Case A26038614

Summary

The Veteran served in the United States Marine Corps from February 1984 to October 1993, receiving an Honorable discharge due to hardship. The Veteran appealed the denial of service connection for hypothyroidism, Reiter's disease, dyslipidemia, gastroesophageal reflux disease (GERD), diabetes mellitus type II, and osteoarthrosis. The Veteran contended that these conditions were caused by toxic exposures during service. The Board denied all claims, finding that the threshold requirement of a current, diagnosed disability was not met for any of the conditions. The medical evidence of record did not include complaints or diagnoses contemporaneous to the appeal period for hypothyroidism, Reiter's disease, dyslipidemia, or GERD. Similarly, for diabetes mellitus type II, the record lacked evidence of current diagnosis, chronicity in service, manifestation within the presumptive period, or continuity of symptomatology. For osteoarthrosis, the Board found no current diagnosis or evidence of functional impairment of earning capacity due to pain. The Board noted that while the Veteran is competent to report symptoms, she cannot provide competent medical evidence establishing a diagnosis. The duty to assist was not triggered as the initial requirement of competent medical evidence of a current disability was not met, even under the PACT Act's provisions for toxic exposure risk activities. The Board also clarified that any evidence submitted after the hearing or more than 90 days following it would not be considered, and advised the Veteran to file a Supplemental Claim for any such evidence.

Rationale

No current diagnosis of hypothyroidism; No persistent or recurrent symptoms; Veteran competent to report symptoms, not diagnose

Full Decision Text

Citation Nr: A26038614
Decision Date: 04/24/26	Archive Date: 04/24/26

DOCKET NO. 210819-181238
DATE: April 24, 2026

ORDER

Entitlement to service connection for hypothyroidism is denied.

Entitlement to service connection for Reiter's disease is denied.

Entitlement to service connection for dyslipidemia is denied.

Entitlement to service connection for gastroesophageal reflux disease (GERD) is denied.

Entitlement to service connection for diabetes mellitus, type II, is denied.

Entitlement to service connection for osteoarthrosis is denied.

FINDINGS OF FACT

1. The medical evidence of record does not reflect a current diagnosis of hypothyroidism during or contemporaneous to the appeal period.

2. The medical evidence of record does not reflect a current diagnosis of Reiter's disease during or contemporaneous to the appeal period.

3. The medical evidence of record does not reflect a current diagnosis of dyslipidemia during or contemporaneous to the appeal period.

4. The medical evidence of record does not reflect a current diagnosis of GERD during or contemporaneous to the appeal period.

5. The medical evidence of record does not reflect a current diagnosis of diabetes mellitus, type II, during or contemporaneous to the appeal period or chronicity of diabetes mellitus, type II, in service, manifestation of diabetes mellitus type II, within one year of separation from the service, or continuity of symptomatology attributable to diabetes mellitus, type II, since service.

6. The medical evidence of record does not reflect a current diagnosis of a disability to account for osteoarthrosis, nor does the record demonstrate functional impairment of earning capacity due to pain associated with osteoarthrosis.  

CONCLUSIONS OF LAW

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

2. The criteria for entitlement to service connection for Reiter's disease have not been met. 38?U.S.C. §§?1110, 1131, 5107; 38?C.F.R. §§?3.102, 3.303. 

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

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

5. The criteria for entitlement to service connection for diabetes mellitus, type II, have not been met. 38?U.S.C. §§?1110, 1131, 5107; 38?C.F.R. §§?3.102, 3.303. 

6. The criteria for entitlement to service connection for osteoarthrosis have not been 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 Marine Corps from February 1984 to October 1993, at which time she received an Honorable discharge due to hardship. 

This matter comes before the?Board of Veterans' Appeals?(Board) on appeal from an April 2021 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) of the Veterans Benefits Administration, which is the agency of original jurisdiction (AOJ).

In the August 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on March 18, 2025. A copy of the hearing transcript is associated with the claims file. 

Therefore, the Board may only consider the evidence of record at the time of the AOJ's April 2021 decision on appeal, as well as any evidence submitted by the Veteran or her representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the
 Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on March 18, 2025. A copy of the hearing transcript is associated with the claims file. 

Therefore, the Board may only consider the evidence of record at the time of the AOJ's April 2021 decision on appeal, as well as any evidence submitted by the Veteran or her representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. 

