SINUSITIS

J. B. FREEMAN · 2026 · Case ID: A26039785

MIXED

Summary

The veteran, who served in the United States Air Force from October 1962 to September 1966, appeals the denial of service connection for sinusitis, sleep apnea, a stomach disability, bilateral carpal tunnel syndrome, and a back disability. The Board denied these claims, finding insufficient evidence to establish service connection. For sinusitis and sleep apnea, the Board determined the veteran's lay statements and Google AI research were not competent to establish a current disability or link it to service, and thus the duty to assist in obtaining a VA examination was not triggered at the time of the initial decision. For the stomach disability claim, the Board found no evidence of persistent or recurrent symptoms causing functional impairment, nor a competent medical opinion linking the symptoms to service. For bilateral carpal tunnel syndrome, the Board found no evidence of a current diagnosis or in-service complaints, and the veteran's testimony indicated symptoms began after service. For the back disability, the Board found no in-service event or complaint related to the current back symptomatology, and the veteran's testimony suggested the onset occurred after service while working for General Electric. The Board considered the benefit of the doubt doctrine but found the evidence against these claims. The Board remanded claims for recurrent laryngitis, recurrent sore throat, heart disability post-bypass surgery, hypertension, and hyperthyroidism, citing a pre-decisional duty-to-assist error for failing to obtain VA examinations and etiology opinions related to the veteran's claimed toxic exposures (jet fuel and radio-frequency radiation).

Rationale

No competent evidence of current diagnosis or persistent/recurrent symptoms; Lay statements and AI research not competent for nexus; Duty to assist not triggered at time of initial decision

Service Branch

AIR FORCE

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250220-519198

Full Decision Text

Citation Nr: A26039785
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 250220-519198
DATE: April 28, 2026

ORDER

Entitlement to service connection for sinusitis is denied.

Entitlement to service connection for sleep apnea is denied.

Entitlement to service connection for a stomach disability is denied.

Entitlement to service connection for left hand carpal tunnel syndrome is denied.

Entitlement to service connection for right hand carpal tunnel syndrome is denied.

Entitlement to service connection for a back disability is denied.

REMANDED

Entitlement to service connection for recurrent laryngitis is remanded.

Entitlement to service connection for recurrent sore throat is remanded.

Entitlement to service connection for a heart disability status post quintuple bypass surgery is remanded.

Entitlement to service connection for hypertension, also claimed as high blood pressure, is remanded.

Entitlement to service connection for hyperthyroidism, also claimed as thyroid disability, is remanded.

FINDINGS OF FACT

1. The Veteran does not have a current disability of sinusitis.

2. The Veteran does not have a current disability of obstructive sleep apnea.

3. The Veteran does not have a current disability of a stomach disability.

4. The Veteran does not have a current disability of bilateral carpal tunnel syndrome.

5. The Veteran's lower back symptoms did not start during service.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for sinusitis are not met. 38 U.S.C. §§ 1101, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for entitlement to service connection for sleep apnea are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for entitlement to service connection for a stomach disability are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for entitlement to service connection for left hand carpal tunnel syndrome are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for entitlement to service connection for right hand carpal tunnel syndrome are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

6. The criteria for entitlement to service connection for a back disability are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran honorably served on active duty in the United States Air Force from October 1962 to September 1966. See DD Form 214.

These matters come before the Board of Veterans' Appeals (Board) on appeal from an April 2024 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO), denying the claims. In February 2025, the Veteran appealed the April 2024 rating decision, and he elected to have a hearing with a Veterans Law Judge (VLJ). See February 2025 VA Form 10182. A hearing was held by the undersigned in December 2025, and a transcript of the hearing is of record.

This appeal has been advanced on the Board's docket pursuant to 38 U.S.C. § 7107; 38 C.F.R. § 20.800.

APPLICABLE EVIDENTIARY WINDOW

The Board may only consider the evidence of record before the AOJ at the time of its decision on the issues on appeal, evidence submitted by the appellant or his or her representative at the Board hearing, to include testimony provided at the hearing; and evidence submitted within 90 days following the Board hearing. 38 C.F.R. §§ 20.300(a), 302(a). If additional evidence was submitted between the dates of the AOJ decision and the hearing, the Board will not consider it unless it is resubmitted during the 90 days following each of these actions. If evidence is not resubmitted, the appellant is welcome to file a supplemental claim to have this evidence considered. Id.; Cook v
VIDENTIARY WINDOW

Service Connection

Service connection may be granted on a direct basis for a disability resulting from a disease or injury incurred or aggravated during active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To substantiate a claim of service connection, there must be evidence of (1) a current disability; (2) incurrence or aggravation of a disease or injury in service; and (3) a causal connection between the disease or injury in service and the current disability. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

In deciding an appeal, 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. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994). Competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. See Layno v. Brown, 6 Vet. App. 465, 469 (1994).

