DIZZINESS

JENNIFER WHITE · 2026 · Case ID: A26039196

DENIED

Summary

The veteran, who served in the Army from July 1982 to August 1992, appeals the denial of service connection for blackouts and fainting spells, a bilateral foot condition, and rheumatoid arthritis. The Board found that no new and relevant evidence had been received to readjudicate the claims for blackouts/fainting spells and the bilateral foot condition. The Board determined that the prior RO finding of new and relevant evidence for these claims was clearly and unmistakably erroneous, citing that the submitted VA treatment records merely confirmed existing contentions of dizziness and fainting spells, and for the foot condition, confirmed contentions of painful arthritic foot issues without addressing the crucial nexus to service. The Board also denied service connection for rheumatoid arthritis, finding the evidence of record weighed persuasively against a diagnosis. The Board noted the absence of service treatment records but acknowledged the receipt of Reserve records and the heightened duty to assist. The VA examiner provided a negative nexus opinion for rheumatoid arthritis, stating it was less likely than not related to service and that the Veteran's extensive history of osteoarthritis accounted for his joint pain, with negative laboratory results for rheumatoid arthritis. The Board found the Veteran's lay statements outweighed by the competent medical evidence, particularly the VA examiner's opinion and negative laboratory results.

Rationale

No new and relevant evidence received; VA treatment records did not address nexus; RO finding of new and relevant evidence was clearly erroneous

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250730-570562

Full Decision Text

Citation Nr: A26039196
Decision Date: 04/27/26 Archive Date: 04/27/26

DOCKET NO. 250730-570562
DATE: April 27, 2026

ORDER

New and relevant evidence has not been received to readjudicate the claim for entitlement to service connection for blackouts and fainting spells.

New and relevant evidence has not been received to readjudicate the claim for entitlement to service connection for a bilateral foot condition.

Entitlement to service connection for rheumatoid arthritis is denied.

FINDINGS OF FACT

1. Entitlement to service connection for blackouts and fainting spells was denied in a March 2021 rating decision; since that time, new and relevant evidence has not been received to readjudicate the claim. The AOJ finding that new and relevant had been received was clear and unmistakable error.

2. Entitlement to service connection for a bilateral foot condition was denied in a March 2021 rating decision; since that time, new and relevant evidence has not been received to readjudicate the claim. The AOJ finding that new and relevant had been received was clear and unmistakable error.

3. The evidence of record weight persuasively against a finding that the Veteran has been diagnosed with rheumatoid arthritis.

CONCLUSIONS OF LAW

1. The criteria to readjudicate the claim for service connection for blackouts and fainting spells have not been met. 38 U.S.C. § 5108; 38 C.F.R. §§ 3.156, 3.2501, 20.1103.

2. The criteria to readjudicate the claim for service connection for a bilateral foot condition have not been met. 38 U.S.C. § 5108; 38 C.F.R. §§ 3.156, 3.2501, 20.1103.

3. The criteria for entitlement to service connection for rheumatoid arthritis have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran has confirmed service from July 1982 to August 1992 with additional periods of service in the Army Reserve indicated by the record.

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

In the July 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 May 2023 rating decision, which was subsequently subject to higher-level review, as well as any evidence submitted by the Veteran [or representative] 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 May 2023 rating decision, which was subsequently subject to higher-level review, 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.

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.

With regard to the rheumatoid arthritis disability, the Board acknowledges the AOJ's finding in the May 2023 rating decision that new and relevant evidence had been received. As this finding was not clearly and unmistakably erroneous, the Board will proceed to adjudication herein.

The Board notes that the AOJ requested the Veteran submit any relevant private treatment records or submit information with which VA can assist the Veteran in obtaining private treatment records. Required notice and information were provided in the claim form which the Veteran signed, certifying to the fact that such notice was received and further than they have included or identified relevant evidence. VA requested records for which the Veteran submitted a proper release and/or adequately identified. The duty to assist is not a one-way street. If
the rheumatoid arthritis disability, the Board acknowledges the AOJ's finding in the May 2023 rating decision that new and relevant evidence had been received. As this finding was not clearly and unmistakably erroneous, the Board will proceed to adjudication herein.

