ANEMIA

Summary

The Veteran served from February 2016 to October 2023. The Veteran appealed the denial of service connection for primary anemia and sought service connection for a traumatic deviated septum. The Board denied service connection for primary anemia, finding no current diagnosis of anemia in the Veteran's service treatment records, post-service medical records, or VA examinations. The Board noted the Veteran's blood count testing showed normal red blood cell levels, and the Veteran provided no evidence or argument supporting a service connection. The Board gave more weight to the medical evidence, concluding the Veteran did not have the claimed disorder. The claim for a traumatic deviated septum was remanded due to pre-decisional duty to assist errors. The VA examiner concluded the deviated septum was likely congenital but provided no rationale and did not review lay statements. The Board found this opinion inadequate and remanded the case for new examinations to determine the nature, extent, onset, and etiology of the deviated septum, including review of all submitted lay statements and provision of adequate reasons and bases for the opinions.

Rationale

No current diagnosis of anemia; Service treatment records silent for anemia; Post-service medical records silent for anemia; VA examinations show normal red blood cell counts; Veteran provided no evidence or argument for service connection

Full Decision Text

Citation Nr: A26038583
Decision Date: 04/24/26	Archive Date: 04/24/26

DOCKET NO. 250222-520165
DATE: April 24, 2026

ORDER

Entitlement to service connection for primary anemia is denied.

REMANDED

Entitlement to service connection for a traumatic deviated septum is remanded.

FINDING OF FACT

The Veteran does not have a diagnosis of primary anemia.

CONCLUSION OF LAW

The criteria for entitlement to service connection for primary anemia have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active-duty service from February 2016 to October 2023.

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

Therefore, the Board may only consider the evidence of record at the time of the February 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 claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

However, because the Board is remanding the Veteran's service connection claim for a traumatic deviated septum, 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

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

1. Entitlement to service connection for primary anemia

The Veteran seeks service connection for primary anemia which he generally argues is related to his active-duty service. After a review of the evidence of record, the Board finds that service connection cannot be granted. 

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

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

The Board notes that the Veteran's service treatment records do not contain any treatment for or symptoms related to anemia. However, this alone is not a bar to service connection. The Veteran for his part has not provided any evidence in support of his claim. 

The Veteran's post-service medical records are similarly silent for any mentions of anemia or a lack of hemoglobin (red blood cells). The July 2023 and January 2025 VA examinations reiterate the lack of a diagnosis finding that the Veteran's blood count testing shows a normal number of red blood cells, 13.3 g/dL in June 2023 and 14.8 g/dL in January 2025. Private testing from September 2024 shows levels at 13.7 g/dL. 

Given that the testing levels support the findings of the VA examiners of record, the Board concludes that the Veteran does not currently have the currently claimed disorder of anemia. Furthermore, as noted above, the Veteran's medical records are silent for any diagnosis or
 silent for any mentions of anemia or a lack of hemoglobin (red blood cells). The July 2023 and January 2025 VA examinations reiterate the lack of a diagnosis finding that the Veteran's blood count testing shows a normal number of red blood cells, 13.3 g/dL in June 2023 and 14.8 g/dL in January 2025. Private testing from September 2024 shows levels at 13.7 g/dL. 

Given that the testing levels support the findings of the VA examiners of record, the Board concludes that the Veteran does not currently have the currently claimed disorder of anemia. Furthermore, as noted above, the Veteran's medical records are silent for any diagnosis or treatment and he has provided no argument as to why the disorder is related to service. 

While the Veteran believes there is a current anemia disorder, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education.  Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. Accordingly, as the evidence does not support a finding of current disability, service connection is not warranted for a primary anemia.

REASONS FOR REMAND

1. Entitlement to service connection for a traumatic deviated septum is remanded.

The Veteran seeks service connection for a deviated septum. After a review of the evidence of record, the Board concludes that the claim must be remanded to correct pre-decisional duty to assist errors. 

At issue are the conclusions of the November 2024 examiner. The examiner concluded that the Veteran's deviated septum is likely congenital. However, they did not provide a rationale for this conclusion. Moreover, there is no indication that they reviewed the various lay statements submitted by the Veteran and fellow servicemembers. Thus, the Board finds this opinion and examination to be inadequate. The reliance on this inadequate opinion by the AOJ in the decisions issued represents a pre-decisional duty to assist error. 

The matters are REMANDED for the following action:

1. Schedule the Veteran for new examinations, with an appropriate clinician, to determine the nature, extent, onset, and etiology of his deviated septum. 

The complete claims file should be made available to the examiner(s).  The examiner(s) should provide opinions as to whether it is at least as likely as not that his deviated septum is etiologically related to the Veteran's period of service, or to another diagnosed disorder.  

All opinions must include a discussion of all submitted lay statements. 

All opinions should be accompanied by adequate reasons and bases. If the examiner(s) cannot provide the requested opinion without resorting to mere speculation, they should provide a complete explanation stating why this is so.

In so doing, the examiner(s) should explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that they have exhausted the limits of current medical knowledge in providing an answer to that particular question(s).

 

 

JIMMY L. BARDIN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Hernan, Quincy

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.