Case A26038574

B. D. WATSON · 2026 · Case ID: A26038574

MIXED

Summary

The Veteran served in the United States Army from October 1979 to September 1982. The Veteran appealed the denial of service connection for several conditions, including PTSD, dizziness, scratchy throat, shortness of breath, bilateral knee disabilities, bilateral ankle disabilities, prostate cancer, dry eye syndrome, hypertension, and obstructive sleep apnea. The Board dismissed the appeals for PTSD, dizziness, scratchy throat, and shortness of breath, finding that no preceding final decision existed for these claims at the time of the appeal. For bilateral knee and ankle disabilities, the Board denied service connection, finding no nexus to service, as the Veteran's contentions were not supported by service treatment records or persuasive medical opinions. A private medical opinion cited general literature but did not specifically address the Veteran's case. The Board found the VA examiner's opinion, which noted the lack of corroborating service treatment records and found less than a likelihood of nexus, to be persuasive. Service connection for prostate cancer, dry eye syndrome, hypertension, and obstructive sleep apnea was denied due to a lack of evidence of current diagnosis or nexus to service. The Board remanded claims for service connection for a lumbar spine disability and a skin condition. For the lumbar spine, the Veteran's statement of an in-service injury and continuity of symptoms was sufficient to require a VA examination, which was not provided by the RO. For the skin condition, the Board found a conflict between the VA examiner's positive nexus opinion for lichen planus and the examiner's statement that the condition had improved and was no longer present, requiring further clarification.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250412-537068

Full Decision Text

Citation Nr: A26038574
Decision Date: 04/24/26 Archive Date: 04/24/26

DOCKET NO. 250412-537068
DATE: April 24, 2026

ORDER

The appeal for service connection for posttraumatic stress disorder is dismissed.

The appeal for service connection for dizziness is dismissed.

The appeal for service connection for scratchy throat is dismissed.

The appeal for service connection for shortness of breath is dismissed.

Entitlement to service connection for bilateral knee disabilities is denied.

Entitlement to service connection for bilateral ankle disabilities is denied.

Entitlement to service connection for prostate cancer is denied.

Entitlement to service connection for dry eye syndrome is denied.

Entitlement to service connection for hypertension is denied.

Entitlement to service connection for obstructive sleep apnea is denied.

REMANDED

Entitlement to service connection for a lumbar spine disability is remanded.

Entitlement to service connection for a skin condition, including but not limited to tinea pedis, is remanded.

FINDINGS OF FACT

1. The February 2025 and April 2025 rating decisions both deferred a final decision on the claim for service connection for posttraumatic stress disorder.

2. The April 2025 rating decision deferred a final decision on the claim for service connection for dizziness, scratchy throat, and shortness of breath.

3. The evidence persuasively shows that the Veteran's bilateral knee disabilities do not have a nexus to any in-service injury.

4. The evidence persuasively shows that the Veteran's bilateral ankle disabilities do not have a nexus to any in-service injury.

5. There is no evidence showing that the Veteran's prostate cancer has a nexus to any in-service injury.

6. There is no evidence showing that the Veteran has dry eye syndrome.

7. There is no evidence showing that the Veteran has hypertension.

8. There is no evidence showing that the Veteran has obstructive sleep apnea.

CONCLUSIONS OF LAW

1. The criteria for dismissal of the appeal for service connection for posttraumatic stress disorder have been met. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

2. The criteria for dismissal of the appeal for service connection for dizziness have been met. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

3. The criteria for dismissal of the appeal for service connection for scratchy throat have been met. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

4. The criteria for dismissal of the appeal for service connection for shortness of breath have been met. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

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

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

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

8. The criteria for service connection for dry eye syndrome are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

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

10. The criteria for service connection for obstructive sleep apnea are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from October 1979 to September 1982.

This matter comes to the Board of Veterans' Appeals (Board) from a pair of rating decisions issued by a Regional Office (RO) of the Department of Veterans Affairs (VA) in February 2025 and April 2025.

