PARKINSON'S DISEASE

JOHN J. CROWLEY · 2026 · Case ID: A26036437

DENIED

Summary

The veteran, a Marine Corps veteran who served from August 1979 to November 1980, appeals the denial of service connection for Parkinson's disease and dystonic tremors. The veteran claims these conditions are due to exposure to contaminated water at Camp Lejeune, a fact the Board found to be a favorable finding of fact binding on the Board. The Board found the veteran competent and credible to report on his experiences. For Parkinson's disease, the Board noted that the veteran's service treatment records and post-service records were negative for a diagnosis or complaints of Parkinson's disease. A VA examiner opined the veteran did not have Parkinson's disease, and the Board found this opinion competent, credible, and the most probative evidence, particularly as the veteran's own statements and treatment records documented symptoms but not a definitive diagnosis. The Board distinguished this case from precedent where a diagnosis was present. For dystonic tremors, the Board found service treatment records negative for complaints or diagnosis, and post-service records showed no tremors until decades later. The Board also found the VA examiner's opinion that the tremors were not due to service to be competent, credible, and the most probative evidence, noting the lack of a nexus opinion from the veteran and the absence of continuity of symptomatology. Both claims were denied as the evidence preponderated against service connection.

Rationale

Service treatment records negative for Parkinson's disease; Post-service records negative for Parkinson's disease diagnosis; VA examiner opinion found competent, credible, and most probative

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251223-616950

Full Decision Text

Citation Nr: A26036437
Decision Date: 04/20/26 Archive Date: 04/20/26

DOCKET NO. 251223-616950
DATE: April 20, 2026

ORDER

Entitlement to service connection for Parkinson's disease is denied.

Entitlement to service connection for dystonic tremors is denied.

FINDING OF FACT

1. The most probative evidence of record shows that the Veteran was not diagnosed with Parkinson's disease at any time during the pendency of the appeal.

2. The most probative evidence of record shows that dystonic tremors was not present on active duty or until years thereafter and is not related to service or to an incident of service origin.

CONCLUSION OF LAW

The criteria for service connection for Parkinson's disease and dystonic tremors have not been met. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The Veteran served on active duty in the United States Marine Corps from August 1979 to November 1980.

This appeal comes to the Board of Veterans' Appeal (Board) under the Appeals Modernization Act (AMA) review system. See 38 C.F.R. §§ 3.2400 to 3.2601, 20.200 to 20.205.

Specifically, the appeal comes to the Board from a December 2024 rating decision that denied the above claims. In December 2025 the Veteran filed with the regional office (RO) his VA Form 10182, Decision Review Request: Board Appeal (AMA Notice of Disagreement) and at that time he elected the Evidence Review Lane.

As to the characterization of the issues on appeal, the Board finds that despite the earlier denial of the claim of service connection for Parkinson's disease this issue needs to be treated as an original claim. The Board has reached this conclusion because the December 2024 rating decision treated it as an original claim and this finding is binding on the Board. See 38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c).

Given the Veteran's Evidence Review Lane election, the Board may only consider the evidence of record at the time of the December 2024 agency of original jurisdiction (AOJ) decision on appeal as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182. See 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. See 38 C.F.R. §§ 20.300, 20.303, 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. See 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.

The Service Connection Claims

The Veteran and his representative claim, in substance, that the appellant is entitled to service connection for Parkinson's disease and dystonic tremors because they are due to his exposure to contaminated water at Camp Lejeune 46 years ago.

Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection if the disability is one that is listed in 38 C.F.R. § 3.309. 38 C.F.R. § 3.303(b); see also Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

In addition, service connection may also be granted on the basis of
line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection if the disability is one that is listed in 38 C.F.R. § 3.309. 38 C.F.R. § 3.303(b); see also Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

In addition, service connection may also be granted on the basis of a post-service initial diagnosis of a disease, where the physician relates the current condition to the period of service. 38 C.F.R. § 3.303(d). Other specifically enumerated disorders will be presumed to have been incurred in service if they manifested to a compensable degree within the first year following separation from active duty. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309.

In this regard, to establish service connection for the claimed disorders, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999).

The Board also notes that in order to establish presumptive service connection for a disease associated with exposure to contaminated water at Camp Lejeune, a veteran, former reservist, or member of the National Guard must show the following: (1) that he or she served at Camp Lejeune for no less than 30 days (either consecutive or nonconsecutive) from August 1, 1953, to December 31, 1987; (2) that he or she currently suffers from a disease associated with exposure to contaminants in the water supply at Camp Lejeune enumerated under 38 C.F.R. § 3.309(f); and (3) that the current disease process manifested to a degree of 10 percent or more at any time after service. 38 C.F.R. §§ 3.307(a)(7), 3.309(f).

