CHRONIC BRONCHITIS

Summary

The veteran, who served in the U.S. Army from August 1998 to August 2002, including service in Southwest Asia, appeals the denial of service connection for chronic bronchitis, chronic rhinitis, chronic sinusitis, lumbar strain, right ankle injury, right foot injury, and tinnitus. The veteran alleged these conditions were due to in-service environmental hazard and toxin exposure, as well as acoustic trauma from tank engines and gunfire for tinnitus. The Board reviewed the evidence of record at the time of the agency of original jurisdiction decisions in October 2024 and February 2025. The veteran's service treatment records and post-service treatment records were silent regarding diagnoses or complaints of the claimed respiratory conditions and musculoskeletal injuries. While the veteran's service in Southwest Asia and participation in Toxic Exposure Risk Activity (TERA) were conceded, the Board found no objective medical evidence supporting current diagnoses for these conditions. VA examinations in December 2024 and January 2025 found no objective evidence for chronic bronchitis, sinusitis, or rhinitis, and attributed the veteran's respiratory complaints to various potential causes other than service. Similarly, for the musculoskeletal claims, the Board found no current diagnoses or objective evidence, and noted that these conditions are not associated with TERA. For tinnitus, while the veteran's MOS as a tank driver suggested potential acoustic trauma and TERA exposure was conceded, the VA examiner found the tinnitus was less likely than not related to service, citing normal audiograms and lack of objective otologic damage. The Board found the VA examiner's opinions highly probative and dispositive, noting the lack of contrary opinions and the veteran's lay assertions regarding etiology were not competent for complex medical questions. Consequently, all claims were denied.

Rationale

No current diagnosis of chronic bronchitis; Service treatment records silent for complaints/treatment/diagnoses; Post-service treatment records silent for chronic bronchitis; VA examiner found no objective medical evidence for chronic bronchitis; Examiner attributed respiratory complaints to various potential causes other than service

Full Decision Text

Citation Nr: A26037331
Decision Date: 04/21/26	Archive Date: 04/21/26

DOCKET NO. 250331-530529
DATE: April 21, 2026

ORDER

Entitlement to service connection for chronic bronchitis, to include as due to in-service environmental hazard and toxin exposure, is denied. 

Entitlement to service connection for chronic rhinitis, to include as due to in-service environmental hazard and toxin exposure, is denied. 

Entitlement to service connection for chronic sinusitis, to include as due to in-service environmental hazard and toxin exposure, is denied. 

Entitlement to service connection for lumbar strain is denied. 

Entitlement to service connection for a right ankle injury is denied. 

Entitlement to service connection for a right foot injury is denied. 

Entitlement to service connection for tinnitus, to include as due to in-service environmental hazard and toxin exposure, is denied. 

FINDINGS OF FACT

1.  At no time during, or prior to, the pendency of the claim does the Veteran have a diagnosis of chronic bronchitis.  

2.  At no time during, or prior to, the pendency of the claim does the Veteran have a diagnosis of chronic rhinitis.

3.  At no time during, or prior to, the pendency of the claim does the Veteran have a diagnosis of chronic sinusitis.

4.  At no time during, or prior to, the pendency of the claim does the Veteran have a diagnosis of lumbar strain.

5. At no time during, or prior to, the pendency of the claim does the Veteran have a diagnosis of a right ankle injury.

6. At no time during, or prior to, the pendency of the claim does the Veteran have a diagnosis of a right foot injury.

7. The Veteran's claimed ringing in the ears has been attributed to a known clinical diagnosis of tinnitus, and is not related to, or manifestations of, an undiagnosed illness or other qualifying chronic disability.

8. Tinnitus is not shown to be causally or etiologically related to any disease, injury, or incident in service, to include exposure to environmental hazards and toxins in Southwest Asia and did not manifest within one year of service discharge.

CONCLUSIONS OF LAW

1. The criteria for service connection for chronic bronchitis have not been met.  38 U.S.C. §§ 1110, 1112, 1116, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 

2. The criteria for service connection for chronic rhinitis have not been met.  38 U.S.C. §§ 1110, 1112, 1116, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

3. The criteria for service connection for chronic sinusitis have not been met.  38 U.S.C. §§ 1110, 1112, 1116, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

4. The criteria for service connection for lumbar strain have not been met.  38 U.S.C. §§ 1110, 1112, 1116, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

5. The criteria for service connection for a right ankle injury have not been met.  38 U.S.C. §§ 1110, 1112, 1116, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

6. The criteria for service connection for a right foot injury have not been met.  38 U.S.C. §§ 1110, 1112, 1116, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

7. The criteria for service connection for tinnitus have not been met.  38 U.S.C. §§ 1101, 1110, 1112, 1117, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.317.


