CHILBLAIN, FROSTBITE

Summary

The Veteran, a veteran who served from May 1972 to May 1993, including service in Germany, appeals the denial of service connection for chilblain, frostbite, of the bilateral hand and fingers. The Veteran claimed the condition had its onset in service and was related to cold weather exposure during his military service, citing complaints of pain, cold sensitivity, and functional difficulty in his hands noted on his discharge examination in June 1993. The Board found evidence of a current diagnosis from a VA examination and service treatment records indicating complaints of pain and functional difficulty in cold weather, as well as issues with his thumbs requiring surgery in 1988. While a VA examiner opined the condition was less likely than not related to service, the Board found this opinion unpersuasive as it failed to address the Veteran's specific in-service complaints and the continuity of symptomatology. The Board found the Veteran's testimony regarding the onset and cause of his condition to be credible and plausible. Furthermore, a private medical opinion submitted within 90 days of the Veteran's hearing opined it was "highly likely" that the condition was a direct result of cold exposure during military service, which the Board found to be greater than the "at least as likely as not" standard. The Board found this private opinion persuasive and concluded that all three elements for direct service connection were met. Service connection for chilblain, frostbite, of the bilateral hand and fingers is granted.

Rationale

Evidence of current diagnosis from VA examination; Evidence of in-service complaints of pain and functional difficulty in cold weather; Persuasive private medical opinion finding highly likely related to military cold exposure

Full Decision Text

Citation Nr: A26040655
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 241217-501863
DATE: April 30, 2026

ISSUE

Entitlement to service connection for chilblain, frostbite, of the bilateral hand and fingers.

ORDER

Entitlement to service connection for chilblain, frostbite, of the bilateral hand and fingers is GRANTED.

FINDING OF FACT

The Veteran's chilblain, frostbite, of the bilateral hand and fingers had onset in, and is related to, his active military service.

CONCLUSION OF LAW

The criteria for service connection for chilblain, frostbite, of the bilateral hand and fingers have been met. 38?U.S.C. §§ 1110, 1131, 5107; 38?C.F.R. § 3.303. 

FACTUAL AND PROCEDURAL HISTORY

The Veteran served on active duty in the Armed Forces of the United States from May 1972 to May 1993. The Veteran filed a claim with the Department of Veterans Affairs (VA) on January 23, 2024. On July 3, 2024, the VA Regional Office (RO) issued a rating decision pertinent to the issue on appeal. On December 17, 2024, the Veteran noted a timely appeal of the rating decision to the Board. The appeal was prosecuted pursuant to the modernized review system. 

REASONS AND BASES FOR FINDING AND CONCLUSION

The Board has reviewed the evidence in the record-the Veteran's claims file.  Although the Board has an obligation to provide adequate reasons and bases supporting this Decision, there is no requirement that every piece of evidence submitted by the Veteran or obtained on his behalf be discussed in detail.  Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the claims file shows, or fails to show, with respect to the claim.  See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000); Timberlake v. Gober, 14 Vet. App. 122, 128-130 (2000).

I.

Service Connection Claim - Legal Criteria

Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish direct service connection for a claimed disorder, there must be (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the current disability.  Hickson v. West, 12 Vet. App. 247, 253 (1999). Chilblain, frostbite, is not a chronic disease listed under section 3.309(a) of Title 38 of the Code of Federal Regulations; therefore, the presumptive service connection provisions based on "chronic" in-service symptoms and "continuous" post-service symptoms under section 3.303(b) do not apply.  Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service.  Presumptive periods are not intended to limit service connection to diseases so diagnosed when the evidence warrants direct service connection.  The presumptive provisions of the statute and VA regulations implementing them are intended as liberalizations applicable when the evidence would not warrant service connection without their aid.  38 C.F.R. § 3.303(d).

II.

Service Connection Claim - Analysis

The Veteran contends, and testified before the undersigned in January 2026, that service connection is warranted for chilblain, frostbite, of the bilateral hand and fingers as it had onset in and is etiologically related to service. Specifically, the Veteran testified that his claimed chilblain, frostbite, of the bilateral hand and fingers is related to his complaints on his discharge examination in June 1993 of pain, cold sensitivity, and functional difficulty in his hands during cold weather. He also testified, and submitted a written statement at the same time, attesting that his claimed chilblain, frostbite, of the bilateral hand and fingers was related to his exposure to cold weather while serving in Germany.