The Board notes that at the March 2025 hearing, the Veteran's representative indicated that additional evidence would be submitted within 90 days of the hearing. The claims file does not reflect that any evidence was received within 90 days of the March 18, 2025, Board hearing. 

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.

1. Entitlement to service connection for hypothyroidism

2. Entitlement to service connection for Reiter's disease

3. Entitlement to service connection for dyslipidemia

4. Entitlement to service connection for GERD

The Veteran contends that her hypothyroidism, Reiter's disease, dyslipidemia, and GERD were caused by toxic exposures during her service. 

Generally, in order to prove service connection, a Veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called "nexus" requirement.  See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

The threshold requirement for any theory of service connection is a currently diagnosed disability during or contemporaneous to the appeal period, even if such existed and subsequently resolved. Boyer v. West, 210 F.3d at 1353; Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013)

The medical evidence of record does not include complaints or diagnosis of hypothyroidism, Reiter's disease, dyslipidemia, or GERD during or contemporaneous to the appeal period.

The Board notes that the Veteran is competent to report symptoms that she experiences on a first-hand basis. See Jandreau v. Nicholson, 492 F.3D. 1372, 1377 (Fed. Cir. 2007). However, the Board finds the question of the exact diagnosis of hypothyroidism, Reiter's disease, dyslipidemia, and GERD to be complex in nature. Woehlaert v. Nicholson, 21?Vet. App.?456, 462 (2007). Therefore, while the Veteran is competent to describe her symptoms, she cannot, as a layperson, provide competent medical evidence establishing a diagnosis of hypothyroidism, Reiter's disease, dyslipidemia, or GERD.

Although the Veteran has not been afforded an examination in conjunction with these appealed issues, the Board finds that the duty to assist was not triggered in this regard.  A medical examination or opinion is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but: (1) contains competent evidence of a current diagnosed disability or persistent or recurrent symptoms of a disability; (2) establishes that an event, injury, or disease occurred in service or certain diseases manifested during an applicable presumptive period for which the claimant qualifies; and (3) indicates that the disability or symptoms may be associated with the established event, injury, or disease in service or with another service-connected disability. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 C
, the Board finds that the duty to assist was not triggered in this regard.  A medical examination or opinion is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but: (1) contains competent evidence of a current diagnosed disability or persistent or recurrent symptoms of a disability; (2) establishes that an event, injury, or disease occurred in service or certain diseases manifested during an applicable presumptive period for which the claimant qualifies; and (3) indicates that the disability or symptoms may be associated with the established event, injury, or disease in service or with another service-connected disability. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 C.F.R. § 3.159(c)(4).  Here, the first prong of the McLendon criteria have not been met. There is no competent evidence of a current diagnosis of hypothyroidism, Reiter's disease, dyslipidemia, and GERD, nor persistent or recurrent symptoms of these disabilities.

In August 2022, the President signed into law the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxins Act of 2022,?Pub. L. No. 117-168,?136 Stat. 1759?(2022) (commonly known as the "Honoring Our PACT Act of 2022" or "PACT Act"). In pertinent part, the Act established a lower threshold to obtain examinations or medical opinions under VA's duty to assist for veterans with presumed toxic exposures or who participated in toxic exposure risk activities (TERA) in service.?38 U.S.C. § 1168. 

The PACT Act provides that VA is required to obtain a medical opinion where (1) the Veteran has evidence of a disability, (2) there is evidence of participation in a TERA, and (3) the evidence is not sufficient to establish service connection for the disability. 38 U.S.C. § 1168(a). 

Under the PACT Act, the first requirement for a TERA opinion is evidence of a disability. As discussed above, there is no competent medical evidence of hypothyroidism, Reiter's disease, dyslipidemia, or GERD. The duty to provide a TERA opinion is also not triggered with regard to these claims. 

Because the medical evidence of record does not reflect a current diagnosis of hypothyroidism, Reiter's disease, dyslipidemia, or GERD during or contemporaneous to the appeal period, service connection for these disabilities is denied. 

5. Entitlement to service connection for diabetes mellitus, type II

The Veteran contends that her diabetes mellitus, type II, were caused by toxic exposures during her active duty. 

