Back to BVA DecisionsDENIEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 251222-617454
ALLERGIC OR VASOMOTOR RHINITIS
M. DONOHUE · 2026 · Case ID: A26040523
Summary
The veteran, who served from August 2007 to December 2020, appeals the denial of service connection for chronic rhinitis, chronic sinusitis, and chronic fatigue syndrome (CFS). The veteran contended these conditions were related to service in Southwest Asia, citing a favorable TERA finding from the RO. The Board reviewed a January 2025 VA examination, which found no diagnosis of chronic rhinitis or sinusitis, and noted that diagnostic imaging showed no acute abnormalities. While the veteran's medical records included these conditions in a problem list since August 2022, the Board found no formal diagnosis was ever established by either VA or private providers. The Board also considered whether the Veteran's reported symptoms constituted a disability even without a formal diagnosis, but concluded that the evidence did not support functional impairment of earning capacity. For CFS, the VA examiner concluded the Veteran did not meet the diagnostic criteria and found no functional impairment. The Board noted that the Veteran's reported fatigue was considered within his already service-connected psychiatric disorder. The Board found the VA examinations adequate and the evidence persuasively against the Veteran's claims, thus denying service connection for all three conditions.
Rationale
No diagnosis of chronic rhinitis found in medical records.; VA examination found no diagnosis and no acute abnormalities.; Symptoms did not cause functional impairment of earning capacity.
Full Decision Text
Citation Nr: A26040523 Decision Date: 04/30/26 Archive Date: 04/30/26 DOCKET NO. 251222-617454 DATE: April 30, 2026 ORDER Service connection for chronic rhinitis is denied. Service connection for chronic sinusitis is denied. Service connection for chronic fatigue syndrome (CFS) is denied. FINDINGS OF FACT 1. The probative evidence of record persuasively weighs against a finding that the Veteran has had a diagnosis of chronic rhinitis at any time during the pendency of the claim. 2. The probative evidence of record persuasively weighs against a finding that the Veteran has had a diagnosis of chronic sinusitis at any time during the pendency of the claim. 3. The probative evidence of record persuasively weighs against a finding that the Veteran has had a diagnosis of chronic fatigue syndrome (CFS) at any time during the pendency of the claim. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for chronic rhinitis have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for entitlement to service connection for chronic sinusitis have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for entitlement to service connection for chronic fatigue syndrome have not been 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 August 2007 to December 2020. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2025 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In the December 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the direct review docket. Therefore, the Board may only consider the evidence of record at the time of the March 2025 RO decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the RO 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 evidence that was submitted that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a supplemental claim are included with this decision. Law and Regulations Service connection may be granted for 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; and (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). When considering the existence of a disability, VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed Cir. 2009); 38 U.S.C. § 1154(a). Lay evidence may be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). When the evidence is in approximate balance in the veteran's favor or nearly equal regarding any issue material to the determination of a matter, the Secretary shall 3, 1316 (Fed Cir. 2009); 38 U.S.C. § 1154(a). Lay evidence may be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). When the evidence is in approximate balance in the veteran's favor or nearly equal regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). Service connection for chronic rhinitis is denied. Service connection for chronic sinusitis is denied. The Veteran seeks entitlement to service connection for chronic rhinitis and chronic sinusitis, which he generally contends are related to his service in Southwest Asia. See December 2024 VA Form 21-4138 Statement in Support of Claim. As a threshold matter, the RO has issued a favorable finding related to these claims, which is binding on the Board absent clear and unmistakable error. 38 C.F.R. § 3.104. Specifically, the RO determined that the Veteran participated in toxic exposure risk activities (TERA) based on his service in Southwest Asia and based upon his military occupational specialty as a chemical operations specialist. See March 2025 Rating Decision; see also, July 2024 TERA Memorandum (associated with the claims file as "Identification Materials"). Turning to the first element of service connection, the Veteran was afforded a VA medical examination to evaluate his claimed conditions in January 2025. During the examination, the clinician documented their review of the claims file, and they performed an in-person examination of the Veteran. Additionally, the examiner documented the Veteran's lay reports that he experiences difficulty breathing out of the right side of his nose, which he first noticed while in service in 2016. Further, the examiner noted that the Veteran has been previously evaluated by otolaryngology and that his symptoms are treated with Flonase, saline nasal spray, and a Neomed nose rinse. See January 2025 VA Sinusitis/Rhinitis Disability Benefits Questionnaire (DBQ). In addition to considering the Veteran's lay reports of symptomatology, the examiner ordered and reviewed diagnostic testing of the Veteran's paranasal sinuses, which found no acute abnormalities in the Veteran's visualized sinuses. See January 2025 Diagnostic Imaging. Ultimately, following completion of the examination, the examiner determined that the Veteran does not have a diagnosis of chronic sinusitis or rhinitis. In addition to its consideration of the January 2025 VA medical examination, the Board reviewed the remainder of the Veteran's medical records to determine whether he has had a diagnosis of either claimed condition at any time during the pendency of the claim or recent thereto. