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Case A26038863

JONATHAN B. KRAMER · 2026 · Case ID: A26038863

DENIED

Summary

The Veteran, an Army veteran who served from August 1974 to January 1986, appeals the denial of service connection for residuals of a concussion (claimed as a "knot on back of head"/hematoma) and a forehead scar, both allegedly incurred during an in-service motor vehicle accident in 1985. The Veteran also appealed the denial of service connection for a cardiovascular disability, claiming it was related to diesel fume exposure during service, and a vision disability, which was withdrawn. The Board found new and relevant evidence submitted post-decision, including the Veteran's testimony and representative's clarification, warranted readjudication for the concussion residuals and forehead scar. However, for both conditions, the Board found the evidence of record weighed against a current disability or symptoms. The Veteran missed scheduled VA examinations for these claims without good cause, and the Board found VA fulfilled its duty to assist. The cardiovascular claim was denied due to lack of in-service complaints, normal separation examination findings, no post-service treatment linking the condition to service, and no medical opinion supporting the claimed diesel fume exposure nexus. The vision disability claim was dismissed due to withdrawal. Service connection for all claimed conditions was denied.

Rationale

No current disability or symptoms of concussion residuals found.; No medical evidence of diagnosis or treatment for concussion residuals.; Veteran missed scheduled VA examinations without good cause.; Board found VA fulfilled duty to assist.; Evidence weighed against a current disability.

Service Branch
ARMY
Special Benefit
NO SPECIAL BENEFIT
Docket No.
231227-408993

Full Decision Text

Citation Nr: A26038863
Decision Date: 04/27/26	Archive Date: 04/27/26

DOCKET NO. 231227-408993
DATE: April 27, 2026

ORDER

The request to readjudicate the claim for service connection for residuals of a concussion, to include a hematoma, is granted.

The request to readjudicate the claim for service connection for a forehead scar is granted.

Entitlement to service connection for residuals of a concussion, to include a hematoma, is denied.

Entitlement to service connection for a forehead scar is denied.

Entitlement to service connection for a cardiovascular disability is denied.

Entitlement to service connection for a vision disability is dismissed.

FINDINGS OF FACT

1. New and relevant evidence was received during the relevant evidence window that tends to prove or disprove the claim for service connection for residuals of a concussion.

2. New and relevant evidence was received during the relevant evidence window that tends to prove or disprove the claim for service connection for a forehead scar.

3. The evidence of record persuasively weighs against finding that the Veteran has had a disability related to residuals of a concussion at any time during or approximate to the pendency of the claim.

4. The evidence of record persuasively weighs against finding that the Veteran has had a disability of a forehead scar at any time during or approximate to the pendency of the claim.

5. The Veteran's cardiovascular disability was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury or disease.

6. At the January 2026 hearing and in subsequent briefing, the Veteran requested to withdraw the appeal for entitlement to service connection for a vision disability.

CONCLUSIONS OF LAW

1. The criteria for readjudication of the claim of entitlement to service connection for residuals of a concussion, to include a hematoma, have been met. 38 U.S.C. §§ 5103A, 5108; 38 C.F.R. § 3.2501.

2. The criteria for readjudication of the claim of entitlement to service connection for a forehead scar have been met. 38 U.S.C. §§ 5103A, 5108; 38 C.F.R. § 3.2501.

3. The criteria for service connection for residuals of a concussion, to include a hematoma, are not met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for a forehead scar are not met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for service connection for a cardiovascular disability are not met.  38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

6. The criteria for dismissal of the appeal for entitlement to service connection for a vision disability have been met. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from August 1974 to January 1986.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2023 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

The Board notes that this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.800(c).

In June 2023, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of the claims for service connection for residuals of a concussion (claimed as "knot on back of head") and service connection for a forehead scar, most recently addressed in a November 2018 rating decision. In September 2023, the Veteran filed a new claim for service connection for a cardiovascular disability and a vision disability. In December 2023, the agency of original jurisdiction (AOJ) issued the supplemental claim decision on appeal addressing both the new and supplemental claims. With respect to the claims for service connection for residuals of a concussion and a forehead scar, the AOJ found that new and relevant evidence had not been received. 