 The criteria for service connection for a right foot injury have not been met.  38 U.S.C. §§ 1110, 1112, 1116, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

7. The criteria for service connection for tinnitus have not been met.  38 U.S.C. §§ 1101, 1110, 1112, 1117, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.317.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from August 1998 to August 2002, to include service in Southwest Asia. The rating decisions on appeal were issued in October 2024 and February 2025.  In March 2025 the Veteran submitted VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) and elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the October 2024 and February 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 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 Board must discuss all theories of entitlement raised by the Veteran or by the evidence of record.  Robinson v. Mansfield, 21 Vet. App. 545 (2008).

Accordingly, the Board has recharacterized the claims as indicated above to afford the Veteran the broadest possible scope of review.  See Clemons v. Shinseki, 23 Vet. App. 1, 5-6 (2009).

In light of Williams v. McDonough, 37 Vet. App. 305 (2024), the Board sent a docket switch waiver letter to the Veteran in January 2026 and held the case in abeyance for 75 days pending submission of any docket switch requests. However, as no response has been received, the Board will proceed with adjudication of the claims.  

Service Connection Claims 

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a).  Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303 (d).

Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury.  Id.; also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff'd, 78 F.3d 604 (Fed. Cir. 1996) [(table)].

Where a Veteran served for at least 90 days during a period of war or after December 31, 1946, and manifests certain chronic diseases to a degree of 10 percent within one year, from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service.  38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309.

Alternatively, when a disease at 38 C.F.R. § 3.309 (a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service.  See 38 C.F.R. § 3.303 (b).  However, the use of continuity of
 from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service.  38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309.

Alternatively, when a disease at 38 C.F.R. § 3.309 (a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service.  See 38 C.F.R. § 3.303 (b).  However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309 (a) and does not apply to other disabilities which might be considered chronic from a medical standpoint.  See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Under the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act), effective from August 10, 2022, Section 303 implemented 38 U.S.C. § 1168, requiring a disability examination and medical opinion be requested for certain non-presumptive conditions involving toxic exposure risk activity (TERA).  For such claims, VA is required to provide a disability examination and medical opinion when the Veteran submits a claim for compensation, has evidence of a disability, has evidence of participation in a TERA, and such evidence is not sufficient to establish service connection for the disability.  A Veteran can claim participation in a TERA explicitly or implicitly through service in a location presumed associated with toxic exposure, or records showing participation in a TERA; or, if VA has conceded exposure in a prior claim, or the file has a claim attributable to toxic exposure.  Other ways to claim or establish participation in a TERA include, when a Veteran's military occupational specialty (MOS) is associated with toxic exposure; when medical records suggest exposure to a toxic substance, chemical, or airborne hazard such as VHA exposure screening; or, with any other relevant evidence of record to include garrison exposures.

Service connection may also be granted for a disability due to a qualifying chronic disability of a Veteran who served in the Southwest Asia theater of operations during the Persian Gulf War provided that such disability became manifest during either active service in the Southwest Asia theater of operations during the Persian Gulf War or to a degree of 10 percent or more, under the appropriate diagnostic code of 38 C.F.R. Part 4, not later than December 31, 2021, and by history, physical examination, and laboratory tests, the disability cannot be attributed to any known clinical diagnosis.  38 U.S.C. § 1117; 38 C.F.R. § 3.317 (a)(1).

In the instant case, the record reflects that the Veteran had service in Southwest Asia theater of operations and, therefore, such laws and regulations are applicable to his claims.

A chronic qualifying disability means a chronic disability resulting from an (A) undiagnosed illness; (B) the following medically unexplained chronic multisymptom illnesses that are defined by a cluster of signs or symptoms: (1) chronic fatigue syndrome; (2) fibromyalgia; (3) IBS; or (4) any other illness that the Secretary determines meets the criteria in paragraph (a)(2)(ii) of this section for a medically unexplained chronic multisymptom illness; or (C) any diagnosed illness that the Secretary determines in regulations prescribed under 38 U.S.C. § 1117 (d) warrants a presumption of service connection.  38 C.F.R. § 3.317 (a)(2)(i).

For the purposes of this section the term medically unexplained chronic multisymptom illness means a diagnosed illness without conclusive pathophysiology or etiology, that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. Chronic multisymptom illnesses of partially understood etiology and pathophysiology will not be considered medically unexplained. 38 C.F.R. § 3.317 (a)(2)(ii).

"Objective indications of chronic disability" include both "signs," in the medical sense of objective evidence perceptible to an examining physician, and other, non-medical indicators that are capable of independent verification.  38 C.F.R. § 3.317 (a)(3).

