TINNITUS

DANETTE MINCEY · 2026 · Case ID: A26039228

MIXED

Summary

The veteran, who served in the Louisiana Army National Guard via ACDUTRA from August to November 1981 as a Cannon Crewmember, appeals the denial of service connection for tinnitus, a lower back condition, and bilateral radiculopathy (claimed as sciatica). The Board denied service connection for tinnitus, finding the evidence persuasively weighed against a service connection. The VA examiner opined the tinnitus was less likely than not caused by military noise exposure, citing a later onset than service. The veteran testified to an earlier onset during service, but this was deemed inconsistent with the VA exam and afforded no probative weight. The Board also denied service connection for the lower back condition, noting the lack of a current diagnosis in the claims file, though the veteran's testimony about functional impairment was acknowledged. However, the Board found it lacked the authority to develop this claim further as it was not raised prior to the May 2021 rating decision. The claims for bilateral radiculopathy were denied due to the absence of a current diagnosis and insufficient lay testimony to establish a disability. The Board remanded the claim for bilateral hearing loss, finding the VA examination inadequate because the examiner failed to provide a supported analysis for the opinion that the hearing loss was less likely than not related to noise exposure, despite conceding hazardous noise exposure and the well-documented link between noise and hearing loss.

Rationale

Service treatment records silent to tinnitus complaints; VA examiner opined less likely than not related to noise exposure; Veteran's testimony inconsistent with VA exam regarding onset

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210524-161455

Full Decision Text

Citation Nr: A26039228
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 210524-161455
DATE: April 28, 2026

ORDER

Entitlement to service connection for tinnitus is denied.

Entitlement to service connection for lower back condition (claimed as lower back injury) is denied.

Entitlement to service connection for radiculopathy, right lower extremity, as secondary to lower back condition (claimed as sciatica and radiculopathy, right lower extremity secondary to lower back), is denied.

Entitlement to service connection for radiculopathy, left lower extremity, as secondary to lower back condition (claimed as sciatica and radiculopathy, left lower extremity secondary to lower back), is denied.

REMANDED

Entitlement to service connection for sensorineural hearing loss, bilateral (claimed as bilateral hearing loss) is remanded.

FINDINGS OF FACT

1. Evidence weighs against finding that the Appellant's tinnitus is related to his service.

2. Evidence weighs against finding that the Appellant's lower back pain is related to his service.

3. The Appellant does not have a current diagnosis of radiculopathy, right lower extremity.

4. The Appellant does not have a current diagnosis of radiculopathy, left lower extremity.

CONCLUSIONS OF LAW

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

2. The criteria for service connection for lower back condition are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for radiculopathy, right lower extremity, are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. The criteria for service connection for radiculopathy, left lower extremity, are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Appellant served on active duty for training (ACDUTRA) in the Louisiana Army National Guard from August 1981 to November 1981.

The Appeals Modernization Act (AMA) automatically applies to all claims for which VA issues notice of an initial decision on or after February 19, 2019. See 38 C.F.R. § 3.2400(a)(1). The rating decision on appeal was issued in May 2021 and constitutes an initial decision; therefore, the modernized review system, also known as the AMA, applies.

In the May 25, 2021VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Appellant timely appealed the May 2021 rating decision and elected the Hearing docket. A Board hearing was held on February 20, 2025, and a transcript of the hearing is of record.

Therefore, the Board may only consider the evidence of record at the time of the May 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Appellant 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 Appellant would like VA to consider any evidence that was submitted that the Board could not consider, the Appellant may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

However, because the Board is remanding the claim of entitlement to service connection for bilateral hearing loss, any evidence the Board could not consider will be considered
20.302(a), 20.801.

However, because the Board is remanding the claim of entitlement to service connection for bilateral hearing loss, any evidence the Board could not consider will be considered by the AOJ in the adjudication of the claim. 38 C.F.R. § 3.103(c)(2)(ii).

In May 2021, the Board notified the Appellant that the appeal has been placed on the Hearing docket. Thus, the appeal is properly before the Board, and this decision follows.

Service Connection

In general, service connection may be granted for a disability or injury incurred in or aggravated by active military service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) an in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. See Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be established by credible lay evidence and medical evidence provided by the veteran or otherwise. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303.

