CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

PAUL SORISIO · 2026 · Case ID: A26040248

MIXED

Summary

The veteran served from October 1970 to May 1974, and again from May 1974 to August 1978. The veteran appeals the denial of service connection for chronic obstructive pulmonary disease (COPD), sleep apnea, sinusitis, and bilateral flat feet, while service connection for tinnitus was granted. The Board conceded the veteran's exposure to toxic exposure risk activity (TERA) due to herbicide agents for the COPD claim, but found no direct or presumptive link, noting COPD is not a presumptive condition and the primary risk factor was smoking. A VA examiner opined COPD was less likely than not caused by TERA, citing smoking as the main factor. For sleep apnea, service records were silent, and a VA examiner found it less likely than not related to TERA, citing risk factors like age, obesity, and smoking. The sinusitis claim was denied due to lack of objective medical evidence of a current diagnosis, with a VA examiner finding no diagnosis after examination. Tinnitus was granted, with the Board finding the veteran's lay statements credible regarding its onset during service due to noise exposure, despite a VA examiner's opinion that it was less likely than not service-related due to lack of in-service complaints. The bilateral flat feet claim was denied due to lack of in-service event or nexus, with the Board finding the veteran's lay statements regarding onset not competent due to inconsistencies and lack of corroboration.

Rationale

No presumptive link for COPD with herbicide exposure.; VA examiner found COPD less likely than not caused by TERA.; Smoking identified as primary risk factor for COPD.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250502-539570

Full Decision Text

Citation Nr: A26040248
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 250502-539570
DATE: April 29, 2026

ORDER

Service connection for chronic obstructive pulmonary disease (COPD) is denied.

Service connection for sleep apnea is denied.

Service connection for sinusitis is denied.

Service connection for tinnitus is granted.

Service connection for bilateral flat feet is denied.

FINDINGS OF FACT

1. The Veteran's COPD was not related to in-service TERA and the disability is not otherwise etiologically related to an in-service injury or disease.

2. The Veteran's sleep apnea was not related to in-service TERA and the disability is not otherwise etiologically related to an in-service injury or disease.

3. The evidence of record persuasively weighs against finding that the Veteran has had sinusitis at any time during or approximate to the pendency of the claim.

4. The Veteran's tinnitus is related to in-service hazardous noise exposure.

5. The evidence of record persuasively weighs against finding that bilateral flat feet began during active service or is otherwise related to an in-service injury or disease.

CONCLUSIONS OF LAW

1. The criteria for service connection for COPD are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

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

3. The criteria for service connection for sinusitis are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for service connection for bilateral flat feet are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from October 1970 to May 1974, and from May 1974 to August 1978.

These matters come before the Board of Veterans' Appeals (Board) on appeal from a December 3, 2024 rating decision that denied service connection for bilateral flat feet and tinnitus, a March 17, 2025 rating decision that denied service connection for sleep apnea and sinusitis, and an April 14 , 2025 rating decision that denied service connection for COPD issued by the Department of Veterans Affairs (VA) Regional Office (RO).

In the May 2025 VA form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct Review docket. Based upon the selection of the Direct Review option, the Board may only consider the evidence of record pertaining to bilateral flat feet and tinnitus as of December 2, 2024, the evidence of record pertaining to sleep apnea and sinusitis as of March 17, 2025, and the evidence of record pertaining to COPD as of April 14, 2025-the dates of the rating decisions on appeal. If the Veteran submitted evidence that was added to the record after for the specific issues noted after the dates of the related rating decisions pertaining to those issues, the Board did not consider it. If the Veteran wishes to have VA consider any evidence that was not considered, a supplemental claim should be submitted identifying such evidence. See 38 C.F.R. § 3.2501.

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; (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).

The Veteran is competent to report symptoms and experiences observable by his senses. See Jandreau
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; (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).