Disabilities that have existed for 6 months or more and disabilities that exhibit intermittent episodes of improvement and worsening over a 6-month period will be considered chronic.  The
, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. Chronic multisymptom illnesses of partially understood etiology and pathophysiology will not be considered medically unexplained. 38 C.F.R. § 3.317 (a)(2)(ii).

"Objective indications of chronic disability" include both "signs," in the medical sense of objective evidence perceptible to an examining physician, and other, non-medical indicators that are capable of independent verification.  38 C.F.R. § 3.317 (a)(3).

Disabilities that have existed for 6 months or more and disabilities that exhibit intermittent episodes of improvement and worsening over a 6-month period will be considered chronic.  The 6-month period of chronicity will be measured from the earliest date on which the pertinent evidence establishes that the signs or symptoms of the disability first became manifest.  38 C.F.R. § 3.317 (a)(4).

Signs or symptoms which may be manifestations of undiagnosed illness or medically unexplained chronic multi-symptom illness include, but are not limited to: (1) fatigue, (2) unexplained rashes or other dermatological signs or symptoms, (3) headache, (4) muscle pain, (5) joint pain, (6) neurological signs and symptoms, (7) neuropsychological signs or symptoms, (8) signs or symptoms involving the upper or lower respiratory system, (9) sleep disturbances, (10) gastrointestinal signs or symptoms, (11) cardiovascular signs or symptoms, (12) abnormal weight loss, and (13) menstrual disorders.  38 C.F.R. § 3.317 (b).

Pertinent to a claim for service connection, such a determination requires a finding of current disability that is related to an injury or disease in service.  See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).  The requirement of a current disability is satisfied when the Veteran has a disability at the time, he files his service connection claim or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim.  McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).  However, when the record contains a recent diagnosis of disability prior to the Veteran's filing of a claim for benefits based on that disability, the report of the diagnosis is relevant evidence that the Board must address in determining whether a current disability existed at the time the claim was filed or during its pendency.  Romanowsky v. Shinseki, 26 Vet. App. 289 (2013).  Under applicable regulation, the term "disability" means impairment in earning capacity resulting from diseases and injuries and their residual conditions.  38 C.F.R. § 4.1; see also Hunt v. Derwinski, 1 Vet. App. 292 (1991).

When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant.  38 U.S.C. §§ 5107 (b); 38 C.F.R. § § 3.102.  When all of the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which case the claim is denied.  Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990).

Entitlement to service connection for chronic bronchitis, chronic rhinitis, and chronic sinusitis, to include as due to in-service environmental hazard and toxin exposure, are denied. 

The Veteran contends that he suffers from chronic bronchitis, sinusitis, and rhinitis as a result of his active-duty service. Specifically, he alleges that he was exposed to various environmental hazards and toxins during his service and that such resulted in his claimed disabilities. 

The Veteran's service treatment records are silent for any complaints, treatment, or diagnoses related to respiratory conditions, to include bronchitis, sinusitis, and/or rhinitis. Furthermore, the Veteran's post-service treatment records are also silent for such disabilities. However, VA TERA Memoranda issued in December 2022, January 2023, and September 2024 reflect that the Veteran served in Kuwait from January 2002 to March 2002 and therefore he is presumed to have been exposed to environmental hazards and toxins during his service. Furthermore, in the October 2024 and February 2025 rating decisions, the AOJ conceded that the Veteran participated in TERA
 his service and that such resulted in his claimed disabilities. 

The Veteran's service treatment records are silent for any complaints, treatment, or diagnoses related to respiratory conditions, to include bronchitis, sinusitis, and/or rhinitis. Furthermore, the Veteran's post-service treatment records are also silent for such disabilities. However, VA TERA Memoranda issued in December 2022, January 2023, and September 2024 reflect that the Veteran served in Kuwait from January 2002 to March 2002 and therefore he is presumed to have been exposed to environmental hazards and toxins during his service. Furthermore, in the October 2024 and February 2025 rating decisions, the AOJ conceded that the Veteran participated in TERA activities and that he was exposed to environmental and toxic hazards. 

While the Veteran has reported symptoms which he believes began in or were caused by his service, the evidence of record does not support the Veteran's claims. There are simply no indications of any symptoms or diagnoses related to chronic bronchitis, sinusitis, and/or rhinitis either during or after the Veteran's active service.  Consequently, the Board finds that VA is under no obligation to provide the Veteran with examinations in connection with his claims.  See McLendon v. Nicholson, 20 Vet. App. 79 (2006).  However, in light of the Veteran's conceded in-service exposures, the AOJ provided the Veteran with VA examinations and medical opinions in December 2024.