A veteran for VA disability purposes is a person who served in the active military, naval, or air service and who was discharged or released under conditions other "than dishonorable." 38 C.F.R. § 3.1(d). The term "active military, naval, or air service" includes: (1) active duty; (2) any period of ACDUTRA during which the individual concerned was disabled or died from a disease or injury incurred or aggravated in the line of duty; and (3) any period of inactive duty for training (INACDUTRA) during which the individual concerned was disabled or died from an injury incurred or aggravated in the line of duty. 38 U.S.C. § 101(24); 38 C.F.R. § 3.6(a). ACDUTRA includes full-time duty performed by members of the National Guard of any State or the Reserve. 38 C.F.R. § 3.6(c). INACDUTRA includes duty other than full-time duty performed by a member of the Reserve or the National Guard of any State. 38 C.F.R. § 3.6(d).

When a claim for service connection is based only on a period of ACDUTRA, there must be evidence that the appellant became disabled as a result of a disease or injury incurred or aggravated in the line of duty during that period of ACDUTRA. 38 U.S.C. §§ 101 (2), (22), (24); 38 C.F.R. § 3.6 (a); Donnellan v. Shinseki, 24 Vet. App. 167, 172 (2010); Acciola v. Peake, 22 Vet. App. 320, 324 (2008) (citing Mercado-Martinez v. West, 11 Vet. App. 415, 419 (1998); Paulson v. Brown, 7 Vet. App. 466, 470 (1995)). In the absence of such evidence, the period of ACDUTRA would not qualify as "active military, naval, or air service," and the appellant would not qualify as a "veteran" for that period of ACDUTRA or INACDUTRA service alone. 38 U.S.C. § 101 (2), (24); see Acciola, 22 Vet. App. at 324.

Generally, no presumptions (including the presumptions of soundness or aggravation) attach to periods of ACDUTRA unless "veteran" status is attained during those periods. Paulson v. Brown, 7 Vet. App. 466
466, 470 (1995)). In the absence of such evidence, the period of ACDUTRA would not qualify as "active military, naval, or air service," and the appellant would not qualify as a "veteran" for that period of ACDUTRA or INACDUTRA service alone. 38 U.S.C. § 101 (2), (24); see Acciola, 22 Vet. App. at 324.

Generally, no presumptions (including the presumptions of soundness or aggravation) attach to periods of ACDUTRA unless "veteran" status is attained during those periods. Paulson v. Brown, 7 Vet. App. 466, 470 (1995). As to the presumption of soundness, it does not apply to a claimant who had only ACDUTRA service and who is not otherwise a veteran. Id.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Under the AMA, any favorable finding made by AOJ is binding on the Board unless it can be rebutted. 38 C.F.R. § 3.104(c).

The Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material favorable to the claimant. Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination about the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994).

When considering whether lay evidence is competent, the Board must determine, on a case-by-case basis, whether a veteran's disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). A veteran is competent to report symptoms because this requires only personal knowledge, not medical expertise, as it comes to him through his senses. See Layno, 6 Vet. App. 465, 469. Lay testimony is competent to establish the presence of observable symptomatology, where the determination is not medical in nature and is capable of lay observation. Barr v. Nicholson, 21 Vet. App. 303 (2007). Lay evidence may establish a diagnosis of a simple medical condition, a contemporaneous medical diagnosis, or symptoms that later support a diagnosis by a medical professional. Jandreau, 492 F.3d 1372.

Entitlement to service connection for tinnitus is denied.

The Appellant claims entitlement to service connection for tinnitus. Specifically, the Appellant asserts that ringing in his ears started around 1982 due to exposure to firing of guns during his ACDUTRA.

At the outset, the Board finds that the Appellant has not achieved 'veteran' status for the purposes of his claim. Aside from the Appellant's assertions, the record does not support that the Appellant had a disability for a disease or injury incurred or aggravated in the line of duty.