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Notably, the Veteran's medical records do include chronic sinusitis and rhinitis among the conditions noted in his "problem list" since August 2022, and the Board has reviewed each entry. Turning to the original August 2022 entry, the Veteran was seen for an initial VA primary care consultation. During the appointment, the Veteran reported difficulty breathing out of his nose for approximately one year. On examination, the provider observed no discharge, no lesions, no obvious polyps, and that the Veteran's membranes were moist and pink. See March 2024 CAPRI Medical Records. The Veteran's provider documented a plan to address chronic sinus congestion, and recommended a consultation with an ENT. Notably, while sinusitis and rhinitis were included in the Veteran's "problem list" following this appointment, the Veteran's provider did not diagnose the Veteran with either condition. In October 2022, the Veteran was evaluated by an ENT specialist for his sinus congestion, during which time the provider documented that the Veteran's anterior rhinoscopy was normal with limited visualization to the anterior aspect of the interior turbinates, there were no lesions, and no evidence of polyps or other mucosal lesions. The provider prescribed Flonase and intranasal saline for the Veteran's symptoms and recommended a follow up appointment. While this entry included the provider to address chronic sinus congestion, and recommended a consultation with an ENT. Notably, while sinusitis and rhinitis were included in the Veteran's "problem list" following this appointment, the Veteran's provider did not diagnose the Veteran with either condition. In October 2022, the Veteran was evaluated by an ENT specialist for his sinus congestion, during which time the provider documented that the Veteran's anterior rhinoscopy was normal with limited visualization to the anterior aspect of the interior turbinates, there were no lesions, and no evidence of polyps or other mucosal lesions. The provider prescribed Flonase and intranasal saline for the Veteran's symptoms and recommended a follow up appointment. While this entry included the provider's initial impression of allergic rhinitis, neither this entry nor a followup entry in December 2022 established a diagnosis of allergic rhinitis or sinusitis. Id. In July 2024, the Veteran reestablished care with an ENT, following referral by his primary care provider. During the appointment, the provider documented the Veteran's chief complaint of "[c]hronic sinusitis per pcp," and that the Veteran experienced nasal congestion and pressure pain in the sinus cavity. The Veteran denied breathing problems through his nose, face tenderness, and purulent drainage to the nares. The Veteran further denied using a daily sinus regime, though he did endorse having clear nasal drainage at times and feeling stuffy. See July 2024 CAPRI Medical Records. During this examination, the provider visualized the Veteran's nasal passage with a flexible nasal laryngeal scope and documented their observations, that his nasal passages and structures were largely normal. The provider did not order any additional imaging studies, and their note does not include a diagnosis of rhinitis or sinusitis. Id. Based on its review of the Veteran's medical records, the Board finds that the January 2025 VA medical examiner's findings and conclusions, substantiated by diagnostic testing, are generally consistent with the remaining medical evidence, which does not establish that the Veteran has been diagnosed with rhinitis or sinusitis during the pendency of these claims. As a result, the Board finds that the January 2025 VA medical examination is entitled to probative weight. Despite the absence of a formal diagnosis of chronic rhinitis or sinusitis, the Board has considered whether the severity, frequency, and duration of the Veteran's reported symptoms of nasal congestion, stuffiness, and difficulty breathing cause functional impairment of his earning capacity, and thus rise to the level of a disability even absent a formal diagnosis. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). Here, the Board initially observes that neither the January 2025 VA medical examination nor the Veteran's medical record suggest functional impairment related to his symptoms. Moreover, the record does not contain any other lay evidence suggesting he experiences such impairment. In addition to the Veteran's examination and medical records, the Board did consider the relevant rating criteria for rhinitis and the general rating formula for sinusitis as relevant and instructive with regard to whether the Veteran's symptoms cause him functional impairment. See Wait v. Wilkie, 33 Vet. App. 8 (2020). However, with respect to rhinitis, there was no evidence of polyps and no evidence that the Veteran's reported nasal congestion was equivalent to the obstruction of his nasal passages. See 38 C.F.R. § 4.97, Diagnostic Code 6522. With respect to sinusitis, there was no evidence that the Veteran's symptoms were consistent with the severity of symptoms necessary to cause incapacitating episodes characterized by headaches, pain, and purulent discharge or crusting. Id., Diagnostic Code 