MALIGNANT SKIN NEOPLASMS (OTHER THAN MALIGNANT MELANOMA)

Summary

The Veteran, an Air Force Reserves Veteran who served from August 1967 to December 1997, with active duty from August 1976 to November 1967, appealed the denial of service connection for skin cancer and gastroesophageal reflux disease (GERD). The Board of Veterans' Appeals (Board) reviewed the evidence of record at the time of the prior rating decision, as the Veteran elected a Direct Review docket. For the skin cancer claim, the Board found no current diagnosis of skin cancer in the service treatment records or post-service medical records. While the Veteran asserted service connection, the Board noted that laypersons are not competent to provide medical diagnoses. The Board gave more weight to the medical records, which did not show a skin cancer diagnosis, and concluded that the evidence did not preponderate in favor of service connection, making the benefit-of-the-doubt doctrine inapplicable. For the GERD claim, the Board found a current diagnosis but no evidence of in-service incurrence or aggravation. The service treatment records were normal for the abdomen at separation, and post-service records did not show early diagnoses. A VA examiner opined that the GERD was not related to service, citing a lack of substantiating evidence and a cogent explanation. The Veteran's lay opinion was not considered competent for this medically complex issue. The Board concluded the evidence weighed against a causal relationship to service, rendering the benefit-of-the-doubt doctrine inapplicable. Consequently, service connection for both skin cancer and GERD was denied.

Rationale

No current diagnosis of skin cancer; Service treatment records negative for skin cancer; Post-service records negative for skin cancer; Layperson not competent to diagnose; Benefit-of-the-doubt doctrine not applicable

Full Decision Text

Citation Nr: A26039301
Decision Date: 04/28/26	Archive Date: 04/28/26

DOCKET NO. 260326-641065
DATE: April 28, 2026

ORDER

Service connection for skin cancer is denied.

Service connection for gastroesophageal reflux disease (GERD) is denied.

FINDINGS OF FACT

1. The Veteran does not have a current diagnosis of skin cancer.

2. The evidence of record persuasively weighs against finding that GERD began during active service, or is otherwise related to an in-service injury or disease.

CONCLUSIONS OF LAW

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

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

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served honorably in the United States Air Force Reserves from August 1967 to December 1997, including active duty from August 1976 to November 1967. The Board of Veterans' Appeals (Board) thanks the Veteran for his service to our country.

In January 2026, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a December 2025 decision.  In January 2026, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior rating decision.  Therefore, the Board may only consider the evidence of record at the time of the December 2025 decision and any evidence submitted during an applicable evidentiary window.

In the March 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the December 2025 AOJ decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the appeal, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

This matter has been advanced on the docket pursuant to 38C.F.R. §20.902(c).

1. Service connection for skin cancer is denied

As an initial matter, the Board concludes that the Veteran does not have a current diagnosis for skin cancer and has not had any 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).

Specifically, the Veteran's service treatment records (STRs) do not contain complaints, treatment, or diagnosis for any skin cancer condition. Moreover, his post service treatments do not reflect a current disorder. Notably, most recently in August 2025, VA treatment records indicated that the Veteran's skin was "warm, dry, and intact. No rashes, lesions, or bruising noted." 

Further, although extensive medical records of record reflect treatment for multiple other medical conditions, such records are negative for any complaints, treatment, or diagnosis for any skin cancer condition.

While the Veteran asserts service connection for a skin cancer condition, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires knowledge of internal medical matters. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Thus, while laypersons are competent to report observable symptomatology, they are not competent to provide medical opinion evidence. Consequently, the Board gives more probative weight to the medical records which do not show a skin cancer diagnosis. 

Importantly, service connection may only be granted for a current disability; when a claimed disability is not shown, there may be no grant of service connection.  "In the absence of proof
 Veteran asserts service connection for a skin cancer condition, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires knowledge of internal medical matters. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Thus, while laypersons are competent to report observable symptomatology, they are not competent to provide medical opinion evidence. Consequently, the Board gives more probative weight to the medical records which do not show a skin cancer diagnosis. 

Importantly, service connection may only be granted for a current disability; when a claimed disability is not shown, there may be no grant of service connection.  "In the absence of proof of a present disability there can be no valid claim."  See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Here, the record contains no current diagnosis for any skin cancer condition. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

Therefore, service connection for skin cancer is denied.

2. Entitlement to service connection for GERD is denied.

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

The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current diagnosis of GERD, the evidence does not support finding a causal relationship to active military service. 

The Veteran has not provided specific argument or contentions in support of his appeal. The AOJ made no favorable findings in the rating decision on appeal.

The Veteran's active duty service treatment records do not reflect a diagnosis of GERD or any related gastrointestinal complaints and findings. The October 1971 separation examination shows the evaluation of the Veteran's abdomen and viscera was normal.  The notes from the examining clinician contained no reference to GERD.

The Veteran's post-service medical records do not show a diagnosis or treatment of GERD shortly after active duty. The medical records show GERD diagnoses and treatment many years after service and do not contain any medical opinions linking the current GERD to a period of active military service.  

At the Veteran's December 2025 VA examination, he reported the onset of his GERD was in 2010 and that he developed gradual onset of acid reflux and heart burn.  The examiner noted a diagnosis was made in August 2024.  Following the physical examination and record review, the examiner opined the GERD was not related to service and did not onset therein. The examiner explained that there is a lack of substantiating evidence supporting a nexus between the current disorder and service. The examiner's opinion is probative because it is based on an accurate medical history and provides a cogent explanation. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). There is no medical nexus opinion to the contrary.

The Veteran believes GERD is related to an in-service injury, event, or disease but is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of the gastrointestinal system. The record does not show that the Veteran 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). 

The evidence of record persuasively weighs against finding that the Veteran's GERD began during service or is otherwise related to an in-service injury, event, or disease.  As such, the evidence is not in approximate balance.  Therefore, the benefit of the doubt is not for application.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).  Service connection for GERD is denied.

 

 

D. JOHNS
 Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). 

The evidence of record persuasively weighs against finding that the Veteran's GERD began during service or is otherwise related to an in-service injury, event, or disease.  As such, the evidence is not in approximate balance.  Therefore, the benefit of the doubt is not for application.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).  Service connection for GERD is denied.

 

 

D. JOHNSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Dourmashkin, Mark W.

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.