The Board notes that the AOJ requested the Veteran submit any relevant private treatment records or submit information with which VA can assist the Veteran in obtaining private treatment records. Required notice and information were provided in the claim form which the Veteran signed, certifying to the fact that such notice was received and further than they have included or identified relevant evidence. VA requested records for which the Veteran submitted a proper release and/or adequately identified. The duty to assist is not a one-way street. If a Veteran desires help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining evidence. Wood v. Derwinski, 1 Vet. App. 190 (1991). Thus, the Board finds that VA has satisfied the duty to assist. No further notice or assistance to the Veteran is required to fulfill VA's duty to assist in development. Smith v. Gober, 14 Vet. App. 227 (2000); Dela Cruz v. Principi, 15 Vet. App. 143 (2001); Quartuccio v. Principi, 16 Vet. App. 183 (2002).

The standard set forth in 38 C.F.R. § 3.103(c)(2)(iii) only permits constructive receipt of Veterans Health Administration (VHA) records that not only existed prior to the issuance of the AOJ decision on appeal, but also for which the claimant furnished sufficient information to make the Veterans Benefits Administration (VBA) aware of the existence of those records. Thus, the Board's consideration of VHA records is limited to the same. Here, the Board finds that VA treatment records were obtained and reviewed consistent with 38 C.F.R. § 3.103(c)(2)(iii) and the AMA framework.

New and Relevant Evidence

Except as otherwise provided, a claimant or his or her authorized representative who disagrees with a prior VA decision may file a supplemental claim, regardless of whether the claim is pending or has become finally adjudicated. 38 C.F.R. § 3.2501. If new and relevant evidence is presented or secured with respect to the supplemental claim, the agency of original jurisdiction (AOJ) will readjudicate the claim taking into consideration all of the evidence of record. 38 C.F.R. §§ 3.156 (d), 3.2501. New evidence is evidence not previously part of the actual record before agency adjudicators. 38 C.F.R. § 3.2501 (a)(1). Relevant evidence is information that tends to prove or disprove a matter at issue in a claim, including evidence that raises a theory of entitlement that was not previously addressed. Id.

The evidentiary record for a supplemental claim includes all evidence received by VA before VA issues notice of a decision on the supplemental claim. For VA to readjudicate the claim, the evidentiary record must include new and relevant evidence that was not of record as of the date of notice of the prior decision. 38 C.F.R. § 3.2501 (b). Upon receipt of a substantially complete supplemental claim, VA's duty to assist in the gathering of evidence is triggered and includes any such assistance that may help secure new and relevant evidence to complete the supplemental claim application. 38 C.F.R. § 3.2501(c).

The determination that new and relevant evidence has been received is a finding favorable to the claimant and is binding on the Board unless rebutted by evidence that identifies a clear and unmistakable error in the favorable finding. 38 C.F.R. §§ 3.104(c), 20.801(a).

Case law establishes that the "clear and unmistakable error" standard is a more demanding than the "clear and convincing evidence" standard required by Congress in 38 U.S.C. § 5104A. See Vanerson v. West, 12 Vet. App. 254, 258 (1999) (noting that the clear-and-unmistakable-evidence standard is more demanding than the clear-and-convincing-evidence standard, which in turn is higher than the preponderance-of-the-evidence standard). The Court of Appeals for Veterans Claims has held that the clear and unmistakable standard is an "onerous" and "very demanding" evidentiary standard, requiring that the evidence be "undebatable." See Cotant v. West, 17 Vet. App. 116, 131 (2003).

Unlike the regulations governing clear and unmistakable errors in prior final decisions (38 C.F.R. §§ 3
v. West, 12 Vet. App. 254, 258 (1999) (noting that the clear-and-unmistakable-evidence standard is more demanding than the clear-and-convincing-evidence standard, which in turn is higher than the preponderance-of-the-evidence standard). The Court of Appeals for Veterans Claims has held that the clear and unmistakable standard is an "onerous" and "very demanding" evidentiary standard, requiring that the evidence be "undebatable." See Cotant v. West, 17 Vet. App. 116, 131 (2003).

Unlike the regulations governing clear and unmistakable errors in prior final decisions (38 C.F.R. §§ 3.105, 20.1403), the favorable finding regulation does not explain what constitutes a clear and unmistakable error and what does not. As a result, the Board will look to the other regulations for guidance.

Section 3.105 states that a "clear and unmistakable error is a very specific and rare kind of error. It is the kind of error, of fact or of law, that when called to the attention of later reviewers compels the conclusion, to which reasonable minds could not differ, that the result would have been manifestly different but for the error. If it is not absolutely clear that a different result would have ensued, the error complained of cannot be clear and unmistakable." The Board will adopt this definition for its analysis.