1. Entitlement to service connection for sinusitis.

During the December 2025 Board hearing, the Veteran testified that when he has a cold, he has some post-nasal drip which he characterized as sinusitis. See December 2025 Hearing Transcript.

The Veteran testified that when he was assigned to Lockbourne Air Force Base to work as flight simulator technician, the simulator was in a hanger next to the one where the radio group was working on the "101B radars." Id. It is the Veteran's contention that his sinusitis is related to his exposure to jet fuel, specifically JP4, and to radio-frequency radiation from the radars installed on the aircrafts, frequently parked near the hanger where he was working. Id.

The Veteran did not present evidence that he has a current diagnosis of sinusitis, nor is evidence of such a disability otherwise present in the record. While the Veteran's service treatment record (STR) shows he was treated for a cold with acute laryngitis in December 1962, the STR is silent for any complaints, treatments or diagnosis of sinusitis. See January 2024 STR. Notably, the Board has separately remanded the issue of entitlement to service connection for sore throat and laryngitis.

The Board acknowledges that the Veteran was not provided with a VA examination for his sinusitis. However, it finds that the evidence at the time of the April 2024 rating decision on appeal did not trigger the AOJ's duty to assist the Veteran, and to order a VA examination for the claimed sinusitis.

In that regard, the AOJ has a duty to provide a VA medical examination to a claimant when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service or, for certain diseases, manifestation of the disease during an applicable presumptive period for which the claimant qualifies; and (3) an indication that the disability or persistent or recurrent symptoms of the disability may be associated with the veteran's service or with another service-connected disability; but (4) insufficient competent medical evidence on file for the Secretary to make a decision on the claim. 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(I).

However, with respect to the claimed sinusitis, the Board finds that at the time of the April 2024 rating decision on appeal, the claims file did not contain evidence that the Veteran was ever diagnosed with sinusitis or that at any point he had
disease during an applicable presumptive period for which the claimant qualifies; and (3) an indication that the disability or persistent or recurrent symptoms of the disability may be associated with the veteran's service or with another service-connected disability; but (4) insufficient competent medical evidence on file for the Secretary to make a decision on the claim. 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(I).

The Board also finds that Veteran did not report a lay observable diagnosis, and he had not proffered evidence that he has the training, education, or experience to qualify as a medical expert. 38 C.F.R. § 3.159(a)(1). Thus, he is a lay witness. Furthermore, he did not report what a medical professional has told him. Accordingly, the Board finds his basic assertion that he should be service connected for sinusitis was not competent to establish the existence of the disability and trigger the AOJ's duty to assist. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).

The Board acknowledges that the term "disability" used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability." Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018).

Here, however, at the time of the April 2024 rating decision on appeal, the Veteran had not stated what his symptoms were, and the evidence did not reflect that the Veteran had recurrent or persistent symptoms of sinusitis causing functional impairment of earning capacity. Thus, at the time of the April 2024 rating decision on appeal, the duty to provide the Veteran with a VA medical examination for the claimed sinusitis was not triggered. The Board, therefore, concludes that the duty to assist did not entitle the Veteran to an examination in this appeal. See 38 U.S.C. § 5103A(d)(2); 38 C.F.R. §§ 3.159(c)(4)(i), 20.301.

Furthermore, after the April 2024 rating decision on appeal, the Veteran testified at the December 2025 Board hearing about his symptoms and their etiology, and in January 2026, he submitted a statement along with a Google research summary. Therefore, the Board will proceed to the merits of this claim based on the evidence of record, including evidence received at the December 2025 Board hearing, and in the 90 days thereafter.

First, the Veteran testified at the December 2025 Board hearing that he experiences some symptoms consistent with post-nasal drip whenever he has a cold. See December 2025 Hearing Transcript. Next, it is his contention that his sinusitis symptoms are related to his exposure to jet fuel, specifically JP4, and to radio-frequency radiation from the radars installed on the aircraft parked near the hanger where he was working. Id. Finally, in support of a link between his symptoms and his service, the Veteran submitted Google's Artificial Intelligence (AI)'s responses to his questions about the type of radars used in the 1960s F101B, and the health hazards associated with exposure to radars, jet fuel exhaust, and any other health risks associated with working on F101B-type of aircrafts. See January 2026 Correspondence.

