TIBIA AND FIBULA IMPAIRMENT OF

Summary

The veteran, who served from September 2004 to September 2008, appeals the denial of service connection for varicocele and the prior denial of service connection for bilateral shin splints and an ulcer condition. The Board reviewed evidence from the March 2025 VA examination, which was obtained following the veteran's August 2024 supplemental claim for shin splints. This examination confirmed bilateral shin splints and provided a rationale supporting direct service connection, noting the physically demanding nature of the veteran's service and initial entry training, and that service treatment records showed treatment for lower extremity symptoms. The Board found this evidence, when weighed against the prior denial and resolving reasonable doubt in the veteran's favor, warranted service connection for bilateral shin splints. For the ulcer condition, the veteran sought service connection, and the VA examiner noted a duodenal ulcer diagnosis linked to excessive NSAID use, anticoagulants, and stress from hospitalization and vascular surgery. Given the veteran's service connection for DVT and related psychiatric impairment, the Board found the examiner's opinion supported secondary service connection for the duodenal ulcer, resolving reasonable doubt in the veteran's favor. For varicocele, the Board denied service connection, finding the evidence persuasively against a current disability. The March 2025 VA examiner found no current disability, and treatment records did not reference varicocele issues. The Board noted that while symptoms may have occurred post-service, service connection requires a current disability, which was not established. Service connection for bilateral shin splints and the ulcer condition was granted, while the varicocele claim was denied.

Rationale

New and material evidence submitted; Supports direct service connection; Resolving reasonable doubt in veteran's favor

Full Decision Text

Citation Nr: A26040529
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 250409-537447
DATE: April 30, 2026

ORDER

Entitlement to service connection for left shin splints is granted.

Entitlement to service connection for right shin splints is granted.

Entitlement to service connection for an ulcer condition, diagnosed as duodenal ulcer, is granted.

Entitlement to service connection for varicocele is denied.

FINDINGS OF FACT

1. VA received new and material evidence in conjunction with the Veteran's August 2024 supplemental claim for left shin splints, which was submitted in response to an August 2024 rating decision that previously denied the claim; this evidence establishes the Veteran's current left shin splints are at least as likely as not the result of disease or injury incurred in active service.

2. VA received new and material evidence in conjunction with the Veteran's August 2024 supplemental claim for right shin splints, which was submitted in response to an August 2024 rating decision that previously denied the claim; this evidence establishes the Veteran's current right shin splints are at least as likely as not the result of disease or injury incurred in active service.

3. The Veteran's claimed ulcer condition, diagnosed a duodenal ulcer, is at least as likely as not the result of service-connected disability.

4. The evidence is persuasively against a finding of a current disability for the Veteran's service connection claim for varicocele.

CONCLUSIONS OF LAW

1. The criteria for service connection for left shin splints have been met.  38 U.S.C. §§ 1110, 5107, 5108; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.2501.

2. The criteria for service connection for right shin splints have been met.  38 U.S.C. §§ 1110, 5107, 5108; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.2501.

3. The criteria for service connection for ulcer condition, diagnosed as duodenal ulcer, have been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

4. The criteria for service connection for varicocele have not been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from September 2004 to September 2008.