In the April 2025 VA Form 10182, Decision Review Request
criteria for service connection for obstructive sleep apnea are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from October 1979 to September 1982.

In the April 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the February 2025 or April 2025 agency of original jurisdiction (AOJ) decisions on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision 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.

However, because the Board is remanding the claims for service connection for skin and lumbar spine disabilities, 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).

Service Connection

A Veteran is entitled to service connection for a disability resulting from a disease or injury incurred or aggravated during active service. See 38 U.S.C. § 1110; 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). To substantiate a claim of service connection, there must be evidence of (1) a current disability (for which service connection is sought); (2) incurrence or aggravation of a disease or injury in service; and (3) a causal connection between the disease or injury in service and the current disability. See Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004).

Service connection may be established on a secondary basis for a disability that is proximately due to or the result of, or aggravated by, a service-connected disability. 38 C.F.R. § 3.310 (a). To establish secondary service connection there must be evidence: (1) of a current disability (for which secondary service connection is sought); (2) of an already service-connected disability; and (3) that the current disability for which service connection is sought was either (a) caused or (b) aggravated by the service-connected disability. 38 C.F.R. § 3.310 (a); see Allen v. Brown, 7 Vet. App. 439 (1995) (en banc).

The appeal for service connection for posttraumatic stress disorder is dismissed.

The appeal for service connection for dizziness is dismissed.

The appeal for service connection for scratchy throat is dismissed.

The appeal for service connection for shortness of breath is dismissed.

In the April 2025 Notice of Disagreement, the Veteran indicated his intent to appeal claims for service connection for posttraumatic stress disorder, dizziness, scratchy throat, and shortness of breath. See April 12, 2025 VA Form 10182. However, no rating decision issued in the year preceding the April 2025 Notice of Disagreement contained a final decision on those claims.

The AOJ's decision to defer a ruling until a later date does not constitute a final decision by the agency since all factual and legal questions relevant to the claim have been reserved for adjudication at a later date. Shipley v. Shinseki, 24 Vet. App. 458 (2011). Therefore, the Board finds that the April 2025 appeal of the claims for service connection for posttraumatic stress disorder, dizziness, scratchy throat, and shortness of breath, are dismissed because there
breath. See April 12, 2025 VA Form 10182. However, no rating decision issued in the year preceding the April 2025 Notice of Disagreement contained a final decision on those claims.

The AOJ's decision to defer a ruling until a later date does not constitute a final decision by the agency since all factual and legal questions relevant to the claim have been reserved for adjudication at a later date. Shipley v. Shinseki, 24 Vet. App. 458 (2011). Therefore, the Board finds that the April 2025 appeal of the claims for service connection for posttraumatic stress disorder, dizziness, scratchy throat, and shortness of breath, are dismissed because there is no preceding determination presenting an issue of fact or law for the Board to adjudicate. See 38 U.S.C. § 7105 (a notice of disagreement must identify the specific determination with which the claimant disagrees).

The Board notes that each of these claims was adjudicated in a June 2025 rating decision. The deadline to appeal that decision to the Board, or to request some other form of administrative review, is June 16, 2026. Should the Veteran wish to do so, he may file the appropriate form before that date.

Entitlement to service connection for bilateral knee disabilities is denied.

Entitlement to service connection for bilateral ankle disabilities is denied.

The Veteran has been diagnosed with bilateral ankle strain and bilateral knee strain, as well as left knee meniscal tear. See February 2025 VA Ankle Conditions DBQ; February 2025 VA Knee and Lower Leg Conditions DBQ. This is sufficient to show a current disability for a claim for service connection.

The Veteran presents the same theory of the case for his bilateral ankle and knee disabilities. He contends that "physical training exercises and the nature of his service that required wearing heavy gear and weapons, lifting and moving heavy items, marching and running in military boots all contributed to the wear and tear on his ankles while on active duty." See February 2025 VA Medical Opinion DBQs (two documents); see also August 2024 Statement in Support of Claim. However, the evidence of record persuasively weighs against a nexus between the Veteran's current disability and any in-service wear and tear on his knees and ankles.