1. New and relevant evidence has not been received to readjudicate the claim for entitlement to service connection for blackouts and fainting spells.

The claim for entitlement to service connection for blackouts and fainting spells was denied in a March 2021 rating decision, which was subsequently subject to higher-level review. A March 2022 higher-level review rating decision also denied the claim. The Veteran and his representative were notified of this decision and their appeal rights in a March 31, 2022 letter but did not initiate an appeal. Instead, they submitted a VA Form 20-0995 Supplemental Claim Application in March 2023 and requested readjudication of the claim based on new and relevant evidence.

In the May 2023 supplemental claim decision on appeal, which was subsequently subject to higher-level review, the RO found that new and relevant evidence had been received to readjudicate the claims of entitlement to service connection for blackouts and fainting spells.

When the Veteran's claim for entitlement to service connection for blackouts and fainting spells was last denied in March 2021, the record contained his reserve service treatment records, military personnel records, post-service VA treatment records, and lay statements. Based on this record, the RO made a favorable finding of dizziness and fainting; but denied the claim for entitlement to service connection for blackouts and fainting spells because there was no nexus showing the dizziness and fainting was related to the Veteran's military service.

In the May 2023 supplemental claim decision on appeal, which was subsequently subject to higher-level review, the RO found that new and relevant evidence had been secured apparently based on the Veteran's VA treatment records, received on February 6, 2023. For the reasons set forth below, the Board finds that these records are not relevant and the RO's finding that new and relevant evidence had been secured is clearly erroneous.

The supplemental claim decision did not state why the VA treatment records were new and relevant; however, the decision may have been governed by the Adjudication Manual, M21-1, Part X, Subpart ii, Chapter 2, Section C - Definition; New and Relevant.

In pertinent part, the adjudication manual states that new evidence that affirms findings previously deemed favorable to the claimant is still relevant. To illustrate this guidance, the M21-1 provides an example of a hypothetical veteran whose service connection claim for a back disability is denied based on a medical opinion finding that the current back disability is not related to an in-service injury. Following the denial, if VA medical center records show ongoing complaints of back pain, the adjudication manual instructs to readjudicate the claim because these treatment records are both new and relevant, despite relating only to a previously established fact.

Although the VA adjudication manual may be binding on those within VBA, the Board does not conclude that it is, or should be, binding on the Board. See DAV v. Sec'y of Veterans Affairs, 859 F.3d 1072, 1077 (Fed. Cir. 2017); see also Overton v. Wilkie, 30 Vet. App. 257 (2018).

First, the manual's provision is contrary to the regulation which defines relevant evidence as information that tends to prove or disprove a matter at issue in a claim. Returning to the manual's example, evidence which merely documents continued diagnosis and treatment of disease, without addressing the crucial matter of a nexus, does not tend to prove or disprove a matter at issue. In fact, the prior decision's favorable finding that the claimant had a current disability would be binding on future adjudicators. Thus, the existence of a disability is no longer "a matter at issue" and ongoing treatment records which further document this element are not relevant.

In Kisor v. McDonough, 995 F.3d 1316 (Fed. Cir. 2020) (Kisor IV), in applying the definition in the context of a different regulation, the Federal Circuit agreed with the Board that "in order to be 'relevant,' a record must speak to the issue that was dispositive against the Veteran." Conversely, evidence that does not tend to prove a fact of consequence to the claim is not relevant. In so holding, the Federal Circuit stated that this definition of relevant is consistent with the definition for that term in connection with "supplemental claims" under the modernized system. Id., Fn. 4. While the Federal Circuit in Kisor IV was addressing the definition of "relevant" as it pertains to § 3.156, the case provides guidance on how the word is used for supplemental claims.

Second, application of the manual's guidance renders the regulation's definition meaningless because some disabilities, by their very nature, require regular and reoccurring treatment. See, e.g., 38 C.F.R. § 4.119, Diagnostic Code 7913 (requiring twice a month visits to a diabetic care provider). For these disabilities, medical treatment records would always serve as a basis for readjudication, regardless of the content of the records, and the requirement that the records tend to prove or disprove a matter at issue would be superfluous. When the existence of a current disability has been already been established, it is clear that the regulations require more than duplicative evidence of this disability.