These matters come before the Board of Veterans' Appeals (Board) on appeal from a March 2025 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In April 2025, the Veteran submitted a notice of disagreement (VA Form 10182), requesting direct review of the March 2025 rating decision by a Veterans Law Judge.  The Board notes the Veteran's April 2025 VA Form 10182 listed several other issues in addition to the issues of service connection for bilateral shin splints, an ulcer condition, and varicocele that are not encompassed by the present appeal.  In May 2025, the Veteran requested a docket switch for his appeals of the ratings assigned for deep vein thrombosis (DVT), as well as the issue of entitlement to a total disability rating based on individual unemployability (TDIU), requesting these issues be reviewed under the Board's evidence-submission docket.  The Board granted the Veteran's docket change request in July 2025 and issued a decision on his evidence-submission appeal in January 2026 under docket number 250409-537447.  Other issues noted in the Veteran's April 2025 notice of disagreement, to include service connection for a bilateral foot condition, a stomach condition, anemia, and an acquired psychiatric disorder, claimed as post-traumatic stress disorder (PTSD), as well as a higher rating for traumatic brain injury (TBI), were deferred at the time of the March 2025 rating decision.  Finally, the Veteran listed several issues from an August 2022 rating decision in his April 2025 notice of disagreement - some of which were not adjudicated in a subsequent decision.  The Veteran's April 2025 notice of disagreement is not timely filed with respect to the August 2022 rating decision.  There is no evidence of record that raises or otherwise suggests good cause to excuse the failure
2025 notice of disagreement, to include service connection for a bilateral foot condition, a stomach condition, anemia, and an acquired psychiatric disorder, claimed as post-traumatic stress disorder (PTSD), as well as a higher rating for traumatic brain injury (TBI), were deferred at the time of the March 2025 rating decision.  Finally, the Veteran listed several issues from an August 2022 rating decision in his April 2025 notice of disagreement - some of which were not adjudicated in a subsequent decision.  The Veteran's April 2025 notice of disagreement is not timely filed with respect to the August 2022 rating decision.  There is no evidence of record that raises or otherwise suggests good cause to excuse the failure to comply with the mandatory claims processing rule regarding a timely filed notice of disagreement, and VA has not implicitly or explicitly waived application of such rule.  As a result, the issues from the August 2022 rating decision that were not adjudicated in a subsequent decision issued after April 2024 are not encompassed in the present appeal and will therefore not be addressed further by the Board in the context of the present appeal.  The Veteran is advised of the supplemental claim option should he intend to pursue additional compensation benefits for these issues.  See 38 C.F.R. § 3.2501.

Applicable Evidentiary Window

In accordance with the provisions of the Appeals Modernization Act (AMA), the Board's review in this case is limited to evidence considered by the Agency of Original Jurisdiction (AOJ) in the March 2025 rating decision on appeal.  See 38 C.F.R. § 20.301.  If evidence was associated with the claims file after the evidentiary record for this appeal closed, the Board has not considered it at this time.  See 38 C.F.R. § 20.300.  The Veteran is advised of the supplemental claim option if he desires consideration of any evidence that is not encompassed by the record for the present appeal.  See 38 C.F.R. § 3.2501; see also Cook v. McDonough, 36 Vet. App. 175 (2023).

Analysis

Service connection is granted for a disability resulting from disease or injury incurred in or aggravated by active service.  38 U.S.C. § 1110; 38 C.F.R. § 3.303.

Establishing service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the current disability.  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

In accordance with these principles, service connection may also be granted when a claimed disability is found to be due to or the result of a service-connected disability, or when any increase in severity (aggravation) of a nonservice-connected disease or injury is found to be proximately due to or the result of a service-connected disability.  38 C.F.R. § 3.310.  A secondary service connection grant based on causation does not require a baseline reduction and is therefore equivalent to an award of direct service connection.  Id.

When there is an approximate balance of positive and negative evidence regarding any material issue, reasonable doubt will be resolved in favor of the claimant.  See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (holding evidence is not in approximate balance, or nearly equal, when the evidence "persuasively favors one side or the other").

1. Entitlement to service connection for left shin splints is granted.

2. Entitlement to service connection for right shin splints is granted.

The March 2025 rating decision denied readjudication of the issue of service connection for bilateral shin splints based on a finding that new and relevant evidence had not been received since a previous August 2024 rating decision that initially denied the claims.

Under the modernized review system, a claimant who disagrees with a prior VA decision may file a supplemental claim.  38 U.S.C. § 5108; 38 C.F.R. §§ 3.156(d), 3.2501.  If new and relevant evidence is presented or secured with respect to the supplemental claim, the AOJ will readjudicate the previously denied claim taking into consideration all of the evidence of record.  Id.  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
 finding that new and relevant evidence had not been received since a previous August 2024 rating decision that initially denied the claims.