The Veteran submitted an August 2024 document containing statements from various medical professionals, including one from T.M., a nurse practitioner. T.M. summarized medical literature in support of the Veteran's theory of his case for his knee claims. T.M.'s medical opinion states that "it is more likely than not that the intensity and frequency of physically demanding activities inherent in military service can lead to knee injuries, and that these injuries often go untreated and persist for years and even decades, resulting in chronic pain and knee strain disabilities." See August 2024 correspondence. However, neither T.M. nor any of the other medical professionals whose opinions are contained in the August 2024 document ever states an opinion regarding the Veteran's case specifically-indeed, none of them state whether they have treated the Veteran, reviewed his records, or even met him; they do not even state the Veteran's name. This evidence is persuasive that the Veteran's theory of the case is possible, but it provides no support for a finding that it happened in the Veteran's case specifically. Therefore, the Board affords it no probative weight.

Accompanying T.M.'s opinion was an unsigned request to "consider the medical [literature] evidence below that supports the relationship between ankle sprains/strains and active-duty military service." It is not clear whether the request came from T.M. or one of the other medical professionals whose opinions are contained within the August 2024 document. The Board affords it no probative weight for the same reasons as T.M.'s opinion.

The Veteran also submitted his own written statements, describing in-service injuries to his bilateral knees and ankles. He contends that he received treatment several times for his bilateral ankles and bilateral knees due to in-service injuries. See August 2024 VA Forms 21-4138 (four documents).

The Veteran's service treatment records do not show evidence of the treatment described in his August 2024 statements, although treatment for other medical conditions is shown. Nor were any knee or ankle musculoskeletal conditions noted at the Veteran's exit examination, or subsequent examinations during reserve service. See service treatment records dated October 29, 1980 (fungal infection located at left ankle, right knee); March 10, 1981 (stiffness, weakness, tenderness, abrasions of right hand after truck backed into it); July 16, 1982 (exit examination); June 25, 1983 (regular physical during reserve service).

VA obtained nexus opinions from a medical examiner in February 2025. The examiner noted the Veteran
's service treatment records do not show evidence of the treatment described in his August 2024 statements, although treatment for other medical conditions is shown. Nor were any knee or ankle musculoskeletal conditions noted at the Veteran's exit examination, or subsequent examinations during reserve service. See service treatment records dated October 29, 1980 (fungal infection located at left ankle, right knee); March 10, 1981 (stiffness, weakness, tenderness, abrasions of right hand after truck backed into it); July 16, 1982 (exit examination); June 25, 1983 (regular physical during reserve service).

VA obtained nexus opinions from a medical examiner in February 2025. The examiner noted the Veteran's theory of the case, specifically including his contention that he received treatment for his bilateral knee and ankle pain during active-duty service. The examiner noted further that the Veteran's service treatment records were silent regarding any such treatment. Between that discrepancy and the lack of any other evidence in support of a nexus, the examiner found it less likely than not that the Veteran's current disabilities are related to his military service. See February 2025 VA Medical Opinion DBQs (two documents).

The Board finds the February 2025 examiner's reasoning to be persuasive. The examiner did not merely cite the absence of corroborating service treatment records, but specifically noted that this absence contradicts the Veteran's account of his in-service medical treatment. While corroborating service treatment records are not strictly required for a claim for service connection, the absence of such evidence in this case is itself evidence against the Veteran's account. This conclusion is further supported by the presence of evidence showing treatment for an unrelated musculoskeletal complaint regarding the Veteran's right wrist, and the presence of evidence showing treatment for unrelated skin conditions located at the Veteran's knees and ankles.

Therefore, the Board finds that the evidence of record persuasively shows that there is no nexus between the Veteran's current disabilities and his military service.

Entitlement to service connection for prostate cancer is denied.

The Veteran was diagnosed with prostate cancer in 2019, and his condition continues to be under medical surveillance. See medical records dated February 29, 2024. This is sufficient to show a current disability for a claim for service connection. However, the record before the Board does not show that the Veteran has submitted any evidence or contentions regarding a nexus to military service.