The AOJ, in its May 2021 rating decision, found that the Appellant had been diagnosed with a disability and that noise exposure was conceded based on the Appellant's military occupational specialty (MOS) of Cannon Crewmember. The AOJ's favorable findings are not rebutted and are binding on the Board. The first two elements of service connection are satisfied. Holton, 557 F.3d 1362. Therefore, the key inquiry is whether the Appellant's tinnitus began during ACDUTRA or is at least as likely as not related to an in-service injury, event, or disease during ACDUTRA.

The Board concludes that the evidence of record persuasively weighs against finding that the Appellant's tinnitus
2021 rating decision, found that the Appellant had been diagnosed with a disability and that noise exposure was conceded based on the Appellant's military occupational specialty (MOS) of Cannon Crewmember. The AOJ's favorable findings are not rebutted and are binding on the Board. The first two elements of service connection are satisfied. Holton, 557 F.3d 1362. Therefore, the key inquiry is whether the Appellant's tinnitus began during ACDUTRA or is at least as likely as not related to an in-service injury, event, or disease during ACDUTRA.

The Board concludes that the evidence of record persuasively weighs against finding that the Appellant's tinnitus began during ACDUTRA or is otherwise related to an in-service injury, event, or disease. Service treatment records are silent to complaints, treatments, or diagnoses of tinnitus.

In May 2021, the Appellant was afforded a VA examination. The Appellant reported recurrent tinnitus with an onset of around 10 years prior. The examiner opined the Appellant's tinnitus was less likely than not caused by or a result of military noise exposure and that although the relationship between noise, auditory damage, and tinnitus was well documented, auditory damage and tinnitus were not conceded based on noise alone. As rationale, the examiner stated that the onset of the Appellant's tinnitus postdated his military service. The examiner said that noise induced tinnitus does not present with a latent onset. The examiner's opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).

During the February 2025 Board hearing, the Appellant testified that his condition started in 1981 from exposure to loud noise from guns. He stated that the provided ear plugs were not adequate enough and would fall out of his ear. He also stated that the ringing started in 1982 and that he has been suffering since.

The Board acknowledges the Appellant's Board testimony but finds that the May 2021 VA examiner's opinion warrants greater probative weight than the Appellant's Board testimony. The Appellant's Board testimony is inconsistent with objective medical examinations. The Appellant testified during the hearing that his tinnitus started in 1982. However, during the May 2021 VA examination, the Appellant reported that his tinnitus started 10 years prior, making it around 2011. Due to the inconsistency in the Appellant's testimony warrants with his statement to the May 2021 VA examination, his Board testimony is afforded no probative weight. The VA examiner's nexus opinion was based on an accurate medical history and provided an explanation that contained clear conclusions and supporting data, including the Appellant's statements.

The Appellant believes the claimed tinnitus is related to an in-service injury, event, or disease. The Board notes that as a lay person, the Appellant is not competent to opine as to medical etiology or render medical opinions in that respect. Barr v. Nicholson, 21 Vet. App. 303 (2007); see Grover v. West, 12 Vet. App. 109, 112 (1999). The issue is medically complex, as it requires knowledge of pathology and the interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Appellant because the record does not show that he has the medical training or credentials to make such a determination. Jandreau, 492 F.3d 1372; see also Kahana, 24. Vet. App. 428. Consequently, the Board gives greater probative weight to the medical evidence and the opinion of the May 2021 VA examiner.

In sum, the evidence persuasively weighs against the claim of entitlement to service connection for tinnitus. The benefit of the doubt doctrine is not applicable. Lynch, 21 F.4th 776 (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application). Consequently, the entitlement to service connection claim for tinnitus is not warranted. Entitlement to service connection for tinnitus is denied.

Entitlement to service connection for lower back condition is denied.

The Appellant claims entitlement to service connection for lower back condition.

The claims file lacks evidence that indicates the Appellant has been diagnosis for a lower back condition. The Appellant had not submitted evidence in support of a diagnosis of a lower back condition.

During the February 2025 Board hearing, the Appellant testified that his back was excruciating at times with limited range of motion
21 F.4th 776 (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application). Consequently, the entitlement to service connection claim for tinnitus is not warranted. Entitlement to service connection for tinnitus is denied.

Entitlement to service connection for lower back condition is denied.