Under the modernized review system, a claimant who disagrees with a prior VA decision may file a supplemental claim.  38 U.S.C. § 5108; 38 C.F.R. §§ 3.156(d), 3.2501.  If new and relevant evidence is presented or secured with respect to the supplemental claim, the AOJ will readjudicate the previously denied claim taking into consideration all of the evidence of record.  Id.  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.  Id.  "New evidence" is evidence not previously part of the actual record before agency adjudicators.  38 C.F.R. § 3.2501(a)(1).  "Relevant evidence" is evidence that tends to prove or disprove a matter in issue.  Id.

The Board finds readjudication of the issue of service connection for bilateral shin splints is clearly warranted based on the evidentiary record.  The Board notes the AOJ scheduled the Veteran for a new examination following his August 2024 supplemental claim, which resulted in confirmation of a current disability, as well as favorable evidence regarding a direct service connection nexus opinion, which will be discussed in more detail below.  This evidence was not of record at the time of the August 2024 rating decision and tends to prove a matter in issue.

As previously noted, a March 2025 VA examination report, obtained pursuant to the Veteran's August 2024 supplemental claim, establishes a diagnosis of bilateral shin splints.  The AOJ asked the March 2025 VA examiner to provide an opinion addressing the presumptive provisions for Persian Gulf veterans outlined in 38 C.F.R. § 3.317.  Although the March 2025 VA examiner provided a negative opinion in this regard, her rationale supports the direct service connection theory of entitlement raised by the Veteran.  More specifically, the March 2025 VA examiner explained service connection is not warranted for bilateral shin splints on presumptive basis under 38 C.F.R. § 3.317 because the condition has a clear and specific etiology, specifically musculoskeletal injury from trauma and or wear and tear from excessive running as asserted by the Veteran, who has asserted the condition onset during his initial entry training in late 2004.  Service treatment records show the Veteran sought treatment for lower extremity symptoms during active service due to physical training.  His military occupational specialty (MOS) was also physically demanding.  After service, he was experienced issued related to DVT that impair his ability to run; therefore, the Board finds the physical nature of his service is at least as likely as not the cause of his bilateral shin splints when compared with his post-service activities.  Resolving reasonable doubt in the Veteran's favor, service connection for bilateral shin splints is warranted.  See Wise v. Shinseki, 26 Vet. App. 517, 531 (2014) ("By requiring only an 'approximate balance of positive and negative evidence' the Nation, 'in recognition of our debt to our veterans,' has 'taken upon itself the risk of error' in awarding . . . benefits.").