In December 2024 the Veteran underwent a VA Gulf War General Medical examination with an accompanying disability benefits questionnaire (DBQ). The examiner found no evidence of any diagnosed illnesses for which no etiology was established and no undiagnosed illnesses or diagnosed medically unexplained chronic multi-symptom illnesses. 

In December 2024 the Veteran also underwent a VA Respiratory Conditions examination with an accompanying DBQ. The Veteran reported that when he returned from Kuwait, he began to experience coughing fits with phlegm. He indicated that while he was not diagnosed with bronchitis, he was told to take allergy medications and see if they helped. He further stated that he noticed his coughing and regurgitation were worse in the winter months. Following an examination of the Veteran, the examiner found that he did not have diagnoses for any Gulf War related conditions (i.e. gastrointestinal symptoms consistent with functional gastrointestinal disorders such as irritable bowel syndrome and functional dyspepsia, chronic fatigue syndrome, and gulf war illness or chronic multi-symptom illness). Furthermore, the examiner found that the Veteran did not exhibit a disability pattern consistent with "an undiagnosed illness" or "a diagnosable but medically unexplained chronic multi-symptom illness of unknown etiology." Finally, the examiner found no objective medical evidence to support a diagnosis of chronic bronchitis. Rather the examiner indicated that the Veteran's complaints of cough and phlegm could be attributed to various conditions to include but not limited to infections, pulmonary conditions, gastrointestinal conditions, cardiac conditions, and environmental factors. 

In addition, in December 2024, the Veteran underwent a VA Sinusitis, Rhinitis, and Other Conditions of the Nose, Throat, Larynx and Pharynx examination with an accompanying DBQ. The Veteran reported that he experienced daily congestion, runny nose, pressure in his head and behind his eyes, and nose bleeds. He stated that he was told to use allergy medication, nasal sprays, and a Netti pot. The examiner found no objective evidence to support diagnoses of chronic rhinitis and chronic sinusitis. 

In addition to the examinations, the examiner also provided medical opinions in regard to the Veteran's claimed disabilities.  The examiner opined that the Veteran's claimed chronic bronchitis, chronic sinusitis, and chronic rhinitis were less likely than not caused by the Veteran's indicated TERA, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic combined effect of all TERA of the Veteran.  Furthermore, the examiner opined that the Veteran's claimed chronic bronchitis, chronic sinusitis, and chronic rhinitis were not caused by or related to the Veteran's Gulf War Service. The examiner provided the rationale that there was no objective medical evidence regarding diagnoses of chronic bronchitis, chronic sinusitis, and/or chronic rhinitis and no medical evidence to confirm chronicity. Therefore, as there was no medical evidence of the claimed disabilities, such could not be caused by or related to the Veteran's indicated TERA and subsequent exposures.  As the examiner provided clear conclusions supported by medically based rationales, the Board finds them highly probative.  See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124
is were not caused by or related to the Veteran's Gulf War Service. The examiner provided the rationale that there was no objective medical evidence regarding diagnoses of chronic bronchitis, chronic sinusitis, and/or chronic rhinitis and no medical evidence to confirm chronicity. Therefore, as there was no medical evidence of the claimed disabilities, such could not be caused by or related to the Veteran's indicated TERA and subsequent exposures.  As the examiner provided clear conclusions supported by medically based rationales, the Board finds them highly probative.  See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions").  Finally, the Board notes that there are no contrary medical opinions of record. 

Throughout the appeal, the Veteran has submitted lay statements in support of his claims.  Alleging not only that he suffers from his claimed chronic disabilities, but that such were caused by or began during his active service.

Following a thorough review of the evidence of record, the Board finds that service connection is not warranted for the Veteran's claimed chronic bronchitis, sinusitis, and rhinitis, as the probative evidence of record fails to demonstrate current disabilities related to the Veteran's military service.

In the instant case, the probative evidence of record fails to demonstrate current diagnoses of chronic bronchitis, sinusitis, and rhinitis.  While the Board has also considered the Court's holding in Romanowsky, supra, there is also no probative evidence of recent diagnoses of chronic bronchitis, sinusitis, and rhinitis prior to the Veteran's claims.  While the Veteran's in-service environmental hazard and toxin exposure has been conceded, his service treatment records are silent for any complaints, treatment, or diagnoses of respiratory disabilities to include bronchitis, sinusitis, and/or rhinitis. Furthermore, the Veteran's post-service treatment records are entirely silent for any complaints, treatment, or diagnoses of chronic bronchitis, sinusitis, and rhinitis.  In addition, the December 2024 VA examiner specifically found that there was no objective medical evidence to support diagnoses of chronic bronchitis, sinusitis, and/or rhinitis, and therefore no basis for such to be etiologically related to the Veteran's service to include his in-service toxin and environmental hazard exposures. Finally, the Board notes that it has found the December 2024 examinations probative, and as there are no contrary opinions of record, they are also dispositive on the issues of diagnoses.    

