ARTERIOSCLEROTIC HEART DISEASE (CORONARY ARTERY DISEASE)

Summary

The veteran, who served from February 1968 to January 1970, appeals the denial of service connection for coronary artery disease (CAD), hypertension, prostate condition, strokes, and obstructive sleep apnea (OSA). The veteran alleged these conditions were related to toxic exposures, including PFAS and contaminated waters at Fort Dix. The Board reviewed the evidence, including a VA examination conducted in April 2025 and an addendum opinion in August 2025. For each condition, the VA examiner opined that it was less likely than not caused by service or alleged toxic exposures, citing risk factors like diabetes, obesity, and smoking as primary contributors. The examiner also noted that current medical evidence does not support a link between PFAS and these conditions. The Board found the VA examiner's opinions highly probative, well-reasoned, and consistent with the evidence, which indicated the conditions manifested decades after service and were likely due to non-service-related risk factors. Lay statements were deemed not competent to establish medical etiology. The Board also considered articles submitted by the veteran regarding toxic exposures but found them general in nature and lacking specific probative value without supporting medical opinions. Consequently, service connection for all claimed conditions was denied.

Rationale

No in-service incurrence or relation to service; VA examiner opined less likely than not caused by PFAS/TERA; Risk factors like diabetes, obesity, smoking contributed

Full Decision Text

Citation Nr: A26036511
Decision Date: 04/20/26	Archive Date: 04/20/26

DOCKET NO. 251219-625356
DATE: April 20, 2026

ORDER

Entitlement to service connection for coronary artery disease (CAD) is denied.

Entitlement to service connection for hypertension is denied.

Entitlement to service connection for prostate condition, removal, residual (prostate condition) is denied.

Entitlement to service connection for strokes is denied.

Entitlement to service connection for obstructive sleep apnea (OSA), to include as secondary to strokes, is denied.

FINDINGS OF FACT

1. The Veteran's CAD did not begin during active service, nor is otherwise etiologically related to an in-service injury or disease.

2. The Veteran's hypertension did not begin during active service, nor is otherwise etiologically related to an in-service injury or disease.

3. The Veteran's prostate condition did not begin during active service, nor is otherwise etiologically related to an in-service injury or disease.

4. The Veteran's strokes did not begin during active service, nor is otherwise etiologically related to an in-service injury or disease.

5. The Veteran's OSA are not shown to be causally or etiologically related to any disease, injury, or incident in-service, or caused or aggravated by a service-connected disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for a CAD are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309.

2. The criteria for service connection for hypertension are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309.

3. The criteria for service connection for prostate condition are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for?service connection?for strokes are not met.?38?U.S.C. §§?1110, 1131, 5107;?38?C.F.R. §§?3.102, 3.303, 3.310.

5. The criteria for service connection for OSA, to include as secondary to strokes, are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from February 1968 through January 1970.

By way of history, in January 2025, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a December 2024 decision. 

In March 2025, the agency of original jurisdiction (AOJ) issued a HLR decision that found that there had been a duty to assist error in the prior December 2024 rating decision. Subsequently, an August 2025 rating decision was promulgated. 

In a December 2025 VA Form 10182, Decision Review Request: Board Appeal, the Veteran appealed the August 2025 rating decision and elected the Direct Review docket. Although the Veteran initially requested Higher-Level Review when submitting the January 2025 VA Form 20-0996, Decision Review Request: Higher-Level Review, the Higher-Level Reviewer determined that there had been a duty to assist error and transferred the claim to the Supplemental Claim decision review option for additional development. Therefore, the Board may only consider the evidence of record at the time of the decision on appeal.

Service Connection

Generally, service connection requires evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus, or link, between the current disability and the in-service disease or injury. 38 C.F.R. § 3.303(a).

Certain chronic diseases, such as hypertension and CAD and hypertension, will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service (typically one year); or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease.  38 U.S.C. §§ 1101, 1112, 111
ation of a disease or injury, and (3) a nexus, or link, between the current disability and the in-service disease or injury. 38 C.F.R. § 3.303(a).

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

Secondary service connection may be granted for a disability that is proximately due to, the result of, or aggravated by, a service-connected disease or injury. 38 C.F.R. § 3.310. Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists, (2) an already service-connected disability, and (3) that the disability for which secondary service connection is sought was either (a) caused or (b) aggravated by the already service-connected disability. See Allen v. Brown, 7 Vet. App. 439 (1995).

1. Entitlement to service connection for CAD is denied. 

The Veteran contends that his CAD is related to service. Specifically, he alleged that his CAD is related to his exposure to toxins, to include polyfluoroalkyl substances (PFAS), and contaminated waters at Fort Dix.