The enumerated diseases associated with exposure to contaminants in the water supply at Camp Lejeune are as follows: (1) kidney cancer, (2) liver cancer, (3) non-Hodgkin's lymphoma, (4) adult leukemia, (5) multiple myeloma, (6) Parkinson's disease, (7) aplastic anemia and other myelodysplastic syndromes, and (8) bladder cancer. 38 C.F.R. § 3.309(f).

The availability of presumptive service connection for a disability does not preclude a Veteran from establishing service connection with proof of direct causation. Stefl v. Nicholson, 21 Vet. App. 120 (2007); see also Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994).

The requirement of a current disability is "satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim." See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

In evaluating the evidence, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. Owens v. Brown, 7 Vet. App. 429, 433 (1995).

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding
Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. Owens v. Brown, 7 Vet. App. 429, 433 (1995).

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where 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; 38 C.F.R. § 3.102; see also Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

Lastly, the Board notes that in Medlin v. Collins, 2025 U.S. App. Vet.?Claims LEXIS 1122 (13 Aug 2025), the Court recently held that to satisfies its duty to provide adequate reasons and bases under 38 U.S.C. § 7104(d)(1) its' decisions should include the following: 1. address legal authorities potentially applicable to the claim; 2. analyze the credibility and probative value of evidence; 3. account for evidence that it finds persuasive or unpersuasive; and 4. provide reasons for rejecting any material evidence potentially favorable to the claimant.

I. Some Initial Matters

The December 2024 rating decision on appeal contains the following Favorable Finding of Fact that is binding on the Board: the Veteran had the required service at Camp Lejeune to be presumed to have been exposed to its' contaminated water. See 38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c).

Next, the Board finds that the Veteran is competent and credible to report on what comes to him via their own senses and events while on active duty. See Davidson, supra.

II. Parkinson's disease

As to the claim of service connection for Parkinson's disease, the Board finds it significant that the Veteran's service treatment records, including the November 1980 separation examination, are negative for a history, complaints, diagnoses, or treatment for Parkinson's disease. 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 fact, when examined for separation in November 1980 it was opined that his neurological examination was normal and this medical opinion is not contradicted by any other medical evidence of record. Id.

Similarly, and much more importantly, the Board finds that the most probative evidence of records is the post-service records which are also negative for a diagnosis of Parkinson's disease. See Owens, supra.

In this regard, the RO in June 2024 provided the Veteran with a VA examination to obtain the missing diagnosis and that examiner opined that he did not have Parkinson's disease.

Moreover, the Board finds this medical opinion both competent and credible as well as the most probative evidence of record for the following reasons: it considered the appellant's lay claims regarding observable events and symptomatology; it considered the Veteran's presumptive exposure to contaminated water at Camp Lejeune; it is supported by citation to the service treatment; it is supported by citation to the appellant's post-service medical records; it is supported by medical reasoning; it is supported by ciation to controlling medical literature; and it is not contradicted by any other medical evidence of record. See Guerrieri v. Brown, 4 Vet. App. 467, 473 (1993) ("the probative value of medical opinion evidence is based on the medical expert's personal examination of the patient, the physician's knowledge and skill in analyzing the data, and the medical conclusion the physician reaches.... As is true with any piece of evidence, the credibility and weight to be attached to these opinions [are] within the province of the [Board as] adjudicators..."); Wray v. Brown, 7 Vet. App. 488, 493 (1995) (holding that the adoption of an expert medical opinion may satisfy the Board's statutory requirement of an adequate statement of reasons and bases if the expert fairly considered the material evidence seemingly supporting the veteran's position); Also see Colvin, supra.

In reaching the above conclusion
("the probative value of medical opinion evidence is based on the medical expert's personal examination of the patient, the physician's knowledge and skill in analyzing the data, and the medical conclusion the physician reaches.... As is true with any piece of evidence, the credibility and weight to be attached to these opinions [are] within the province of the [Board as] adjudicators..."); Wray v. Brown, 7 Vet. App. 488, 493 (1995) (holding that the adoption of an expert medical opinion may satisfy the Board's statutory requirement of an adequate statement of reasons and bases if the expert fairly considered the material evidence seemingly supporting the veteran's position); Also see Colvin, supra.

In reaching the above conclusion, the Board has not overlooked the fact that some of the Veteran's post-service treatment records document his complaints and treatment for symptoms that could arguably be attributable to Parkinson's disease, the appellant's claims of his having been diagnosed with Parkinson's disease, notes that he may have Parkinson's disease, notes that he is developing Parkinson's disease, and notes that he is taking medication for Parkinson's disease. However, the Board finds that these treatment records do not provide the Veteran with the missing diagnosis because a history of a disorder as well as a note that he may have or is developing a disorder is not a diagnosis and information recorded by a medical examiner, unenhanced by medical opinion, is not competent evidence. Id; Also see LeShore v. Brown, 8 Vet. App. 406 (1995); Godfrey v. Brown, 8 Vet. App. 113, 121 (1995) (holding that the Board is not required to accept evidence that is simply information recorded by a medical examiner, unenhanced by medical opinion).

