CHRONIC SINUSITIS

KRISTI L. GUNN · 2026 · Case ID: A26037027

MIXED

Summary

The veteran, who served from August 1978 to December 1986, appeals the denial of service connection for sinusitis, bilateral shin splints, and gastroenteritis. The Board denied these claims, finding no current diagnosis or evidence supporting service connection. The VA examiner determined that the veteran did not have a diagnosis of sinusitis, noting only subjective symptoms and no supporting findings. For shin splints, the examiner found no current diagnosis, but rather bilateral knee strain, and noted the absence of diagnosis or treatment in private records. Similarly, for gastroenteritis, the VA examiner found no diagnosis despite subjective symptoms, and private treatment records did not support the claim. The Board gave more weight to the competent medical evidence over the veteran's self-diagnosis. The Board remanded claims for headaches, left hip pain, vertigo, bilateral radiculopathy, lower back pain, and fibromyalgia due to duty to assist errors. The remand instructions require a TERA memorandum, adequate medical opinions addressing onset and continuity of symptoms, and consideration of the veteran's reports and physical duties as a jet engine mechanic, which involved significant physical strain. The Board noted that a negative opinion cannot be based solely on the absence of treatment in service.

Rationale

No current diagnosis of sinusitis; No supporting medical evidence; VA examiner found no objective findings; Private records lack diagnosis/treatment

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251006-595370

Full Decision Text

Citation Nr: A26037027
Decision Date: 04/21/26 Archive Date: 04/21/26

DOCKET NO. 251006-595370
DATE: April 21, 2026

ORDER

Entitlement to service connection for sinusitis is denied.

Entitlement to service connection for bilateral shin splints is denied.

Entitlement to service connection for gastroenteritis is denied.

REMANDED

Entitlement to service connection for headaches is remanded.

Entitlement to service connection for left hip pain is remanded.

Entitlement to service connection for vertigo is remanded.

Entitlement to service connection for radiculopathy of left lower extremity is remanded.

Entitlement to service connection for lower back pain is remanded.

Entitlement to service connection for radiculopathy of the right lower extremity is remanded.

Entitlement to service connection for fibromyalgia is remanded.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that the Veteran has had sinusitis at any time during or approximate to the pendency of the claim.

2. The evidence of record persuasively weighs against finding that the Veteran has had shin splints at any time during or approximate to the pendency of the claim.

3. The evidence of record persuasively weighs against finding that the Veteran has had gastroenteritis at any time during or approximate to the pendency of the claim.

CONCLUSIONS OF LAW

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

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

3. The criteria for service connection for gastroenteritis 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 had active military service from August 1978 to December 1986.

This matter comes before the Board of Veterans' Appeals (Board) from June 2025 and August 2025 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO).

In the October 2025 VA Forms 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket on both forms.

Therefore, the Board may only consider the evidence of record at the time of the June 2025 or August 2025 agency of original jurisdiction (AOJ) decisions on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decisions on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], 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 claims of service connection for headaches, left hip pain, vertigo, radiculopathy of the left lower extremity, lower back pain, radiculopathy of the right lower extremity and fibromyalgia, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

During the July 2025 Knee and Lower Leg examination, the examiner explained that the Veteran did not have a current diagnosis of shin splints but instead has a diagnosis of bilateral knee strain. The Veteran told the examiner that she wished to pursue a claim for service connection for bilateral knee strain. To do so, the Veteran or her representative will need to file a claim for entitlement to service connection for bilateral knee strain.

The Board interprets the Veteran's statements on the VA Form 10182 and Advanced of the Docket Status as reflecting an intent to have this matter reviewed in an expeditious manner, which the Board finds to be an implicit waiver of the requirement that the Board delay issuing a decision until the period to request to
)(ii).

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

1. Service connection for sinusitis is denied.

The Veteran contends that she was treated for sinusitis during service and still suffers from the condition. See April 2025 Veteran's statement.

The question is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

The Board concludes that the Veteran does not have a current diagnosis of sinusitis and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

The April 2025 VA examiner determined that, while the Veteran experienced subjective symptoms include sinus tenderness, rhinorrhea, sneezing, and cough, the Veteran did not have a diagnosis of sinusitis because there were no findings, signs or symptoms to support a diagnosis. Further, the only medical records included in the file are private treatment records dated from April 2017 to February 2020 that do not include a diagnosis of or treatment for sinusitis.

While the Veteran believes there is a current diagnosis of sinusitis, the Veteran is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence.

2. Service connection for bilateral shin splints is denied.

The Veteran contends that she was treated with shin splints in service and still suffers from this condition. See April 2025 Veteran's statement.

The question is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

The Board concludes that the Veteran does not have a current diagnosis of shin splints and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

The July 2025 VA examiner determined that, while the Veteran experienced subjective symptoms of pain, the Veteran did not have a diagnosis of shin splints but instead pain from bilateral knee strain. Further, despite treatment from April 2017 to February 2020, treatment records do not show a diagnosis or treatment of shin splints.

