ANXIETY DISORDER

Summary

The Veteran, who served in the United States Navy from September 1968 to June 1970, appeals the denial of service connection for anxiety. The Veteran also claims that his unspecified mild neurocognitive disorder, unspecified depressive disorder, and unspecified anxiety disorder are secondary to his existing service-connected conditions, which include obstructive sleep apnea, pansinusitis, allergic rhinitis, peripheral neuropathy, tinnitus, hypertension, bilateral hearing loss, and hypothyroidism. The Board found no competent medical or lay evidence of record to establish a nexus between the Veteran's psychiatric diagnoses and his service or his service-connected disabilities. While the Veteran expressed a belief that tinnitus and anxiety are linked, the Board noted that lay individuals are not competent to determine the etiology of psychiatric disabilities. The Board also considered VA treatment records mentioning anxiety related to CPAP use but found this insufficient due to a lack of rationale. The Veteran failed to attend a scheduled VA examination in April 2025 without good cause, which the Board noted thwarts VA's duty to assist and may lead to adverse adjudication based on an incomplete record. Consequently, the Board denied service connection for anxiety and the other psychiatric conditions due to the lack of nexus.

Rationale

No competent medical or lay evidence of nexus; Veteran not competent to determine etiology; Failure to attend VA exam thwarted development

Full Decision Text

Citation Nr: A26037093
Decision Date: 04/21/26	Archive Date: 04/21/26

DOCKET NO. 260105-633779
DATE: April 21, 2026

ORDER

Entitlement to service connection for anxiety is denied.

FINDINGS OF FACT

1. The Veteran did not attend an April 2025 VA examination for the claim without providing good cause. 

2. The weight of the persuasive evidence does not support that the Veteran's anxiety is etiologically linked to his active-duty service or secondary to his service-connected disabilities.

CONCLUSION OF LAW

The criteria for service connection for anxiety have not been met. 38 U.S.C. §§ 1110, 1117, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.655.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Navy from September 1968 to June 1970.

In the present case, the agency of original jurisdiction (AOJ) decided the issue on appeal on June 7, 2025. The Veteran filed a timely appeal of that decision using VA Form 10182 on January 5, 2026 and requested the Evidence Lane with the Board. Accordingly, the Board will consider evidence of record up to the June 7, 2025 AOJ decision and evidence submitted within 90 days of the January 5, 2026 VA Form 10182. Evidence submitted outside of this time frame cannot be considered. 38 C.F.R. § 20.300.

Entitlement to service connection for anxiety

Service connection may be granted for a disability which is proximately due to or the result of service-connected disability. 38 C.F.R. § 3.310 (a). Additional disability resulting from the aggravation of a nonservice-connected disability by a service-connected disability is also compensable under 38 C.F.R. § 3.310 (a). Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). In order to prevail on the issue of secondary service connection, the record must show: (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical nexus evidence establishing a connection between the service-connected disability and the current disability. Wallin v. West, 11 Vet. App. 509, 512 (1998).

Pursuant 38 C.F.R. § 3.655 (a), when entitlement or continued entitlement to a benefit cannot be established or confirmed without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination, or reexamination, action shall be taken in accordance with paragraph (b) or (c) as appropriate. Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, and death of an immediate family member. See 38 C.F.R. § 3.655.

Analysis

In its June 2025 rating decision, the AOJ favorably found that the Veteran had been diagnosed with unspecified mild neurocognitive disorder, unspecified depressive disorder, and unspecified anxiety disorder. 

The Veteran claims these conditions are secondary to his service-connected disabilities. There is no dispute that the Veteran is service connected for obstructive sleep apnea, pansinusitis, allergic rhinitis, peripheral neuropathy, tinnitus, hypertension, bilateral hearing loss, and hypothyroidism.

Nevertheless, the claim must fail for lack of nexus. There is no competent, medical or lay evidence of record to establish a relationship between the Veteran's psychiatric diagnoses and his service-connected disabilities. In an October 2023 claim, the Veteran stated that' "tinnitus and anxiety are linked conditions. People with tinnitus often live with high levels of stress and anxiety and tinnitus can trigger worsening episodes of anxiety and depression. That is what is happening to me." Although the Veteran is competent to identify observable symptoms such as stress, he is not competent to determine the etiology of his psychiatric disabilities, and their potential relationship to his service-connected disabilities. These questions are complicated and require greater knowledge of medicine and science than a lay person such as the Veteran possesses. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Woehlaert v. Nicholson, 21 Vet. App. 456, 462.

The Board acknowledges, and has considered, VA treatment records which note that the Veteran was not using his CPAP because it "causes anxiety due to reminiscence to XRT setting." However, the note is insufficient to establish a nexus. Its probative
 identify observable symptoms such as stress, he is not competent to determine the etiology of his psychiatric disabilities, and their potential relationship to his service-connected disabilities. These questions are complicated and require greater knowledge of medicine and science than a lay person such as the Veteran possesses. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Woehlaert v. Nicholson, 21 Vet. App. 456, 462.

The Board acknowledges, and has considered, VA treatment records which note that the Veteran was not using his CPAP because it "causes anxiety due to reminiscence to XRT setting." However, the note is insufficient to establish a nexus. Its probative value is limited as it is conclusory and contains no rationale. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008) (holding that a medical opinion that is not factually accurate, fully articulated, or based on sound reasoning, is not probative).  

In April 2025, the VA attempted to schedule the Veteran for a VA examination. The Veteran opted not to attend. The Veteran was notified that if he did not attend the VA examination, the claim may be decided based on the evidence of record pursuant to 38 C.F.R. § 3.655 (b). The "duty to assist is not always a one-way street," and the Veteran has an obligation to actively participate in the retrieving of information pertinent to his claim, to include attending a requested VA examination.  A veteran is expected to cooperate in the efforts to adjudicate the claim, and the failure to do so subjects him or her to the risk of an adverse adjudication based on an incomplete and underdeveloped record.  See Wood v. Derwinski, 1 Vet. App. 190, 193(1991); Kowalski v. Nicholson, 19 Vet. App. 171, 178 (2005) (although a claimant is of course "free to refuse to report for a scheduled VA examination[,]... the consequences of that refusal may result in the adjudication of the matter based on the evidence of record").  

The Board finds that there is no adequate evidence of record to support a nexus between the Veteran's unspecified mild neurocognitive disorder, unspecified depressive disorder, or unspecified anxiety disorder and either his service or his service-connected conditions.  VA's attempt to develop this evidence was thwarted by the Veteran's refusal to attend a VA examination that was necessary in assessing the status and etiology of his disorders without providing good cause.  Consequently, entitlement to service connection for unspecified mild neurocognitive disorder, unspecified depressive disorder, and unspecified anxiety disorder, is denied.  

 

 

GAYLE STROMMEN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Sherman, C

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.