Case A26039376

Summary

The Veteran, who served in the U.S. Coast Guard from July 1983 to December 1989, appeals the denial of service connection for hair loss and high cholesterol. The Board denied service connection for hair loss, finding that patterned hair loss alone is not considered a disability for VA purposes and that the Veteran had not been diagnosed with an underlying condition causing hair loss or any related economic impairment. The Board also noted the absence of complaints or treatment for hair loss in the medical records and that the Veteran did not provide sufficient evidence to trigger a VA duty to assist in obtaining an examination. For high cholesterol (mixed hyperlipidemia), the Board denied service connection, citing VA regulations and precedent that laboratory findings like high cholesterol are not, in themselves, disabilities for which compensation is payable. The case was remanded for entitlement to service connection for a left arm condition. The Board found the June 2023 VA opinion inadequate because it provided a conclusory opinion linking the Veteran's current left arm symptoms to diabetes mellitus rather than the conceded in-service bursitis diagnosis, and the January 2025 examination did not address the left arm condition. A new VA examination is required to determine the nature and etiology of the left arm condition and its relationship to service.

Rationale

No complaints or treatment for hair loss in medical records; No diagnosed underlying condition causing hair loss; Patterned hair loss not a disability for VA purposes; No evidence of functional impairment of earning capacity

Full Decision Text

Citation Nr: A26039376
Decision Date: 04/28/26	Archive Date: 04/28/26

DOCKET NO. 251208-612832
DATE: April 28, 2026

ORDER

Entitlement to service connection for hair loss is denied.

Entitlement to service connection for high cholesterol is denied.

REMANDED

Entitlement to service connection for a left arm condition is remanded.

FINDINGS OF FACT

1. The Veteran's current hair loss is not a disability for Department of Veterans Affairs (VA) compensation purposes.

2. High cholesterol, or hyperlipidemia, is not a disability for which VA disability benefits may be awarded.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for hair loss have not been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 4.1.

2. The criteria for entitlement to service connection for high cholesterol have not been met.  38?U.S.C. §§?1101, 1131, 5107;?38?C.F.R. §§?3.102, 3.303, 3.304.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the U.S. Coast Guard from July 1983 to December 1989.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2025 rating decision by a Department of Veterans Affairs (VA) regional office (RO).  In December 2024, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a November 2024 rating decision.  In March 2025, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior November 2024 rating decision.  Therefore, the Board may only consider the evidence of record at the time of the prior rating decision.  The Veteran timely appealed the rating decision by submitting a VA Form 10182 and requested direct review of the evidence considered by the AOJ under the Veterans Appeals Improvement Modernization Act of 2017 (AMA).  Under direct review, the Board cannot hold a hearing or accept additional evidence into the record.  38 C.F.R. § 20.301 (2019).  Therefore, the Board will consider the evidence of record as of November 20, 2024, the date of the notification letter for the November 2024 rating decision.  Id.

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, 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).  Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303(d). 

1. Entitlement to service connection for hair loss is denied.

The Veteran seeks service connection for hair loss.  On his June 2024 VA Form 21-526EZ, he asserted that his hair loss was a result of a line of duty incident that caused the injury or aggravation of it.  The Board notes that, according to a July 2024 Toxic Exposure Risk Activity (TERA) memorandum, the Veteran was exposed to ionizing radiation and asbestos.

A review of the Veteran's medical records does not show any complaints or treatment for hair loss or any condition related thereto.  Additionally, the Veteran has not been diagnosed with an underlying condition that would cause hair loss, such as alopecia areata or any other disability listed in VA's Schedule for Rating Disabilities as compensable for VA purposes.  See 38 C.F.R. § 4.118, Diagnostic Code (DC) 7831.  Patterned hair loss is not, by itself, considered a disability for which service connection may be granted.  Additionally, the Veteran has not asserted, and the relevant evidence of record does not show, that his hair loss is a result of any underlying
 to ionizing radiation and asbestos.

A review of the Veteran's medical records does not show any complaints or treatment for hair loss or any condition related thereto.  Additionally, the Veteran has not been diagnosed with an underlying condition that would cause hair loss, such as alopecia areata or any other disability listed in VA's Schedule for Rating Disabilities as compensable for VA purposes.  See 38 C.F.R. § 4.118, Diagnostic Code (DC) 7831.  Patterned hair loss is not, by itself, considered a disability for which service connection may be granted.  Additionally, the Veteran has not asserted, and the relevant evidence of record does not show, that his hair loss is a result of any underlying condition or was productive of any economic impairment.  

In so determining, the Board notes that the Veteran was not afforded a VA examination for his condition.  However, a requirement for triggering VA's duty to assist by providing an examination is some indication of a current disability, with either medical evidence of a diagnosis, or even lay persistent or current symptoms of a disability.  See McLendon v. Nicholson, 20 Vet. App. 79 (2006).  As stated above, no such evidence is part of the record that is available for review in this case.  Therefore, the Board finds that VA has satisfied its duty to assist in this matter.  See 38 C.F.R. § 3.159.   Neither the Veteran nor his representative have raised any other issues with respect to VA's duties to notify and assist in this matter.  See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board"); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument).

