ANAL FISSURE

J.P. NORMAN · 2026 · Case ID: A26040422

MIXED

Summary

The veteran, who served in the United States Navy from January 1988 to January 1999, appeals the denial of service connection for anal fissure, hemorrhoids, herpes, and vertigo. The Board found that no new and relevant evidence had been submitted to warrant readjudication of these claims since the prior denial in a June 2024 rating decision. The Board noted that while the veteran filed a supplemental claim in April 2025, no new evidence was submitted with it. VA treatment records between the November 2024 decision and the April 2025 appeal decision did not reflect any treatment for these conditions. Consequently, the Board denied readjudication for anal fissure, hemorrhoids, herpes, and vertigo. The case was remanded for gastroesophageal reflux disease (GERD) and sinusitis, as the Board found a duty to assist error in failing to obtain updated medical opinions. Specifically, the AOJ failed to obtain a PACT Act compliant examination/opinion for GERD and sinusitis, despite favorable findings of current diagnoses and exposure to asbestos during service. The remand instructions require a VA examination and opinion addressing the nexus between GERD/sinusitis and service, including toxic exposure from asbestos.

Rationale

No new and relevant evidence submitted since prior denial; No treatment records for condition found in permissible evidentiary period; Evidence weighs against the claim

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250428-538513

Full Decision Text

Citation Nr: A26040422
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 250428-538513
DATE: April 29, 2026

ORDER

The service connection claim for anal fissure remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

The service connection claim for hemorrhoids remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

The service connection claim for herpes remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

The service connection claim for vertigo remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

REMANDED

Entitlement to service connection for gastroesophageal reflux disease (GERD) is remanded.

Entitlement to service connection for sinusitis is remanded.

FINDING OF FACT

New evidence regarding the claims for anal fissure, hemorrhoids, herpes, and vertigo has not been received since those claims were previously denied in a November 2024 rating decision.

CONCLUSIONS OF LAW

1. The criteria for readjudicating the service connection claim for anal fissure are not met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(d).

2. The criteria for readjudicating the service connection claim for hemorrhoids are not met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(d).

3. The criteria for readjudicating the service connection claim for herpes are not met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(d).

4. The criteria for readjudicating the service connection claim for vertigo are not met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(d).

REASONS AND BASES FOR FINDING AND CONCLUSIONS

The Veteran served on active duty in the United States Navy from January 1988 to January 1999.

In the April 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. The Veteran followed his Form 10182 with a January 2026 written waiver of his right to select a different Board review option, requesting review on the Direct Review docket to proceed as soon as possible. 38 C.F.R. § 20.202(c)(2); Williams v. McDonough, 37 Vet. App. 305 (2024).

Therefore, the Board may only consider the evidence of record at the time of the April 2025 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 Veteran would like VA to consider any such evidence that was submitted that the Board could not consider in relation to the denied claims, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

However, because the Board is remanding the claims related to GERD and sinusitis, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

1. The service connection claim for anal fissure remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

2. The service connection claim for hemorrhoids remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

3. The service connection claim for herpes remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

4. The service connection claim for vertigo remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

The Veteran asserts that he has anal fissure, hemorrhoids, herpes, and vertigo due to active duty service. See January 2024 VA Form 21-526EZ claim. For the following reasons, the Board finds these claims have been denied and cannot be readjud
submitted to readjudicate the claim.

2. The service connection claim for hemorrhoids remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

3. The service connection claim for herpes remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

4. The service connection claim for vertigo remains denied because new and relevant evidence has not been submitted to readjudicate the claim.

The April 2025 rating decision on appeal declined to readjudicate these identified claims, finding no new and relevant evidence had been submitted to warrant readjudication. VA regulations provide that a claimant or veteran who disagrees with a prior VA decision may file a supplemental claim any time after the AOJ issues notice of a decision, regardless of whether the claim is pending or has become finally adjudicated. See 38 C.F.R. § 3.2501. If new and relevant evidence is presented or secured with respect to the supplemental claim, the AOJ will readjudicate the claim. If new and relevant evidence is not presented or secured, the AOJ will issue a decision finding that there was insufficient evidence to readjudicate the claim.

In determining whether new and relevant evidence is presented or secured, VA will consider any VA treatment records reasonably identified by the claimant and any evidence received by VA after VA issued notice of a decision on the claim and while the evidentiary record was closed. 38 C.F.R. § 3.2501. "New evidence" is evidence not previously part of the actual record before agency adjudicators. "Relevant evidence" is information that tends to prove or disprove a matter at issue in a claim. Relevant evidence includes evidence that raises a theory of entitlement that was not previously addressed. For VA to readjudicate the claim, the evidentiary record must include new and relevant evidence that was not of record as of the date of notice of the prior decision. Upon receipt of a substantially complete supplemental claim, VA's duty to assist in the gathering of evidence under § 3.159 of this part is triggered and includes any such assistance that may help secure new and relevant evidence as defined in paragraph (a) of 38 C.F.R. § 3.2501 to complete the supplemental claim application. Id.