The Board notes that the Veteran is competent to report his own symptoms or matters within his personal knowledge.  See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006).  In addition, laypersons may, in some circumstances, opine on questions of diagnosis and etiology.  See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009) (the Board's categorical statement that 'a valid medical opinion' was required to establish nexus, and that a layperson was 'not competent' to provide testimony as to nexus because she was a layperson, conflicts with Jandreau).

However, the matter of medical diagnoses for disabilities not capable of lay observation, such as those of issue here, are matters within the province of trained medical professionals.  See Jones v. Brown, 7 Vet. App. 134, 137-38 (1994). Specifically, the diagnoses of chronic bronchitis, sinusitis, and rhinitis involve medical subjects concerning internal physical processes extending beyond an immediately observable cause-and-effect relationship and requires the administration and interpretation of specialized testing.  In the instant case, there is no suggestion that the Veteran has had any medical training.  Therefore, as the Veteran does not have the appropriate medical training and expertise to competently self-diagnose chronic bronchitis, sinusitis, and rhinitis, the lay assertions in this regard have no probative value. Jandreau, supra at 1377 n.4 ("[s]ometimes the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer"); see also Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins,
.  Therefore, as the Veteran does not have the appropriate medical training and expertise to competently self-diagnose chronic bronchitis, sinusitis, and rhinitis, the lay assertions in this regard have no probative value. Jandreau, supra at 1377 n.4 ("[s]ometimes the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer"); see also Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions).

The Board emphasizes that Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability.  See 38 U.S.C. §§ 1110; 38 C.F.R. §§ 3.30, 3.310.  Thus, where, as here, the probative evidence indicates that the Veteran does not have current diagnoses of chronic bronchitis, sinusitis, and rhinitis for the entire appeal period, there can be no valid claims for service connection.  See Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer, supra.

Therefore, service connection is not warranted for the Veteran's claimed chronic bronchitis, chronic sinusitis, and chronic rhinitis as the probative evidence of record fails to demonstrate current chronic disabilities related to the Veteran's military service.

In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine.  However, as the evidence of record is against the Veteran's claims of entitlement to service connection for chronic bronchitis, chronic rhinitis, and chronic sinusitis, to include as due to in-service environmental hazard and toxin exposure, that doctrine is not applicable in the instant appeal, and his claims must be denied.  38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53.

Entitlement to service connection for lumbar strain, right ankle injury, and right foot injury are denied. 

The Veteran contends that he suffers from lumbar strain, a right ankle injury, and a right foot injury as a result of his active-duty service. Specifically, he alleges that such began in service and have continued ever since.

The Veteran's service treatment records are silent for any complaints, treatment, or diagnoses related to lumbar spine, right ankle, and right foot disabilities. Furthermore, the Veteran's service records are also silent for any related incidents or injuries to the Veteran's back, right ankle, and right foot.  In addition, the Veteran's post service treatment records are also silent for any complaints, treatment, or diagnoses related to lumbar strain, a right ankle injury, and a right foot injury. However, as previously noted, VA TERA Memoranda issued in December 2022, January 2023, and September 2024 reflect that the Veteran served in Kuwait from January 2002 to March 2002 and therefore is presumed to have been exposed to environmental hazards and toxins during his service. Furthermore, in the October 2024 and February 2025 rating decisions, the AOJ conceded that the Veteran participated in TERA activities and that he was exposed to environmental and toxic hazards.

However, while the Veteran has generally reported that his claimed lumbar strain, right ankle injury, and right foot injury began in or were caused by his active-duty service, the evidence of record does not support the Veteran's claims.  There is simply no indication of any current lumbar strain, right ankle injury, and/or right foot injury or symptoms related to such.  Consequently, the Board finds that VA is under no obligation to provide the Veteran with examinations in connection with his claims.  See McLendon, 20 Vet. App. at 79.

Furthermore, although the AOJ conceded in-service exposure to environmental and toxic hazards, TERA opinions are not required here as the record does not contain competent and credible evidence that the Veteran has lumbar strain, a right ankle injury, and/or a right foot injury. In addition, such disabilities are not associated with exposure to environmental and toxic hazards in Southwest Asia.  See 38 U.S.C. § 1168(a); see also 38 C.F.R. § 3.309(f).

Throughout the appeal, the Veteran has submitted lay statements in support of his claims.  Alleging not only that he suffers from his claimed disabilities, but that such were caused by or began during his active service. However, he has provided no evidence
Furthermore, although the AOJ conceded in-service exposure to environmental and toxic hazards, TERA opinions are not required here as the record does not contain competent and credible evidence that the Veteran has lumbar strain, a right ankle injury, and/or a right foot injury. In addition, such disabilities are not associated with exposure to environmental and toxic hazards in Southwest Asia.  See 38 U.S.C. § 1168(a); see also 38 C.F.R. § 3.309(f).

