ALLERGIC OR VASOMOTOR RHINITIS WITHOUT POLYPS

LESLEY A. REIN · 2026 · Case ID: A26040584

MIXED

Summary

The Veteran served from September 2007 to September 2023, with multiple periods of active duty. The Veteran appeals the denial of service connection for allergic rhinitis with deviated nasal septum, left knee disability, right knee disability, sinusitis, tinea pedis, and sleep apnea, and seeks an increased rating for allergic rhinitis. The Board granted service connection for chronic headaches as secondary to the service-connected allergic rhinitis. For allergic rhinitis, the Board denied an increased rating, finding the evidence did not support a rating higher than noncompensable, despite the Veteran's subjective complaints. The Board denied service connection for left and right knee disabilities, finding no competent evidence of functional impairment or current diagnosis, and that the evidence weighed against a service connection. Similarly, service connection for sinusitis, tinea pedis, and sleep apnea were denied due to a lack of competent evidence of a current diagnosis or persistent symptomatology, with the Board finding the evidence persuasively weighed against these claims. The Board applied the benefit of the doubt doctrine to the chronic headaches claim, finding the evidence approximately balanced and resolving the doubt in the Veteran's favor.

Rationale

Evidence persuasively weighs against increased rating.; Veteran did not meet criteria for higher rating (obstruction/polyps).; VA examination findings outweighed Veteran's subjective complaints.

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

6522

Docket No.

240406-432189

Full Decision Text

Citation Nr: A26040584
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 240406-432189
DATE: April 30, 2026

ORDER

Entitlement to a compensable disability rating for allergic rhinitis with deviated nasal septum is denied.

Entitlement to service connection for chronic headaches is granted.

Entitlement to service connection for a left knee disability is denied.

Entitlement to service connection for a right knee disability is denied.

Entitlement to service connection for sinusitis is denied.

Entitlement to service connection for tinea pedis is denied.

Entitlement to service connection for a sleep apnea is denied.

FINDINGS OF FACT

1. Throughout the period on appeal, the Veteran's allergic rhinitis with deviated nasal septum did not result in greater than 50 percent obstruction of the nasal passages on both sides or complete obstruction on one side, and there was no evidence of nasal polyps.

2. Resolving all reasonable doubt in favor of the Veteran, the evidence is approximately balanced to show that his chronic headaches are due to his service-connected allergic rhinitis.

3. The competent and credible evidence does not show that the Veteran had a left knee disability during the period on appeal or approximate thereto.

4. The competent and credible evidence does not show that the Veteran had a right knee disability during the period on appeal or approximate thereto.

5. The competent and credible evidence does not show that the Veteran had sinusitis during the period on appeal or approximate thereto.

6. The competent and credible evidence does not show that the Veteran had tinea pedis during the period on appeal or approximate thereto.

7. The competent and credible evidence does not show that the Veteran had sleep apnea during the period on appeal or approximate thereto, and his sleep impairment is shown to be a symptom of his service-connected posttraumatic stress disorder (PTSD).

CONCLUSIONS OF LAW

1. The criteria for entitlement to a compensable disability rating for allergic rhinitis with deviated nasal septum have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.97, Diagnostic Codes 6502-6522.

2. The criteria for service connection for chronic headaches as secondary to allergic rhinitis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

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

5. 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.

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

7. 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.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from September 2007 to June 2017, October 2020 to September 2021, October 2021 to September 2022, and October 2022 to September 2023.

The rating decisions on appeal were issued in July 2023 and March 2024 and constitute initial decisions; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. The July 2023 rating decision adjudicated the issues of entitlement to service connection for headaches, left knee disability, right knee disability, and sinusitis. The March 2024 rating decision adjudicated the issues of entitlement to service connection for sleep apnea and tinea pedis and increased rating for rhinitis.

2007 to June 2017, October 2020 to September 2021, October 2021 to September 2022, and October 2022 to September 2023.

In the April 6, 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the July 2023 and March 2024 agency of original jurisdiction (AOJ) decisions on appeal, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 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 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.