The record contains a current CAD disability. See April 2025 C&P Exam. Thus, the first element for establishing service connection has been satisfied.

At the onset, the Board has considered whether presumptive service connection is warranted for the Veteran's CAD. In this case, the Veteran's CAD was not noted in service, nor has there been a showing of symptomology that began in-service with continuity since service. Furthermore, there is no evidence to suggest that the Veteran's CAD manifested as 10 percent disabling within one year after service as further discussed below. Therefore, service connection for CAD is not warranted based on presumptive service connection. Thus, the Board will consider whether service connection is warranted on a direct basis.

The remaining questions before the Board are whether there was an in-service incurrence of a disease or injury; and whether his current disability is related to an in-service incurrence, if any.

Service treatment notes are silent for symptoms or diagnoses related to CAD, including entrance and exit examinations. Similarly, post-service treatment notes contain no evidence to suggest that the Veteran's CAD began or otherwise is related to his service.

In April 2025, the Veteran underwent a VA examination for CAD. The Veteran reported his CAD disability had an onset in 2018. CAD was discovered after a stress test showed abnormalities. The examiner opined that CAD is primarily caused by atherosclerosis and has several other risk factors. The Veteran's history of diabetes, hypertension, diabetes mellitus, type II, hyperlipidemia, and history of being overweight support the development of the Veteran's CAD. The examiner further rationalized that medical evidence and literature does not support that CAD is caused by PFAS. Ultimately, the examiner determined that the Veteran's CAD was less likely than not incurred in or caused by exposure to PFAS during service. In an August 2025 addendum opinion, the examiner opined that the Veteran's CAD was less likely than not caused by all types of toxic exposure risk activities (TERA), including leads, volatile organic compounds (VOCs), and contaminated drinking water.

Based on the aforementioned, the Board finds that service connection is not warranted for the Veteran's CAD. In so finding, the Board finds that the April 2025 VA examiner's opinion is highly probative as it was rendered by a medical professional who is competent to provide the opinions expressed, who examined the Veteran and considered the existing record, and who provided sufficient rationale for the opinions expressed. As the record stands, there is no evidence to support that the Veteran's CAD began in service. Rather, the record suggests that his CAD disability first presented more than three decades after his service. The medical evidence also supports that the Veteran had several risk factors that likely contributed to his development of CAD outside of his service and alleged exposures to toxins. As such, the most persuasive evidence of record is against finding that service connection is warranted for CAD.

Although the Veteran sincerely believes that his CAD is related to his service, he is a layperson and lacks the training
ative as it was rendered by a medical professional who is competent to provide the opinions expressed, who examined the Veteran and considered the existing record, and who provided sufficient rationale for the opinions expressed. As the record stands, there is no evidence to support that the Veteran's CAD began in service. Rather, the record suggests that his CAD disability first presented more than three decades after his service. The medical evidence also supports that the Veteran had several risk factors that likely contributed to his development of CAD outside of his service and alleged exposures to toxins. As such, the most persuasive evidence of record is against finding that service connection is warranted for CAD.

Although the Veteran sincerely believes that his CAD is related to his service, he is a layperson and lacks the training/expertise to opine competently on medical questions such as those presented in the instant case. Lay statements are not competent evidence regarding diagnosis or etiology in such case. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007), Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).

After a thorough review of the evidence, to include all arguments and lay statements of record, the Board finds that the most persuasive evidence is against finding that the Veteran's CAD is related to service. The claim is denied.

2. Entitlement to service connection for hypertension is denied.

The Veteran contends that his hypertension is related to service. Specifically, he alleged that his hypertension is related to his exposure to toxins, to include PFAS, and contaminated waters at Fort Dix.

The record contains a current hypertension disability. See April 2025 C&P Exam. Thus, the first element for establishing service connection has been satisfied.

At the onset, the Board has considered whether presumptive service connection is warranted for the Veteran's hypertension. In this case, the Veteran's hypertension was not noted in service, nor has there been a showing of symptomology that began in-service with a continuity since service. Furthermore, there is no evidence to suggest that the Veteran's hypertension manifested as 10 percent disabling within one year after service as further discussed below. Therefore, service connection for hypertension is not warranted based on presumptive service connection. Thus, the Board will consider whether service connection is warranted on a direct basis.

The remaining questions before the Board are whether there was an in-service incurrence of a disease or injury; and whether his current disability is related to an in-service incurrence, if any.