Therefore, for those
-0995, Decision Review Request: Supplemental Claim, and requested readjudication of the claims for service connection for residuals of a concussion (claimed as "knot on back of head") and service connection for a forehead scar, most recently addressed in a November 2018 rating decision. In September 2023, the Veteran filed a new claim for service connection for a cardiovascular disability and a vision disability. In December 2023, the agency of original jurisdiction (AOJ) issued the supplemental claim decision on appeal addressing both the new and supplemental claims. With respect to the claims for service connection for residuals of a concussion and a forehead scar, the AOJ found that new and relevant evidence had not been received. 

Therefore, for those claims, the Board must determine whether new and relevant evidence has been received based only on the evidence of record at the time of the decision on appeal or during the applicable evidentiary window.

In the December 2023 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. The Veteran provided testimony at a January 2026 videoconference hearing before the undersigned Veterans Law Judge at the RO. A transcript of the hearing is associated with the claims folder. 

Therefore, the Board may only consider the evidence of record at the time of the December 2023 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or 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. 

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 request to readjudicate the claim for service connection for residuals of a concussion, to include a hematoma

The request to readjudicate the claim for service connection for a forehead scar

In its December 2023 decision, the AOJ found that new and relevant evidence had not been received regarding the issues of service connection for residuals of a concussion (claimed as "knot on back of head") and service connection for a forehead scar. Therefore, the Board must determine whether new and relevant evidence was before the AOJ at the time of the decision on appeal or received during the applicable evidentiary window.

VA regulations, applicable to the Veterans Appeals Improvement and Modernization Act (AMA) adjudications, provide that if new and relevant evidence is presented or secured with respect to a supplemental claim, the AOJ will readjudicate the claim taking into consideration all the evidence of record. 38 U.S.C. §§ 501, 5108; 38 C.F.R. § 3.156(d). If new and relevant evidence is not presented or secured, the agency of original jurisdiction will issue a decision finding that there was insufficient evidence to readjudicate the claim.

New evidence is evidence not previously part of the actual record before agency adjudicators. Relevant evidence is information that tends to prove or disprove a matter at issue in a claim. Relevant evidence includes evidence that raises a theory of entitlement that was not previously addressed. New and relevant evidence received before VA issues its decision on a supplemental claim will be considered as having been filed in connection with the claim. Id.

At the January 2026 hearing, the Veteran testified that he believed the claimed conditions were related to an in-service motor vehicle accident. In February 2026 post-hearing briefing, the Veteran's representative clarified that the "knot on back of head" was being claimed as a post-concussive hematoma related to the same in-service motor vehicle accident, which occurred in 1985. Additionally, the briefing clarified that the claimed forehead scar was related to an abrasion incurred during this same accident and documented in the service treatment records. The Veteran's representative also submitted an article discussing the most commonly incurred injuries related to motor vehicle accident, including post-concussion syndrome. 

This evidence, including the Veteran's January 2026 testimony, is new because it was not before the AOJ at the time of the prior rating decision. The evidence is relevant because it tends
 In February 2026 post-hearing briefing, the Veteran's representative clarified that the "knot on back of head" was being claimed as a post-concussive hematoma related to the same in-service motor vehicle accident, which occurred in 1985. Additionally, the briefing clarified that the claimed forehead scar was related to an abrasion incurred during this same accident and documented in the service treatment records. The Veteran's representative also submitted an article discussing the most commonly incurred injuries related to motor vehicle accident, including post-concussion syndrome. 

This evidence, including the Veteran's January 2026 testimony, is new because it was not before the AOJ at the time of the prior rating decision. The evidence is relevant because it tends to prove or disprove a matter at issue in a claim, specifically, whether a qualifying event, disease, or injury occurred during service and whether the claimed conditions are related to this event.  

Accordingly, the claims will be readjudicated.

Entitlement to service connection for residuals of a concussion, to include a hematoma

The Veteran seeks entitlement to service connection for residuals of a concussion. Specifically, the Veteran contends that he has a post-concussive hematoma related to an in-service motor vehicle accident. 