The Board notes that in the April 6, 2024 VA Form 10182, the Veteran indicated his desire to appeal the issue of entitlement to an increased rating for foot pain adjudicated in the September 2017 rating decision. As this was last adjudicated more than a year prior to the April 2024 VA Form 10182, the Board finds that the April 2024 VA Form 10182 was untimely as to this issue. 38 C.F.R. §§ 3.2500 (a), 20.202. The Veteran may file a Supplemental Claim as to this and submit or identify new and relevant 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.

The Veteran also indicated his desire to appeal the issues regarding allergic rhinitis, chronic headaches, a left knee disability, a right knee disability, and sinusitis that were adjudicated in the December 2017 rating decision. While this rating decision was issued more than year prior to the April 6, 2024 VA Form 10182, the Board finds that the issues of entitlement to service connection for chronic headaches, a left knee disability, a right knee disability, and sinusitis were last adjudicated in a July 2023 rating decision and the issue of entitlement to an increased rating for allergic rhinitis was last adjudicated in a March 2024 rating decision. As both of these rating decisions were issued within one year of the April 2024 VA Form 10182, the Board will construe that the April 2024 VA Form 10182 as an appeal to those rating decisions.

Additionally, the Board notes that the Veteran had submitted a March 2024 VA Form 20-0996, Higher-Level Review, for the issue of entitlement to service connection for tinea pedis adjudicated in a March 2024 rating decision. However, the AOJ erroneously notified the Veteran that this issue had not been adjudicated in the March 2024 rating decision and did not issue a decision in response to the March 2024 VA Form 20-0996. However, as the Veteran has submitted the April 2024 VA Form 10182 for this issue in the same decision, the Board finds that the procedural defect of concurrent election has been waived and will adjudicate the issue of entitlement to service connection for tinea pedis in this decision.

Under 38 C.F.R.
Form 20-0996, Higher-Level Review, for the issue of entitlement to service connection for tinea pedis adjudicated in a March 2024 rating decision. However, the AOJ erroneously notified the Veteran that this issue had not been adjudicated in the March 2024 rating decision and did not issue a decision in response to the March 2024 VA Form 20-0996. However, as the Veteran has submitted the April 2024 VA Form 10182 for this issue in the same decision, the Board finds that the procedural defect of concurrent election has been waived and will adjudicate the issue of entitlement to service connection for tinea pedis in this decision.

Under 38 C.F.R. § 3.104 (c) provides that any favorable finding made by a VA adjudicator is binding on all subsequent agency of original jurisdiction and the Board unless rebutted by evidence that identifies a clear and unmistakable error in the favorable finding. In the July 2023 rating decision, the AOJ made the favorable finding that VA treatment records showed a history of chronic sinusitis. This finding is binding on the Board. 38 C.F.R. § 3.104 (c). Further, in the March 2024 rating decision, the AOJ made the favorable finding that the July 2023 VA examination diagnosed the Veteran with obstructive sleep apnea. However, in this case, the Board finds that the evidence shows that there was clear and unmistakable error in this favorable finding. First, the July 2023 VA examination did not diagnose the Veteran with obstructive sleep and, in fact, expressly found that the Veteran did not have and had not ever had sleep apnea. In doing so, the examiner identified sleep studies showing that sleep apnea had not been diagnosed. This is further corroborated by the evidence of record. Thus, the Board finds that the favorable finding as to the diagnosis of obstructive sleep apnea is rebutted.

Pursuant to the Veterans Claims Assistance Act (VCAA), VA has duties to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C. §§ 5102, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.156(a), 3.159.

Neither the Veteran nor his representative has raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument).

Increased Rating

1. Entitlement to a compensable disability rating for allergic rhinitis with deviated nasal septum is denied.

Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4. The rating schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of, or incident to, military service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7.