Service treatment notes are silent for symptoms or diagnoses related to hypertension, including entrance and exit examinations. Similarly, post-service treatment notes contain no evidence to suggest that the Veteran's hypertension began or otherwise is related to his service.

In April 2025, the Veteran underwent a VA examination for hypertension. The Veteran reported that his hypertension had an onset in 2010. The examiner determined that the Veteran's hypertension was less likely than not incurred in or caused by exposure to PFAS during service. The examiner rationalized that the Veteran had a history of smoking, hyperlipidemia, and being overweight. These factors are all causes of hypertension. The examiner further explained that the PFAS medical evidence does not support a nexus that PFAS causes hypertension. In an August 2025 addendum opinion, the examiner opined that the Veteran's hypertension was less likely than not caused by all types of TERA, including leads, VOCs, and contaminated drinking water.

Based on the aforementioned, the Board finds that service connection is not warranted for the Veteran's hypertension. In so finding, the Board finds that the April 2025 VA examiner's opinion is highly probative as it was rendered by a medical professional who is competent to provide the opinions expressed, who examined the Veteran and considered the existing record, and who provided sufficient rationale for the opinions expressed. As the record stands, there is no evidence to support that the Veteran's hypertension began in service. Rather, the record suggests that his hypertension disability first presented more than three decades after service. The medical evidence supports that the Veteran had several risk factors that likely contributed to his development of hypertension outside of his service and alleged exposures to toxins. As such, the most persuasive evidence of record is against finding that service connection is warranted for hypertension.

Although the Veteran sincerely believes that his hypertension is related to his service, he is a layperson and lacks the training/expertise to opine competently on medical questions such as those presented in the instant case. Lay statements are not competent evidence regarding diagnosis or etiology in such case. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007), Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).

After a thorough
 of his service and alleged exposures to toxins. As such, the most persuasive evidence of record is against finding that service connection is warranted for hypertension.

Although the Veteran sincerely believes that his hypertension is related to his service, he is a layperson and lacks the training/expertise to opine competently on medical questions such as those presented in the instant case. Lay statements are not competent evidence regarding diagnosis or etiology in such case. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007), Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).

After a thorough review of the evidence, to include all arguments and lay statements of record, the Board finds that the most persuasive evidence is against finding that the Veteran's hypertension is related to service. The claim is denied.

3. Entitlement to service connection for prostate condition is denied.

The Veteran contends that his prostate condition is related to service. Specifically, he alleged that his prostate condition is related to his exposure to toxins, to include PFAS, and contaminated waters at Fort Dix.

The record contains a current prostate condition disability. See April 2025 C&P Exam. Thus, the first element for establishing service connection has been satisfied.

The remaining questions before the Board are whether there was an in-service incurrence of a disease or injury; and whether his current disability is related to an in-service incurrence, if any.

Service treatment notes are silent for symptoms or diagnoses related to a prostate condition, including entrance and exit examinations. Similarly, post-service treatment notes contain no evidence to suggest that the Veteran's prostate condition began or otherwise is related to his service.

In April 2025, the Veteran underwent a VA examination for prostate condition. The Veteran reported his prostate condition had an onset in 2020. He explained that he had elevated PSA and urinary frequency, which led to a prostatectomy. Ultimately, the examiner determined that the Veteran's prostate condition was less likely than not incurred in or caused by exposure to PFAS during service. The examiner explained that the Veteran had a history of benign prostatic hyperplasia (BPH), which caused an elevated PSA and suspicion of prostate cancer and ultimately led to a prostatectomy. Medical evidence supports the idea that the treatment of persistent BPH is prostatectomy. PFAS medical evidence does not support a nexus that PFAS causes prostatectomy. In an August 2025 addendum opinion, the examiner opined that the Veteran's prostate condition was less likely than not caused by all types of TERA, including leads, VOCs, and contaminated drinking water.

Based on the aforementioned, the Board finds that service connection is not warranted for the Veteran's prostate condition. In so finding, the Board finds that the April 2025 VA examiner's opinion is highly probative as it was rendered by a medical professional who is competent to provide the opinions expressed, who examined the Veteran and considered the existing record, and who provided sufficient rationale for the opinions expressed. As the record stands, there is no evidence to support that the Veteran's prostate condition began in service. Rather, the record suggests that his prostate condition first presented more than three decades after service. The medical evidence supports that cause of the Veteran's prostatectomy was elevated PSA and urinary symptoms. There is no evidence to suggest that the Veteran had these conditions during service or that they are related to the Veteran's alleged exposure to toxins and contaminated waters during service. As such, the most persuasive evidence of record is against finding that service connection is warranted for prostate condition.