With respect to the in-service element of service connection, the Board finds that there is no evidence that during service he complained of, or was treated for, sinusitis or symptoms thereof. With respect to the etiology of the Veteran's symptoms, the Board finds there is no competent medical opinion linking them to his service, to include his claimed in-service toxic exposure. Specifically, the Board finds that the relationship between a certain disability, or its symptoms, and service, to include in-service toxic exposure, is a complex medical question that requires medical expertise, and it cannot be established by lay evidence. See Kahana v. Shinseki, 24 Vet. App. 428, 433 (2011); Jandreau, 492 F.3d at 1376-77. Since the record does not show that the Veteran received medical training to make such determination, the Board cannot assign probative weight to his lay statement. Similarly, responses generated by Google AI are not considered competent medical evidence with respect to the etiology of the disability. Google AI's responses do not qualify
-service toxic exposure. Specifically, the Board finds that the relationship between a certain disability, or its symptoms, and service, to include in-service toxic exposure, is a complex medical question that requires medical expertise, and it cannot be established by lay evidence. See Kahana v. Shinseki, 24 Vet. App. 428, 433 (2011); Jandreau, 492 F.3d at 1376-77. Since the record does not show that the Veteran received medical training to make such determination, the Board cannot assign probative weight to his lay statement. Similarly, responses generated by Google AI are not considered competent medical evidence with respect to the etiology of the disability. Google AI's responses do not qualify as competent medical evidence as they do not relate to the Veteran's service and medical history, and to symptoms experienced by him. In sum, without competent evidence to establish a link between a current disability and an in-service event, injury, or exposure, entitlement to service connection cannot be established.

Although he is competent to report what a medical expert has told him, the Veteran has not reported that a medical expert has related his sinusitis symptoms to his service. In sum, without competent evidence to establish a link between the Veteran's current symptoms, characterized as sinusitis, entitlement to service connection cannot be established.

In light of the foregoing, the Board concludes that the criteria for entitlement to service connection for sinusitis are not met. Therefore, the appeal must be denied as to this claim. In reaching this conclusion, the benefit of the doubt doctrine was considered. However, as the evidence is against the claim, this doctrine is not applicable. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

2. Entitlement to service connection for sleep apnea.

The Veteran contends that his sleep apnea is related to his exposure to jet fuel, specifically JP4, and to radio-frequency radiation from the "101B radars" installed on the aircrafts at the Lockbourne Air Force Base, which he testified were parked near the hanger where he was working as flight simulator specialist. See, e.g., December 2025 Hearing Transcript. At the hearing, the Veteran testified that his spouse started to notice he had difficulty breathing at night in the 1980s or 1990s, therefore after service. Id. In terms of symptoms, the Veteran did not report snoring, as he testified "I breathe so shallow," but rather he reported that sometimes he is out of breath when he wakes up. Id. The Veteran did not testify that a doctor diagnosed him with sleep apnea. Id.

The Veteran's service treatment record, to include but not limited to his separation examination, is silent for any complaints, treatments, or diagnosis of sleep apnea or sleeping difficulties. See January 2024 STR.

Furthermore, the Veteran did not present evidence that he has a current diagnosis of sleep apnea or persistent or recurrent symptoms of such disability, nor is evidence of such a disability otherwise present in the record.

The Board acknowledges that the Veteran was not provided with a VA examination for his sleep apnea claim. However, it finds that VA did not need to provide an examination with respect to this claim.

Here, the Board finds that at the time of the April 2024 rating decision on appeal, the claims file did not contain evidence that the Veteran was ever diagnosed with sleep apnea or that at any point he had persistent or recurrent symptoms of sleep apnea. Moreover, the Veteran did not report a lay observable diagnosis, and he had not proffered evidence that he has the training, education, or experience to qualify as a medical expert. 38 C.F.R. § 3.159(a)(1). Thus, he is a lay witness. Furthermore, he is not reporting what a medical professional has told him. Accordingly, the Board finds his basic assertion that he should be service connected for obstructive sleep apnea was not competent to establish the existence of the disability, or persistent or recurrent symptoms thereof,
rating decision on appeal, the claims file did not contain evidence that the Veteran was ever diagnosed with sleep apnea or that at any point he had persistent or recurrent symptoms of sleep apnea. Moreover, the Veteran did not report a lay observable diagnosis, and he had not proffered evidence that he has the training, education, or experience to qualify as a medical expert. 38 C.F.R. § 3.159(a)(1). Thus, he is a lay witness. Furthermore, he is not reporting what a medical professional has told him. Accordingly, the Board finds his basic assertion that he should be service connected for obstructive sleep apnea was not competent to establish the existence of the disability, or persistent or recurrent symptoms thereof, and trigger the AOJ's duty to assist. Jandreau, 492 F.3d at 1377.

The Board acknowledges that the term "disability" used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability." Saunders, supra.

Here, however, at the time of the April 2024 rating decision on appeal, the Veteran had not stated what symptoms were associated with his claimed sleep apnea. The evidence at the time of the rating decision on appeal did not reflect that the Veteran had recurrent or persistent symptoms of sleep apnea causing functional impairment of earning capacity. Thus, at the time of the April 2024 rating decision on appeal, the duty to provide the Veteran with a VA medical examination for the claimed sleep apnea was not triggered. The Board, therefore, concludes that the duty to assist did not entitle the Veteran to an examination in this appeal. See 38 U.S.C. § 5103A(d)(2); 38 C.F.R. §§ 3.159(c)(4)(i), 20.301.