Service connection may be granted for any current disability that is the result of a disease contracted or an injury sustained in the line of duty during active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). 

Service connection on a direct basis generally requires evidence of three elements: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or nexus between the current disability and the disease or injury incurred or aggravated during active service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

Certain chronic diseases 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 a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease.  38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309.  Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

Presumptive service connection for the specified chronic diseases may alternatively be established by way of continuity of symptomatology under 38 C.F.R. § 3.303(b). However, the United States Court of Appeals for the Federal Circuit (Federal Circuit) has held that the theory of continuity of symptomatology can be used only in cases involving those conditions explicitly recognized as chronic in 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall resolve all reasonable doubt in favor of the claimant. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990); 38 C.F.R. § 3.102. This standard does not require the evidence to be exactly equal; rather, it includes "scenarios where the evidence is not in equipoise but nevertheless is in approximate balance. Put differently, if the positive and negative evidence is in approximate balance (which includes but is not limited to equipoise), the claimant receives the benefit of the doubt." Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

Turning to the evidence of record, the Veteran's service treatment records (STRs) contain a January 1984 enlistment examination. The Veteran denied any history of head injury, and his head was evaluated as normal. In January 1985, the STRs indicate that the Veteran was involved in a rollover motor vehicle accident, after which he primarily complained of neck pain. No headaches, neurological defects, or other symptoms of a head injury were noted. On a neurological examination, he was noted to be oriented to time, place, and circumstances. The following day, the Veteran attended a follow-up appointment and continued to complain of cervical and lumbar spine pain, but no complaints related to the head were noted. In December 1985, the Veteran underwent a separation examination
, the Veteran's service treatment records (STRs) contain a January 1984 enlistment examination. The Veteran denied any history of head injury, and his head was evaluated as normal. In January 1985, the STRs indicate that the Veteran was involved in a rollover motor vehicle accident, after which he primarily complained of neck pain. No headaches, neurological defects, or other symptoms of a head injury were noted. On a neurological examination, he was noted to be oriented to time, place, and circumstances. The following day, the Veteran attended a follow-up appointment and continued to complain of cervical and lumbar spine pain, but no complaints related to the head were noted. In December 1985, the Veteran underwent a separation examination. The Veteran denied any history of head injury, and his head was evaluated as normal. No "knots" or hematomas were noted on physical examination.

Post-service VA and private treatment records do not indicate any complaints or treatment for residuals of a concussion, including hematomas.

At the January 2026 hearing, the Veteran testified that he has several "knots" on his head, with the largest being at the back of his head. In February 2026 briefing, the Veteran's representative clarified that the claimed "knots" were most likely scalp hematomas and were post-concussive residuals of the January 1985 motor vehicle accident. 

The claims file contains no additional evidence regarding the claimed post-concussive residuals.

Having considered the above, the Board concludes that the Veteran does not have a current disability related to residuals of a concussion or symptoms of such 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 claims file contains no medical evidence of diagnosis or treatment for residuals of a concussion, including scalp hematomas. 

While the Veteran believes that he has scalp hematomas as residuals of a concussion, and that these alleged hematomas constitute a current disability, the Veteran is not competent to provide a diagnosis in this case. While the Veteran is competent to testify as to the existence of "knots" on his scalp, the actual rendering of a diagnosis requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). 

To that end, the Board notes that a VA examination is not of record that assesses the nature and etiology of the claimed psychiatric disability. The Board is cognizant of its duty to assist pursuant to McLendon v. Nicholson, 20 Vet. App. 79 (2006). However, in this case, the evidence of record indicates that the RO attempted to schedule the Veteran for a VA examination.

The record indicates that on October 18, 2023, the Veteran was scheduled for a November 27, 2023 VA examination in relation to this claim. On November 15, 2023, VA mailed the Veteran an appointment reminder, which was delivered November 16, 2023. On November 29, 2023, the scheduled appointment was determined to have been cancelled due to "no show." The record does not reflect any response by the Veteran challenging this determination. The Veteran has not asserted lack of notice or other cause for non-attendance. 