The Appellant claims entitlement to service connection for lower back condition.

During the February 2025 Board hearing, the Appellant testified that his back was excruciating at times with limited range of motion. The Appellant would not have been able to make it days to work most without the use of over-the-counter medication. He stated that he was currently disabled and unable to work due to his lower back. The Appellant said that rigorous physical training from running and crawling led to a pulled muscle in his lower back and that he has been dealing with back pain since his service

The Board has considered Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), in which the Federal Circuit held that "pain alone, without an accompanying diagnosis of a present disease, can qualify as a disability" if it "reaches the level of a functional impairment of earning capacity." Id. at 1367-69. Based on the Appellant's testimony at the February 2025 Board hearing, the Board finds that although the Appellant has not been diagnosed with a lower back condition, his testimony supports a finding that his lower back pain results in functional impairment leading to decreased earning capacity. Therefore, the Appellant has a lower back disability, and the first element of service connection is satisfied. Holton, 557 F.3d 1362.

As the Appellant's testimony regarding functional impairment of earning capacity due to his lower back pain and the Board's finding of a disability were not raised prior to the May 2021 rating decision, the Board does not have the authority to order additional development pertaining this claim. 38 C.F.R. § 20.802(a). Thus, the Board will proceed to adjudicate this issue based on the evidence of record at the time of the May 2021 rating decision, as well as any evidence, such as his testimony, submitted by the Appellant or representative at the hearing or within 90 days following the hearing. Id.

During the February 2025 Board hearing, the Appellant asserted that his current lower back pain was due to rigorous training that led to a pulled muscle during his service. He complained about it and was allowed to go to sick call where he stayed for a week or two. He was provided with a muscle relaxant. The Appellant's service treatment records document his physical injuries during his service but does not document lower back pain. As the Appellant's testimony is not supported by and is inconsistent with objective medical evidence, his testimony is assigned no probative weight.

The claims file lacks competent medical evidence linking the Appellant's lower back pain to his asserted injury during service. The Board recognizes that the Appellant is competent to testify as to his general belief that he has lower back pain is related to his service. However, there is nothing in the record to suggest that the Appellant has the appropriate training, experience, or expertise to render a medical opinion regarding etiology of his condition. See 38 C.F.R. § 3.159(a)(1) (setting forth that competent medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions). While the Appellant is competent to report what he has experienced, he is not competent to ascertain the etiology of any current condition, as the causative factors for such are not readily subject to lay observation. See Charles v. Principi, 16 Vet. App. 370, 374-75 (2002); Layno, 6 Vet. App. 465 (1994); see also Jandreau, 492 F.3d 1372 (Fed. Cir. 2007).

After considering evidence of record, the Board finds that it does not support a finding that the Appellant's lower back pain is due to his service. As such, the Board must find that entitlement to service connection for this condition is not warranted. The Board has considered the benefit of the doubt doctrine. However, as the evidence persuasively weighs against the claim, the benefit of the doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. §§
2002); Layno, 6 Vet. App. 465 (1994); see also Jandreau, 492 F.3d 1372 (Fed. Cir. 2007).

After considering evidence of record, the Board finds that it does not support a finding that the Appellant's lower back pain is due to his service. As such, the Board must find that entitlement to service connection for this condition is not warranted. The Board has considered the benefit of the doubt doctrine. However, as the evidence persuasively weighs against the claim, the benefit of the doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3; Lynch 21 F.4th 776. Accordingly, the claim for entitlement to service connection for lower back pain is denied.

Entitlement to service connection for radiculopathy, right lower extremity as secondary to lower back condition, is denied.

Entitlement to service connection for radiculopathy, left lower extremity as secondary to lower back condition, is denied.

The Appellant claims entitlement to service connection for radiculopathy, right lower extremity, and for radiculopathy, left lower extremity.

The claims file lacks competent medical evidence that indicates the Appellant has been diagnosis for radiculopathy, right lower extremity, or radiculopathy, left lower extremity.

The threshold requirement for the granting of service connection is evidence of a current disability. In the absence of evidence of a current disability there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The requirement in a claim of service connection of current disability "is satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim and that a claimant may be granted service connection even though the disability resolves prior to the Secretary's adjudication of the claim." See McClain v. Nicholson, 21 Vet. App. 319 (2007).