Furthermore, after the April 2024 rating decision on appeal, the Veteran testified at the December 2025 Board hearing about his symptoms and their etiology, and in January 2026, he submitted a statement along with the results of a Google research. See January 2026 Correspondence. Therefore, the Board will proceed to the merits of this claim based on the evidence of record, including evidence received at the December 2025 Board hearing, and in the 90 days thereafter.

First, the Veteran testified at the December 2025 Board hearing that he experiences shortness of breath when he wakes up. See December 2025 Hearing Transcript. It is his contention that his sleep apnea symptoms are related to his exposure to jet fuel, specifically JP4, and to radio-frequency radiation from the radars installed on the aircrafts parked near the hanger where he was working. Id. In support of a nexus, the Veteran submitted the result of a google research. See January 2026 Correspondence. Specifically, the Veteran asked Google's AI about the type of radars used in the 1960s F101B, and the health hazards associated with exposure to radars, jet fuel exhaust, and any other health risks associated with working on F101B type of aircraft. Id.

With respect to the in-service element of service connection, the Board finds that there is no evidence that during service he complained of, or was treated for, sleep apnea or symptoms thereof. Moreover, the Veteran testified at the Board hearing that his symptoms were first observed by his spouse in the 1980s or 1990s, therefore after service. With respect to the third element of service connection, namely a link between a current disability and service, the Board finds that there is no competent medical opinion linking the Veteran's symptoms to his service, including his claimed in-service toxic exposure. Specifically, the Board finds that the relationship between a certain disability, or its symptoms, and service, to include in-service toxic exposure, is a complex medical question that requires medical expertise, and it cannot be established by lay evidence. See Kahana, 24 Vet. App. at 433; Jandreau, at 1376-77. Since the record does not show that the Veteran received medical training to make such determination, the Board cannot assign probative weight to his lay statement. Similarly, responses generated by Google AI are not considered competent medical evidence with respect to the etiology of the disability. Google AI's responses do not qualify as competent medical evidence as they do not relate to the Veteran's service and medical history, and to symptoms experienced by him. Although he is competent to report what a medical expert has told him, the Veteran has not reported that a medical expert has related his sleep apnea symptoms to his service. In sum, even assuming that the Veteran's shortness of breath is a symptom of sleep apnea, without competent evidence to establish a link between a current disability and an in-service event, injury, or
received medical training to make such determination, the Board cannot assign probative weight to his lay statement. Similarly, responses generated by Google AI are not considered competent medical evidence with respect to the etiology of the disability. Google AI's responses do not qualify as competent medical evidence as they do not relate to the Veteran's service and medical history, and to symptoms experienced by him. Although he is competent to report what a medical expert has told him, the Veteran has not reported that a medical expert has related his sleep apnea symptoms to his service. In sum, even assuming that the Veteran's shortness of breath is a symptom of sleep apnea, without competent evidence to establish a link between a current disability and an in-service event, injury, or exposure, entitlement to service connection cannot be established.

In light of the foregoing, the Board concludes that the criteria for entitlement to service connection for sleep apnea are not met. Therefore, the appeal must be denied as to this claim. In reaching this conclusion, the benefit of the doubt doctrine was considered. However, as the evidence is against the claim, this doctrine is not applicable. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

3. Entitlement to service connection for a stomach disability.

In a December 2023 statement, the Veteran contended that his stomach symptomatology is related to the stress and poor diet he followed while in the military. See December 2023 Statement in Support of Claim.

At the December 2025 Board hearing, the Veteran testified that his stomach symptoms started before he got married, presumably during service, and that they continued since. See December 2025 Hearing Transcript. Specifically, with respect to the reported symptoms, the Veteran testified at the Board hearing that after a meal he feels bloated, like he ate too much. Id. Finally, during the hearing the Veteran mentioned that he was concerned these symptoms could relate to his in-service exposure to radar radiation and jet fuel. Id.

The Veteran's STR, to include but not limited to his separation examination, is silent for any complaints, treatments or diagnosis of a stomach disability, or recurrent symptomatology. See January 2024 STR. Furthermore, at the time of the April 2024 rating decision on appeal, the Veteran did not present evidence that he had a current diagnosis of a stomach disability, or recurrent symptomatology, nor was evidence of such disability otherwise present in the record.

The Board acknowledges that the Veteran was not provided with a VA examination for his stomach disability claim. However, it finds that VA did not need to provide an examination with respect to this claim.