As the Court has held, "[t]he duty to assist in the development and adjudication of a claim is not a one-way street." Wamhoff v. Brown, 8 Vet. App. 517, 522 (1996). "If a [claimant] wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence." Wood v. Derwinski, 1 Vet. App. 190, 193 (1991).

VA regulations state that when entitlement to a benefit cannot be established or confirmed without a current VA examination and a claimant, without good cause, fails to report for such examination, an original compensation claim shall be rated based on the evidence of record. Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, death of an immediate family member, etc. 38 C.F.R. § 3.655(a)-(b).

Here, considering that the Veteran has failed to provide good cause to miss his examinations, the Board must find that the VA has sufficiently fulfilled its duty to assist the Veteran and decide the claim based on the evidence of record. 38 C.F.R. § 3.655(b
 regulations state that when entitlement to a benefit cannot be established or confirmed without a current VA examination and a claimant, without good cause, fails to report for such examination, an original compensation claim shall be rated based on the evidence of record. Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, death of an immediate family member, etc. 38 C.F.R. § 3.655(a)-(b).

Here, considering that the Veteran has failed to provide good cause to miss his examinations, the Board must find that the VA has sufficiently fulfilled its duty to assist the Veteran and decide the claim based on the evidence of record. 38 C.F.R. § 3.655(b).

Accordingly, the Board finds that the probative evidence of record is against finding that the Veteran has a current disability of residuals of a concussion, to include hematoma. Therefore, the Board concludes that service connection is not warranted, and the claim is denied.

In denying the claim, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the evidence persuasively weighs against the claim, that doctrine is not applicable. 38 U.S.C. § 5107; see Lynch, 21 F.4th at 781; 38 C.F.R. § 3.102.

Entitlement to service connection for a forehead scar

The Veteran seeks entitlement to service connection for a forehead scar. Specifically, the Veteran contends that he has a forehead scar related to an in-service motor vehicle accident. 

Turning to the evidence of record, the Veteran's service treatment records (STRs) contain a January 1984 enlistment examination. The Veteran denied any history of head injury, and his head and skin were evaluated as normal. In January 1985, the STRs indicate that the Veteran was involved in a rollover motor vehicle accident. Treatment records note a small abrasion. In December 1985, the Veteran underwent a separation examination. The Veteran denied any history of head injury, and his head and skin were evaluated as normal. No scars were noted on physical examination.

Post-service VA and private treatment records do not indicate a forehead scar.

At the January 2026 hearing and in February 2026 briefing, the Veteran testified as to the presence of a scar on his forehead. 

The claims file contains no additional evidence regarding the claimed forehead scar.

Having considered the above, the Board concludes that the Veteran does not have a current disability or symptoms of such 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 claims file contains no medical evidence of diagnosis or treatment of a forehead scar. 

While the Veteran contends that he has a scar on his forehead and that the presence of this scar constitutes a current disability, the Veteran is not competent to provide a diagnosis in this case. While the Veteran is competent to testify as to the appearance of a scar on his forehead, a finding of a current disability requires additional information regarding the nature of the alleged scar, which the Veteran does not have the specialized knowledge to provide. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). 

To that end, the Board notes that an adequate VA examination is not of record that assesses the nature and etiology of the claimed scar. The Board is cognizant of its duty to assist pursuant to McLendon v. Nicholson, 20 Vet. App. 79 (2006). However, in this case, the evidence of record indicates that the RO attempted to schedule the Veteran for a VA examination.

The record indicates that on October 18, 2023, the Veteran was scheduled for a November 27, 2023 VA examination in relation to this claim. On November 15, 2023, VA mailed the Veteran an appointment reminder, which was delivered November 16, 2023. On November 29, 2023, the scheduled appointment was determined to have been cancelled due to "no show." The record does not reflect any response by the Veteran challenging this determination. The Veteran has not asserted lack of notice or other cause for non-attendance. 

Here, considering that the Veteran has failed to provide good cause to miss his examinations, the Board must find that the VA has sufficiently fulfilled its duty to assist the Veteran and decide the claim based on the evidence of record. 38 C.F.R. § 3.655(b).