The Veteran is competent to report symptoms and experiences observable by his senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed Cir. 2009).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

1. Entitlement to service connection for COPD

In the April 2025 rating decision, the AOJ conceded the Veteran's exposure to a toxic exposure risk activity (TERA), based on his exposure to herbicide agents, and found that the Veteran has been diagnosed with COPD. The Board is bound by these favorable findings. 38 C.F.R. § 3.104(c).

If a Veteran was exposed to an herbicide agent during active military, naval, or air service, several diseases are entitled to presumptive service connection even though there is no record of such disease during service. 38 C.F.R. § 3.309(e). COPD is not on the list of diseases entitled to presumptive service connection based on exposure to herbicide agents; thus, the presumption of service connection will not be discussed further.

Additionally, although service connection is possible for certain disabilities on a presumptive basis as a chronic disease in accordance with 38 C.F.R. §§ 3.307 and 3.309, COPD is not included in the list of chronic diseases contained in 38 C.F.R. § 3.309(a), and presumptive service connection is therefore not possible for COPD as a chronic disease.

When a claimed disorder is not included as a presumptive disorder, direct service connection may nevertheless be established by evidence demonstrating that the disease was in fact "incurred" during service, to include as based on exposure to herbicide agents. See Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994).

Service connection is also possible for chronic disabilities listed in § 3.309(a) under 38 C.F.R. § 3.303(b) based on a continuity of symptomatology. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). However, as noted above, COPD is not considered a chronic disability under 38 C.F.R. § 3.309(a); thus, continuity of symptomatology is not for consideration.

Accordingly, the key inquiry is whether there is a causal relationship between the diagnosed COPD and the Veteran's exposure to herbicide agents as a TERA.

The Veteran's service treatment records are silent for complaints, treatment, or diagnosis for COPD.

A 2022 private treatment record shows that the Veteran was treated for COPD.

A January 2025 VA disability benefits questionnaire (DBQ) shows that the VA examiner opined that it was as likely as not that COPD was caused by the indicated toxic exposure risk activity after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic combined effect of all toxic exposure risk activities. The VA examiner noted that the Veteran had been exposed to herbicide agents but that there was no conclusive evidence that agent orange directly caused COPD. However, the VA examiner noted that exposure to agent orange could trigger COPD especially when combined with smoking.

An April 2025 VA DBQ shows the VA examiner noted that COPD was a common and treatable disease characterized by progressive airflow limitation and tissue destruction. The VA examiner noted that the condition was associated with structural lung changes due to chronic inflammation from prolonged exposure to noxious particles or gases most commonly cigarette smoke. The VA examiner noted that the Veteran had a lengthy history of cigarette smoking and the prevalence of COPD increased with increasing age. The VA examiner noted that the Veteran was exposed to TERA during active service and the primary risk factor for the development of COPD is smoking which the Veteran had a significant history. The VA examiner noted that although environmental toxins have been linked to negative health effects, the evidence does not support a direct etiologic or significant contributory relationship between the TERA and the subsequent development of COPD. The VA examiner remarked that the Veteran's COPD was more likely related to factors outside of service, specifically cigarette smoke. Therefore, the VA examiner determined that the Veteran's diagnosis of COPD was less likely than not caused by caused by his duties after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic combined effect of all toxic exposure risk activities of the Veteran. A thorough review of the available medical evidence, medical literature, claims file, and service treatment records were reviewed.

Initially, the Boad notes that while the January 2025 VA DBQ shows that the VA examiner provided a positive nexus opinion but the rationale provided actually tend to be against the Veteran's claim. Here, the VA examiner noted that the there was no conclusive evidence that agent orange directly caused COPD. However, the VA examiner did report that exposure combined with cigarette smoking could trigger COPD. After a review of the January 2025 VA examination report, the Board finds that this opinion is inadequate for adjudication purposes thus it is not probative regarding the nexus element of service connection. Specifically, the VA examiner reported that there was no evidence that COPD could be directly caused by herbicide exposure but that such exposure combined with smoking could cause COPD. The Board finds this rationale to speculative, as the VA examiner did not cite to medical literature to support the opinion and the use speculative language, specifically "could." For these reasons, the Board places low probative value on this medical opinion.