The AOJ has a duty to provide a VA medical examination to a claimant when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service or, for certain diseases, manifestation of the disease during an applicable presumptive period for which the claimant qualifies; and (3) an indication that the disability or persistent or recurrent symptoms of the disability may be associated with the veteran's service or with another service-connected disability; but (4) insufficient competent medical evidence on file for the Secretary to make a decision on the claim. 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(I).

Here, the Board finds that at the time of the April 2024 rating decision on appeal, the claims file did not contain evidence that the Veteran was ever diagnosed with a stomach disability, or that at any point prior to the rating decision on appeal he had persistent or recurrent symptoms of a stomach disability. Moreover, the Veteran did not report a lay observable diagnosis, and he had not proffered evidence that he has the training, education, or experience to qualify as a medical expert. 38 C.F.R. § 3.159(a)(1). Thus, he is a lay witness. Furthermore, he did not report what a medical professional had told him. Accordingly, the Board finds his basic assertion that he should be service connected for a stomach disability was not competent to establish the existence of the disability, or persistent or recurrent symptoms thereof. Jandreau, at 1377.

The Board acknowledges that the term "disability" used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability." Saunders, supra.

Here, however, at the time of the April 2024 rating decision on appeal, the Veteran had not provided a statement indicating what symptoms were associated with his claimed stomach disability. The evidence at the time of the rating decision on appeal did not reflect that the Veteran had recurrent or persistent symptoms of a stomach disability causing functional impairment of earning capacity. Thus
be service connected for a stomach disability was not competent to establish the existence of the disability, or persistent or recurrent symptoms thereof. Jandreau, at 1377.

The Board acknowledges that the term "disability" used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability." Saunders, supra.

Here, however, at the time of the April 2024 rating decision on appeal, the Veteran had not provided a statement indicating what symptoms were associated with his claimed stomach disability. The evidence at the time of the rating decision on appeal did not reflect that the Veteran had recurrent or persistent symptoms of a stomach disability causing functional impairment of earning capacity. Thus, at the time of the April 2024 rating decision on appeal, the duty to provide the Veteran with a VA medical examination for the claimed stomach disability was not triggered. The Board, therefore, concludes that the duty to assist did not entitle the Veteran to an examination in this appeal. See 38 U.S.C. § 5103A(d)(2); 38 C.F.R. §§ 3.159(c)(4)(i), 20.301.

Furthermore, after the April 2024 rating decision on appeal, the Veteran testified at the December 2025 Board hearing about his symptoms and their etiology, and in January 2026, he submitted a statement along with the results of a Google AI's research. See January 2026 Correspondence. Therefore, the Board will proceed to the merits of this claim based on the evidence of record, including evidence received at the December 2025 Board hearing, and in the 90 days thereafter.

First, the Veteran testified at the December 2025 Board hearing that he feels bloated after a meal, like he "ate too much." See December 2025 Hearing Transcript. It is his contention that his stomach symptoms are related to stress and poor diet during service, or his exposure to jet fuel, specifically JP4, and to radio-frequency radiation from the radars installed on the aircraft, which he testified were frequently parked near the hanger where he was working. Id. In support of a nexus, the Veteran submitted the result of a Google AI's research. See January 2026 Correspondence. In essence, the Veteran asked Google's AI about the type of radars used in the 1960s F101B, and the health hazards associated with exposure to radars, jet fuel exhaust, and any other health risks associated with working on F101B type of aircraft. Id. Google's AI provided some generalized information pulled from internet data about potential risks associated with exposure to that type of radiofrequency and to jet fuel.

With respect to the first element of service connection, the Board finds that there is no evidence of persistent or recurrent symptoms of a stomach disability. Here, the evidence does not reflect, and the Veteran did not contend, that he has stomach-related symptoms causing functional impairment of earning capacity. At the Board hearing, the Veteran testified about feeling like he had too much food and experiencing bloating after a meal, but he did not testify as to whether these symptoms cause functional impairment of earning capacity. With respect to the in-service element of service connection, the Board finds that there is no evidence that during service he complained of, or was treated for, a stomach disability or symptoms thereof. With respect to the third element of service connection, namely a link between a current disability and service, the Board finds that there is no competent medical opinion linking the Veteran's symptoms to his service. Specifically, the Board finds that the relationship between a certain disability, or its symptoms, and service, is a complex medical question that requires medical expertise, and it cannot be established by lay evidence. See Kahana, at 433; Jandreau, at 1376-77. Since the record does not show that the Veteran received medical training to make such determination, the Board cannot assign probative weight to his lay statement. Similarly, although he is competent to report what a medical expert has told him, the Veteran has not reported that a medical expert has related his stomach symptoms to his service. Similarly, responses generated by Google AI are not considered competent medical evidence with respect to the disability's etiology. Google AI's responses do not qualify as competent medical evidence as they do not relate to the Veteran's service and medical history, and to symptoms experienced by him. In sum, without competent evidence to establish a link between a current disability and an in-service event, injury, or exposure, entitlement to service connection cannot be established.