The Board notes that under certain circumstances, Vietnam-era Veterans with prostate cancer are entitled to presumptive service connection. See, e.g., 38 C.F.R. § 3.309. While the Veteran's military service falls outside of the time period for presumptive service connection, the Board has considered whether the evidence of record raises the question of exposure to herbicides sufficiently to require VA to obtain a nexus opinion. However, The Board's review of the record shows no evidence clearly raising that possibility.

In the absence of any evidence or contentions regarding in-service injury or nexus thereto, entitlement to service connection for prostate cancer is denied.

Entitlement to service connection for dry eye syndrome is denied.

Entitlement to service connection for hypertension is denied.

Entitlement to service connection for obstructive sleep apnea is denied.

The Board's review of the record shows no evidence of a diagnosis for any of these disabilities. Further, other than the bare listing of these disabilities on his claim for benefits, the Board's review of the record shows no contentions from the Veteran regarding these disabilities or any symptoms clearly related to them. In the absence of any evidence of record showing that the Veteran suffers from these disabilities, entitlement to service connection is denied.

REASONS FOR REMAND

Entitlement to service connection for a lumbar spine disability is remanded.

A Veteran is entitled to a VA examination in connection with his claim when the record includes (1) competent evidence of a disability, (2) competent evidence of an event, injury, or disease in service, and (3) evidence that indicates that the claimed disability may be associated with the in-service event, injury or disease. See McLendon v. Nicholson, 20 Vet. App. 79 (2006).

The Veteran submitted an August 2024 statement describing an in-service lumbar injury, current lumbar symptoms, and describing a continuity of symptoms between the two points in time. While this evidence is not sufficient for VA to currently grant a claim for service connection for a lumbar spine disability, it is sufficient to require VA to provide an examination investigating the claim.

The RO failed to do so. This constitutes a pre-decisional duty to assist error; therefore, the claim must be remanded for correction of the error.

Entitlement to service connection for a skin condition, including but not limited to tinea pedis, is remanded.

The Veteran was diagnosed with a fungal infection of the skin during active-duty service. VA obtained an examination and
The Veteran submitted an August 2024 statement describing an in-service lumbar injury, current lumbar symptoms, and describing a continuity of symptoms between the two points in time. While this evidence is not sufficient for VA to currently grant a claim for service connection for a lumbar spine disability, it is sufficient to require VA to provide an examination investigating the claim.

The RO failed to do so. This constitutes a pre-decisional duty to assist error; therefore, the claim must be remanded for correction of the error.

Entitlement to service connection for a skin condition, including but not limited to tinea pedis, is remanded.

The Veteran was diagnosed with a fungal infection of the skin during active-duty service. VA obtained an examination and nexus opinion regarding his claim for service connection in March 2025. The examiner indicated that the Veteran did not have a current skin disability, describing current symptoms as "improved." However, the Veteran noted that his skin condition "emotionally affects" him. Further, the examiner provided a positive nexus opinion for lichen planus, and noted that while most patients experience spontaneous resolution within 1 to 2 years of onset, "recurrences are common, and residual skin hyperpigmentation often persists." See March 2025 VA Medical Opinion DBQ.

The March 2025 examiner's positive nexus opinion conflicts with his affirmative statement that he does not currently suffer from a skin condition. The RO's reliance on this contradictory opinion constitutes a pre-decisional duty to assist error. Therefore, the claim must be remanded for correction of the error.

The matters are REMANDED for the following action:

1. Schedule the Veteran for a VA examination for a lumbar spine disability. 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 the Veteran's lumbar spine disability at least as likely as not related to service?

Provide a rationale to support the opinion(s).

2. Schedule the Veteran for a VA examination for a skin disability. The examiner must review the claims file.

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

Has the Veteran suffered from any symptoms of a skin condition, to include recurrences or residuals from any past lichens planus infection, since August 2024 when he filed his claim?

If so, are these symptoms at least as likely as not related to his military service?

Provide a rationale to support the opinion(s).

B. D. WATSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Sparks, Robert S.

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.

Analyze in VA Law Explorer