Requiring more than duplicative medical records to readjudicate a claim is not a higher evidentiary threshold than the previous new and material evidence standard. Under the legacy system, the United States Court of Appeals for the Federal Circuit held that evidence that is merely cumulative of other evidence in the record cannot be new and material. See Anglin v. West, 203 F. 3d 1343, 1347 (Fed. Cir. 2000). The Court of Appeals for Veterans Claims similarly held that medical evidence which merely documents continued diagnosis and treatment of disease, without addressing the crucial matter of a nexus, does not constitute new and material evidence. See Cornele v. Brown, 6 Vet. App. 59, 62 (1993).

The new and relevant evidence test is a lesser burden than the legacy system's new and material evidence requirement. Significantly, evidence that disproves a matter at issue will result in readjudication. C.f. Villalobos v. Principi, 3 Vet. App. 450 (1992) (evidence that is unfavorable to the appellant is not new and material). New theories of entitlement will also require that the claim be addressed on the merits. C.f. Boggs v. Peake, 520 F.3d 1330, 1336 (Fed. Cir. 2008) (new theory of causation for same disease or injury that was subject of previously denied claim cannot be basis of new claim). However, these lesser standards do not apply to this case.

Returning to the claim before the Board, the existence of a current disability is not at issue. As discussed above, the Veteran's claim for entitlement to service connection for blackouts and fainting spells was previously denied because there was no medical evidence showing the dizziness and fainting spells were related to the Veteran's military service. The newly received VA treatment records merely confirm evidence that was already in the record, i.e. a dizziness and fainting spells condition, and thus does not constitute new and relevant evidence. This information was previously in the file and considered by the RO in the previous decision. Thus, no records have been added which
denied claim cannot be basis of new claim). However, these lesser standards do not apply to this case.

Returning to the claim before the Board, the existence of a current disability is not at issue. As discussed above, the Veteran's claim for entitlement to service connection for blackouts and fainting spells was previously denied because there was no medical evidence showing the dizziness and fainting spells were related to the Veteran's military service. The newly received VA treatment records merely confirm evidence that was already in the record, i.e. a dizziness and fainting spells condition, and thus does not constitute new and relevant evidence. This information was previously in the file and considered by the RO in the previous decision. Thus, no records have been added which are relevant to the Veteran's claim for a dizziness and fainting spells condition.

The received evidence may be "new," in that it was not previously part of the actual record at the time of the prior final denial; however, the evidence is not "relevant" as it does not tend to prove or disprove a matter at issue in this appeal. The RO's finding that new and relevant evidence had been received or secured is clearly erroneous. In the absence of such evidence, readjudication of the claim for entitlement to service connection for blackouts and fainting spells is not warranted; and as a result, the claim is denied.

2. New and relevant evidence has not been received to readjudicate the claim for entitlement to service connection for a bilateral foot condition.

The claim of entitlement to service connection for a foot condition was denied in a March 2021 rating decision, which was subsequently subject to higher-level review. A March 2022 higher-level review rating decision also denied the claim. The Veteran and his representative were notified of this decision and their appeal rights in a March 31, 2022 letter but did not initiate an appeal. Instead, they submitted a VA Form 20-0995 Supplemental Claim Application in March 2023 and requested readjudication of the claim based on new and relevant evidence.

In the May 2023 supplemental claim decision on appeal, which was subsequently subject to higher-level review, the RO found that new and relevant evidence had been received to readjudicate the claim for entitlement to service connection for a foot condition.

When the Veteran's claim for entitlement to service connection for a foot condition was last denied in March 2021, the record contained his reserve service treatment records, military personnel records, post-service VA treatment records, and lay statements. Based on this record, the RO denied the claim for entitlement to service connection for a foot condition because, "[T]his condition neither occurred in nor was caused by service. The evidence does not show a current diagnosed disability."

In the May 2023 supplemental claim decision on appeal, which was subsequently subject to higher-level review, the RO found that new and relevant evidence had been secured apparently based on the Veteran's VA treatment records, received on February 6, 2023. For the reasons set forth below, the Board finds that these records are not relevant and the RO's findings that new and relevant evidence had been secured is clearly erroneous.

The rating decision did not state why the VA treatment records were new and relevant; however, the decision may have been governed by the Adjudication Manual, M21-1, Part X, Subpart ii, Chapter 2, Section C - Definition; New and Relevant.