The Board finds that the April 2025 VA medical opinion is probative and persuasively against the Veteran's claim that his COPD was caused by the conceded herbicide exposure. The VA examiner opined that the Veteran's COPD was less likely than not caused by the indicated TERA, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERA of the Veteran, including herbicide exposure. The examiner cited to relevant medical literature and explained that the Veteran has a significant history of smoking which was significant risk factor for the development of COPD. The Board finds the opinion is reasoned and supported by other, relevant evidence of record. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). Therefore, the Board assigns probative weight to the opinion and finds it to be persuasive on the matter of nexus.

The Board acknowledges the statements of the Veteran as to the cause of his COPD, and that the Veteran is competent to give evidence about what he experienced. For example, he is competent to discuss the fact that he experiences difficulty breathing. See Layno v. Brown, 6 Vet. App. 465 (1994). However, while the Veteran is competent to report his current symptoms, as a lay person he does not have the education, training, or experience to diagnose or opine as to the etiology of the condition of COPD as this is a complex matter involving the body's respiratory system. See Jandreau v. Nicholson, 492 F.3d 1372, 1377-78 (Fed. Cir. 2007). As such, the Veteran's statements regarding etiology are not competent and lack weight.

In sum, the evidence persuasively weighs against a finding that the Veteran's COPD is associated with his military service, including TERA, and the Veteran is not competent to link his claimed disability to service. As the relevant, competent evidence is persuasively against the Veteran's claim for entitlement to service connection for COPD, the benefit of the doubt doctrine is not applicable, and the service connection for COPD is denied. 38 U.S.C. § 5107(b);
See Jandreau v. Nicholson, 492 F.3d 1372, 1377-78 (Fed. Cir. 2007). As such, the Veteran's statements regarding etiology are not competent and lack weight.

In sum, the evidence persuasively weighs against a finding that the Veteran's COPD is associated with his military service, including TERA, and the Veteran is not competent to link his claimed disability to service. As the relevant, competent evidence is persuasively against the Veteran's claim for entitlement to service connection for COPD, the benefit of the doubt doctrine is not applicable, and the service connection for COPD is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

2. Entitlement to service connection for sleep apnea

The Veteran asserts that his sleep apnea onset during active service.

A review of the Veteran's service treatment records shows no reports or diagnosis for sleep apnea.

A February 2016 VA medical record shows an at home sleep evaluation was performed which showed there were no central apneas. The Veteran was assessed with a clinically significant sleep-disordered breathing.

A May 2016 VA medical record shows that the Veteran was advised to undergo a complete sleep study.

A September 2023 VA sleep apnea DBQ shows that the Veteran was not diagnosed with sleep apnea as he had failed to scheduled his sleep study through VA medical services.

A January 2025 VA sleep apnea DBQ shows that the VA examiner opined that it was less likely than not that the sleep apnea was caused by the indicated toxic exposure risk activity after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic combined effects of all toxic exposure risk activities. The VA examiner noted that the Veteran was diagnosed with sleep apnea in 2016 and had separated from active service in 1978. The VA examiner noted that well-defined risk factors for sleep apnea included older age, male sex, obesity, and craniofacial and upper airway abnormalities. Potential risk factors were identified as smoking, family history of snoring or OSA, and nasal congestion. Rates of sleep apnea were also noted to increase in association with certain medical conditions, most commonly obesity hypoventilation syndrome, pregnancy, end-stage kidney disease, congestive heart failure, chronic lung disease, type 2 diabetes mellitus, and stroke; others include acromegaly, hypothyroidism, polycystic ovary syndrome, and floppy eyelid syndrome. The VA examiner noted that the Veteran had known risk factors to include increase age, obesity and tobacco use.

