BONE NEOPLASM BENIGN

NATHANIEL DOAN · 2026 · Case ID: A26037352

MIXED

Summary

The Veteran, who served from September 1979 to October 1979, appeals the denial of service connection for a left leg disability, including a bone tumor, and a thyroid disability, including hypothyroidism and a thyroid nodule. The Veteran claims these conditions are due to toxic exposure at Fort McClellan. The Board found that the Veteran had a current disability for both conditions, as noted in the AOJ's favorable findings. However, the Board determined that the Veteran did not meet the criteria for a "radiation-exposed veteran" under 38 C.F.R. § 3.309(d) because the record did not establish exposure to ionizing radiation or participation in a radiation-risk activity. The VA examiner noted the left leg condition was a benign fibroma, likely present since adolescence, and the thyroid nodule was also benign. The Board found no credible evidence of in-service injury, event, or disease for direct service connection, and the radiation presumptions were inapplicable. The weight of the evidence was against the claims, thus denying service connection for the leg and thyroid conditions. The claim for a brain tumor, including headaches, was remanded for a VA examination to determine if the Veteran's current intermittent headaches are related to service, specifically addressing a reported severe headache in 1980.

Rationale

Current disability met; No evidence of in-service incurrence or aggravation; No credible evidence of radiation or toxic exposure; Weight of evidence against claim

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251015-600816

Full Decision Text

Citation Nr: A26037352
Decision Date: 04/21/26 Archive Date: 04/21/26

DOCKET NO. 251015-600816
DATE: April 21, 2026

ORDER

Service connection for left leg disability, to include bone tumor, including as due to radiation exposure or other toxic risk exposure activity, is denied.

Service connection for thyroid disability, to include hypothyroidism, thyroid nodule, and left partial thyroidectomy, including as due to radiation exposure or other toxic risk exposure activity, is denied.

REMANDED

Entitlement to service connection for brain tumor, including headaches, is remanded.

FINDINGS OF FACT

1. The Veteran was not exposed to ionizing radiation.

2. The Veteran's left leg disability, diagnosed as left tibia nonossifying fibromas and causes left leg pain, and thyroid disability, diagnosed as hypothyroidism, thyroid nodule, and left partial thyroidectomy, did not begin in service.

CONCLUSIONS OF LAW

1. The criteria for service connection for left leg disability, to include bone tumor, have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. § 3.303, 3.307, 3.309, 3.311.

2. The criteria for service connection for thyroid disability, to include hypothyroidism, thyroid nodule, and left partial thyroidectomy, have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. § 3.303, 3.307, 3.309, 3.311.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from September 1979 to October 1979.

The rating decision on appeal was issued in October 2024 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the October 15, 2025, VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket.

Therefore, the Board may only consider the evidence of record at the time of the October 2024 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801. The Board notes that the Veteran reported generally in her VA Form 10182 that certain forms had not been received from her. In the evidence window, she did not further explain what forms these were or submit additional evidence. The record does not otherwise reflect a due process error in this regard.

For the issues denied in this decision, 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, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service.?38?C.F.R. §?3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all 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.; see also Caluza v. Brown, 7?Vet. App.?498, 506 (1995) aff'd, 78 F.3d 604 (Fed. Cir. 1996).

Additionally, service connection is warranted for certain conditions due
Service connection may also be granted for any disease diagnosed after discharge, when all 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.; see also Caluza v. Brown, 7?Vet. App.?498, 506 (1995) aff'd, 78 F.3d 604 (Fed. Cir. 1996).

Additionally, service connection is warranted for certain conditions due to radiation exposure in service. Service connection may be presumed for certain diseases claimed to be due to ionizing radiation exposure, provided the disease manifests in a radiation exposed veteran and is found five years or more after service. 38 C.F.R. § 3.309(d), 3.311(b)(2)(xxiii); Ramey v. Brown, 9 Vet. App. 49 Vet. App. 40 (1996). The term radiation-exposed veteran means either a veteran who while serving on active duty, or an individual who, while a member of a reserve component of the Armed Forces during a period of active duty for training or inactive duty training, participated in a radiation-risk activity. 38 C.F.R. § 3.309(d)(3)(i). "Radiation-risk activity" is defined to mean: onsite participation in a test involving the atmospheric detonation of a nuclear device; the occupation of Hiroshima or Nagasaki, Japan, by United States forces during the period beginning on August 6, 1945, and ending on July 1, 1946; internment as a prisoner of war in Japan that resulted in an opportunity for exposure to ionizing radiation comparable to that of veterans who were in the occupation forces of Hiroshima or Nagasaki during the period August 6, 1945, to July 1, 1946; or certain service on the grounds of gaseous diffusion plants located in Paducah, Kentucky, Portsmouth, Ohio, and Oak Ridge, Tennessee; or, in certain circumstances, service on Amchitka Island, Alaska. See 38 C.F.R. § 3.309(d)(ii).