3. Entitlement to service connection for an ulcer condition, diagnosed as duodenal ulcer, is granted.

The Veteran seeks service connection for an ulcer condition.  The AOJ scheduled him for an examination in March 2025 to obtain an opinion regarding his claim due to his qualifying service in the Southwest Asia theater of operations during the Gulf War period.  See 38 C.F.R. § 3.317.  Much like the previously discussed bilateral shin splint claims, the March 2025 VA examiner provided an opinion indicating the provisions of 38 C.F.R. § 3.317 do not apply in the Veteran's case because the claimed ulcer condition has a clear and specific etiology.  The March 2025 VA examiner noted the Veteran has been diagnosed with a duodenal ulcer, which resulted from "excessive use of [nonsteroidal anti-inflammatory drugs], anticoagulants and stress from hospitalization and from vascular surgery."  The Board notes the Veteran is entitled to service connection for the DVT, which led to his vascular surgery, as well as any related psychiatric impairment; therefore, the Board finds the March 2025 VA examiner's opinion supports an award of service connection for duodenal ulcer under 38 C.F.R. § 3.310(a) when reasonable doubt is resolved in his favor.  The Board notes the Veteran's April 2024 supplemental claim raised the issue of service connection for ulcerative colitis in the context of his
 Veteran has been diagnosed with a duodenal ulcer, which resulted from "excessive use of [nonsteroidal anti-inflammatory drugs], anticoagulants and stress from hospitalization and from vascular surgery."  The Board notes the Veteran is entitled to service connection for the DVT, which led to his vascular surgery, as well as any related psychiatric impairment; therefore, the Board finds the March 2025 VA examiner's opinion supports an award of service connection for duodenal ulcer under 38 C.F.R. § 3.310(a) when reasonable doubt is resolved in his favor.  The Board notes the Veteran's April 2024 supplemental claim raised the issue of service connection for ulcerative colitis in the context of his more general service connection claim for an ulcer condition; however, the expert evidence of record, to include the March 2025 VA examiner's report and treatment records, establish he has a duodenal ulcer, which onset in March 2022, rather than ulcerative colitis.  The Veteran is not required, nor expected, to arrive at the precise diagnosis or etiology to support his claim but rather to describe the symptoms he believes resulted from his active service.  See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009).  In this case, the Veteran has raised the issue of service connection for a condition manifest through ulcers and therefore met his burden to describe the symptoms he believes resulted from his active service.  This condition - diagnosed as a duodenal ulcer - has been associated with service via a secondary service connection theory of entitlement not explicitly raised by the Veteran but rather raised by the evidence of record.  The Board must consider all theories of entitlement raised by the record.  See Robinson v. Shinseki, 557 F.3d 1355 (2009).  The Veteran's claim should not be denied simply because he has raised an erroneous diagnosis that has not been confirmed by experts.  Resolving reasonable doubt in the Veteran's favor, the Board finds service connection for an ulcer condition, diagnosed as duodenal ulcer, is warranted.  See Wise, supra.

4. Entitlement to service connection for varicocele is denied.

In contrast to the previously discussed claims, the evidence of record fails to establish a current disability for the Veteran's service connection claim for varicocele.  Neither the March 2025 rating decision - nor any past decision - includes a favorable finding regarding a current disability for the varicocele claim.  Indeed, the evidence is persuasively against a finding of current disability for the varicocele claim.  The Veteran was scheduled for an examination in March 2025, and his March 2025 VA examiner concluded there is no current disability to support his varicocele claim.  There is also no indication in the available treatment records that the Veteran has been treated for or been diagnosed as having varicocele in the period leading up to his service connection claim.  The Board recognizes a diagnosis is not required to establish service connection for symptoms that result in functional impairment in earning capacity.  See Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018).  Yet, in this case, there does not appear to be any symptoms that result in functional impairment in earning capacity.  The March 2025 VA examiner noted the Veteran's lay reports that the "varicocele was many years ago" further noting "[h]e does not recall the exact date when it started" but "has not had any issues since then."  This lay report is consistent with the Veteran's well documented treatment history, which includes consistent treatment for numerous other conditions but does not reference any issue related to varicocele.

The Board notes the existence of a current disability is the cornerstone of a claim for VA disability compensation.  Degmetich v. Brown, 104 F.3d 1328 (1997).  Here, the evidence is persuasively against a finding of a current disability.  The Board acknowledges the Veteran may have experienced symptoms of varicocele during or shortly after his separation for active service; however, service connection cannot be awarded for past symptoms when a condition has completely resolved resulting in no current disability at the time of claim.  See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).  Since the evidence is persuasively against a finding of a current disability, the benefit-of-the-doubt doctrine does not apply, and his service connection claim for varicocele must be denied.  See Lynch, supra.

 

 

M. HYLAND

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	L. S. Kyle, Counsel

The Board's decision in this case is binding only with respect
 during or shortly after his separation for active service; however, service connection cannot be awarded for past symptoms when a condition has completely resolved resulting in no current disability at the time of claim.  See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).  Since the evidence is persuasively against a finding of a current disability, the benefit-of-the-doubt doctrine does not apply, and his service connection claim for varicocele must be denied.  See Lynch, supra.

 

 

M. HYLAND

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	L. S. Kyle, 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.