Although the Veteran sincerely believes that his prostate condition is related to his service, he is a layperson and lacks the training/expertise to opine competently on medical questions such as those presented in the instant case. Lay statements are not competent evidence regarding diagnosis or etiology in such case. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007), Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).

After a thorough review of the evidence, to include all arguments and lay statements of record, the Board finds that the most persuasive evidence is against finding that the Veteran's prostate condition is related to service. The claim is denied.

4. Entitlement to service connection for strokes is denied. 

The Veteran contends that his strokes are related to service. Specifically, he alleged that his strokes are related to his exposure to toxins, to include PFAS, and contaminated waters at Fort Dix.

The record contains a current stroke disability. See April 2025 C&P Exam. Thus, the first element for establishing service connection has been satisfied.

The remaining questions before the Board are whether there
 1377 n.4 (Fed. Cir. 2007).

After a thorough review of the evidence, to include all arguments and lay statements of record, the Board finds that the most persuasive evidence is against finding that the Veteran's prostate condition is related to service. The claim is denied.

4. Entitlement to service connection for strokes is denied. 

The Veteran contends that his strokes are related to service. Specifically, he alleged that his strokes are related to his exposure to toxins, to include PFAS, and contaminated waters at Fort Dix.

The record contains a current stroke disability. See April 2025 C&P Exam. Thus, the first element for establishing service connection has been satisfied.

The remaining questions before the Board are whether there was an in-service incurrence of a disease or injury; and whether his current disability is related to an in-service incurrence, if any.

Service treatment notes are silent for symptoms or diagnoses related to strokes, including entrance and exit examinations. Post-service treatment notes document that the Veteran had strokes in 2017 and 2021.

In April 2025, the Veteran underwent a VA examination for strokes. The Veteran reported his stroke disability had its onset in approximately in 2021. It was discovered that he had a stroke incidentally when he had a brain CT after complaining of hearing loss. Ultimately, the examiner determined that the Veteran's strokes were less likely than not incurred in or caused by exposure to PFAS during service. The examiner noted that medical evidence from the Veteran's CT shows high-grade stenosis, or intraluminal filing defect, which supports a narrowing or blockage of a blood vessel, which can restrict blood flow and increase a risk of stroke. PFAS medical evidence does not support a nexus that PFAS causes a stroke. The examiner further explained that current diagnostics support causes of strokes are due to central atherosclerosis. In an August 2025 addendum opinion, the examiner opined that the Veteran's strokes were less likely than not caused by all types of TERA, including leads, VOCs, and contaminated drinking water.

Based on the aforementioned, the Board finds that service connection is not warranted for the Veteran's strokes. In so finding, the Board finds that the April 2025 VA examiner's opinion highly probative as it was rendered by a medical professional who is competent to provide the opinions expressed, who examined the Veteran and considered the existing record, and provided sufficient rationale for the opinions expressed. As the record stands, there is no evidence to support that the Veteran's strokes or cerebral atherosclerosis began in service or is related to the Veteran's alleged toxic exposures or drinking of contaminated waters. Rather, the record suggests that his strokes first presented more than three decades after service. The medical evidence further supports that the Veteran had several risk factors that likely contributed to his development of strokes. As such, the most persuasive evidence of record is against finding that service connection is warranted for strokes.

Although the Veteran sincerely believes that his strokes are related to his service, he is a layperson and lacks the training/expertise to opine competently on medical questions such as those presented in the instant case. Lay statements are not competent evidence regarding diagnosis or etiology in such case. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007), Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).

After a thorough review of the evidence, to include all arguments and lay statements of record, the Board finds that the most persuasive evidence is against finding that the Veteran's strokes are related to service. The claim is denied.

5. Entitlement to service connection for OSA, to include as secondary to strokes, is denied.

The Veteran contends that his OSA is related to service. Specifically, he alleged that his OSA is related to his exposure to toxins, to include PFAS, and contaminated waters at Fort Dix.  Alternatively, he alleged that his OSA is caused or aggravated his stroke disorder.

At the onset, the Board notes that although the Veteran has alleged that his OSA is secondary his strokes, as addressed above, his strokes are not a service-connected disability. As such, the second element for service connection is not met. Thus, the Board will consider whether entitlement to service connection is warranted on a direct basis.

The record contains a current OSA disability. See April 2025 C&P Exam. Thus, the first element for establishing service connection has been satisfied.

The remaining questions before the Board are whether there was an in-service incurrence of a disease or injury; and whether his current disability is related to an in-service incurrence, if any.