If a radiation risk activity has been shown, VA need not document a veteran's radiation exposure level. For those Veterans who do not meet the criteria of §§ 3.307, 3.309, development will be completed pursuant to § 3.311 for radiogenic diseases, including cancer. Such development includes obtaining dose assessments to determine whether a Veteran had exposure to ionizing radiation. If such exposure is found, then further development for a determination regarding a relationship between such exposure and the radiogenic disease will be completed. See generally 38 C.F.R. § 3.311.

Other "radiogenic" disease, such as any form of cancer, listed under 38 C.F.R. § 3.11(b)(2), found five or more years after service (for most of the listed diseases) in an ionizing radiation exposed veteran may be service-connected if VA Under Secretary for Benefits determines it is related to ionizing radiation exposure while in service or if they are otherwise linked medically to ionizing radiation exposure in service. Other claimed diseases may be considered radiogenic if the Veteran has cited or submitted competent scientific or medical evidence that supports that finding. 38 C.F.R. § 3.311(b)(4).

1. Entitlement to service connection for left leg disability, to include bone tumor, including as due to radiation exposure or other toxic risk exposure activity.

2. Entitlement to service connection for thyroid disability, to include hypothyroidism, thyroid nodule, and left partial thyroidectomy, including as due to radiation exposure or other toxic risk exposure activity.

The Veteran contends that her left leg bone tumor and thyroid tumor are due to toxic exposure at Fort McClellan.

The Veteran has not provided any specificity with regard to the toxic exposures activity she was exposed to or radiation risk activity she participated in during service at Fort McClellan.

In the October 2024 rating decision, the AOJ found that the Veteran is diagnosed with a left leg disability, based private treatment records reflecting complaints of left leg pain. The AOJ also found that the Veteran is diagnosed with hypothyroidism, thyroid nodule, and left partial thyroidectomy. The Board is bound by the AOJ's favorable findings under the AMA. 38 C.F.R. § 3.104(c). According, the Board finds that the first element of service connection, a current disability, is met for both claims.

With regard to the second element of service connection,
regard to the toxic exposures activity she was exposed to or radiation risk activity she participated in during service at Fort McClellan.

With regard to the second element of service connection, an in-service event, injury, or exposure, in this case, the Veteran has not alleged, and her records do not reflect, that her service included any of the circumstances listed under 38 C.F.R. § 3.309(d)(3). Therefore, she is not a "radiation-exposed veteran" within the meaning of the regulations, and the associated presumptions are not applicable.

In August 2024, the AOJ developed the Veteran's claim based on exposure to radiation while performing military duties at Fort McClellan, AL from September 1979 to October 1979. The Board finds that the AOJ adequately developed this theory of entitlement and that the resulting documents of record are sufficient to support the finding of no service-related radiation exposure. Considering the totality of the evidence of record, the Board finds that the credible evidence of record does not establish exposure to ionizing radiation in service.

Upon VA examination of the Veteran's leg condition in April 2024, the VA examiner indicated the Veteran's diagnosis of left tibia nonossifying fibromas. The Veteran reported the onset of the condition was in 2015, at which time she had constant pain. The Veteran reported that surgery could not be done and that she currently experiences intermittent left leg pain. The examiner indicated that such fibromas are benign and are managed via observation, as they are benign. The examiner also incorporated a July 2015 private treatment note which indicates that such benign bone tumors have likely been present since the Veteran was an adolescent.

