TUBERCULOSIS PULMONARY CHRONIC

Summary

The veteran, who served in the United States Marine Corps from June 1984 to December 1988 and April 1989 to April 1993, appeals the denial of service connection for pulmonary fibrosis. The veteran claimed the condition was related to toxic exposure during service, specifically mentioning oil field fires in Kuwait in January and February 1991. The Board reviewed the evidence of record, including service treatment records (STRs), VA examinations, and treatment notes. The veteran's STRs showed no complaints, treatment, or diagnosis of pulmonary fibrosis, only a viral syndrome assessment in 1985. A VA examination in October 2020 noted mild COPD and mild chronic interstitial changes, but a subsequent HRCT in May 2022 showed no acute cardiopulmonary findings or interstitial lung disease. A VA pulmonologist in January 2024 assessed no evidence of pulmonary fibrosis, attributing the veteran's chronic cough to possible asthma, allergic rhinitis, and GERD. A February 2025 VA examination also assessed COPD but did not report interstitial lung disease. The Board found no competent medical evidence of a pulmonary fibrosis diagnosis, noting that the objective medical evidence did not support it. The Board also found the veteran's lay assertions of a diagnosis, which appeared in some treatment notes, to be not probative as they lacked medical expertise. The Board concluded that the evidence weighed against the claim, making the benefit-of-the-doubt rule inapplicable, and therefore denied service connection for pulmonary fibrosis.

Rationale

No competent medical evidence of pulmonary fibrosis diagnosis; Objective medical evidence (HRCT, pulmonologist assessment) did not support diagnosis; Veteran's lay assertions of diagnosis were not probative without medical expertise

Full Decision Text

Citation Nr: A26039631
Decision Date: 04/28/26	Archive Date: 04/28/26

DOCKET NO. 250507-541569
DATE: April 28, 2026

ORDER

Entitlement to service connection for pulmonary fibrosis is denied.

FINDING OF FACT

There is no evidence that the Veteran has a current diagnosis of pulmonary fibrosis.

CONCLUSION OF LAW

The criteria for entitlement to service connection for pulmonary fibrosis have not been met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2025).

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service in the United States Marine Corps from June 1984 to December 1988 and April 1989 to April 1993.

This case comes before the Board of Veterans' Appeals (Board) on appeal of a March 2025 Higher-Level Review (HLR) rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). Originally, the Veteran was denied entitlement to service connection for pulmonary fibrosis in a February 2025 rating decision. In March 2025, the Veteran submitted a VA Form 20-0996, Decision Review Request: HLR, requesting a review of February 2025 rating decision. The March 2025 HLR rating decision on appeal was issued in response to that request. 

In the May 2025 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 February 2025 agency of original jurisdiction (AOJ) rating decision, which was subsequently subject to HLR. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the February 2025 rating decision, that was subsequently subject to HLR, the Board did not consider it in its decision. 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 claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

The Board acknowledges the Veteran's claimed clear and unmistakable error (CUE) that was raised at the time he filed his March 2025 VA Form 20-0996. Specifically, the Veteran noted CUE and a duty to assist (DTA) error in regard to the VA failing to grant benefits for his condition of pulmonary fibrosis. The Board initially notes that that the AOJ overturned its previous favorable finding that the Veteran had a diagnosis of pulmonary fibrosis in the March 2025 HLR rating decision. However, the Board also notes that the AOJ did not address the Veteran's allegation of CUE in the denial of his claim for entitlement to service connection for pulmonary fibrosis in the first instance in that March 2025 HLR rating decision. See Jarrell v. Nicholson, 20 Vet. Ap. 326 (2006). Additionally, the Board notes that a claim for CUE can be raised when a final decision has been entered. In this case, at the time of the Veteran's claim for CUE, on the March 2025 VA Form 20-0996, his appeal was still active and being adjudicated, therefore the decisions on appeal are not final and a discussion of CUE is not warranted. Further, the Board notes that the Veteran did not raise allegations of CUE, in relation to his claim for entitlement to service connection for pulmonary fibrosis, on the May 2025 VA Form 10182. As such, the Board will proceed with adjudicating entitlement to service connection for pulmonary fibrosis without consideration of CUE. 

Service Connection - Pulmonary Fibrosis

The Veteran asserts that he has a diagnosis of pulmonary fibrosis that is related to his active service. Specifically, the Veteran asserts that his claimed pulmonary fibrosis is related to toxic exposure during his active service. 

The Veteran's service treatment records (STRs) reveal that he complained of nasal congestion, a cough, and intermittent fever and was assessed to have viral syndrome in December 1985. Otherwise, his STRs are absent of any complaint of, treatment for, or diagnosis of pulmonary fibrosis, or any resultant symptoms
 the May 2025 VA Form 10182. As such, the Board will proceed with adjudicating entitlement to service connection for pulmonary fibrosis without consideration of CUE. 