The Veteran was afforded a
, and testified before the undersigned in January 2026, that service connection is warranted for chilblain, frostbite, of the bilateral hand and fingers as it had onset in and is etiologically related to service. Specifically, the Veteran testified that his claimed chilblain, frostbite, of the bilateral hand and fingers is related to his complaints on his discharge examination in June 1993 of pain, cold sensitivity, and functional difficulty in his hands during cold weather. He also testified, and submitted a written statement at the same time, attesting that his claimed chilblain, frostbite, of the bilateral hand and fingers was related to his exposure to cold weather while serving in Germany.

The Veteran was afforded a VA-contracted examination in May 2024 in which the examiner noted a diagnosis for bilateral hand and fingers chilblain and frostbite. Accordingly, the Board finds the first element of service connection to be satisfied.

Service personnel records show that the Veteran served in Germany. Service treatment records show that in an April 1993 report of medical history that the Veteran complained of still getting pain in cold weather status post-surgery in 1988. Service treatment records are also replete for complaints of right and left thumb issues, including reconnection surgery of the right thumb tendon in 1988. Accordingly, the Board finds the second element of service connection to be satisfied.

Turning to the third element, causation, the Veteran was afforded a VA-contracted examination in May 2024 in which the examiner opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner stated that the Veteran had no additional medical reports for treatment of the claimed condition apart from the application claim. However, the examiner did not address the aforenoted April 1993 report of medical history in which the Veteran complained of still getting pain in cold weather status post-surgery in 1988. Moreover, it is symptoms, however, not treatment, which are the essence of any evidence of continuity of symptomatology. Savage v. Gober, 10 Vet. App. 488, 496 (1997) (citing Wilson v. Derwinski, 2 Vet. App. 16, 19 (1991)). The Board does not afford the May 2024 opinion probative value; it is unpersuasive.     

As discussed above, the Veteran testified before the undersigned in January 2026 that service connection is warranted for chilblain, frostbite, of the bilateral hand and fingers as it is related to his complaints on his discharge examination in June 1993 of pain, cold sensitivity, and functional difficulty in his hands during cold weather. He also testified that his claimed chilblain, frostbite, of the bilateral hand and fingers was related to his exposure to cold weather while serving in Germany. The Board closely studied the Veteran's testimonial demeanor and found no signs of falsity, evasion, or deceit. And finds his explanation for the onset and cause of his chilblain, frostbite, of the bilateral hand and fingers plausible. The Board believes the Veteran on this issue.

Within 90 days of his hearing before the undersigned, in January 2026, the Veteran submitted a private opinion in which the examiner noted his symptoms in service. The examiner noted that the Veteran had been under his care and received physical examination and X-rays. The examiner opined that it was highly likely that the Veteran's condition was a direct result of his cold exposure during his military. The examiner stated that the Veteran's symptoms of cold intolerance were clearly related to his exposure during military service. In this case, although the private examiner did not strictly adhere to the the legal standards; that is, whether it is "approximately at least as likely as not" that chilblain, frostbite, of the bilateral hand and fingers, had onset in service and is otherwise etiologically related to service, the Board finds that the finding of "highly likely" as greater than "approximately at least as likely as not". 

The Board finds the January 2026 opinion to be competent and persuasive evidence that the Veteran's chilblain, frostbite, of the bilateral hand and fingers is related to his active military service because it considers all relevant evidence and contains a rationale that clearly explains how it was formed-what factors were considered and why they were of moment.  This allows the Board to evaluate each step in the line of reasoning and examine each for soundness.  Doing so here, the Board is satisfied that each inference drawn is supported and so the ultimate conclusion is predicated on a solid foundation of reasoning.  It does not crumble under the Board's probing gaze. It stands firm.  It is given probative weight.  For these reasons, the Board concludes that all three elements
6 opinion to be competent and persuasive evidence that the Veteran's chilblain, frostbite, of the bilateral hand and fingers is related to his active military service because it considers all relevant evidence and contains a rationale that clearly explains how it was formed-what factors were considered and why they were of moment.  This allows the Board to evaluate each step in the line of reasoning and examine each for soundness.  Doing so here, the Board is satisfied that each inference drawn is supported and so the ultimate conclusion is predicated on a solid foundation of reasoning.  It does not crumble under the Board's probing gaze. It stands firm.  It is given probative weight.  For these reasons, the Board concludes that all three elements of direct service connection are met for the claim at issue. The appeal is granted. 

 

STEVEN V. ADLER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	R.M.K., 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.