Simply stated, the Veteran saying he has this problem, even if the Veteran believes he has this problem, does not provide medical evidence of this disability.

Moreover, the Board finds that the facts of this claim for service connection are distinguishable from those in Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), because the record is negative for medical evidence showing that the claimed disorder results in functional impairment that affects earning capacity caused by this issue. See Owens, supra. Again, the Veteran is not medically qualified to diagnosis himself with this problem.

The Board notes that while a lay person like the Veteran is competent to report on the symptoms and events they observe, the Board finds that he is not competent to provide the missing diagnosis because diagnosing Parkinson's disease requires special medical training that he does not have. See Davidson, supra.

In this regard, a condition precedent for establishing service connection, regardless of the Veteran's theory of entitlement, is a diagnosis. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) ("Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability," and held that "[i]n the absence of proof of a present disability[,] there can be no valid claim."); Degmetich v. Brown, 104 F.3d 1328 (1997) (38 U.S.C. §§ 1110, 1131 requires existence of present disability for VA compensation purposes). Moreover, and as discussed above, the Board finds that the most probative evidence of record shows that the Veteran does not have a diagnosis of Parkinson's disease despite his presumptive exposure to contaminated water at Camp Lejeune. See Owens, supra.

Therefore, the Board finds that the claim of service connection for Parkinson's disease is denied. See 38 U.S.C. §§ 1101, 1112, 1113, 1131; 38 C.F.R. §§ 3.303, 3.307, 3.309.

III. Dystonic tremors

As to service connection for dystonic tremors under 38 C.F.R. § 3.303(a), the Board notes that service treatment records, including the November 1980 separation examination, are negative for a history, complaints, diagnoses, or treatment for symptoms off dystonic tremors. See Colvin, supra.

In fact, when examined for separation in November 1980 it was opined that his neurological examination was normal. Id.

In this regard, the Board finds that the detailed service medical records provide particularly negative evidence against the claim, clearly indicating treatment for problems other than the issue before the Board. See Owens, supra.

Therefore, the Board finds that the most probative evidence of record shows that the Veteran did not sustain a disease or injury while on active duty that caused his post-service dystonic tremors despite his presumptive exposure to contaminated water at Camp Lejeune.
0 separation examination, are negative for a history, complaints, diagnoses, or treatment for symptoms off dystonic tremors. See Colvin, supra.

In fact, when examined for separation in November 1980 it was opined that his neurological examination was normal. Id.

Therefore, the Board finds that the most probative evidence of record shows that the Veteran did not sustain a disease or injury while on active duty that caused his post-service dystonic tremors despite his presumptive exposure to contaminated water at Camp Lejeune. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a); Owens, supra.

As to service connection for dystonic tremors based on the presumptions found at 38 C.F.R. § 3.309(a), the Board finds that the record is negative for medical records generated in the first post service year showing the Veteran being diagnosed with dystonic tremors. Therefore, the Board finds that the presumptions found at 38 C.F.R. § 3.309(a) do not help the Veteran establish service connection for dystonic tremors despite his presumptive exposure to contaminated water at Camp Lejeune. See 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. § 3.307.

As to service connection for dystonic tremors based on the presumptions found at 38 C.F.R. § 3.309(f), the Board finds that despite the Veteran's documented service at Camp Lejeune during the required time period, the claimed disorder is not a specifically enumerated disease process. Therefore, the Board finds that the presumptions found at 38 C.F.R. § 3.309(f) do not help the appellant establish service connection for dystonic tremors. See 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. § 3.307.

The Board will next consider whether the Veteran is entitled to service connection for dystonic tremors due to continuity of symptomatology. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303(b).

In this regard, the Board notes that the that the post-service record does not show that the Veteran had a continued problem with dystonic tremors in and since his service ended 46 years ago despite his claims to the contrary.

In fact, as noted above, service treatment records, including the November 1989 separation examination, are negative for a history, complaints, diagnoses, or treatment for dystonic tremors. See Colvin, supra. The best evidence in this case provides highly probative evidence against the claim.

Likewise, and as important, the post-service record is negative for complaints, diagnoses, or treatment for any type of tremors, until, at the earliest 2018, 38 years after his active duty ended in 1980. See, e.g., VA treatment records dated in March 2018.

In this regard, the Board also finds it significant that when the Veteran was first provided with a VA examination in June 2012, albeit in connection with an unrelated disability, the appellant did not report and the examiner did not note that the claimant had a history of tremors and/or a diagnosis of dystonic tremors. See Owens, supra.