Based on the above, the Board finds that the evidence of record does not show a current disability for VA disability compensation purposes.  See 38 U.S.C. § 1110; 38 C.F.R. § 3.303; Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) ("Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability," and "[i]n the absence of proof of a present disability[,] there can be no valid claim."); Rabideau v. Derwinski, 2 Vet. App. 141, 143-44 (1992).  In sum, the most persuasive evidence demonstrates that the Veteran's hair loss was not a manifestation of a disability for which service connection is available.  As noted above, the Veteran's hair loss does not constitute a disability for VA compensation purposes.  The evidence of record does not show functional impairment of earning capacity caused by his hair loss.  See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018).

Accordingly, the Board finds that the claim for service connection for hair loss must be denied.  See 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303.  The benefit of the doubt doctrine is not for application at this time.  See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

2. Entitlement to service connection for high cholesterol is denied.

Here, the Veteran's medical records show he has been diagnosed with mixed hyperlipidemia.  See September 2024 CAPRI, p. 54.  The Veteran's June 2024 benefits application shows he is seeking service connection for "h cholesterol."

However, laboratory findings, such as high cholesterol/hyperlipidemia, do not qualify as disabilities for VA purposes.  See 61 Fed. Reg. 20.440, 20.445 (May 7, 1996) (For example, diagnoses of hyperlipidemia, elevated triglycerides, and elevated cholesterol are laboratory results and are not, in and of themselves, disabilities; they are, therefore, not disabling entities for which compensation is payable under VA's rating schedule).  The Veteran has not identified any disease associated with his high cholesterol/hyperlipidemia.

Therefore, with regard to high cholesterol/hyperlipidemia, because the Veteran does not have a disability subject to service connection, as a matter of law, service connection for high cholesterol must be denied.  See Sabonis v. Brown, 6 Vet. App. 426
 Fed. Reg. 20.440, 20.445 (May 7, 1996) (For example, diagnoses of hyperlipidemia, elevated triglycerides, and elevated cholesterol are laboratory results and are not, in and of themselves, disabilities; they are, therefore, not disabling entities for which compensation is payable under VA's rating schedule).  The Veteran has not identified any disease associated with his high cholesterol/hyperlipidemia.

Therefore, with regard to high cholesterol/hyperlipidemia, because the Veteran does not have a disability subject to service connection, as a matter of law, service connection for high cholesterol must be denied.  See Sabonis v. Brown, 6 Vet. App. 426 (1994).

REASONS FOR REMAND

3. Entitlement to service connection for a left arm condition is remanded.

The Veteran underwent a VA examination in June 2023, in which the examiner diagnosed the Veteran with left upper extremity neuropathy.  The examiner opined that the Veteran's left arm condition was less likely than not related to his service, despite acknowledging an acute episode involving the left upper deltoid and a diagnosis of bursitis from June 1985.  She found that the Veteran's current symptoms were not associated with resolved acute condition in service and that the Veteran's neuropathy was from his diabetes mellitus that was diagnosed after service.  

A January 2025 VA examination report reflects that the Veteran did not have peripheral nerve condition or peripheral neuropathy, and the examiner did not provide an etiological opinion.  However, it appears the January 2025 examiner only considered whether there was a left or right foot condition. 

The Board finds the June 2023 VA opinion inadequate for adjudication purposes.  The examiner provided a conclusory opinion that the Veteran's current left arm symptoms were not related to his conceded in-service left deltoid diagnosis of bursitis without any explanation other than it was related to his diabetes mellitus.  There was no explanation as to why the left arm condition was related to his diabetes mellitus and not his in-service injury.  Additionally, the January 2025 examination report appears to pertain to bilateral foot conditions, and the examiner did not consider whether the Veteran had a left arm condition.  Given that the AOJ found the June 2023 opinion adequate, and this was prior to the decision on the claim, the Board finds that this is a pre-decisional duty to assist error warranting remand under the AMA and implementing regulations.  38 C.F.R. § 20.802(a).  Accordingly, remand for a new VA examination and etiological opinion is warranted.

The matters are REMANDED for the following action:

Schedule the Veteran for a VA examination to determine the nature and etiology of his left arm condition.  The claims file should be made available to the examiner for review in connection with the examination. 

Based on review of the record and an examination of the Veteran, the examiner should respond to the following: 

(a.) Obtain a detailed history of the Veteran's left arm conditions and identify any currently diagnosable condition associated with the Veteran's left arm condition.  

(b.) For each diagnosed condition, determine whether it is at least as likely as not that the Veteran's left arm condition had its onset in or are related to service, to include June 1985 diagnosis of mild arthritis of left deltoid. 

(Continued on the next page)

?

The examiner must provide the rationale for all proffered opinions.  If the examiner is unable to provide any required opinion, he or she should explain why.  If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so.  If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed.

 

 

A. S. CARACCIOLO

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	T. L. Park, 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.