The veteran's entire history is to be considered when making disability evaluations. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Where an increase in the level of a service-connected disability is at issue, the primary concern is the present level of disability. Francisco v. Brown, 7 Vet. App. 55 (1994). Nevertheless, the Board acknowledges that a claimant may experience multiple distinct degrees of disability that might result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Hart v. Mansfield, 21 Vet. App. 505, 509 - 10 (2007).

The Veteran's allergic rhinitis is currently rated as
.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Where an increase in the level of a service-connected disability is at issue, the primary concern is the present level of disability. Francisco v. Brown, 7 Vet. App. 55 (1994). Nevertheless, the Board acknowledges that a claimant may experience multiple distinct degrees of disability that might result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Hart v. Mansfield, 21 Vet. App. 505, 509 - 10 (2007).

The Veteran's allergic rhinitis is currently rated as noncompensably disabling under 38 C.F.R. § 4.97, Diagnostic Codes 6502-6522.

Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the evaluation assigned. In this case, the hyphenated code indicates that the Veteran's disability is evaluated as allergic rhinitis found under Diagnostic Code 6522.

Under Diagnostic Code 6522, a 10 percent rating is assigned for allergic or vasomotor rhinitis without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side. A maximum 30 percent rating is assigned for allergic or vasomotor rhinitis with polyps.

In a November 2023 VA examination, the Veteran was diagnosed with allergic rhinitis and deviated nasal septum. The Veteran reported that his current symptoms included itchy, watery eyes and sneezing. There were occasional flare up episodes throughout the year. His current treatment included Flonase saline wash. Upon physical examination, the examiner found that the Veteran did not have greater than 50 percent obstruction of the nasal passage on both sides, complete obstruction on one side, or nasal polyps.

Post-service VA treatment records did not show complaints of or treatment for his allergic rhinitis.

Based on a careful review of the subjective and clinical evidence, the Board finds that the evidence persuasively weighs against finding that an increased rating is warranted for the Veteran's allergic rhinitis. In other words, the Board finds that the Veteran's allergic rhinitis was not characterized by greater than 50 percent obstruction of nasal passage on both sides or complete obstruction on one side, or nasal polyps.

The Veteran is certainly competent to report his symptoms of allergic rhinitis with deviated nasal septum. Layno v. Brown, 6 Vet. App. 465, 470 (1994). He is not, however, competent to identify a specific level of disability. Competent evidence concerning the nature and extent of the Veteran's service-connected disability has been provided by a VA medical professional who has examined him. The medical findings adequately address the criteria under which the disability is evaluated and clearly demonstrate that the degree of impairment attributable to the service-connected disability. The Board accords these findings greater weight than the Veteran's complaints as to symptomatology. See Cartwright v. Derwinski, 2 Vet. App. 24, 25 (1991). Accordingly, the Veteran's assertion that he is entitled to a higher rating for his allergic rhinitis is outweighed by the objective medical findings of record. That is, the Board assigns greater probative value to the pertinent objective findings in the VA examination and treatment records.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether an initial compensable disability rating for allergic rhinitis with deviated nasal septum is warranted. Rather, the evidence persuasively weighs against finding in favor of the Veteran's increased rating claim. The benefit of the doubt doctrine, see 38 U.S.C. § 5107 (b), is therefore not for application as to this claim. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Generally, service connection requires: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. See Shedden v. Principi, 381 F.3d 1163
(en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Generally, service connection requires: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. See Shedden v. Principi, 381 F.3d 1163, 1166 - 67 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d).

In addition, service connection may be established on a secondary basis for a disability which is shown to be proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310. Establishing service connection on a secondary basis requires evidence sufficient to show that a current disability exists and that the current disability was either caused by or aggravated by a service-connected disability. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995).

The first requirement for any service connection claim is evidence of a disability. Boyer v. West, 210 F.3d 1351 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223 (1992).

1. Entitlement to service connection for chronic headaches is granted.

In a November 2019 VA examination, the Veteran was diagnosed with headaches. He reported headaches described with sinus congestion, across the forehead and the temporal and nasal area with light sensitivity and occasional nausea. The examiner opined that it was less likely than not that the Veteran's headaches were due to his active duty service. She further found that the headaches were associated with symptoms of allergic rhinitis.