Similarly, to the extent that any of the Veteran's post-service treatment records document his reports, in substance, of having problems with dystonic tremors since service and/or for many years, the Board finds that these treatment records, as a whole, do not provide continuity of symptomatology because evidence that is simply information recorded by a medical examiner, unenhanced by medical opinion, is not probative evidence. See LeShore, supra; Godfrey, supra.

Given this record, the Board finds that the evidence in the form of the service medical records and the post-service medical records provides highly probative evidence, each, overall, against the claim. See Owens, supra. Moreover, the Board finds this evidence more probative than the Veteran's writings to the RO and any statements to VA healthcare professionals regarding his having observable symptoms of dystonic tremors in and since service. Id.

The records in this case, both during service and, as importantly, after service, are detailed and the Board cannot, unfortunately, ignore this evidence.

Therefore, given the service medical records which are negative for a diagnosis of the claimed disorder and the post-service records which are negative for a diagnosis of

The records in this case, both during service and, as importantly, after service, are detailed and the Board cannot, unfortunately, ignore this evidence.

Therefore, given the service medical records which are negative for a diagnosis of the claimed disorder and the post-service records which are negative for a diagnosis of the claimed disorder until many decades after service, the Board finds that the most probative evidence of record shows that the Veteran did not have a continued problem with dystonic tremors, in and since his last period service ended 46 years ago despite any claims of having visible symptoms of it while in service and since that time and despite his presumptive exposure to contaminated water at Camp Lejeune. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303(b). The facts of this case provide highly probative evidence against the claim.

Next, the Board will consider whether the Veteran is entitled to service connection for dystonic tremors due to a nexus between the post-service disorder and his military service. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303(d); also see Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992) (establishing service connection requires finding a relationship between a current disability and events in service or an injury or disease incurred therein).

In this regard, the Board finds that the most probative evidence of record shows that the Veteran's post-service dystonic tremors is not due to his military service despite any claims by the Veteran to the contrary. See Owens, supra. The Board has reached this conclusion because it finds the December 2024 VA examiner's opinion that the Veteran's dystonic tremors are not due to his military service is both competent and credible as well as the most probative evidence of record for the following reasons: it considered the appellant's lay claims regarding observable events and symptomatology; it considered his presumptive exposure to contaminated water at Camp Lejeune; it is supported by citation and discussion of the service and post-service medical records; it is supported by medical reasoning; and it is not contradicted by any other medical evidence of record. See Guerrieri, supra; Wray; Colvin, supra.

The Board also finds that the Veteran is not competent to provide the missing nexus opinion because he does not have the required medical expertise to provide an answer to this complex medical question (i.e., what caused his post-service dystonic tremors). See Davidson, supra. Simply stated, the Veteran cannot diagnose the problem and then associate the problems to a disease or injury while he was last on active duty 46 years ago (the second part being the most important).

Therefore, the Board finds that the most probative evidence of record shows that the Veteran's dystonic tremors are not due to his military service despite his presumptive exposure to contaminated water at Camp Lejeune. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303(d); also see Rabideau, supra.

Lastly, the Board finds that the key question in this case is whether any disease or injury the Veteran had during active duty 46 years ago (nearly half a century) was at least as likely as not (generally a 50 percent or greater chance) a cause of the current dystonic tremors. The fact that he may, or may not, have had a disease or injury on active duty, to include being exposed to contaminated water at Camp Lejeune, and has a current problem does not always provide the basis to find that service connection is warranted for the problem.

There are other factors, such as age, other illnesses, post-service injuries, and general health. Sometimes, in some cases, the best evidence provides evidence against such claims. In this case, the Board finds that there is now significant evidence in this record, in both the service and post-service, that provides highly probative evidence against the claim that clearly outweigh all evidence that supports the claim.

It is vital for the appellant to understand that the Board has taken his concerns seriously (see above), however, there is now prodigious medical and factual evidence against the claim that it cannot ignore, either of which provide a basis to deny the claim. In this regard, the active duty and post-service treatment records, as noted above, have been found by the Board to provide highly probative evidence against the claim and either one of which, standing alone, provide a valid basis to deny the claim. There is no basis to assume that obtaining another medical opinion in this case will provide a basis to grant any of the claims considering this record.

IV. Conclusion

In reaching the above conclusions, and in?accordance with Medlin, supra, the Board's decision including the following: 1. It addressed all legal authorities potentially applicable to the claims; 2. It analyzes the credibility and probative value of evidence; 3. It accounted for evidence that it found and unpersuasive; and 4. It provided reasons for rejecting any material evidence potentially favorable to the claimant.

Also in reaching the above conclusions, the Board considered the doctrine of reasonable doubt. 38 U.S.C. § 5107(b). However, as the most probative evidence of record is against the claims (i.e., the evidence for and against the claims are not approximately in balance), the Board finds that the doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001); Lynch, supra.

John J. Crowley

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Werner, Neil T.

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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