Throughout the appeal, the Veteran has submitted lay statements in support of his claims.  Alleging not only that he suffers from his claimed disabilities, but that such were caused by or began during his active service. However, he has provided no evidence in support of his allegations. 

Following a thorough review of the evidence of record, the Board finds that service connection is not warranted for the Veteran's claimed lumbar strain, right ankle injury, and right foot injury, as the probative evidence of record fails to demonstrate current disabilities related to the Veteran's military service.

In the instant case, the probative evidence of record fails to demonstrate current diagnoses of lumbar strain, a right ankle injury, and a right foot injury.  Although the Board has also considered the Court's holding in Romanowsky, supra, there is also no probative evidence of recent diagnoses of these disabilities prior to the Veteran's claims.  While the Veteran's in-service environmental hazard and toxin exposure has been conceded, his service treatment records are silent for any complaints, treatment, or diagnoses of lumbar strain, a right ankle injury, and/or a right foot injury.  Furthermore, the Veteran's post-service treatment records are entirely silent for any complaints, treatment, or diagnoses of lumbar strain, a right ankle injury, and a right foot injury. Finally, the Board notes that regardless of the Veteran's in-service exposures, his claimed lumbar strain, right ankle injury, and right foot injury, are not associated with exposure to environmental and toxic hazards in Southwest Asia.

The Board notes that the Veteran is competent to report his own symptoms or matters within his personal knowledge.  See Jandreau, 492 F.3d at 1377; Buchanan, 451 F.3d at 1331.  In addition, laypersons may, in some circumstances, opine on questions of diagnosis and etiology.  See Davidson, 581 F.3d at 1316.

However, the matter of medical diagnoses for disabilities not capable of lay observation, such as those of issue here, are matters within the province of trained medical professionals. See Jones, 7 Vet. App. at 137-38.  Specifically, the diagnoses of lumbar strain, a right ankle injury, and a right foot injury, involve medical subjects concerning internal physical processes encompassing various internal systems, extending beyond an immediately observable cause-and-effect relationship and require the administration and interpretation of specialized testing.  In the instant case, there is no suggestion that the Veteran has had any medical training.  Therefore, as the Veteran does not have the appropriate medical training and expertise to competently self-diagnose lumbar strain, a right ankle injury, and a right foot injury, the lay assertions in this regard have no probative value.  Jandreau, supra at 1377 n.4 ("[s]ometimes the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer"); see also Woehlaert, 21 Vet. App. at 456.  Moreover, the Veteran has offered only conclusory statements regarding his alleged lumbar strain, right ankle injury, and right foot injury and their relationship to his service.  

The Board emphasizes that Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability.  See 38 U.S.C. §§ 1110; 38 C.F.R. §§ 3.30, 3.310.  Thus, where, as here, the probative evidence indicates that the Veteran does not have current diagnoses for lumbar strain, a right ankle injury, and a right foot injury for the entire appeal period, there can be no valid claims for service connection.  See Gilpin, 155 F.3d at 1353; Brammer, supra.

In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine.  However, as the evidence of record is against the Veteran's claims of entitlement to service connection for lumbar strain, a right ankle injury, and a right foot injury, that doctrine is not applicable in the instant appeal, and his claims must be denied.  38 U.S.C. § 5107; 38 C.F.R. § 3.102.

Entitlement to service connection
 strain, a right ankle injury, and a right foot injury for the entire appeal period, there can be no valid claims for service connection.  See Gilpin, 155 F.3d at 1353; Brammer, supra.

In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine.  However, as the evidence of record is against the Veteran's claims of entitlement to service connection for lumbar strain, a right ankle injury, and a right foot injury, that doctrine is not applicable in the instant appeal, and his claims must be denied.  38 U.S.C. § 5107; 38 C.F.R. § 3.102.

Entitlement to service connection for tinnitus, to include as due to in-service environmental hazard and toxin exposure, is denied. 

The Veteran contends that he suffers from tinnitus as a result of his service. Specifically, he alleges that such was caused by his in service acoustic trauma from tank engines and gun fire. In the alternative, he alleges that his tinnitus was caused by his in-service environmental hazard and toxin exposure. 