The Board finds the January 2025 opinion is reasoned and supported by the evidence of record. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). Therefore, the Board assigns significant probative weight to the opinion.

The Board acknowledges the statements of the Veteran as to the cause of his sleep apnea, and that the Veteran is competent to give evidence about what he experienced. For example, he is competent to discuss the fact that he experiences difficulty breathing. See Layno v. Brown, 6 Vet. App. 465 (1994). However, while the Veteran is competent to report his current symptoms, as a lay person he does not have the education, training, or experience to diagnose or opine as to the etiology of the condition of sleep apnea. See Jandreau v. Nicholson, 492 F.3d 1372, 1377-78 (Fed. Cir. 2007). As such, the Veteran's statements regarding etiology are not competent and lack weight.

In sum, the evidence persuasively weighs against a finding that the Veteran's sleep apnea is associated with his military service, including TERA, and the Veteran is not competent to link his claimed disability to service. As evidence is persuasively against the Veteran's claim for entitlement to service connection for sleep apnea, the benefit of the doubt doctrine is not applicable, and service connection for sleep apnea is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

3. Entitlement to service connection for sinusitis

The Veteran contends that service connection is warranted for chronic sinusitis as the condition onset during active service and had persisted since separation from service. The Veteran has also asserted that the condition was caused by conceded TERA.

A review of the Veterans service treatment record shows no assessments or diagnosis of sinusitis during active service.

Post-separation
to service connection for sleep apnea, the benefit of the doubt doctrine is not applicable, and service connection for sleep apnea is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

3. Entitlement to service connection for sinusitis

A review of the Veterans service treatment record shows no assessments or diagnosis of sinusitis during active service.

Post-separation from service, there is no evidence of treatment for chronic sinusitis or self-reports of chronic sinusitis until the Veteran filed his claim for service connection in 2023. The Board notes this included a review of private and VA post-service medical treatment records.

An August 2023 VA sinusitis DBQ shows that physical examination to include x-rays showed that the Veteran did not have a current diagnosis of sinusitis.

A January 2025 VA DBQ shows no diagnosis of sinusitis was assessed after a physical examination and review of the claims file.

An April 2025 VA medical opinion DBQ shows that after an in-person examination and review of the record, that a chronic sinusitis was less likely than not caused by the indicated toxic exposure risk activity(ies), after considering the total potential exposure through all applicable military deployments of the veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. The VA examiner noted that the Veteran did not have a current diagnosis of chronic sinusitis as there was no objective medical evidence to support the claimed condition.

A review of the Veteran's post-service treatment records do not show a diagnosis of chronic sinusitis or any like symptoms or residuals. Likewise, the medical opinions in August 2023, January 2025, and April 2025, also showed no diagnosis of a sinusitis condition.

The Court has held that "Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability. In the absence of proof of a present disability there can be no valid claim." Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Because the record does not show a diagnosis of chronic sinusitis, service connection is not warranted.

Although the Veteran believes he has chronic sinusitis, and he is considered competent to report specific symptoms observable through the senses, he is not considered competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education, training, and/or experience, which the record does not show that the Veteran possesses regarding the body's respiratory system. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, his assertions that he has sinusitis are not competent and lack weight.

In summary, there is no probative, competent evidence of record that the Veteran has had a diagnosis of chronic sinusitis (or persistent or recurrent symptoms of disability) at any time during or proximate to the pendency of the claim. As discussed above, in the absence of proof of a current disability, there can be no valid claim for service connection as the first element of service connection is not met. Brammer, 3 Vet. App. at 225. Without evidence of a current disability, the Board need not address the other elements of service connection.

As the evidence is persuasively against the Veteran's claim for entitlement to service connection for chronic sinusitis, the benefit of the doubt doctrine is not applicable, and the appeal must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

4. Entitlement to service connection for tinnitus

The Veteran contends that his diagnosed tinnitus onset during active service.