6510-6514. Thus, based on a totality of the record, the Board concludes that the Veteran does not experience functional impairment of his earning capacity as a result of his symptoms, sufficient to constitute a disability of rhinitis or sinusitis. Given the aforementioned findings, the Veteran does not have a disability for the claimed conditions and consequently, the first element of service connection is not met for either condition. In the absence of a disability, there can be no valid claim for service connection, and the Board need not address the remaining elements of service connection. See Brammer v. Derwinski, 3 Vet. App. 223 (1992). In reaching this conclusion, the Board notes its consideration of the Veteran's arguments, submitted through his representative service organization, that the January 2025 VA medical examination is inadequate because the examiner failed to confirm diagnoses previously rendered by his treating providers. See December 2025 Appellate Argument (associated with the claims file in the December 202 , the Veteran does not have a disability for the claimed conditions and consequently, the first element of service connection is not met for either condition. In the absence of a disability, there can be no valid claim for service connection, and the Board need not address the remaining elements of service connection. See Brammer v. Derwinski, 3 Vet. App. 223 (1992). In reaching this conclusion, the Board notes its consideration of the Veteran's arguments, submitted through his representative service organization, that the January 2025 VA medical examination is inadequate because the examiner failed to confirm diagnoses previously rendered by his treating providers. See December 2025 Appellate Argument (associated with the claims file in the December 2025 VA Form 10128). However, the Board finds that this argument is without merit because, as addressed above, the record does not contain evidence of a diagnosis for either of the claimed conditions during the pendency of the claims. Finally, the Board acknowledges the Veteran's sincere belief that his symptoms of nasal congestion are attributable to diagnoses of rhinitis and/or sinusitis. However, the record does not include any evidence to suggest that the Veteran has medical training; consequently, the Board finds that he is not competent to render a diagnosis for either of the claimed conditions in this case. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Veteran has not submitted any competent evidence of a sinusitis or rhinitis disability. See 38 U.S.C. § 5107(a) (it is the claimant's responsibility to support a claim for VA benefits.) Notably, the record does not contain any contrary medical examinations or opinions regarding the claimed conditions for the Board to consider. As the competent and credible evidence of record is persuasively against the Veteran's position, the benefit of the doubt doctrine does not apply in this case and the claim for service connection must unfortunately be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). Service connection for chronic fatigue syndrome (CFS) is denied. The Veteran seeks entitlement to service connection for chronic fatigue syndrome, which he generally contends is related to his service in Southwest Asia. See December 2024 VA Form 21-4138 Statement in Support of Claim. As noted above, the record includes a favorable finding relevant to this claim, that the Veteran participated in a toxic exposure risk activities (TERA) related to his service in Southwest Asia, and based upon his military occupational specialty as a chemical operations specialist. See March 2025 Rating Decision; see also, July 2024 TERA Memorandum (associated with the claims file as "Identification Materials"). Turning to the first element of service connection, the Veteran was afforded a VA medical examination to evaluate his claimed condition in January 2025. During the examination, the Veteran's examiner documented their review of the claims file, and they performed an in-person examination of the Veteran. The examiner documented the Veteran's lay reports that he developed fatigue in 2010, after returning from his first deployment. Further, that the Veteran reported a progression of his symptoms, that he feels tired on a daily basis, and that he lacks motivation. See January 2025 Chronic Fatigue Disability Benefits Questionnaire (DBQ). While it is clear from the Veteran's medical examination that his examiner fully considered his reported symptoms, upon completion of the examination the examiner ultimately concluded that the Veteran's reported symptoms do not support a diagnosis of chronic fatigue syndrome (CFS). In reaching their conclusion, the examiner found that the Veteran did not presently exhibit, nor had he ever had, six or more of the symptoms necessary to warrant a diagnosis of chronic fatigue syndrome. Id.; see also, 38 C.F.R. § 4.88(a). Further, the examiner found no evidence of an acute onset of chronic fatigue syndrome nor a debilitating fatigue severe enough to reduce daily activity to less than 50 percent of the usual level for at least six months. Finally, the Veteran did not report, and the examiner did not document any evidence of functional impairment due to his symptoms. Notably, the Board observes that the examiner's findings are generally corroborated by the remainder of the medical evidence within the record, which does not contain a diagnosis for chronic fatigue syndrome. While the Veteran's medical records do include reports of fatigue dating from August 2022, these entries are limited to the Veteran's reports of feeling tired and/or "off," that he has no energy, and that he has a low libido. See March 2024 CAPRI Medical Records. nor a debilitating fatigue severe enough to reduce daily activity to less than 50 percent of the usual level for at least six months. Finally, the Veteran did not report, and the examiner did not