In pertinent part, the adjudication manual states that new evidence that affirms findings previously deemed favorable to the claimant is still relevant. To illustrate this guidance, the M21-1 provides an example of a hypothetical Veteran whose service connection claim for a back disability is denied based on a medical opinion finding that the current back disability is not related to an in-service injury. Following the denial, if VA medical center records show ongoing complaints of back pain, the adjudication manual instructs to readjudicate the claim because these treatment records are both new and relevant, despite relating only to a previously established fact.

First, the manual's provision is contrary to the regulation which defines relevant evidence as information that tends to prove or disprove a matter at issue in a claim. Returning to the manual's example, evidence which merely documents continued diagnosis and treatment of disease, without addressing the crucial matter of a nexus, does not tend to prove or disprove a matter at issue. In fact, the prior decision's favorable finding that the claimant had a current disability would
, binding on the Board. See DAV v. Sec'y of Veterans Affairs, 859 F.3d 1072, 1077 (Fed. Cir. 2017); see also Overton v. Wilkie, 30 Vet. App. 257 (2018).

Second, application of the manual's guidance renders the regulation's definition meaningless because some disabilities, by their very nature, require regular and reoccurring treatment. See, e.g., 38 C.F.R. § 4.119, Diagnostic Code 7913 (requiring twice a month visits to a diabetic care provider.) For these disabilities, medical treatment records would always serve as a basis for readjudication, regardless of the content of the records, and the requirement that the records tend to prove or disprove a matter at issue would be superfluous. When the existence of a current disability has been already been established, it is clear that the regulations require more than duplicative evidence of this disability.

The newly received VA treatment records do not contain a diagnosis of a foot condition, and do not contain any medical evidence showing that the Veteran's claimed foot condition is related to the Veteran's military service. The newly received VA treatment records merely confirm evidence that was already in the record, i.e. contentions of a painful arthritic foot condition, and thus does not constitute new and relevant evidence. Similarly, the Board notes the Veteran's September 2021 lay statement also does not contain any relevant evidence to the Veteran's claim for a foot condition as it too merely contains contentions of a painful arthritic foot condition. This information was previously in the file and considered by the RO in the previous decision. Thus, no records have been added which are relevant to the Veteran's claim for a foot condition.

The received evidence may be "new," in
evidence showing that the Veteran's claimed foot condition is related to the Veteran's military service. The newly received VA treatment records merely confirm evidence that was already in the record, i.e. contentions of a painful arthritic foot condition, and thus does not constitute new and relevant evidence. Similarly, the Board notes the Veteran's September 2021 lay statement also does not contain any relevant evidence to the Veteran's claim for a foot condition as it too merely contains contentions of a painful arthritic foot condition. This information was previously in the file and considered by the RO in the previous decision. Thus, no records have been added which are relevant to the Veteran's claim for a foot condition.

The received evidence may be "new," in that it was not previously part of the actual record at the time of the prior final denial; however, the evidence is not "relevant" as it does not tend to prove or disprove a matter at issue in this appeal. The ROs finding that new and relevant evidence had been received or secured is clearly erroneous. In the absence of such evidence, readjudication of the claim for entitlement to service connection for a foot condition is not warranted; and as a result, the claim is denied.

3. Entitlement to service connection for rheumatoid arthritis is denied.

Legal Criteria?- Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Generally, to establish service connection for a disability resulting from a disease or injury incurred in service, there must be (1) competent evidence of the current existence of the disability for which service connection is being claimed; (2) competent evidence of incurrence of a disease or injury in active service; and (3) competent evidence of a nexus or connection between the current disability and the disease or injury incurred in service. Horn v. Shinseki, 25 Vet. App. 231, 236 (2010); Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); cf. Gutierrez v. Principi, 19 Vet. App. 1, 5 (2004) (citing Hickson v. West, 12 Vet. App. 247, 253 (1999)).

Competency, however, must be distinguished from weight and credibility. The former is a legal concept determining whether testimony may be heard and considered by the trier of fact, while the latter is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. See Layno v. Brown, 6 Vet. App. 465, 469 (1994).

VA shall consider all information and lay and medical evidence of record in a case and when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (benefit-of-the-doubt rule not for application when evidence persuasively favors one side or the other).