As noted above, the threshold consideration in a claim for service connection is evidence of a current disability.  

Certain chronic diseases, including diabetes mellitus, will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within the presumptive period of one year following separation from service; or, if they were not shown as chronic in service (or within the applicable presumptive period) then service connection can be supported with a showing continuity of symptomatology since service attributable to the chronic disease. 38 U.S.C. §§ 1112, 1113, 1137; 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

Here, the medical evidence of record does not reflect a current diagnosis of diabetes mellitus, type II, during or contemporaneous to the appeal period. The medical evidence of record also does not show chronicity of diabetes mellitus, type II, in service, manifestation of diabetes mellitus type II within one year of separation from the service, or continuity of symptomatology attributable to diabetes mellitus, type II, since service.

The Board notes that the Veteran is competent to report her symptoms. See Jandreau v. Nicholson, 492 F.3D. 1372, 1377 (Fed. Cir. 2007). However, the Board finds the question of the exact diagnosis of diabetes mellitus type II to be complex in nature. Woehlaert v. Nicholson, 21?Vet. App.?456, 462 (2007). Therefore, while the Veteran is competent to describe her symptoms, she cannot, as a layperson, provide competent medical evidence establishing a diagnosis of diabetes mellitus type II.

Although the Veteran has not been afforded an examination in conjunction with her claim, the Board finds that the duty to assist was not triggered
 Board notes that the Veteran is competent to report her symptoms. See Jandreau v. Nicholson, 492 F.3D. 1372, 1377 (Fed. Cir. 2007). However, the Board finds the question of the exact diagnosis of diabetes mellitus type II to be complex in nature. Woehlaert v. Nicholson, 21?Vet. App.?456, 462 (2007). Therefore, while the Veteran is competent to describe her symptoms, she cannot, as a layperson, provide competent medical evidence establishing a diagnosis of diabetes mellitus type II.

Although the Veteran has not been afforded an examination in conjunction with her claim, the Board finds that the duty to assist was not triggered in this regard.  The first prong of both the McLendon criteria and the PACT Act's TERA opinion criteria, described above, have not been met. There is neither competent evidence of a current diagnosed disability nor persistent or recurrent symptoms of a disability during or contemporaneous to the appeal period.

Because the medical evidence of record does not reflect a current diagnosis of diabetes mellitus, type II, during or contemporaneous to the appeal period or chronicity of diabetes mellitus, type II, in service, manifestations of diabetes mellitus, type II, within one year of separation from the service, or continuity of symptomatology attributable to diabetes mellitus, type II, since service, service connection is denied. 

6. Entitlement to service connection for osteoarthrosis

The Veteran contends that her osteoarthritis was caused by toxic exposures during her active duty

As noted above, the threshold consideration in a claim for service connection is evidence of a current disability. Typically, that requires a diagnosis of a disability established in medical records. However, pain or other symptoms without a diagnosis may establish a disability if they result in functional impairment of earning capacity. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). Such functional impairment means to "diminish the body's ability to function," and "VA must undertake an individualized assessment, which includes a preliminary evaluation of the degree of impairment" of earning capacity. Wait v. Wilkie, 33 Vet. App. 8, 15 (2020).

The medical evidence of record does not include complaints related to or diagnosis of osteoarthritis. There are no other statements of record describing the Veteran's pain or how it affects her ability to function. Therefore, the Board finds that there is no disability for which service connection may be granted. The claim must be denied. 

The Board notes that the Veteran is competent to report her symptoms. See Jandreau v. Nicholson, 492 F.3D. 1372, 1377 (Fed. Cir. 2007). However, the Board finds the question of the exact diagnosis of osteoarthritis to be complex in nature. Woehlaert v. Nicholson, 21?Vet. App.?456, 462 (2007). Therefore, while the Veteran is competent to describe her symptoms, she cannot, as a layperson, provide competent medical evidence establishing a diagnosis of osteoarthritis.

Although the Veteran has not been afforded an examination in conjunction with her claim, the Board finds that the duty to assist was not triggered in this regard.  The first prong of both the McLendon criteria and the PACT Act's TERA opinion criteria, described above, have not been met. There is no competent evidence of a current diagnosed disability, nor persistent or recurrent symptoms of a disability.

 

 

Scott W. Dale

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Gibbons, Douglas K.

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.