In light of the foregoing, the Board concludes that the criteria for entitlement to service connection for a stomach disability are not met. Therefore, the appeal must be denied as to this claim. In reaching this conclusion, the benefit of the doubt doctrine was considered. However, as the evidence is
symptoms to his service. Similarly, responses generated by Google AI are not considered competent medical evidence with respect to the disability's etiology. Google AI's responses do not qualify as competent medical evidence as they do not relate to the Veteran's service and medical history, and to symptoms experienced by him. In sum, without competent evidence to establish a link between a current disability and an in-service event, injury, or exposure, entitlement to service connection cannot be established.

4. Entitlement to service connection for left hand carpal tunnel syndrome.

5. Entitlement to service connection for right hand carpal tunnel syndrome.

In a December 2023 statement, the Veteran argued that his current bilateral CTS is due to "my job duties and constant use of my hands." See December 2023 Statement in Support of Claim. At the December 2025 Board hearing, the Veteran testified that when he was working for General Electrics (GE) in the 1970s, he was putting some strain on his wrists and hands due to "lots of movements with vises and skids, and doors and everything," and he started to notice fatigue in his hands, which continued to the present. See December 2025 Hearing Transcript.

Here, the Veteran did not present evidence that he has a current diagnosis of bilateral carpal tunnel syndrome (CTS), nor is evidence of such a disability otherwise present in the record.

The Board acknowledges that the Veteran was not provided with a VA examination for his bilateral CTS. However, it finds that VA did not need to provide an examination with respect to this claim.

The VA has a duty to provide a VA medical examination to a claimant when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service or, for certain diseases, manifestation of the disease during an applicable presumptive period for which the claimant qualifies; and (3) an indication that the disability or persistent or recurrent symptoms of the disability may be associated with the veteran's service or with another service-connected disability; but (4) insufficient competent medical evidence on file for the Secretary to make a decision on the claim. 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(I).

Here, the Board finds that at the time of the April 2024 rating decision on appeal, the claims file did not contain evidence that the Veteran was ever diagnosed with CTS, or that at any point prior to the rating decision on appeal he had persistent or recurrent symptoms of CTS. Moreover, the Veteran was not reporting a lay observable diagnosis, and he had not proffered evidence that he has the training, education, or experience to qualify as a medical expert. 38 C.F.R. § 3.159(a)(1). Thus, he is a lay witness. Furthermore, he did not report what a medical professional had told him. Accordingly, the Board finds his basic assertion that he should be service connected for bilateral CTS was not competent to establish the existence of the disability, or existence of persistent or recurrent symptoms associated with CTS. Jandreau, at 1377.

The Board acknowledges that the term "disability" used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability," and that the court held that "pain alone can serve as a functional impairment and therefore qualify as a disability." Saunders, supra. Thus, where pain alone results in functional impairment, even if there is no identified underlying diagnosis, it can constitute a disability.

However, here, the evidence of record at the time of the April 2024 rating decision on appeal did not reflect that the Veteran complained of bilateral hand or wrist pain causing functional impairment of earning capacity. Thus, at the time of the April 2024 rating decision on appeal, the duty to provide the Veteran with a VA medical examination for the claimed bilateral CTS was not triggered. The Board, therefore, concludes that the duty to assist did not entitle the Veteran to an examination in this appeal. See 38 U.S.C. § 5103A(d)(2); 38 C.F.R. §§ 3.159(c)(4)(i), 20.301.

Furthermore, after the April 2024 rating
.

Furthermore, after the April 2024 rating decision on appeal, the Veteran testified at the December 2025 Board hearing about his symptoms and their etiology. See December 2025 Hearing Transcript. Therefore, the Board will proceed to the merits of this claim based on the evidence of record, including evidence received at the December 2025 Board hearing, and in the 90 days thereafter.

Initially, Veteran contended that his bilateral CTS was related to his job duties and constant use of his hands during service. See December 2023 Statement in Support of Claim. At the December 2025 Board hearing, however, he testified that the first time he started noticing hand and/or wrist symptoms was when he was working for GE in the 1970s, when he was putting some strain on his wrists and hands due to "lots of movements with vises and skids, and doors and everything." See December 2025 Hearing Transcript.