The Board concludes that the Appellant does not have a current diagnosis of radiculopathy, 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, 21 Vet. App. 319. The Appellant's medical records lack substantive references to radiculopathy. The Appellant has not submitted an opinion from a medical professional opining a current diagnosis of radiculopathy.

The Board recognizes that the Appellant believes that he suffers from radiculopathy, which he believes is a result of his service. During the February 2025 Board hearing, the Appellant described not having enough strength in his legs in the mornings. It was as though blood stopped flowing through them. It caused him to have difficulty walking. He would need to shake and move around before he can start the day. He also experienced numb feet. The Board acknowledges that there are instances in which a layperson may be competent to offer testimony on medical matters, such as describing symptoms observable to the naked eye or even diagnosing simple conditions. See Jandreau, 492 F.3d 1372. The Board finds, however, that the questions posed by these claims are generally of such complexity as to require that individuals who provide competent medical evidence on this matter possess a level of expertise that a layperson simply does not possess. To the extent they are within a lay person's competence, the Board has considered whether they are sufficient to rise to the level of a current disability in the absence of a medically diagnosed disability but concludes that they are not, as discussed above. The only evidence of record relating the Appellant's claimed disability are the Appellant's own general statements.

In short, after considering the competent evidence of record, the Board finds that the evidence persuasively weighs against a finding that the Appellant had a diagnosis of radiculopathy at any time relevant to the appeal. Brammer, 3 Vet. App. 223; McClain, 21 Vet. App. 319. As such, the Board must find that entitlement to service connection for this condition is not warranted. The Board has considered the benefit of the doubt doctrine. However, as the evidence persuasively weighs against the claims, the benefit of the doubt rule is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3; Lynch, 21 F.
Board finds that the evidence persuasively weighs against a finding that the Appellant had a diagnosis of radiculopathy at any time relevant to the appeal. Brammer, 3 Vet. App. 223; McClain, 21 Vet. App. 319. As such, the Board must find that entitlement to service connection for this condition is not warranted. The Board has considered the benefit of the doubt doctrine. However, as the evidence persuasively weighs against the claims, the benefit of the doubt rule is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3; Lynch, 21 F.4th 776. Accordingly, the claims for entitlement to service connection for radiculopathy, right lower extremity, and for radiculopathy, left lower extremity, are denied.

REASONS FOR REMAND

Entitlement to service connection for sensorineural hearing loss, bilateral (claimed as bilateral hearing loss) is remanded.

The Appellant claims entitlement to service connection for bilateral hearing loss.

In May 2021, the Appellant was afforded a VA examination for hearing loss. He was diagnosed with bilateral sensorineural hearing loss. The examiner opined that condition was less likely than not caused by or a result of military noise exposure. As rationale, the examiner noted that the Appellant serviced from August to November 1981 and that the Appellant had an MOS of Cannon Crewmember, which conceded hazardous noise exposure. The examiner stated that although noise exposure was conceded and the relationship between noise, auditory damage and hearing loss is well documented; auditory damage and hearing loss were not conceded based on noise alone. The examiner did not provide an analysis on why the hearing loss was not conceded based on noise. The examiner's opinion is conclusory and not supported by an adequate analysis. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007) (stating that a medical opinion must support its conclusion with an analysis that the Board can weigh, and a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision). Therefore, the examination is inadequate. As the AOJ did not obtain an addendum to correct the deficiency at the time of the decision on appeal, such was a pre-decisional duty to assist error; a remand is necessary to correct it. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (once VA undertakes the effort to provide an examination when developing a service connection claim, even if not statutorily obligated to do so, it must provide one that is adequate for purposes of the determination being made).

The matter is REMANDED for the following action:

Obtain an addendum opinion addressing the etiology of the Appellant's bilateral hearing loss. The examiner should state whether it is at least as likely as not that it was incurred in, or is otherwise related to, the Appellant's service. The need for another in-person examination is left to the discretion of the examiner. A fully supported rationale should accompany any opinion provided.

Danette Mincey

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T. Hahn

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.

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