While the Veteran originally filed a claim for shin splints, the Veteran is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence.

3. Service connection for gastroenteritis is denied.

The Veteran contends that she was treated for acute gastroenteritis during service
pain from bilateral knee strain. Further, despite treatment from April 2017 to February 2020, treatment records do not show a diagnosis or treatment of shin splints.

3. Service connection for gastroenteritis is denied.

The Veteran contends that she was treated for acute gastroenteritis during service and still suffers from this condition. See April 2025 Veteran's statement.

The question is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

The Board concludes that the Veteran does not have a current diagnosis of gastroenteritis and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

The April 2025 VA examiner determined that, while the Veteran experienced subjective symptoms of nausea and vomiting, the Veteran did not have a diagnosis of gastroenteritis. Further, despite treatment from April 2017 to February 2020, treatment records do not show a diagnosis or treatment of gastroenteritis. In fact, four treatment records between August 2019 to February 2020 note that the Veteran denied increased appetite, heartburn, kidney disease, loss of appetite, nausea, vomiting, diarrhea, rectal bleeding/black tarry stool, constipation, abdominal pain, increased gas, gastric bypass, gastritis, IBS, ulcers and pain with bowel movement.

While the Veteran believes there is a current diagnosis of gastroenteritis, the Veteran is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires the ability to interpret complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence.

REASONS FOR REMAND

1. Service connection for headaches is remanded.

The Veteran contends that she was exposed to environmental hazards during service that resulted in a headache disability. Specifically, as a general engine mechanic, the Veteran noted she was exposed to the smell of several toxic chemicals, such as MEK, lead, Trichloroethylene, benzene, and asbestos.

On August 10, 2022, President Biden signed into law the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxins Act of 2022 (PACT Act). Under the PACT Act, VA is required to provide a disability examination and obtain a medical opinion when a veteran submits a claim for compensation and has (1) evidence of a disability and (2) participation in a toxic exposure risk activity (TERA), but the evidence is not sufficient to establish service connection for the disability. 38 U.S.C. § 1168(a).

In light of the PACT Act and the Veteran's alleged TERAs, the Board finds remand to correct pre-decisional duty to assist errors is necessary. A TERA memo and Individual Longitudinal Exposure Record (ILER) must be prepared prior to new VA opinions that adequately address all relevant questions in this case and satisfy VA's statutory duty in light of 38 U.S.C. § 1168.

The Veteran also reported a head injury during service where she lost consciousness for several minutes that resulted in a concussion injury. Alternatively, she believes that her migraines could be related to that injury.

2. Service connection for left hip pain is remanded.

3. Service connection for vertigo is remanded.

4. Service connection for radiculopathy of left lower extremity is remanded.

5. Service connection for lower back pain is remanded.

6. Service connection for radiculopathy of the right lower extremity is remanded.

4. Service connection for radiculopathy of left lower extremity is remanded.

5. Service connection for lower back pain is remanded.

6. Service connection for radiculopathy of the right lower extremity is remanded.

The issues of entitlement to (1) left hip pain; (2) vertigo; (3) radiculopathy of left lower extremity; (4) lower back pain; (5) radiculopathy of the right lower extremity are remanded to correct a duty to assist error that occurred prior to the August 2024 rating decisions on appeal. The Agency of Original Jurisdiction (AOJ) obtained a July 2025 medical opinion prior to the August 2025 rating decisions on appeal. However, these medical opinions do not provide an adequate rationale regarding whether the Veteran's (1) left hip pain; (2) vertigo; (3) radiculopathy of left lower extremity; (4) lower back pain; (5) radiculopathy of the right lower extremity had its onset in service or is otherwise related to service.

For the claimed left hip disability, the July 2025 examiner opined that it was less likely as not related to the Veteran's service because although noted in service, the examiner could not find a follow-up for these instances. For the claimed vertigo disability, the July 2025 examiner opined that it was less likely as not related to the Veteran's service because although noted in service, the examiner could not find a follow-up for these instances. For the claimed lower back pain disability, the July 2025 examiner opined that it was less likely as not related to the Veteran's service because the examiner could not find documentation that she was treated for it during service. For the claimed radiculopathy/neuropathy of the lower extremities disability, the July 2025 examiner opined that it was less likely as not related to the Veteran's service because although treated for peripheral neuropathy during service, the examiner could not find follow-ups for these instances. A medical opinion based solely on the absence of documentation in the record is inadequate and a medical opinion is inadequate if it does not take into account the Veteran's reports of symptoms and history (even if recorded in the course of the examination). Dalton v. Peake, 21 Vet. App. 23 (2007). Furthermore, service treatment records show treatment for back pain. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (a medical opinion based on an inaccurate factual premise is not probative); see also Monzingo v. Shinseki, 26 Vet. App. 97, 107 (2012) ("If the opinion is based on an inaccurate factual premise, then it is correct to discount it entirely") (citing Reonal)).