With respect to the first element of service connection, the Board finds that there is no evidence of a diagnosed CTS. However, the Board will consider the Veteran's reporting of recurrent bilateral hand and/or wrist symptoms. With respect to the in-service element of service connection, the Board finds that there is no evidence that during service he complained of, or was treated for, CTS or hand pain. Moreover, at the December 2025 Board hearing, the Veteran testified that his symptoms started after military service, when he started working for GE. With respect to the third element of service connection, namely a link between a current disability and service, the Board finds that there is no competent medical opinion linking the Veteran's claimed disability to his service. Specifically, the Board finds that the relationship between a certain disability, or its symptoms, and service, is a complex medical question that requires medical expertise, and it cannot be established by lay evidence. See Kahana, at 433; Jandreau, at 1376-77. Since the record does not show that the Veteran received medical training to make such determination, the Board cannot assign probative weight to his lay statements. Similarly, although he is competent to report what a medical expert has told him, the Veteran has not reported that a medical expert has related his symptoms to his service. In sum, without competent evidence to establish a link between a current disability and an in-service event, injury, or exposure, entitlement to service connection cannot be established.

In light of the foregoing, the Board concludes that the criteria for entitlement to service connection for bilateral CTS are not met. Therefore, the appeal must be denied as to this claim. In reaching this conclusion, the benefit of the doubt doctrine was considered. However, as the evidence is against the claim, this doctrine is not applicable. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

6. Entitlement to service connection for a back disability.

The Veteran contended that his back pain was due to his job duties as flight simulator technician during service. See December 2023 Statement in Support of Claim. At the December 2025 Board hearing, the Veteran testified that he first started to notice some back discomfort when working for GE, in the 1970s, as he had to move some heavy loads, and that eventually he started to have some back pain that continued since. See December 2025 Hearing Transcript.

The Veteran's military personnel record shows that the job duties associated with the Veteran's military occupational specialty (MOS) included the inspection, installation, maintenance, operation, and testing of the MB-40 simulator. See January 2024 Military Personnel Record, p. 34.

The Veteran's STR, to include but not limited to his separation examination, is silent for any complaints, treatments or diagnosis of a back disability. See January 2024 STR.

The Board acknowledges that the Veteran was not provided with a VA examination for his back claim. However, it finds that VA did not need to provide an examination with respect to this claim.

The VA has a duty to provide a VA medical examination to a claimant when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a
Veteran's military occupational specialty (MOS) included the inspection, installation, maintenance, operation, and testing of the MB-40 simulator. See January 2024 Military Personnel Record, p. 34.

The Veteran's STR, to include but not limited to his separation examination, is silent for any complaints, treatments or diagnosis of a back disability. See January 2024 STR.

The Board acknowledges that the Veteran was not provided with a VA examination for his back claim. However, it finds that VA did not need to provide an examination with respect to this claim.

Here, there is no evidence of an in-service event, injury, or disease relating to the Veteran's current back symptomatology, which he testified is related to events that happened around the 1970s, when he was employed by GE, therefore after service. Furthermore, there is no evidence in the claims file that the Veteran complained of, or was treated for, a back disability during service.

The Board, therefore, concludes that the duty to assist did not entitle the Veteran to an examination in this appeal.

The Board further concludes that the criteria for entitlement to service connection for a back disability are not met. Therefore, the appeal must be denied as to this claim. In reaching this conclusion, the benefit of the doubt doctrine was considered. However, as the evidence is against the claim, this doctrine is not applicable. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

REASONS FOR REMAND

1. Entitlement to service connection for recurrent laryngitis.

2. Entitlement to service connection for recurrent sore throat.

In December 2023, the Veteran submitted a statement indicating that his acute laryngitis, and sore throat were due to his toxic exposure, to include exposure to radio-frequency radiation. See December 2023 Statement in Support of Claim. During the December 2025 Board hearing, the Veteran testified that during service he got a cold and experienced laryngitis, and that every time he had a cold after service, he would experience laryngitis. See December 2025 Hearing Transcript. Specifically, the Veteran reported that during service, he was treated for laryngitis with humidifiers and some cough medications. Id. The Veteran also testified that when he was assigned to Lockbourne Air Force Base to work as flight simulator technician, the simulator was in the hanger next to the one where the radio group was, and that they were always working on the "101B radars." Id. It is the Veteran's contention that his recurrent laryngitis and sore throat are related to his exposure to jet fuel, specifically JP4, and to radiation from the radars installed on the aircrafts, often parked near the hanger where he was working. Id.

The Veteran's STR shows he was treated for a cold with acute laryngitis and "loss of voice" in December 1962, and for tonsillitis in October 1963. See January 2024 STR.

In April 2024, the RO made the favorable finding that the Veteran was treated for acute laryngitis during service, but it did not afford the Veteran with an opportunity to report to a VA examination, nor obtained an opinion on whether these disabilities were related to the Veteran's claimed toxic exposure.

Pursuant to Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act), VA must provide a VA examination and/or medical opinion when there exists evidence of a disability and evidence of participation in a toxic exposure risk activity (TERA) when such evidence is not sufficient to establish service connection for the disability. 38 U.S.C. § 1168(a).