Based on a careful review of the evidence and resolving all reasonable doubt in favor of the Veteran, the Board finds that the evidence is approximately balanced that the Veteran's chronic headaches are due to his service-connected allergic rhinitis.

The November 2019 VA examiner found that the Veteran's headaches were associated with his allergic rhinitis.

Accordingly, and resolving all reasonable doubt in favor of the Veteran, the Board finds that the evidence is in approximate balance that his chronic headaches are secondary to his service-connected allergic rhinitis. Accordingly, his service connection claim for chronic headaches is granted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102.

2. Entitlement to service connection for a left knee disability is denied.

3. Entitlement to service connection for a right knee disability is denied.

Service treatment records show that Veteran injured his left knee after a fall in 2010. According to a December 2011 assessment, he had immediate swelling after the fall, which resolved. He reported occasional knee pain, especially with deep bends. He was diagnosed with bilateral knee chondromalacia patella in April 2016. A February 2016 left knee x-ray showed no bony abnormality.

In an August 2017 VA treatment record, the Veteran reported chronic bilateral knee pain. An August 2017 bilateral knee x-ray showed no significant abnormality of the knees.

In a November 2019 VA examination, the examiner found that the Veteran did not have a current diagnosis associated with his bilateral knees. The Veteran reported bilateral knee pain during physical training and ruck marches. He reported injuring his left knee when he slipped on a helicopter ramp. He reported intermittent bilateral knee pain with running, walking upstairs, and prolonged sitting. Upon physical examination, the examiner found no loss of range of motion in either knee, even considering repetitive use testing and repeated use over time, loss of muscle strength, muscle atrophy, ankylosis, joint instability after testing, or functional impact.

Based on a careful review of all of the subjective and clinical evidence, the Board finds that the evidence persuasively weighs against finding that service connection for a left or right knee disability is warranted.

In Saunders v. Wilkie, 886 Fed. Cir. 1356 (2018), the United States Court of Appeals for the Federal Circuit (Federal Circuit) held that pain can
helicopter ramp. He reported intermittent bilateral knee pain with running, walking upstairs, and prolonged sitting. Upon physical examination, the examiner found no loss of range of motion in either knee, even considering repetitive use testing and repeated use over time, loss of muscle strength, muscle atrophy, ankylosis, joint instability after testing, or functional impact.

In Saunders v. Wilkie, 886 Fed. Cir. 1356 (2018), the United States Court of Appeals for the Federal Circuit (Federal Circuit) held that pain can constitute a disability under 38 U.S.C. § 1110. However, the Federal Circuit did not hold that the Veteran could demonstrate service connection simply by asserting subjective pain. Rather, to establish a disability, the Veteran's pain must amount to a functional impairment. The Federal Circuit held that to establish the presence of a disability, the Veteran will need to show that his or her pain reaches the level of a functional impairment of earning capacity. Id. at 28. In Wait v. Wilkie, 33 Vet. App. 8 (2020), the Court clarified that under Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), there must be competent evidence demonstrating that the claimed symptoms result in functional impairment that in fact affects the veteran's earning capacity. In determining whether a veteran's impairment rises to a level affecting earning capacity, VA can consider manifestations of similar severity, frequency, and duration as those VA has determined by regulation would cause impaired earning capacity in an average person.

In this case, the Board finds that the Veteran has not presented any competent evidence that his bilateral knee pain results in functional impairment that in fact affects his earning capacity. Further, the November 2019 VA examination shows that the Veteran's knees did not have any functional impairment, such as loss of range of motion or instability.

In sum, the Veteran has not presented, identified, or alluded to the existence of any post-service medical evidence of a left or right knee disability. Here, no underlying disability has been clinically diagnosed during the appeal period or proximate thereto. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013).