During the vertigo examination, the Veteran has explained that she hit her head during service and sustained a concussion injury. The Veteran reported that ever since that time, she has had vertigo, tinnitus and decrease hearing.

During the hip and back examination, the Veteran explained that her job as jet engine mechanic was physically demanding. Her duties included bending, squatting, stooping, and crawling under aircraft while carrying a toolbox that weighed over 60 pounds. She frequently climbed ladders in awkward positions and walked along jet engine wings with her tools in hand. She was also required to walk long distances on hard surfaces such as concrete, gravel, rock, and asphalt, often while carrying heavy equipment. Over time, these repetitive and physically intense tasks led to the onset of chronic left hip pain and back pain. The pain from her back radiates down both of her legs causing bilateral radiculopathy.

The examiner did not consider the Veteran's history and account and did not provide a complete rationale for the opinions. For these reasons, a remand for adequate opinion is needed.

7. Service connection for fibromyalgia is remanded.

The issue of entitlement to service connection for fibromyalgia is remanded to correct a duty to assist error that occurred prior to the June 2024 rating decision on appeal. The Agency of Original Jurisdiction (AOJ) did not obtain a VA examination prior to the June 2024 rating decision on appeal regarding whether fibromyalgia had its onset in service or is otherwise related to the Veteran's service. However, based on the evidence associated with the claims file prior to the June 2024 rating decision, the Board finds that a VA examination and medical opinion is required to determine whether fibromyalgia is related to service. Specifically, pain clinic treatment records note a diagnosis of fibromyalgia. See Pain Clinic records dated in August 2017. The Veteran also reports having fatigue, headaches, joint and muscle pain and
to assist error that occurred prior to the June 2024 rating decision on appeal. The Agency of Original Jurisdiction (AOJ) did not obtain a VA examination prior to the June 2024 rating decision on appeal regarding whether fibromyalgia had its onset in service or is otherwise related to the Veteran's service. However, based on the evidence associated with the claims file prior to the June 2024 rating decision, the Board finds that a VA examination and medical opinion is required to determine whether fibromyalgia is related to service. Specifically, pain clinic treatment records note a diagnosis of fibromyalgia. See Pain Clinic records dated in August 2017. The Veteran also reports having fatigue, headaches, joint and muscle pain and difficulty sleeping during service that she still suffers with currently. See April 2025 Veteran's statement.

The matters are REMANDED for the following action:

1. Prepare a TERA memorandum and ILER, specifying the nature of the Veteran's toxic exposure related to her service as a jet engine mechanic.

2. After the development of the first directive has been completed, obtain addendum opinions from an appropriate clinician(s) regarding the Veteran's headaches. The claims file and a copy of this remand must be made available to the examiner. The need for an examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion. The examiner should respond to the following:

(a.) Is it as least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's condition had its onset in or is otherwise etiologically related to active duty service, to include his TERA?

(b.) With respect to TERA, the examiner must consider the Veteran's total potential exposure through all applicable military deployments and the synergistic and combined effect of all toxic exposure risk activities.

A rationale must be provided in support of all opinions.

3. After the development of the first directive has been completed, obtain addendum opinions from an appropriate clinician(s) regarding the Veteran's headaches. The claims file and a copy of this remand must be made available to the examiner. The need for an examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion. The examiner should respond to the following:

(a.) Is it as least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's headaches had its onset in or is otherwise etiologically related to active duty service? Please provide an opinion for each claimed condition.

(b.) In forming his or her opinion, the examiner should address the Veteran's contentions regarding the onset and continuity of his disabilities.

The examiner is advised that a negative opinion cannot be based solely on the absence of treatment in service.

A rationale must be provided in support of all opinions.

4. Schedule the Veteran for a VA examination for the entitlement to service connection for fibromyalgia. The examiner must review the claims file.

If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below.

The examiner is asked to provide a response to the following:

Is fibromyalgia at least as likely as not related to service?

The Veteran reported that she had fatigue, headaches, joint and muscle pain, and trouble sleeping during service.

Provide a rationale to support the opinion(s).

5. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's (1) left hip pain; (2) vertigo; (3) radiculopathy of left lower extremity; (4) lower back pain; (5) radiculopathy of the right lower extremity are at least as likely as not related to service.

The Veteran's contentions must be considered by the examiner:

The Veteran alleges that a head injury led to vertigo disability.

The Veteran's military occupation was jet engine mechanic. It was a physically demanding position. Her duties included bending, squatting, stooping, and crawling under aircraft while carrying a toolbox that weighed over 60 pounds. She frequently climbed ladders in awkward positions and walked along jet engine wings with her tools in hand. She was also required to walk long distances on hard surfaces such as concrete, gravel, rock, and asphalt, often while carrying heavy equipment.

The Veteran alleges that these repetitive and physically intense tasks led to the onset of chronic left hip pain and back pain. The pain from her back radiates down both of her legs causing bilateral radiculopathy.

KRISTI L. GUNN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T. Samadani, Counsel

The Board's decision in this case is binding only with respect to the instant matter

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