Service Connection - Pulmonary Fibrosis

The Veteran asserts that he has a diagnosis of pulmonary fibrosis that is related to his active service. Specifically, the Veteran asserts that his claimed pulmonary fibrosis is related to toxic exposure during his active service. 

The Veteran's service treatment records (STRs) reveal that he complained of nasal congestion, a cough, and intermittent fever and was assessed to have viral syndrome in December 1985. Otherwise, his STRs are absent of any complaint of, treatment for, or diagnosis of pulmonary fibrosis, or any resultant symptoms.

During an October 2020 VA examination, the Veteran reported that he developed a chronic cough in 1993 just after separation. He also reported that he was exposed to oil field fires in Kuwait in January and February 1991. He also reported that he had been treated with steroids at walk in clinics several times throughout the years, but nothing had helped to permanently stop his cough. At that time, a VA examiner assessed that the Veteran had a diagnosis of chronic obstructive pulmonary disease (COPD).

An October 2020 radiology report revealed that the Veteran was assessed to have mild COPD with mild chronic interstitial changes. 

An April 2022 treatment note documented the Veteran's report that he was diagnosed with pulmonary fibrosis as a result of being exposed to oil fires during the first gulf war. At that time, it was also noted that a pulmonary function test (PFT) and high-resolution computerized tomography (HRCT) of the chest would be obtained for the Veteran, followed by a pulmonary referral. 

A May 2022 treatment note revealed that the Veteran had history of pulmonary fibrosis and that he had just started a pulmonary evaluation ordered by his primary care provider. Later in May 2022, a CT revealed that the Veteran had no acute cardiopulmonary findings, no indication of interstitial lung disease identified, and residuals of a previous granulomatous disease. Subsequently, in a June 2022 note from the VA, the Veteran was informed that the findings of his recent HRCT of the chest showed no acute findings of the heart and lungs and no findings of interstitial lung disease (such as pulmonary fibrosis). 

A January 2024 treatment note revealed that a VA pulmonologist, Dr. H.F., assessed that the Veteran did not have any evidence of pulmonary fibrosis. At that time, Dr. H.F. also assessed that the Veteran's chronic cough could be related to cough variant asthma, allergic rhinitis, and gastrointestinal esophageal reflux disease (GERD).

A February 2025 spirometry checklist indicated that the Veteran reported he had pulmonary fibrosis and chronic obstructive pulmonary disease (COPD). During a February 2025 VA examination, the Veteran reported that he experienced a gradual onset of shortness of breath, wheezing, and non-productive cough during mild and moderate physical activities. He also reported that his symptoms progressed to become more frequent and persistent and that he follows up with pulmonology annually. At that time, the VA examiner assessed that the Veteran had COPD. The VA examiner did not report that the Veteran had interstitial lung disease.

In this case, based on the evidence above, the Board finds that there is no competent evidence of record indicating that the Veteran has a diagnosis of pulmonary fibrosis. In this regard, as noted above, the objective medical evidence, to include the HRCT results, did not show that the Veteran had a diagnosis of pulmonary fibrosis. 

Additionally, the Board acknowledges the Veteran's sincere belief that he has a diagnosis of pulmonary fibrosis. However, the Board finds that the Veteran is not competent to diagnose pulmonary fibrosis as that requires medical testing and expertise that is beyond the knowledge of a common lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). As such, his lay reports of a diagnosis of pulmonary fibrosis, which were the basis of the May 2022 and February 2025 notations in his medical history, are not probative. Moreover, as noted above, the Board finds that there is no evidence to support the Veteran's lay assertions as the medical evidence does not show a diagnosis of pulmonary fibrosis.

For a disability to be service connected, it must be present at the time a claim for VA disability compensation is filed or during or contemporary to, the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). Here, there is no evidence
 a diagnosis of pulmonary fibrosis, which were the basis of the May 2022 and February 2025 notations in his medical history, are not probative. Moreover, as noted above, the Board finds that there is no evidence to support the Veteran's lay assertions as the medical evidence does not show a diagnosis of pulmonary fibrosis.

For a disability to be service connected, it must be present at the time a claim for VA disability compensation is filed or during or contemporary to, the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). Here, there is no evidence of record showing the Veteran to have a diagnosis of pulmonary fibrosis. Congress has specifically limited entitlement to service-connected benefits to cases where there is a current disability. In the absence of proof of a present disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223 (1992).

Accordingly, the Board finds that the benefit-of-the-doubt rule is not applicable as the evidence weighs persuasively against the claim and is not in approximate balance. Therefore, entitlement to service connection for pulmonary fibrosis is not warranted. 38 U.S.C. § 5107(b) (2018); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). 

 

 

LESLEY A. REIN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Randall

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.