Upon VA examination of the Veteran's thyroid condition in April 2024, the VA examiner identified the Veteran's diagnoses of hypothyroidism (2012) and thyroid nodule (2012). The Veteran reported that in 2012, she noticed a node on the side of her neck, which was deemed "abnormal" and underwent a left partial thyroidectomy in 2012. Her symptoms have since improved. The examiner indicated that 2012 diagnostic testing and biopsy indicated that such was a colloid nodule, which is a benign growth in the thyroid gland. The examiner indicated that the Veteran has not been diagnosed with thyroid cancer, based on the findings in the private treatment records.

Based on the foregoing, the Board finds that the Veteran is not diagnosed with a diagnosis that would qualify as a radiogenic disease which would require consideration of the procedural requirements outlined in 38 C.F.R. § 3.311. The Board recognizes that development outlined in this regulation was not undertaken in this case. However, because the record does not have credible evidence of exposure, further development is not required, and it is unnecessary to further delay resolution of the claims.

The presumptive regulations, however, do not preclude a claimant from establishing service connection with proof of direct causation. See Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994). Therefore, the Board has considered whether the Veteran's claims can be established on direct basis.

To that end, the Veteran does not contend that her claimed conditions had their onsets in service. Veteran's service treatment records (STRs) reflect no findings for or treatment of leg pain or a thyroid condition. The Veteran's claims are based solely on her claimed exposure to ionizing radiation, which, as noted above, has not been established by the weight of the evidence of record. Moreover, the October 2024 Toxic Exposure Risk Activity (TERA) Memorandum reflects that the Veteran did not participate in any TERA during her service, to include non-deployment related exposures consistent with the circumstances of her service. Accordingly, there are no other theories of entitlement to service connection for consideration.

In sum, the weight of the evidence is against the claims as the record does not have competent and credible evidence of in-service injury, event, or disease. The existence of in-service incident is a cornerstone of a service connection claim. Absent evidence showing this element, service connection cannot be established. Therefore, the Board need not address the final element of a service connection claim, the nexus element.

Based on the foregoing, the Board
Moreover, the October 2024 Toxic Exposure Risk Activity (TERA) Memorandum reflects that the Veteran did not participate in any TERA during her service, to include non-deployment related exposures consistent with the circumstances of her service. Accordingly, there are no other theories of entitlement to service connection for consideration.

Based on the foregoing, the Board finds that the weight of the evidence is against the claims for service connection for the Veteran's left leg disability or thyroid disorder. As the weight of the evidence is against the claims, the doctrine of reasonable doubt is not for application. See 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 3.102, 4.3. Hence, the claims are denied.

REASONS FOR REMAND

Entitlement to service connection for brain tumor, including headaches.

The Veteran asserts that her brain tumor is due to exposures at Fort McClellan.

Upon VA examination in April 2024, the Veteran explained that in 1980, the Veteran had the "worst headache of her life;" she sought treatment with neurology who conducted a CT scan which was positive for tumor. Upon surgery consultation, another scan was completed and no brain tumor was found on second scan. The Veteran reported that she still experiences intermittent headaches for which she takes prescription medication, as needed.

While the Veteran's claim was for "brain tumor," the Board notes that a claim should not be limited to the disorder as characterized by the Veteran, but must be addressed based on the reasonable expectations of the non-expert claimant and the evidence in processing the claim. Clemons v. Shinseki, 23 Vet. App. 13 Vet. App. 1, 4-5 (2009).

Accordingly, the Board finds that the Veteran's report of intermittent headaches from the time of onset of the worst headache in 1980, within a year of separation from service, warrants additional development. In this regard, the Board finds that it was a pre-decisional duty to assist error that the AOJ did not obtain a medical opinion as to whether the Veteran's current intermittent headaches began during active service. Based on the foregoing, the Board finds that remand is required to conduct such development.

The matter is REMANDED for the following action:

Schedule the Veteran for a VA examination for the intermittent headaches. 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 below.

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

Are the Veteran's current headaches approximately at least as likely as not related to service, including her reported headache in 1980?

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Provide a rationale to support the opinion.

In providing the requested opinion, consider the Veteran's description of the in-service symptoms as well as post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported symptoms in service and thereafter represented the onset of the current disability, this should be noted. Stated another way, do the Veteran's reports about the symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible?

Nathaniel Doan

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board N. M. Younan

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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