ARTERIOSCLEROTIC HEART DISEASE (CORONARY ARTERY DISEASE)

Summary

The Veteran served on active duty from June to November 1971 and in the Army National Guard from June 1971 to June 1981. The Veteran appealed the denial of service connection for coronary artery disease and diabetes mellitus, type II, and the remand of claims for bilateral hearing loss and tinnitus. The Board denied the claims for coronary artery disease and diabetes mellitus, type II, finding no competent evidence of current diagnoses for these conditions. The Veteran's lay statements were deemed to have little probative value as he is not a medical professional. The Board noted that while National Guard service records were missing, this did not warrant a remand for those specific claims due to the lack of current disability evidence. The claims for bilateral hearing loss and tinnitus were remanded due to pre-decisional duty to assist errors. Specifically, the Board found that outstanding National Guard service records were missing and that the January 2025 VA audiological opinion was inadequate for hearing loss, as it was based on an incomplete review of the Veteran's history. For tinnitus, the Board found the evidence was in approximate balance regarding a current diagnosis and that the January 2025 VA audiological examination was inadequate in addressing the etiology of the Veteran's conceded tinnitus. Remand is for obtaining National Guard records and obtaining new VA audiological nexus opinions for both hearing loss and tinnitus, considering the etiology and any noise exposure.

Rationale

No competent evidence of current diagnosis; Veteran's lay statements lack probative value; Preponderance of evidence against claim

Full Decision Text

Citation Nr: A26039360
Decision Date: 04/28/26	Archive Date: 04/28/26

DOCKET NO. 250522-548407
DATE: April 28, 2026

ORDER

Entitlement to service connection for coronary artery disease is denied.

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

REMANDED

Entitlement to service connection for bilateral hearing loss is remanded.

Entitlement to service connection for tinnitus is remanded.

FINDINGS OF FACT

1. The Veteran does not have a current disability of coronary artery disease.

2. The Veteran does not have a current disability of diabetes mellitus, type II.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for coronary artery disease have not been met.  See 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303. 

2. The criteria for entitlement to service connection for diabetes mellitus, type II have not been met.  See 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303. 

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

Preliminary Matters

The Veteran served on active duty from June to November 1971.  The Veteran also served in the United States Army National Guard.

In an April 2025, rating decision, a U.S. Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) denied service connection for bilateral hearing loss, coronary artery disease, tinnitus, and diabetes mellitus, type II.  In May 2025, the Veteran submitted a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), timely appealing those issues to the Board of Veterans' Appeals (Board).  

In the May 2025 Notice of Disagreement, the Veteran requested the Direct Review docket, indicating that he did not want a Board hearing and would not submit any additional evidence in support of the appeal.  Therefore, the Board only may consider the evidence of record at the time of the AOJ decision on appeal.  38 U.S.C. § 7113(a); 38 C.F.R. § 20.301.  

Regarding the claims adjudicated in this decision, if the Veteran identifies additional evidence that he would like considered, the Veteran may file a Supplemental Claim and submit or identify this evidence.  If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered.  Specific instructions for filing a Supplemental Claim are included with this decision.  However, regarding the remanded claims, any evidence the Board was not permitted to consider will be considered by the AOJ when it adjudicates those claims.  

The Veteran submitted argument, as well as a copy of his DD Form 214 and NGB Form 22, along with his May 2025 VA Form 10182.  New evidence submitted with a VA Form 10182 on which the Direct Review docket is selected creates uncertainty as to which Board review option the claimant intended, triggering the Board's duty to seek clarification under 38 C.F.R. § 20.202(f).  See Edwards v. McDonough, 36 Vet. App. 56 (2023).  However, in this case, the Board finds that the Veteran's May 2025 statement was merely argument, not evidence.  (Moreover, the Veteran's DD Form 214 and NGB Form 22 would not be considered additional evidence, as a copy of the DD Form 214 was already of record, and the Board was already aware from his service records that he served in the National Guard.)  Therefore, the Board will proceed with this Direct Review docket appeal.  

As discussed further below, at the time of the AOJ decision on appeal, the claims filed appeared to be missing service records related to the Veteran's National Guard service.  However, as the Board is denying the Veteran's claims for coronary artery disease and diabetes mellitus, type II due to the lack of a current disability, no purpose would be served by remanding these issues to obtain service records from several decades ago.  As such, the Board will proceed to adjudicate those claims.