Accordingly, the Board finds that the probative evidence of record is against finding that the Veteran
 VA mailed the Veteran an appointment reminder, which was delivered November 16, 2023. On November 29, 2023, the scheduled appointment was determined to have been cancelled due to "no show." The record does not reflect any response by the Veteran challenging this determination. The Veteran has not asserted lack of notice or other cause for non-attendance. 

Here, considering that the Veteran has failed to provide good cause to miss his examinations, the Board must find that the VA has sufficiently fulfilled its duty to assist the Veteran and decide the claim based on the evidence of record. 38 C.F.R. § 3.655(b).

Accordingly, the Board finds that the probative evidence of record is against finding that the Veteran has a current disability of a forehead scar. Therefore, the Board concludes that service connection is not warranted, and the claim is denied.

In denying the claim, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the evidence persuasively weighs against the claim, that doctrine is not applicable. 38 U.S.C. § 5107; see Lynch, 21 F.4th at 781; 38 C.F.R. § 3.102.

Entitlement to service connection for cardiovascular disability

The Veteran seeks entitlement to service connection for a cardiovascular disability. Specifically, he contends that he has a current chronic cardiovascular disability related to exposure to diesel fumes during service. 

First, the Board will consider whether the Veteran is entitled to service connection on a direct basis. 

Turning to the evidence of record, the Veteran's service treatment records (STRs) contain a January 1984 enlistment examination. The Veteran denied any history of heart trouble, shortness of breath, pain or pressure in the chest, heart palpitations, or pounding heart, and his heart was evaluated as normal. STRs are silent for any complaints or treatment of cardiovascular symptoms during service. In December 1985, the Veteran underwent a separation examination. The Veteran denied any history of heart trouble, shortness of breath, pain or pressure in the chest, heart palpitations, or pounding heart, and his heart was evaluated as normal. The Veteran underwent a chest x-ray, which was negative for any abnormalities. The heart size, mediastinal contour, and pulmonary vessels were all noted to be normal. 

Post-service medical treatment records indicate that the Veteran underwent a cardiac catheterization and stent placement in June 2018, followed by a percutaneous cardiac intervention in July 2018 and a second cardiac catheterization in December 2021. In May 2024, he was diagnosed with coronary artery disease. 

An April 2023 VA Memorandum concluded that the Veteran did not participate in a toxic exposure risk activity (TERA). 

At the January 2026 hearing, the Veteran testified that during service, he worked in the motor pool and inhaled diesel fumes. He attributed his current cardiovascular disability to these exposures because he was not aware of any other possible causes. 

Based on the post-service medical treatment evidence of record, the Board finds that the Veteran has a current cardiovascular disability and that the first element of service connection is satisfied. 

However, having considered the above, the Board finds that the evidence of record persuasively weighs against finding that the Veteran's cardiovascular disability began during active service is etiologically related to an in-service injury or disease.

The STRs do not show any complaints of cardiovascular conditions or symptoms during service. At separation, the Veteran denied any history of relevant symptoms, and the associated chest x-ray indicated normal findings. The post-service treatment records do not demonstrate cardiovascular treatment until several decades after separation from service, and the Veteran's treating providers have not attributed the Veteran's current condition to his service. Additionally, although the Veteran contends that he was exposed to diesel fumes during service, the April 2023 TERA Memorandum did not indicate any exposures related to the Veteran's military occupational specialty (MOS). Moreover, even if the Veteran was exposed to diesel fumes in service, the claims file contains no medical opinions of record endorsing a nexus between the Veteran's coronary artery disease and the claimed exposures.

While the Veteran believes that his cardiovascular disability is related to in-service exposures because he is not aware of any potential alternative etiologies, as a layperson, the Veteran is not competent to provide an opinion regarding the etiology of his cardiovascular disability. The issue is medically complex, as it requires knowledge of the pathology of chronic cardiovascular disease, and the record does not show that the Veteran has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). 


 and the claimed exposures.

While the Veteran believes that his cardiovascular disability is related to in-service exposures because he is not aware of any potential alternative etiologies, as a layperson, the Veteran is not competent to provide an opinion regarding the etiology of his cardiovascular disability. The issue is medically complex, as it requires knowledge of the pathology of chronic cardiovascular disease, and the record does not show that the Veteran has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). 