document any evidence of functional impairment due to his symptoms. Notably, the Board observes that the examiner's findings are generally corroborated by the remainder of the medical evidence within the record, which does not contain a diagnosis for chronic fatigue syndrome. While the Veteran's medical records do include reports of fatigue dating from August 2022, these entries are limited to the Veteran's reports of feeling tired and/or "off," that he has no energy, and that he has a low libido. See March 2024 CAPRI Medical Records. The entries indicate that the Veteran's medical provider(s) discussed the possibility of his symptoms being related to a psychological condition, and that they ordered testosterone testing. The Veteran's medical records do not include evidence of additional symptoms or functional impairment not otherwise considered by the January 2025 VA medical examiner, and the entries do not include a diagnosis of chronic fatigue syndrome. Despite the absence of a formal diagnosis for the claimed disability, the Board considered whether the Veteran's reported symptoms cause functional impairment of his earning capacity and thus rise to the level of a disability even absent a formal diagnosis. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). However, here the evidence does not support such a finding. Initially, as noted above, the January 2025 medical examiner concluded that the Veteran's reported symptoms did not cause functional impairment. Moreover, the record does not contain any lay statements by the Veteran, or any other evidence, that his reports of tiredness and a lack of motivation or energy, are of such severity that they cause any functional impairment of his earning capacity, despite his experiencing these symptoms on a daily basis. See January 2025 VA Chronic Fatigue Syndrome DBQ. Moreover, the Board considered the VA's rating schedule for chronic fatigue syndrome as relevant and instructive with regard to whether the Veteran's symptoms cause him functional impairment. See Wait v. Wilkie, 33 Vet. App. 8 (2020). However, the evidence does not show, and the Veteran does not otherwise contend, that he experiences debilitating fatigue or cognitive impairments, or a combination of other signs and symptoms that at a minimum, cause any periods of incapacitation or require continuous medication to control. See 38 C.F.R. § 4.88(b), Diagnostic Code 6354. Taken together, the Board concludes that the evidence does not support a finding that the Veteran experiences functional impairment sufficient to constitute a disability of chronic fatigue syndrome. Significantly, the Board observes that the Veteran has been awarded service connected for a psychological disorder. A January 2026 rating decision clearly indicates that the assigned 50 percent rating contemplates the Veteran's reported chronic sleep impairment. See January 2026 rating decision; see also, January 2026 Codesheet. In sum, the Board concludes that the Veteran does not have a disability for the claimed condition and the first element of service connection is not met. Moreover, his reported symptoms are contemplated as part of his already service-connected psychiatric disorder. In the absence of a disability, there can be no valid claim for service connection, and the Board need not address the remaining elements of service connection. See Brammer v. Derwinski, 3 Vet. App. 223 (1992). On a final note, the Board again acknowledges the Veteran's sincere belief that he has a chronic fatigue syndrome disability that is related to his service. However, while the Veteran is competent to report his lay symptoms, as they are within the realm of his personal knowledge and observation, the Board concludes that the Veteran is not competent to determine that his symptoms constitute a medical diagnosis of chronic fatigue syndrome. See Layno v. Brown, 6 Vet. App. 465, 471 (1994); see also, Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Additionally, the Board again considered the arguments made by the Veteran's service organization, to the effect that the January 2025 VA examination is inadequate because it failed to confirm a diagnosis for this condition where one had been shown in the Veteran's treatment records. See December 2025 Appellate Argument (associated with the claims file in the December 2025 VA Form 10128). However, as discussed above, the Board has reviewed the entirety of record, and it does not contain a diagnosis for chronic fatigue syndrome, despite the fact that the Veteran was seen by his providers for symptoms of fatigue. Consequently, the Veteran's argument is without merit. Instead, the 1377 (Fed. Cir. 2007). Additionally, the Board again considered the arguments made by the Veteran's service organization, to the effect that the January 2025 VA examination is inadequate because it failed to confirm a diagnosis for this condition where one had been shown in the Veteran's treatment records. See December 2025 Appellate Argument (associated with the claims file in the December 2025 VA Form 10128). However, as discussed above, the Board has reviewed the entirety of record, and it does not contain a diagnosis for chronic fatigue syndrome, despite the fact that the Veteran was seen by his providers for symptoms of fatigue. Consequently, the Veteran's argument is without merit. Instead, the Board finds the January 2025 VA medical examination adequately evaluated the Veteran for the claimed condition and determined that he does not have a current diagnosis as detailed above. As the competent and credible evidence of record is persuasively against the Veteran's position, the benefit of the doubt doctrine does not apply in this case and the claim for service connection must unfortunately be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). M. Donohue Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Todd; 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.