnitus as the limitations associated with such disability at that time were not of a frequency or severity to significantly impact his ability to perform substantially gain
$140), it is slightly higher than the federal poverty threshold for one person. The federal poverty threshold for a family size of one, under 65 years old was $13,465 in 2020. See, Poverty Thresholds, U.S. Census Bureau, http://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-thresholds.html (last visited March 20, 2026).

Given the evidence, the Board finds that the probative evidence of record does not show that employment by the Veteran was precluded on account of the service-connected tinnitus as the limitations associated with such disability at that time were not of a frequency or severity to significantly impact his ability to perform substantially gainful employment, as he was able to work as ride-share driver and as a Mystery Shopper which require him to interact with people on a regular basis, concentrate on tasks such as obeying traffic laws, and follow directions including in noisy circumstances such as traffic. As such, the Veteran is not prevented from obtaining and maintaining substantially gainful employment due to his service-connected disability of tinnitus.

Accordingly, the evidence is persuasively against entitlement to a TDIU. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable in that regard, and the appeal must be denied. 38 C.F.R. § 4.16.

Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 69-70 (2017).

REASONS FOR REMAND

Remand by the Board in the AMA is proper for 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. 38?C.F.R. §?20.802(a).

The Veteran seeks service connection for an acquired psychiatric disability to include PTSD and depression. Specifically, the Veteran's primary contention is that he witnessed a December 1999 Sea Knight helicopter crash which profoundly impacted him and contributed to his mental health symptoms. See December 2024 Correspondence.

Remand is necessary to attempt to verify the Veteran's primary stressor and to obtain a VA examination and opinion.

In this case, the Veteran has diagnoses of PTSD and depression based on the DSM-5 criteria, as documented in the January 2018 Mental Health Initial Assessment-Consult.

Although the record contains a positive nexus opinion from December 2017 from physician assistant E.F. who stated the Veteran's PTSD was secondary to his military combat experience, this opinion is inadequate because it is based on an inaccurate factual premise. The Veteran has stated he did not directly see combat and, although the Veteran was deployed overseas, the record does not currently support that the Veteran engaged in combat. Reonal v. Brown, 5 Vet. App. 458, 461 (1993); Military Personnel Record, December 2017 Medical Treatment Record, and January 2018 Mental Health Initial Assessment-Consult.

V.A. clinical psychologist C.A.G. diagnosed the Veteran with PTSD based, in part, of the Veteran's reported in-service stressors. However, the stressor events were vaguely referred to as "multiple index traumas that occurred during his deployment to Afghanistan." The Veteran reported multiple stressors, such as witnessing a helicopter crash and witnessing an individual being physically assaulted. However, to date, none of the Veteran's stressors have been verified.

The record shows that in December 2017, the Veteran submitted an article describing a December 1999 helicopter crash, titled, "Search intensifies for 7 Marines after helicopter crash." At that time, however, the Veteran provided no context as to how this event was relevant to his claim. Nonetheless, the Board observes that in January 2018 VA treatment notes, the Veteran, in describing his military traumas during an initial mental health intake consultation, stated that he witnessed a helicopter crash where "lives were lost and bodies not recovered." Notably, prior to adjudicating the claim, the AOJ did not attempt to verify this stressor. On remand, such should be accomplished.

Further, the Board finds that the AOJ erred in not providing Veteran with a VA examination and opinion in conjunction with the instant appeal because the McLendon criteria had been met prior to the adjudication of the claim. Indeed, at the time of the rating decision on appeal, the claims file contained evidence of a current psychiatric disorder, the December 1999 article titled, "
2018 VA treatment notes, the Veteran, in describing his military traumas during an initial mental health intake consultation, stated that he witnessed a helicopter crash where "lives were lost and bodies not recovered." Notably, prior to adjudicating the claim, the AOJ did not attempt to verify this stressor. On remand, such should be accomplished.

Further, the Board finds that the AOJ erred in not providing Veteran with a VA examination and opinion in conjunction with the instant appeal because the McLendon criteria had been met prior to the adjudication of the claim. Indeed, at the time of the rating decision on appeal, the claims file contained evidence of a current psychiatric disorder, the December 1999 article titled, "Search intensifies for 7 Marines after helicopter crash," submitted by the Veteran in December 2017, and VA mental health initial consultation notes showing the Veteran's statements about witnessing the December 1999 Sea Knight helicopter crash. Accordingly, a remand is necessary to cure the pre-decisional duty to assist error. 38 U.S.C. § 5103A (d); McLendon v. Nicholson, 20 Vet. App. 79, 81-83.

The matter is REMANDED for the following action:

1. Make reasonable efforts to verify the Veteran's reported in-service stressors to include witnessing the December 1999 Sea Knight helicopter crash. In doing so, consider:

" December 1999 article "Search intensifies for 7 Marines after helicopter crash," submitted as December 2017 Correspondence.

" January 2018 Mental Health Initial Assessment-Consult, and

" September 2024 Board Hearing testimony.

Document all efforts made to verify the stressors and any determinations made regarding the reported stressors.

2. Then, provide the Veteran with a VA examination to help determine the likely etiology of the diagnosed acquired psychiatric disorders, including PTSD. The claims file, including a copy of this Remand, must be made available to, and reviewed by, the examiner.

(a) After a thorough review of the entire claims file, the examiner is asked to identify all psychiatric disorders consistent with the DSM-5.

In doing so, address the diagnoses of PTSD and depression documented in the record including the January 2018 Mental Health Initial Assessment-Consult.

(b) If PTSD consistent with the DSM-5 is currently diagnosed, indicate what stressor(s) were relied upon to render such diagnosis. In doing so, address the Veteran's reported stressor of witnessing the December 1999 Sea Knight helicopter crash.

(c) For each current acquired psychiatric disorder, opine whether it at least as likely as not had its onset during service or is otherwise related to it, including the 1999 Sea Knight helicopter crash the Veteran described.

In doing so, the examiner should consider the following evidence.

" April 2005 VA Psych Assessment - the Veteran was first diagnosed with major depression.

" December 2017 correspondence- containing a December 1999 article titled, "Search intensifies for 7 Marines after helicopter crash," which reported about a helicopter that crashed into the sea near the USNS Pecos after taking off from the USS Bonhomme Richard.

" January 2018 Mental Health Initial Assessment-Consult - documenting the Veteran's diagnosis of PTSD and depression under the DSM-5 criteria, and the Veteran's reported in-service stressor events including witnessing a physical assault and witnessing a helicopter crash.

" September 2024 Hearing Transcript - the Veteran testified at a Board hearing that he had been stationed on the USS Bonhomme Richard during his entire service and, during that time, he witnessed a helicopter crash from the bridge in 1999.

A complete rationale with clear conclusions, citations to medical evidence, and a reasoned medical explanation connecting the two must be provided for all expressed opinions.

S. B. MAYS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Elsbach, E. R.

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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