Favorable findings noted on the rating decision on appeal show that a qualifying event, injury, or disease had its onset during the Veteran's service as his military occupational specialty was a Tactical Aircraft Maintenance Specialist, which was consistent with acoustic trauma. Additionally, the Veteran was determined to have a current diagnosis of tinnitus. The Board sees no reason to disturb these favorable findings. As such, the first two elements of service connection are established.

A review of the Veteran's service treatment records shows no reported or diagnosis of tinnitus

Thus, the question becomes whether the Veteran's current tinnitus is related to his in-service hazardous noise exposure.

A June 2023 VA hearing loss and t
that his diagnosed tinnitus onset during active service.

A review of the Veteran's service treatment records shows no reported or diagnosis of tinnitus

Thus, the question becomes whether the Veteran's current tinnitus is related to his in-service hazardous noise exposure.

A June 2023 VA hearing loss and tinnitus DBQ shows that the Veteran reported tinnitus onset from exposure to noise from explosion of oxygen cylinder under a pile of wood in 1976 to 1977. The Veteran reported gradual onset on tinnitus in both ears since the incident. The VA examiner opined that the Veteran's tinnitus was as likely as not associated with hearing loss. The VA examiner also opined that it was less likely than not that the Veteran's tinnitus was due to or onset in active duty as there was no significant hearing threshold shifts or complaints of tinnitus during active service. The VA examiner acknowledged that exposure was conceded, there was no evidence of auditory damage on active duty to relate tinnitus to military noise exposure.

After a review of the evidence of record, the Board concludes that the Veteran has provided competent and credible evidence that he noticed tinnitus in service and continued to experience symptoms of ringing in his ears after service. For example, during the November 2023 VA examination, the Veteran reported that his tinnitus began during service in conjunction with his in-service exposure to hazardous noise. The Board finds the Veteran competent and credible regarding having first noted tinnitus in service and having continuity of symptoms of tinnitus since service and places much weight of probative value on his statements in this regard.

The Board recognizes that the November 2023 VA examiner opined that tinnitus was less likely than not due to in-service noise exposure. The examiner's rationale was that the Veteran's service treatment records documented normal bilateral hearing with no significant threshold shifts and no complaints of tinnitus during service. Additionally, the VA examiner reported that the Veteran asserted tinnitus did not onset during active service.

The Board finds the November 2023 VA opinion to be of lower probative value than the Veteran's own statements. The examiner's rationale is limited to a conclusory statement that ignores the Veteran's competent lay evidence that he experienced tinnitus during active service. See Miller v. Wilkie, 32 Vet. App. 249, 258-60 (2020) (holding that an examination that does not address credible and relevant lay evidence does not include enough detail to inform the Board's decision and, thus, is inadequate).

In sum, there is evidence that the Veteran had noise exposure in service and the Veteran provided competent and credible statements that he first noticed tinnitus in service. The Board finds the Veteran competent and credible with regard to having continuity of symptoms of tinnitus since service and places great weight of probative value on his statements in this regard. Indeed, the Veteran's lay reports are sufficient to establish manifestation of tinnitus since service and continuously thereafter. See Charles v. Principi, 16 Vet. App. 370, 374 (2002). For these reasons, service connection for tinnitus is granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

5. Entitlement to service connection for bilateral flat feet

The Veteran contends that he has bilateral flat feet that were as a result of active service.

The December 2024 rating decision on appeal contains a favorable finding that Houston VAMC records note a diagnosis of flat feet. The Board sees no reason to disturb this favorable finding. As such, the first element of service connection is established.

A review of the Veteran's service treatment records shows no reports or diagnosis of flat feet or foot problems. Additionally, the Veteran did not self-report or injuries or problems with his feet during active service.

A review of post-service VA treatment records shows that the Veteran was noted to have a past medical history of flat feet in December 2015.

