AMYOTROPHIC LATERAL SCLEROSIS (ALS)

Summary

The Veteran, who served honorably in the U.S. Army from March 1954 to December 1955, died in August 1999 from respiratory failure due to motor neuron disease, specifically ALS. His surviving spouse appealed the denial of service connection for the cause of death. The appeal was filed under the Direct Review docket, limiting the Board's review to evidence of record at the time of the prior agency decision. The appellant submitted several buddy statements from family and friends, including one from the Veteran's oldest child, attesting to his ALS diagnosis in 1997 and the subsequent rapid progression of the disease. The Board noted that ALS is a motor neuron disease and that there is a presumption of service connection for ALS under 38 C.F.R. § 3.318, provided there is no affirmative evidence to the contrary and the Veteran had at least 90 days of active service. The Board found no such contrary evidence and that the Veteran met the service duration requirement. Although the appellant requested the VA proceed quickly, the Board found the existing evidence sufficient to decide the claim, avoiding a remand that could be construed as an attempt to deny the claim. Given the buddy statements indicating an ALS diagnosis and the presumption of service connection for ALS, the Board found the evidence in relative equipoise. Applying the benefit of the doubt doctrine, the Board granted service connection for the cause of death.

Rationale

Presumption of service connection for ALS under 38 C.F.R. § 3.312; No affirmative evidence against service connection; Veteran had 90+ days of active service; Buddy statements indicated ALS diagnosis and progression; Benefit of the doubt resolved in favor of the Veteran

Full Decision Text

Citation Nr: A26040000
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 260318-639382
DATE: April 29, 2026

ORDER

Entitlement to service connection for the Veteran's cause of death is granted.

FINDING OF FACT

The Veteran's death certificate lists the cause of death as motor neuron disease with respiratory failure.

CONCLUSION OF LAW

The criteria for establishing entitlement to service connection for the cause of the Veteran's death have been met. 38 U.S.C. §§ 1110, 1310; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.309, 3.312, 3.318.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had honorable active duty service in the United States Army from March 1954 to December 1955. He died in August 1999. The appellant is his surviving spouse. 

The claim for cause of death was denied in a February 2026 rating decision. In the March 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the appellant elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the February 2026 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

If the appellant would like VA to consider any evidence that was submitted that the Board could not consider, the appellant 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 that the time for a docket switch waiver has not yet elapsed and that the appellant has not submitted a waiver of her right to switch dockets. See Williams v. McDonough, 37 Vet. App. 305 (2024). Notwithstanding, the appeal has been advanced on the docket and the appellant's choice of direct review indicates she is seeking the fastest review possible. See also April 2025 Statement in Support of the Case (requesting the VA make a decision as soon as possible). Accordingly, the Board will proceed with the appeal.

The appellant contends that service connection is warranted for the cause of the Veteran's death.

After consideration of the evidence and applicable law, the Board finds that entitlement to service connection for the cause of the Veteran's death is warranted.

Generally, service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Service connection may also be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Under 38 C.F.R. § 3.303 (b), service connection may be established when the evidence, regardless of its date, shows that a Veteran had a chronic condition in service or during the applicable presumptive period. Certain listed chronic diseases may be presumed to be service connected if manifested to a compensable degree within a year following separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307(a), 3.309(a). For such chronic diseases specified in 38 C.F.R. § 3.309(a), service connection may also be established based on continuity of symptomatology. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

A death will be considered to result from a service-connected disability when the evidence establishes that a disability which is causally related to service, was either the principal or a contributory cause of the Veteran's death. 38 U.S.C. § 1310; 38 C.F.R. § 3.312 (a). For a service-connected disability to constitute a principal (or primary) cause of death, it must be shown that such disability, singly or jointly with some other condition, was the immediate or underlying cause of death or was etiologically related thereto.
 established based on continuity of symptomatology. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