The Veteran's service treatment records are silent for any complaints, treatment, or diagnosis of tinnitus. However, the Veteran's personnel records (i.e. his VA Form DD 214), reflect that his military occupational specialty (MOS) was tank driver, and therefore the Board finds that he likely experienced some acoustic trauma during his service.  Furthermore, as previously noted, VA TERA Memoranda issued in December 2022, January 2023, and September 2024 reflect that the Veteran served in Kuwait from January 2002 to March 2002 and therefore is presumed to have been exposed to environmental hazards and toxins during his service. In addition, the AOJ conceded in the October 2024 and February 2025 rating decisions, that the Veteran participated in TERA activities and that he was exposed to environmental and toxic hazards.  The Veteran's post-service treatment records reflect his reports of ringing in his ears and a diagnosis of tinnitus. See January 2025 VA Hearing Loss and Tinnitus examination. 

In January 2025 the Veteran underwent a VA Hearing Loss and Tinnitus examination with an accompanying DBQ. The examiner noted that the Veteran reported recurrent tinnitus. In addition, while the Veteran did not provide a date of onset, he indicated that his tinnitus was a constant ringing in his ears, louder in his right than in his left. The examiner opined that it was less likely than not that the Veteran's tinnitus was caused by or the result of military noise exposure and/or his in-service TERA. The examiner provided the rationale that while the Veteran was exposed to loud engine noise and gun fire during his service, audiograms conducted in March 1999 and July 2004 revealed normal hearing sensitivity with no shifts between. Furthermore, the examiner noted that the Veteran's hearing was within normal limits at ratable frequencies on current examination. Finally, the examiner noted that there was no evidence of any otologic damage. 

Throughout the appeal, the Veteran has submitted lay statements in support of his claims.  Alleging not only that he suffers from his claimed disabilities, but that such were caused by his active service. However, he has provided no evidence in support of his allegations. 

Following a thorough review of the evidence of record, the Board finds that service connection for tinnitus is not warranted.  

As an initial matter, the Board finds that the Veteran has a current diagnosis of tinnitus. In addition to a confirmed diagnosis of tinnitus by the VA examiner in January 2025, tinnitus is a disorder capable of lay observation, therefore the Board finds that the Veteran could report such, and the first element of service connection, for either presumptive or direct service connection, is met.  See Charles v. Principi, 16 Vet. App. 370 (2002); Barr v. Nicholson, 21 Vet. App. 303 (2007); Jandreau, 492 F.3d at 1372.  

Furthermore, while the Veteran's service treatment records are silent for any complaints, treatment, or diagnosis of tinnitus, the Board concedes that the Veteran experienced some acoustic trauma during service as his VA Form DD 214 noted that his MOS was tank driver.  Moreover, the Veteran is competent to testify as to his in-service noise exposure.  See 38 C.F.R. § 3.159 (a)(2); Washington v. Nicholson, 19 Vet. App. 362, 368 (2005); Layno v. Brown, 6 Vet. App. 465, 469-70 (1994).  Furthermore, that which he has reported is consistent with the circumstances of his service. Finally, as previously noted, the AOJ has conceded the Veteran's in-service exposure to
, treatment, or diagnosis of tinnitus, the Board concedes that the Veteran experienced some acoustic trauma during service as his VA Form DD 214 noted that his MOS was tank driver.  Moreover, the Veteran is competent to testify as to his in-service noise exposure.  See 38 C.F.R. § 3.159 (a)(2); Washington v. Nicholson, 19 Vet. App. 362, 368 (2005); Layno v. Brown, 6 Vet. App. 465, 469-70 (1994).  Furthermore, that which he has reported is consistent with the circumstances of his service. Finally, as previously noted, the AOJ has conceded the Veteran's in-service exposure to environmental hazards and toxins during his service in Southwest Asia, and the Board is bound by such favorable findings. Therefore, the second element of service connection, for either presumptive or direct service connection, has been met.   

Thus, the question remaining before the Board is whether the Veteran's tinnitus was caused by or is related to his in-service acoustic trauma and/or his in-service environmental hazard and toxin exposure. 

The Board has first considered presumptive service connection.  In regard to presumptive service connection under 38 C.F.R. § 3.317, as the Veteran's claimed symptoms have been attributed to a known clinical diagnosis, specifically tinnitus, and not to a medically unexplained chronic multisymptom illness, the provisions of 38 C.F.R. § 3.317 pertaining to an undiagnosed illness do not apply.  As previously noted, the presumption under 38 C.F.R. § 3.317 only operates where the evidence demonstrates an undiagnosed illness, i.e., one that is not attributed to any known clinical diagnoses.   Therefore, entitlement to service connection on a presumptive basis under 38 C.F.R. § 3.317, is not warranted.