The Board has thoroughly reviewed all evidence in the claims file.  The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claim, and the Board's reasons for rejecting evidence favorable to the Veteran.  The Veteran must not assume the Board
J decision on appeal, the claims filed appeared to be missing service records related to the Veteran's National Guard service.  However, as the Board is denying the Veteran's claims for coronary artery disease and diabetes mellitus, type II due to the lack of a current disability, no purpose would be served by remanding these issues to obtain service records from several decades ago.  As such, the Board will proceed to adjudicate those claims.

The Board has thoroughly reviewed all evidence in the claims file.  The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claim, and the Board's reasons for rejecting evidence favorable to the Veteran.  The Veteran must not assume the Board has overlooked evidence not explicitly discussed herein. 

1. Entitlement to service connection for coronary artery disease is denied.

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

The Veteran is seeking service connection for coronary artery disease and diabetes mellitus, type II.  

Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty in the active military, naval, or air service.  38 U.S.C. §§ 1110, 1131.  That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease.  If there is no showing of a resulting chronic condition during service, then a showing of continuity of symptomatology after service is required to support a finding of chronicity.  38 C.F.R. § 3.303(b).  Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service.  38 C.F.R. § 3.303(d).

To establish a right to compensation for a present disability, a claimant must show: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service"-the so-called "nexus" requirement.  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

The threshold requirement for service connection is competent evidence of the existence of the claimed disability at some point during the course of the appeal or in proximity to the claim.  38 U.S.C. § 1110; see Degmetich v. Brown, 104 F.3d 1328, 1332 (1997) (holding that interpretation of 38 U.S.C. §§ 1110 and 1131 as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary); see also McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013).  In the absence of proof of a present disability, there can be no valid claim.  Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).  

In this case, the claims file contains no medical evidence competently demonstrating current diagnoses of coronary artery disease or diabetes mellitus, type II, or any related diagnoses.  

The Board has considered the Veteran's general, implicit contention that he has current disabilities of coronary artery disease and diabetes mellitus, type II .  However, as a lay person, he is not competent to diagnose himself with these claimed disabilities, as he has no medical knowledge, training, or expertise.  Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).  As such, his lay statements and contentions to that effect have little probative value.

While the Board recognizes the Veteran's sincere belief in his claims, there is no competent evidence demonstrating current disabilities for the claimed conditions.  As such, the preponderance of the evidence is against the claims for service connection for coronary artery disease and diabetes mellitus, type II, and these claims must be denied.  The benefit-of-the-doubt rule is not for application.

REASONS FOR REMAND

1. Entitlement to service connection for bilateral hearing loss is remanded.

The Veteran is seeking service connection for bilateral hearing loss.  Remand is required for the AOJ to cure the following pre-decisional duty to assist errors.  38 C.F.R. § 20.802(a).  

First, before the AOJ issued the decision on appeal, it was apparent that service records from the Veteran's National Guard service were missing.  Specifically, in his December 2024
 of the evidence is against the claims for service connection for coronary artery disease and diabetes mellitus, type II, and these claims must be denied.  The benefit-of-the-doubt rule is not for application.

REASONS FOR REMAND

1. Entitlement to service connection for bilateral hearing loss is remanded.

The Veteran is seeking service connection for bilateral hearing loss.  Remand is required for the AOJ to cure the following pre-decisional duty to assist errors.  38 C.F.R. § 20.802(a).  

First, before the AOJ issued the decision on appeal, it was apparent that service records from the Veteran's National Guard service were missing.  Specifically, in his December 2024 claim, the Veteran asserted that he served on active duty from June 1971 to November 1971, and he served in the National Guard from June 1971 to June 1981.  The Veteran's DD Form 214 reflects that he was released from active service in November 1971 to the Army National Guard.  However, the claims file does not contain any service treatment or military personnel records from his time in the National Guard.  

Second, in January 2025 VA audiological opinion, the examiner did not link the Veteran's current hearing loss to service.  However, this opinion was inadequate to the extent that it was based in part on an incomplete review of the Veteran's pertinent history.  Specifically, as discussed above, before the AOJ decision on appeal, it was apparent that service records from the Veteran's National Guard service were missing.

As such, remand is required for the AOJ to cure these pre-decisional duty to assist errors by: attempting to obtain outstanding records related to the Veteran's National Guard service; and to obtain an addendum VA audiological nexus opinion to consider such additional service records.