The Veteran is certainly competent to report his symptoms of left and right knee pain. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the Veteran has not presented any competent and credible evidence of a current diagnosis for a left or right knee disability, and the available evidence does not support that the Veteran has any persistent symptomatology that would suggest that he has an underlying chronic disability. Further, he has not demonstrated that he has the requisite specialized knowledge to diagnose a knee disability. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Accordingly, the Veteran's assertions that he has a current left or right knee disability have little probative value.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for a left or right knee disability is warranted. Rather, the evidence persuasively weighs against finding in favor of the Veteran's service connection claims for a left or right knee disability. The benefit of the doubt doctrine, see 38 U.S.C. § 5107 (b), is therefore not for application as to these claims. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

4. Entitlement to service connection for sinusitis is denied.

Service treatment records show that the Veteran was diagnosed with chronic sinusitis.

In the May 2017 and November 2019 VA examinations for sinusitis/rhinitis, the Veteran was not diagnosed with sinusitis.

While a March 2018 VA treatment record noted a diagnosis of sinusitis and a July 2019 VA treatment record included a complaint of "chronic sinusitis," the April 2018 maxillofacial CT scan showed no significant chronic sinusitis.

Based on a careful review of all of the subjective and clinical evidence, the Board finds that the evidence persuasively weighs against finding that service connection for sinusitis is warranted.

In this case, the Board finds that the Veteran has not presented any competent evidence that he has chronic sinusitis. There is no evidence of any complaints of, treatment for, or diagnosis of sinusitis during the appeal period, which began in August 2022. While a March 2018 VA treatment record noted a diagnosis, a subsequent April 2018 maxillofacial CT scan showed no significant chronic sinusitis. Additionally, the May 2017 and November 2019 VA examinations confirm that the Veteran was not diagnosed with sinusitis.

In sum, the Veteran has not presented, identified, or alluded to the existence of any post-service medical evidence of sinusitis. Here, no underlying disability has been clinically diagnosed during the appeal period or proximate thereto. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013).

The Veteran is certainly competent to report his symptoms of sinusitis. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the Veteran has not presented any competent and credible evidence of a current diagnosis for sinusitis, and the available evidence does not support that the Veteran has any persistent symptomatology that would suggest that he has an underlying chronic disability. Further, he has not demonstrated that he has the requisite specialized knowledge to diagnose sinusitis. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Accordingly, the Veteran's assertions that he has a current diagnosis of sinusitis have little probative value.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for sinusitis is warranted. Rather, the evidence persuasively weighs against finding in favor of the Veteran's service connection claim. The benefit of the doubt doctrine, see 38 U.S.C. § 5107 (b), is therefore not for application as to this claim. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

5. Entitlement to service connection for tinea pedis is denied.

Service treatment records show that the Veteran was diagnosed with tinea pedis.

In an October 2023 VA dermatology note, the Veteran reported skin symptoms on his face and was diagnosed with contact dermatitis. Post-service VA treatment records do not show complaints of or treatment for tinea pedis.

In a November 2023 VA examination, the Veteran was diagnosed with tinea unguium, but not tinea pedis. In fact, the examiner specifically found that there was no pathology to warrant a diagnosis.

Based on a careful review of all of the subjective and clinical evidence, the Board finds that the evidence persuasively weighs against finding that service connection for tinea pedis is warranted.

In this case, the Board finds that the Veteran has not presented any competent evidence that he has tinea pedis. There is no evidence of any complaints of, treatment for, or diagnosis of tinea pedis during the appeal period, which began in August 2022.

In sum, the Veteran has not presented, identified, or alluded to the existence of any post-service medical evidence of tinea pedis. Here, no underlying disability has been clinically diagnosed during the appeal period or proximate thereto. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013).

The Veteran is certainly competent to report his symptoms of tinea pedis. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the Veteran has not presented any competent and credible evidence of a current diagnosis for tinea pedis, and the available evidence does not support that the Veteran has any persistent symptomatology that would suggest that he has an underlying chronic disability. Further, he has not demonstrated that he has the requisite specialized knowledge to diagnose
or proximate thereto. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013).