In this case, the Veteran's service treatment records (STRs) for his active duty service from July 1982 to August 1992 are missing from the record; however, Reserve records have been received. A March 2021 Rating Decision informed him that his STRs were missing and that efforts to obtain his compete STRs from all potential sources were unsuccessful. See 38 C.F.R. § 3.159(c)(2). As such, the Board acknowledges there is a heightened obligation for VA to assist in the development of his claim and to provide reasons or bases for any adverse decision rendered without these records. See O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). However, this heightened obligation does not establish a heightened "benefit of the doubt" or lower the legal standard for proving a claim of service connection. Russo v. Brown, 9 Vet. App. 46 (1996).

Factual Background?

In his November 2019 VA 21-526 EZ, Fully Developed Claim form, the Veteran states that rheumatoid arthritis is related to his Airborne service to include serving in the infantry and as a Sapper combat engineer. The Veteran submitted a November 2019 statement in support of his claim in which he stated his body reminds him every day of the physical demands placed on his body during service which is evidenced by current symptoms like joints locking up, stiffness, and crackling sounds during movement.

The Veteran submitted
establish a heightened "benefit of the doubt" or lower the legal standard for proving a claim of service connection. Russo v. Brown, 9 Vet. App. 46 (1996).

Factual Background?

The Veteran submitted another statement in support of his claim in September 2021 in which he again stated his arthritis issues are due to the taxing physical requirements he maintained in order to perform his duties during service.

December 2021 VA treatment records indicate the Veteran's Rheumatoid Factor Quantity was within the normal reference range.

The Veteran was afforded a VA examination in December 2021 for non-degenerative arthritis (including inflammatory, autoimmune, crystalline and infectious) and decompression illness. The examiner reviewed the Veteran's records and examined the Veteran in-person. The Veteran reported painful joints that lock. The examiner provided a negative nexus opinion for the Veteran's claim for rheumatoid arthritis, opining that the claimed condition was less likely than not (likelihood is less than approximately balanced or nearly equal) incurred in or caused by the claimed inservice injury, event, or illness. The examiner explained that the Veteran has no diagnosis of rheumatoid arthritis and no history of symptoms, complaints, laboratory results, or treatment of rheumatoid arthritis. As further rationale, the examiner stated, "The Veteran has an extensive history of osteoarthritis which is service connected. The extensive history of osteoarthritis accounts for the Veteran's joint pain."

March 2022 VA treatment records indicate the Veteran attended a rheumatology consult. The March 2022 VA treatment records further indicate the laboratory results for the "rheum work up" were negative.

Analysis

Regarding the claim for rheumatoid arthritis, the evidence of record is weighted persuasively against a finding that the Veteran had a diagnosis of rheumatoid arthritis. Accordingly, service connection for rheumatoid arthritis must be denied at this time based on the evidence of record. See 38 C.F.R. §§ 3.303, 3.304; Brammer v. Derwinski, 3 Vet. App. 223 (1995).

The Board has considered the Veteran's lay statements; however, he has not been shown to have the experience, training, or education necessary to diagnose rheumatoid arthritis due to the fact that the complexity of non-degenerative arthritis disabilities like rheumatoid arthritis, and its possible relation to service, are complex medical questions that require specialized training and expertise. Jandreau v. Nicholson, 492 F.3d 1372, 1376-6-77 n. 4 (Fed. Cir. 2007) (explaining that a claimant may be competent to provide diagnoses of simple conditions such as a broken leg but they are not competent to provide evidence on more complex medical questions beyond simple observations).

Overall, the Board finds that the Veteran's contentions and the lay statements are outweighed by the competent and probative medical evidence of record to include the December 2021 VA medical opinion which specifically opined that the Veteran does not have a diagnosis of rheumatoid arthritis and no history of symptoms, complaints, laboratory results, or treatment of rheumatoid arthritis; and, that the Veteran's extensive history of osteoarthritis accounts for the Veteran's joint pain. See King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). Moreover, March 2022 VA treatment records indicate negative rheumatoid arthritis laboratory results. The Board notes in this regard that the Veteran is already service connected for a thoracolumbar spine disability, a left knee disability, a left shoulder strain, a right shoulder strain, and a right knee disability.

Based on the foregoing, the Board finds the evidence of record weighs persuasively against a finding that the Veteran has a rheumatoid arthritis disability related to service. Thus, this claim must be denied. Because the evidence is not in approximate balance or "nearly equal" for and against the claim, the benefit of the doubt doctrine is not for application. Lynch v. McDonough, 21 F.4th 776, 781-82 (2021).

Jennifer White

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Prevost, K.

The Board's decision in this case is

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