2. Entitlement to service connection for tinnitus is remanded.

The Veteran is seeking service connection for tinnitus.  Remand is required for the AOJ to cure the following pre-decisional duty to assist errors.  38 C.F.R. § 20.802(a).  

First, remand is required for a VA audiological opinion.  By way of background, the AOJ denied this claim in part based on the lack of a currently diagnosed disability.  The January 2025 VA audiological examiner did not find that the Veteran had a current tinnitus diagnosis because the Veteran's description of symptoms documented in this report ("intermittent sounds in the ear occurring multiple times per month but less than once a week and for less than 30 second episodes at a time") did not meet a specific, narrow definition of tinnitus (per a cited, 1992 medical authority).  Accordingly, the January 2025 VA examiner opined in the history section of this report that the Veteran's "transient ear noise" was not consistent with noise-induced tinnitus and was less likely than not related to military noise exposure.  The examiner found, "Etiology of tinnitus is not warranted when symptomatology and clinical exam findings do not indicate a diagnosis of recurrent of tinnitus."  Later in the examination report, the examiner indicated that an etiology opinion would not be provided for tinnitus because there was no diagnosis of tinnitus.

However, by filing the December 2024 service connection claim for tinnitus, the Veteran was implicitly asserting that he has a current tinnitus disability.  During the January 2025 VA audiological examination, he reported "intermittent sounds in the ear" (as described by the examiner).  As a lay person, the Veteran was competent to self-diagnose tinnitus, which is "a noise in the ears, such as ringing, buzzing, roaring, or clicking."  See Charles v. Principi, 16 Vet. App. 370, 374 (2002) (quoting DORLAND'S ILLUSTRATED MEDICAL DICTIONARY 1714 (28th ed. 1994)).  

Therefore, the Board finds that at the time of the AOJ decision on appeal, the evidence was at least in approximate balance that the Veteran had a current tinnitus disability, and the January 2025 VA audiological examination report was inadequate to the extent that the examiner only superficially addressed whether the Veteran's audiological complaints related to tinnitus were etiologically related to active service.  Remand is required for the AOJ to cure this pre-decisional duty to assist error by obtaining another VA audiological opinion that considers the etiology of the Veteran's conceded current tinnitus.  

Finally, remand is required for the AOJ to cure the pre-decisional duty to assist error regarding the outstanding National Guard service records (as discussed in more detail in the preceding section).  

The matters are REMANDED for the following action:


 least in approximate balance that the Veteran had a current tinnitus disability, and the January 2025 VA audiological examination report was inadequate to the extent that the examiner only superficially addressed whether the Veteran's audiological complaints related to tinnitus were etiologically related to active service.  Remand is required for the AOJ to cure this pre-decisional duty to assist error by obtaining another VA audiological opinion that considers the etiology of the Veteran's conceded current tinnitus.  

Finally, remand is required for the AOJ to cure the pre-decisional duty to assist error regarding the outstanding National Guard service records (as discussed in more detail in the preceding section).  

The matters are REMANDED for the following action:

1. Attempt to obtain and associate with the claims file all outstanding military personnel records and service treatment records from the Veteran's service in the United States Army National Guard.  (See December 2024 VA Form 21-626EZ, page 12 for reported dates and unit information.)  

Document all records requests and any negative responses in the claims file and notify the Veteran and his representative accordingly.  If the AOJ concludes it is reasonably certain that these records do not exist or further efforts to obtain them would be futile, then it clearly must document why in the claims file, and notify the Veteran and his representative accordingly.

2. Then, after completing Instruction 1 above (to the extent possible), transfer the claims file for VA audiological opinions regarding the service connection claims for hearing loss and tinnitus.  The examiner must note his or her review of the complete claims file, including this remand.  Then, the examiner must address the following:

(a.) Is the evidence at least in approximate balance (i.e., nearly equal) that the Veteran's current bilateral hearing loss disability was incurred in or is otherwise etiologically related to active service, to include acknowledged noise exposure (see January 2025 VA audiological examination report for military noise exposure history)?  

(b.) Is the evidence at least in approximate balance (i.e., nearly equal) that the Veteran's conceded, current tinnitus was incurred in or is otherwise etiologically related to active service, to include acknowledged noise exposure (see January 2025 VA audiological examination report for military noise exposure history)?  

The examiner must provide a full supporting rationale.  If any requested opinion is not possible for any reason, then please explain why. 

 

 

R. JANOFSKY

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	L. Durham, Counsel

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.