The Veteran is certainly competent to report his symptoms of tinea pedis. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the Veteran has not presented any competent and credible evidence of a current diagnosis for tinea pedis, and the available evidence does not support that the Veteran has any persistent symptomatology that would suggest that he has an underlying chronic disability. Further, he has not demonstrated that he has the requisite specialized knowledge to diagnose tinea pedis. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Accordingly, the Veteran's assertions that he has a current diagnosis of tinea pedis have little probative value.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for tinea pedis is warranted. Rather, the evidence persuasively weighs against finding in favor of the Veteran's service connection claim. The benefit of the doubt doctrine, see 38 U.S.C. § 5107 (b), is therefore not for application as to this claim. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

6. Entitlement to service connection for sleep apnea is denied.

Service treatment records show that the Veteran reported sleep issues, such as snoring, occasionally gasping for air while sleeping, and sleeplessness. He was referred for sleep apnea testing, but a July 2016 sleep study showed no apneas or hypopneas. In May 2021, the Veteran reported that he experienced mild sleep apnea and in September 2021, it was noted he had multiple sleep studies done with none having come back with sleep apnea or any large concerns.

According to May 2017 and July 2023 VA examinations for PTSD, the Veteran's psychiatric symptoms included chronic sleep impairment. In the examinations, the Veteran reported nightmares and the examiner noted that the Veteran's sleep disturbance was part of Criterion E (marked alterations in arousal and reactivity associated with traumatic events).

In a November 2023 VA examination, the examiner found that the Veteran had not had or ever had sleep apnea. The Veteran reported symptoms including years of snoring, restless sleep, excessive daytime sleepiness, and fatigue. A November 2023 sleep study showed no obstructive sleep apnea.

In an October 2025 appellate brief, the Veteran's representative contended that the Veteran's sleep apnea was secondary to his service-connected PTSD.

According to post-service VA treatment records, a computerized problem list indicated a diagnosis of sleep apnea on March 28, 2018. However, the March 28, 2018 record only indicated that there was a sleep apnea consult scheduled. Additionally, an October 2019 record indicated that the March 2018 sleep study consult was a no show. An April 2020 record shows that the sleep study was negative for obstructive sleep apnea.

Based on a careful review of all of the subjective and clinical evidence, the Board finds that the evidence persuasively weighs against finding that service connection for sleep apnea is warranted.

In this case, the Board finds that the Veteran has not presented any competent evidence that he has sleep apnea. There is no evidence of any complaints of, treatment for, or diagnosis of sleep apnea during the appeal period, which began in August 2022.

In sum, the Veteran has not presented, identified, or alluded to the existence of any post-service medical evidence of sleep apnea. Here, no underlying disability has been clinically diagnosed during the appeal period or proximate thereto. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013).

Further, according to VA examinations, the Veteran's sleep impairment was not a separate disability, but due to his service-connected PTSD. The evidence consistently shows that one of the Veteran's psychiatric symptoms is chronic sleep impairment and that his sleep impairment was due to his psychiatric symptoms, such as nightmares.

The Veteran is certainly competent to report his symptoms of sleep impairment. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the Veteran has not presented
or proximate thereto. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013).

The Veteran is certainly competent to report his symptoms of sleep impairment. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the Veteran has not presented any competent and credible evidence of a current diagnosis for sleep apnea, and the available evidence does not support that the Veteran has any persistent symptomatology that would suggest that he has an underlying chronic disability. Further, he has not demonstrated that he has the requisite specialized knowledge to diagnose sleep apnea. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Accordingly, the Veteran's assertions that he has a current diagnosis of sleep apnea have little probative value.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for sleep apnea is warranted. Rather, the evidence persuasively weighs against finding in favor of the Veteran's service connection claim. The benefit of the doubt doctrine, see 38 U.S.C. § 5107 (b), is therefore not for application as to this claim. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

LESLEY A. REIN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Ko, Elise

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.

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