Service treatment notes are silent for symptoms or diagnoses related to an OSA, including entrance and exit examinations. Similarly, post-service treatment
 has alleged that his OSA is secondary his strokes, as addressed above, his strokes are not a service-connected disability. As such, the second element for service connection is not met. Thus, the Board will consider whether entitlement to service connection is warranted on a direct basis.

The record contains a current OSA disability. See April 2025 C&P Exam. Thus, the first element for establishing service connection has been satisfied.

The remaining questions before the Board are whether there was an in-service incurrence of a disease or injury; and whether his current disability is related to an in-service incurrence, if any.

Service treatment notes are silent for symptoms or diagnoses related to an OSA, including entrance and exit examinations. Similarly, post-service treatment notes contain no evidence to suggest that the Veteran's OSA began or otherwise is related to his service.

In April 2025, the Veteran underwent a VA examination for OSA. The Veteran reported his OSA disability had an onset in 2024. Ultimately, the examiner determined that the Veteran's OSA was less likely than not incurred in or caused by exposure to PFAS during service. The examiner rationalized that the Veteran has a history of smoking, which can lead to chronic airway inflammation that causes narrowing of the airway passage or a collapse and a history of being overweight, which can contribute to the development of sleep apnea. The examiner further noted that these were significant factors that likely contributed to his OSA. In an August 2025 addendum opinion, the examiner opined that the Veteran's OSA was less likely than not caused by all types of TERA, including leads, VOCs, and contaminated drinking water.

Based on the aforementioned, the Board finds that service connection is not warranted for the Veteran's OSA. In so finding, the Board finds that the April 2025 VA examiner's opinion is highly probative as it was rendered by a medical professional who is competent to provide the opinions expressed, who examined the Veteran and considered the existing record, and provided sufficient rationale for the opinions expressed. As the record stands, there is no evidence to support that the Veteran's OSA began in service. Rather, the record suggests that his OSA disability first presented more than three decades after service. The medical evidence supports that the Veteran had several risk factors that likely contributed to his development of OSA outside of his service and alleged exposures to toxins. As such, the most persuasive evidence of record is against finding that service connection is warranted for OSA.

Although the Veteran sincerely believes that his OSA is related to his service, he is a layperson and lacks the training/expertise to opine competently on medical questions such as those presented in the instant case. Lay statements are not competent evidence regarding diagnosis or etiology in such case. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007), Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).

After a thorough review of the evidence, to include all arguments and lay statements of record, the Board finds that the most persuasive evidence is against finding that the Veteran's OSA is related to service, or is aggravated or caused by a service-connected disability. The claim is denied.

(Continued on the next page)

?

The Board takes notice that the Veteran submitted referenced articles relating to toxic exposures at Fort Dix in support of his claims. See November 2024 VA 21-4138 Statement in Support of Claim. The Board has also considered these articles that suggest a correlation between the Veteran's alleged exposure to toxins and contaminants while stationed at Fort Dix and his CAD, hypertension, prostate condition, strokes, and sleep apnea disabilities. The Board finds, however, that these articles lack any significant probative value. The Court has held that a medical article or treatise "can provide important support when combined with an opinion of a medical professional" if the medical article or treatise evidence discusses generic relationships with a degree of certainty such that, under the facts of a specific case, there is at least "plausible causality" based upon objective facts rather than on an unsubstantiated lay medical opinion. Mattern v. West, 12 Vet. App. 222, 228 (1999); see also Sacks v. West, 11 Vet. App. 314 (1998); Wallin v. West, 11 Vet. App. 509 (1998).

Articles and treatises tend to be general in nature and do not relate to the specific facts in a given claim. In the present case, the articles referenced by the Veteran fall into this general category. Further, these articles are not combined with an opinion from a medical professional supporting that service connection is warranted. Rather, these articles were considered by the VA
 "plausible causality" based upon objective facts rather than on an unsubstantiated lay medical opinion. Mattern v. West, 12 Vet. App. 222, 228 (1999); see also Sacks v. West, 11 Vet. App. 314 (1998); Wallin v. West, 11 Vet. App. 509 (1998).

Articles and treatises tend to be general in nature and do not relate to the specific facts in a given claim. In the present case, the articles referenced by the Veteran fall into this general category. Further, these articles are not combined with an opinion from a medical professional supporting that service connection is warranted. Rather, these articles were considered by the VA examiner who ultimately determined that service connection is not warranted. There is no competent evidence contrary to this opinion. As such, the Board finds that the articles, without anything more, are not persuasive. The claims are denied.

 

 

J. NICHOLS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	N.B. Mmeje, 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.