In regard to presumptive service connection and service connection based on continuity of symptomatology under 38 C.F.R. §§ 3.303, 3.307, 3.309, while tinnitus is a chronic disease subject to such forms of service connection, there is no indication that such manifested to a compensable degree within one year of the Veteran's discharge from service. Rather the first documentation of complaints of tinnitus was not until 2024, approximately 22 years after his discharge from service. Therefore, presumptive service connection or service connection based on continuity of symptomatology is not warranted. 

The Board has also considered direct service connection.  As previously noted, while the Veteran's service treatment records are silent for any complaints, treatment or diagnosis of tinnitus, the Board has found that the in-service element of service connection has been met, as the Veteran's exposure to in-service acoustic trauma and environmental hazards and toxins has been conceded. Furthermore, while the Veteran also has a current diagnosis of tinnitus, the Board finds that the probative evidence of record demonstrates that such is not related to his service, to include his in-service acoustic trauma and his in-service environmental hazard and toxin exposure. In this regard, the Board finds the January 2025 VA examiner's opinions to be highly probative. The January 2025 VA examiner opined that the Veteran's tinnitus was not caused by or related to his in-service acoustic trauma or his in-service TERA and resulting exposures. The examiner's findings were based on a review of the claims file, examination of the Veteran, and appropriate testing. Furthermore, the examiner's findings reflect consideration of all relevant facts, and the examiner provided detailed rationales for the conclusions reached.  See Nieves-Rodriguez, 22 Vet. App. at 295; Stefl, 21 Vet. App. at 124. Furthermore, the Board notes that there are no contrary opinions of record. Therefore, as the probative evidence of record demonstrates that the Veteran's current tinnitus is not related to his service, to include his in-service acoustic trauma and/or his in-service environmental hazards and toxin exposure, direct service connection is not warranted.  

The Board notes that the Veteran has generally contended on his own behalf that his tinnitus is related to his service.  Lay witnesses are competent to provide testimony or statements relating to symptoms or facts of events that the lay witness observed and is within the realm of his or her personal knowledge, but not competent to establish that which would require specialized knowledge or training, such as medical expertise.  Layno, 6 Vet. App. at 469-70.  Lay evidence may also be competent to establish medical etiology or nexus.  Davidson, 581 F.3d at 1316.  However, VA must consider lay evidence but may give it whatever weight it concludes the evidence is entitled to and a mere conclusory generalized lay statement that service event or illness caused
 generally contended on his own behalf that his tinnitus is related to his service.  Lay witnesses are competent to provide testimony or statements relating to symptoms or facts of events that the lay witness observed and is within the realm of his or her personal knowledge, but not competent to establish that which would require specialized knowledge or training, such as medical expertise.  Layno, 6 Vet. App. at 469-70.  Lay evidence may also be competent to establish medical etiology or nexus.  Davidson, 581 F.3d at 1316.  However, VA must consider lay evidence but may give it whatever weight it concludes the evidence is entitled to and a mere conclusory generalized lay statement that service event or illness caused the claimant's current condition is insufficient to require the Secretary to provide an examination.  Waters v. Shinseki, 601 F.3d 1274, 1278 (Fed. Cir. 2010).

The Board finds that the question regarding the potential relationship between the Veteran's tinnitus and any instance of his service to be complex in nature. Woehlaert, 21 Vet. App. at 456.  Specifically, while the Veteran is competent to describe his purported exposure to noise during service as well as the current manifestations of tinnitus, the Board accords his statements regarding the etiology of such disorder little probative value as he is not competent to opine on such a complex medical question. Specifically, where the determinative issue is one of medical causation, only those with specialized medical knowledge, training, or experience are competent to provide evidence on the issue. See Jones, 7 Vet. App. at 137. The question of causation involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. The determination of etiology of tinnitus requires interpretation of results found on physical examination and knowledge of the internal auditory process. The question of etiology in this case may not be competently addressed by lay evidence, and the Veteran's own opinion is nonprobative evidence.

Moreover, the Veteran has offered only conclusory statements regarding the relationship between his in-service noise exposure and in-service toxin exposures and his tinnitus. In contrast, the January 2025 VA examiner took into consideration all the relevant facts in providing opinions, to include the Veteran's in-service noise exposure and in-service environmental hazard and toxin exposure as well as the current nature of his claimed tinnitus. As such, the Board accords greater probative weight to the VA examiner's opinions.

Therefore, the Board finds that tinnitus is not shown to be causally or etiologically related to any disease, injury, or incident during service, and did not manifest within one year of service discharge. Consequently, service connection on a direct or presumptive basis is not warranted.

In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine.   However, as the evidence of record is against the Veteran's claim of entitlement to service connection for tinnitus, to include as due to in-service environmental hazard and toxin exposure, that doctrine is not applicable in the instant appeal, and his claim must be denied.  38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. 

 

L. M. BARNARD

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J. Unger, 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.