To that end, the Board notes that an adequate VA examination is not of record that assesses the nature and etiology of the Veteran's cardiovascular disability. The Board is cognizant of its duty to assist pursuant to McLendon v. Nicholson, 20 Vet. App. 79 (2006). However, in this case, the evidence of record indicates that the RO attempted to schedule the Veteran for a VA examination.

The record indicates that on September 20, 2023, the Veteran was scheduled for an October 20, 2023 x-ray and VA examination in relation to this claim. On September 20, 2023, VA mailed the Veteran a Notification of Appointment. On November 1, 2023, the scheduled appointment was determined to have been cancelled due to "no show." The record does not reflect any response by the Veteran challenging this determination. The Veteran has not asserted lack of notice or other cause for non-attendance. 

Here, considering that the Veteran has failed to provide good cause to miss his examinations, the Board must find that the VA has sufficiently fulfilled its duty to assist the Veteran and decide the claim based on the evidence of record. 38 C.F.R. § 3.655(b).

Accordingly, the Board finds that the probative evidence of record is against finding that the Veteran's current cardiovascular disability is etiologically related to his service, as the claims file contains no medical evidence supporting such a relationship.

Therefore, entitlement to service connection on a direct basis is not warranted. 

Because cardiovascular-renal disease, including hypertension is an enumerated chronic condition under 38 C.F.R. § 3.309(a), the Board has also considered whether the Veteran is entitled to service connection on a presumptive basis. 

However, having considered the evidence of record, the Board finds that the Veteran's coronary artery disease (which is included in the definition of "cardiovascular-renal disease") did not manifest as chronic during service or within an applicable window, nor has the Veteran demonstrated continuity of symptomatology since service. 

Indeed, as discussed above, the STRs did not indicate cardiovascular symptoms during service, and the Veteran's chest x-ray was normal at separation. Treatment for cardiovascular symptoms is not documented until the cardiac catheterization and stent placement in June 2018, over twenty years after separation from service. 

Accordingly, the Board finds that the Veteran is not entitled to presumptive service connection pursuant to 38 C.F.R. § 3.309(a), as his cardiovascular disability did not have its onset within the applicable window nor demonstrate continuity of symptomatology. 

As the Veteran is not entitled to service connection on either a direct or presumptive basis, the claim for entitlement to service connection for a cardiovascular condition is denied.

In denying the claim, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the evidence persuasively weighs against the claim, that doctrine is not applicable. 38 U.S.C. § 5107; see Lynch, 21 F.4th at 781; 38 C.F.R. § 3.102.

Entitlement to service connection for a vision disability

At the January 2026 hearing, the Veteran testified that he wished to withdraw his separate claim for a vision disability. He stated that the claimed condition is a residual of his migraine headaches, for which he is seeking service connection in a separate appeal stream. 

In the February 2026 post-hearing brief, the Veteran's representative reiterated the request to withdraw the appeal for entitlement to service connection for a vision disability. 

An appeal may be withdrawn by the Veteran or representative at any time before the Board promulgates a decision. 38 C.F.R. § 20.205. Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. §19.55.

The Board finds that the Veteran has effectively withdrawn the appeal. Therefore, the issue of entitlement to service connection for a vision disability is dismissed. 

 

 

JONATHAN B. KRAMER

Veterans Law Judge

Board of Veterans' Appeals


 appeal stream. 

In the February 2026 post-hearing brief, the Veteran's representative reiterated the request to withdraw the appeal for entitlement to service connection for a vision disability. 

An appeal may be withdrawn by the Veteran or representative at any time before the Board promulgates a decision. 38 C.F.R. § 20.205. Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. §19.55.

The Board finds that the Veteran has effectively withdrawn the appeal. Therefore, the issue of entitlement to service connection for a vision disability is dismissed. 

 

 

JONATHAN B. KRAMER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Utter, Margaret M.

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. 

   

Denied, 2026: BVA Decision A26038863 | CaseScribe AI