As part of its appellate review, the record shows that the Veteran was not provided with a VA examination concerning his bilateral flat feet claim. After reviewing the relevant lay and medical evidence, the Board finds that it was not a pre-decisional duty to assist error that an examination was not obtained. A medical examination or medical opinion is necessary in a claim for service connection 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 establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a 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. McLendon v. Nicholson, 20 Vet. App. 79, 81-86 (2006); see 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(i).

Here, while the Veteran has a current disability noted as bilateral flat feet, there is no evidence of an in-service event or any indication that the disability may be associated with the Veteran's service. While the Veteran asserts that the bilateral flat feet condition was caused by active service, the Board notes that a VA examination is not warranted based solely upon a Veteran's own conclusory statements indicating a relationship between an in-service event and bilateral flat feet. See Waters v. Shinseki, 601 F.3d 1274, 1278 (Fed. Cir. 2010).

After a review of the evidence of record the Board finds that he evidence is persuasively against the Veteran's claim for entitlement to service connection for bilateral flat feet. As noted above, there are no reports or indications that the Veteran injuries his feet or was assessed with bilateral flat feet during active service. Additionally, it was until 25 years after separation from service, when he was finally diagnosed with bilateral flat feet as noted in a 2015 VA treatment record. The Board finds it noteworthy that in the VA and private treatment records the Veteran did allude or report that the bilateral flat feet was caused by active service. Moreover, there is no positive medical nexus opinion of record aside from the Veteran's assertion to support his claim and the Veteran has not provided any testimony linking his bilateral flat foot disability to active service. 38 U.S.C. § 5107(a).

To the extend the Veteran asserts that his bilateral flat feet disability occurred in service and had persisted since that time have only been made in conjunction with statements or testimony provided in pursuit of his claim for disability benefits. Cartwright v. Derwinski, 2 Vet. App. 24, 25 (1991) (finding that a pecuniary interest may affect the credibility of a claimant's testimony). As noted above, a statement made to a medical professional for the purpose of diagnosis and treatment is highly trustworthy, as the Veteran had a strong motive to describe his medical history and current symptoms to receive proper care, and a not time prior to filing his claim did the Veteran report that his bilateral flat feet were caused by active service. To be clear, the Board is not questioning the Veteran's honesty or moral character. The Veteran is attempting to recollect events that transpired a long time ago and the passage of time, along with the inconsistencies noted above, compels the conclusion that the Veteran is not an accurate historian as to these particular statements. Therefore, the Board assigns his statements low to no probative weight regarding the onset of his bilateral flat feet.

Additionally, the record does not contain a positive opinion determining the onset of arthritis of the spine onset during active service. 38 U.S.C. § 5107(a). Indeed, the record does not reflect that a medical professional opined that a lumbar spine disability is related to service on any basis. While the Veteran has asserted his belief in a connection, he is a lay person, and not competent to offer a probative opinion on nexus in these matters. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). The weight of the competent and probative evidence is persuasively against the claim, and service connection for a bilateral flat feet is not warranted.

In conclusion, all of the necessary criteria for service connection for bilateral flat feet. As most of the evidence weighs against the claim
service. 38 U.S.C. § 5107(a). Indeed, the record does not reflect that a medical professional opined that a lumbar spine disability is related to service on any basis. While the Veteran has asserted his belief in a connection, he is a lay person, and not competent to offer a probative opinion on nexus in these matters. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). The weight of the competent and probative evidence is persuasively against the claim, and service connection for a bilateral flat feet is not warranted.

In conclusion, all of the necessary criteria for service connection for bilateral flat feet. As most of the evidence weighs against the claim (that is to say, is neither in approximate balance nor nearly equal), the benefit-of-the-doubt rule is inapplicable, and the claim for service connection for a low back disability is denied. Lynch v. McDonough, 21 4th 776, 781-82 (Fed. Cir. 2021).

Paul Sorisio

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board J. Dworkin

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.

Analyze in VA Law Explorer