The service connection claims for anal fissure, hemorrhoids, herpes, and vertigo were denied in a June 2024 rating decision, which the Veteran timely appealed in a July 2024 VA Form 20-0996 Request for Higher-Level Review. A November 2024 rating decision identified a duty to assist error in processing a separate sinusitis claim but otherwise denied the service connection claims identified herein. In each case, the AOJ found no current diagnosis or in-service incurrence of the claimed conditions.

The Veteran filed an April 2, 2025, VA Form 20-0995 Supplemental Claim, again requesting service connection for anal fissure, hemorrhoids, herpes, and vertigo, in addition to separate claims regarding GERD and sinusitis. He did not file any evidence regarding these issues with his Supplemental Claim. On April 8, 2025, he filed additional statements regarding GERD and rhinitis. His statement regarding rhinitis included citing sinus pressure and congestion as rhinitis symptoms, in the context of requesting a higher rhinitis disability rating, and he was afforded a new VA examination regarding rhinitis shortly thereafter. Sinusitis was not addressed by the Veteran or the subsequent, April 2025 VA rhinitis examination.

The AOJ issued the rating decision on appeal on April 24, 2025. As a general matter, any VA treatment records are within VA's constructive possession at the time they are generated, and are considered potentially relevant to the issues on appeal. Sullivan v. McDonald, 815 F.3d 786, 793 (Fed. Cir. 2016) (VA has a duty to assist in obtaining sufficiently-identified VA medical records regardless of their relevance). Here however, VA treatment records dated between the November 2024 rating decision denying these claims and the issuance of the April 2025 rating decision on appeal do not reflect any treatment for, complaints of, or concern regarding these claimed conditions.

Considering the entire record in this matter, the Board does not find any new or relevant evidence regarding these claims added to the record within the permissible evidentiary period after the November 2024 rating
they are generated, and are considered potentially relevant to the issues on appeal. Sullivan v. McDonald, 815 F.3d 786, 793 (Fed. Cir. 2016) (VA has a duty to assist in obtaining sufficiently-identified VA medical records regardless of their relevance). Here however, VA treatment records dated between the November 2024 rating decision denying these claims and the issuance of the April 2025 rating decision on appeal do not reflect any treatment for, complaints of, or concern regarding these claimed conditions.

Considering the entire record in this matter, the Board does not find any new or relevant evidence regarding these claims added to the record within the permissible evidentiary period after the November 2024 rating decision. The evidence is not in approximate balance, but rather weighs persuasively against the claim. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). As such, readjudication of the service connection claims for anal fissure, hemorrhoids, herpes, and vertigo is not warranted. Readjudication of these claims is hereby DENIED.

REASONS FOR REMAND

1. Entitlement to service connection for gastroesophageal reflux disease (GERD) is remanded.

2. Entitlement to service connection for sinusitis is remanded.

The Veteran additionally asserts that he has GERD and sinusitis attributable to military service, including as due to toxic exposure risk activities (TERAs) during active duty. The April 2025 rating decision on appeal found new and relevant evidence had been submitted sufficient to readjudicate these claims. However, the Board has found a pre-decisional duty to assist error in failing to provide the Veteran adequate VA medical opinions, requiring remand to remedy. See 38 C.F.R. § 20.802(a).

After the Veteran's July 2024 Request for Higher-Level Review, the AOJ favorably found current diagnoses of the claimed conditions, as well as exposure to asbestos during active duty service. The Veteran submitted April 2025 statements that he has experienced GERD symptoms, sinus pressure, and congestion since service. Despite these findings, the AOJ did not obtain updated medical opinions regarding these claims.

Remand is required to obtain a medical examination and/or opinion pursuant to the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxins Act of 2022 (PACT Act). See 38 U.S.C. § 1168. The PACT Act requires that, when a veteran subjected to participation in a toxic exposure risk activity (TERA) during active service files a claim to service connect an existing disability, VA must provide a VA examination and medical opinion addressing the possibility of a nexus between the claimed disability and the TERA. See 38 U.S.C. § 1168(a)(1). Here, an August 2024 TERA memorandum indicates that the Veteran participated in a TERA during service, resulting in exposure to asbestos. In addition, the AOJ favorably found current diagnoses of the claimed disabilities. See April 2025 rating decision. Despite these findings, VA did not provide the Veteran with a TERA examination/opinion in compliance with the PACT Act. This failure to provide a TERA examination/opinion is the pre-decisional duty to assist error that must be remedied on remand.

Because the Board is unable to grant this claim at this time, and because the requirements to obtain a medical opinion compliant with 38 U.S.C. § 1168 are met, but such opinion has not yet been obtained, a remand is needed for VA to obtain one.

The matters are REMANDED for the following action(s):

Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's claimed GERD and/or sinusitis are at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) related to active service.

The examiner is asked to opine on the following:

1. Is it at least as likely as not that the Veteran's GERD and/or sinusitis are directly related to active service, including that they began during active duty?

2. Is the GERD and/or sinusitis at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) related to the Veteran's in-service exposure to toxins due to asbestos exposure. When providing this opinion, the examiner must consider:

a) the total potential exposure through all applicable deployments; and

b) the synergistic, combined effect of all toxic exposure risk activities of the Veteran.

J.P. Norman

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board W. Stearns, Counsel

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