A death will be considered to result from a service-connected disability when the evidence establishes that a disability which is causally related to service, was either the principal or a contributory cause of the Veteran's death. 38 U.S.C. § 1310; 38 C.F.R. § 3.312 (a). For a service-connected disability to constitute a principal (or primary) cause of death, it must be shown that such disability, singly or jointly with some other condition, was the immediate or underlying cause of death or was etiologically related thereto. 38 C.F.R. § 3.312(b). For a service-connected disability to constitute a contributory cause of death, it must be shown to have contributed substantially and materially to the Veteran's death; combined to cause death; aided or lent assistance to the production of death; or resulted in debilitating effects and general impairment of health to an extent that would render the Veteran materially less capable of resisting the effects of other disease or injury causing death, as opposed to merely sharing in the production of death. 38 C.F.R. § 3.312(c). Although there are primary causes of death which by their very nature are so overwhelming that eventual death can be anticipated irrespective of coexisting conditions, even in such cases, consideration must be given to whether there may be a reasonable basis to hold that a service-connected condition was of such severity as to have a material influence in accelerating death, where the service-connected condition affected a vital organ and was of itself of a progressive or debilitating nature. 38 C.F.R. § 3.312(c). 

There is a presumption of service connection for veterans who develop ALS at any time after separation from service, unless (1) there is affirmative evidence it was not incurred in, or aggravated by, service; (2) there is affirmative evidence that it is due to the Veteran's willful misconduct; or (3) the Veteran did not have continuous active service of 90 days or more. 38 C.F.R. § 3.318. 

There is no affirmative evidence that the Veteran developed ALS was not incurred in or aggravated by service or due to his willful misconduct. The Veteran had continuous active-duty service of 90 days or more. 

The Veteran died in August 1999. See August 1999 death certificate. Cause of death was respiratory failure due to motor neuron disease. Id. 

The appellant submitted several buddy statements from the Veteran's children, sister, brother, nephew, and friends attesting to the Veteran having been diagnosed with or having had symptoms of amyotrophic lateral sclerosis (ALS). Of note, the Veteran's oldest child attested to his diagnosis of ALS in 1997. See May 2024 Sworn Buddy statement. She attested to the progression of the disease and rapid decline of the Veteran. Id.

After several attempts to obtain a proper VA 21-4142 Authorization for release of Information, the appellant notified the VA she had no other medical documentation to submit at the time and requested the VA to make a decision as soon as possible. See April 2025 Statement in Support of Claim.

The Board notes that ALS is recognized as a motor neuron disease. See Amyotrophic Lateral Sclerosis (ALS), https://www.ninds.nih.gov/health-information/disorders/amyotrophic-lateral-sclerosis-als. 

The Board has considered remand to obtain a medical opinion as to the cause of death, but such a request could be construed as obtaining additional evidence for the sole purpose of denying a claim, which is impermissible.  38 C.F.R. § 3.304(c) ("The development of evidence in connection with claims for service connection will be accomplished when deemed necessary but it should not be undertaken when evidence present is sufficient for this determination"); Andrews v. McDonough, 34 Vet. App. 216, 225 (2021) ("Remand is inappropriate where the predominant purpose is not to allow the Board to make a fully informed decision unencumbered by error but to allow VA to obtain more evidence so that it can properly deny the claim").

The above evidence is sufficient to decide the claim.  Based on the available evidence, the Board finds that the Veteran had an ALS diagnosis. See generally Buddy Statements. 

As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, and entitlement to service connection for ALS is warranted.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 

As the cause of death resulted from a motor neuron disorder, to include ALS, entitlement to service connection for cause of death is warranted.

 


 Board to make a fully informed decision unencumbered by error but to allow VA to obtain more evidence so that it can properly deny the claim").

The above evidence is sufficient to decide the claim.  Based on the available evidence, the Board finds that the Veteran had an ALS diagnosis. See generally Buddy Statements. 

As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, and entitlement to service connection for ALS is warranted.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 

As the cause of death resulted from a motor neuron disorder, to include ALS, entitlement to service connection for cause of death is warranted.

 

 

B. MULLINS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Jarman, Timothy

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.