The examination requirement does not apply if the VA Secretary has determined that there is no indication of an association between the disability claimed by the veteran and the toxic exposure risk activity for which the veteran has submitted evidence. 38 U.S.C. § 1168(b). The PACT Act sub-regulatory guidance clarified that claims based on physical trauma, claims for a mental disorder disability, and claims that manifested during service or with an etiology not associated with toxic exposure, are exempted from the TERA examination and medical opinion requirement. See VBA Letter 20-24-06, Updated Guidance on Processing Claims Involving the PACT Act, (Jun. 17, 2024), p.12.

Here, sore throat and laryngitis are not disabilities listed as exempt from the TERA examination and opinion requirement pursuant to the PACT Act, the Veteran is competent to report symptoms of sore throat and laryngitis that may be related to his in-service exposure, and the AOJ did not obtain such VA examinations and opinions.

Based on the above, the Board finds that a remand is necessary to afford the Veteran with a VA examination and etiology opinion prior to deciding the claim.

The Board, therefore, concludes that denying the claims for sore throat and laryngitis without obtaining a VA examination and opinion constitutes a pre-decisional duty-to-assist error that needs to be cured in order to adjudicate the claims on appeal. 38 U.S.C. § 5103A; 38 C.F.R. § 20.802.

3. Entitlement to service connection for a heart disability status post quintuple bypass surgery.

4. Entitlement to service connection for hypertension, also claimed as high blood pressure.

5. Entitlement to service connection for hyperthyroidism, also claimed as thyroid disability.

The Veteran contends that his heart disability, hypertension and hyperthyroidism are all related to his in-service toxic exposure to jet fuel and radio-frequency radiation coming from the radars installed on aircrafts present on base. See December 2023 Statement in Support of Claim and December 2025 Hearing Transcript.

The Veteran's VA treatment records show that he has a current diagnosis of hypertension and hypothyroidism, and that he has a history of coronary artery bypass grafting and carotid artery disease. See July 2024 Capri Records.

Here, heart diseases, hypertension, and hypothyroidism are not disabilities listed as exempt from the TERA examination and opinion requirement pursuant to the PACT Act, and the AOJ did not obtain such VA examinations and opinions.

Based on the above, the Board finds that a remand is necessary to afford the Veteran with VA examinations and etiology opinions prior to deciding the claims.

The Board, therefore, concludes that denying the claims for a heart disability, hypertension, and hypothyroidism without obtaining a VA examination and opinion, constituted a pre-decisional duty-to-assist error that needs to be cured in order to adjudicate the claims on appeal. 38 U.S.C. § 5103A; 38 C.F.R. § 20.802. The Board by this remand makes no determination, expressed or implied, concerning the credibility of any statements on file.

Accordingly, the matters are REMANDED for the following actions
opinions.

Based on the above, the Board finds that a remand is necessary to afford the Veteran with VA examinations and etiology opinions prior to deciding the claims.

Accordingly, the matters are REMANDED for the following actions:

1. Schedule the Veteran for a VA examination for his sore throat and laryngitis claim. The entire claims file and a copy of this remand must be made available to the examiner for review.

After reviewing the entire claims file, the examiner is asked to provide an opinion on whether the Veteran has a sore throat and laryngitis disability that is related to his claimed exposure to JP4 - jet fuel, and radio-frequency radiation coming from the radars installed on "101B" aircrafts.

In rendering this opinion, the examiner must consider the total potential exposure through the Veteran's military deployment and the synergistic, combined effect of all toxic exposure risk activities of the Veteran.

The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be considered. If the examiner rejects the Veteran's reports, the examiner must provide a reason for doing so.

A rationale for all opinions expressed should be provided. A discussion of the facts and the medical principles involved will be of considerable assistance, including citation to any supporting medical treatises.

2. Schedule the Veteran for a VA examination for his heart disability claim. The entire claims file and a copy of this remand must be made available to the examiner for review.

After reviewing the entire claims file, the examiner is asked to provide an opinion on whether the Veteran has a current heart disability that is related to his claimed exposure to JP4 - jet fuel, and radio-frequency radiation coming from the radars installed on "101B" aircrafts.

3. Schedule the Veteran for a VA examination for his hypertension claim. The entire claims file and a copy of this remand must be made available to the examiner for review.

After reviewing the entire claims file, the examiner is asked to provide an opinion on whether the Veteran's hypertension is related to his claimed exposure to JP4 - jet fuel, and radio-frequency radiation coming from the radars installed on "101B" aircrafts.

4. Schedule the Veteran for a VA examination for his hyperthyroidism claim. The entire claims file and a copy of this remand must be made available to the examiner for review.

After reviewing the entire claims file, the examiner is asked to provide an opinion on whether the Veteran's hyperthyroidism is related to his claimed exposure to JP4 - jet fuel, and radio-frequency radiation coming from the radars installed on "101B" aircrafts.

J. B. FREEMAN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board E. Fiorito, Associate 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.

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