BRONCHIAL ASTHMA

M. C. GRAHAM · 2026 · Case ID: A26040692

DENIED

Summary

The veteran, who served from November 1980 to July 1982, including confirmed service at Camp Lejeune, appealed the denial of service connection for asthma (also claimed as shortness of breath/bronchitis), COPD, pancreatitis, stroke, and left arm weakness. The veteran contended these conditions were due to in-service exposure to contaminated water at Camp Lejeune, and that the left arm weakness was secondary to the stroke. The Board acknowledged the veteran's service at Camp Lejeune and the presumption of exposure to contaminated water under 38 C.F.R. § 3.307(a)(7). However, the Board noted that the claimed conditions are not among those presumptively linked to Camp Lejeune exposure under 38 C.F.R. § 3.309(f). The Board reviewed the evidence, including service treatment records showing a viral syndrome in service and post-service treatment records for asthma, COPD, pancreatitis, and stroke. The Board found that the stroke did not manifest within one year of service, precluding presumptive service connection for cardiovascular disability. The Board also found that the veteran's claims of continuity of symptoms from service were not supported, and his lay opinions linking the conditions to service were speculative. VA examinations diagnosed asthma, COPD, and stroke, with examiners opining these conditions were less likely than not related to service, citing the lack of in-service diagnosis and the onset of symptoms years after service. The Board found these opinions persuasive. As service connection for stroke was denied, the claim for left arm weakness secondary to stroke was also denied. The Board denied all claims, finding the weight of the evidence against service connection for any of the claimed conditions, including those related to Camp Lejeune exposure.

Rationale

No presumptive link to Camp Lejeune exposure under 38 C.F.R. § 3.309(f); VA examiner opined less likely than not related to service; Lack of in-service diagnosis and symptoms onset years after service

Special Benefit

NO SPECIAL BENEFIT

Docket No.

220904-274085

Full Decision Text

Citation Nr: A26040692
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 220904-274085
DATE: April 30, 2026

ORDER

Entitlement to service connection for asthma, also claimed as shortness of breath and/or bronchitis, is denied.

Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is denied.

Entitlement to service connection for pancreatitis is denied.

Entitlement to service connection for stroke is denied.

Entitlement to service connection for left arm weakness, claimed as secondary to stroke, is denied.

FINDINGS OF FACT

1. The Veteran's asthma, also claimed as shortness of breath and/or bronchitis, is not related to active service or any incident of service, including as due to in-service exposure to contaminated water at Camp Lejeune.

2. The Veteran's COPD is not related to active service or any incident of service, including as due to in-service exposure to contaminated water at Camp Lejeune.

3. The Veteran's pancreatitis is not related to active service or any incident of service, including as due to in-service exposure to contaminated water at Camp Lejeune.

4. The Veteran's stroke did not manifest within a year of service and is not related to active service or any incident of service, including as due to in-service exposure to contaminated water at Camp Lejeune.

5. The Veteran's left arm weakness is not related to active service or any incident of service, including as due to in-service exposure to contaminated water at Camp Lejeune, nor is it caused or aggravated by a service-connected disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for asthma, also claimed as shortness of breath and/or bronchitis, including as due to in-service exposure to contaminated water at Camp Lejeune, have not been met. 38 U.S.C. §§ 1110, 1116, 1131, 1154, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309.

2. The criteria for service connection for COPD, including as due to in-service exposure to contaminated water at Camp Lejeune, have not been met. 38 U.S.C. §§ 1110, 1116, 1131, 1154, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309.

3. The criteria for service connection for pancreatitis, including as due to in-service exposure to contaminated water at Camp Lejeune, have not been met. 38 U.S.C. §§ 1110, 1116, 1131, 1154, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309.

4. The criteria for service connection for stroke, including as due to in-service exposure to contaminated water at Camp Lejeune, have not been met. 38 U.S.C. §§ 1110, 1116, 1131, 1154, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309.

5. The criteria for service connection for left arm weakness, including as due to in-service exposure to contaminated water at Camp Lejeune, or as secondary to a service-connected disability have not been met. 38 U.S.C. §§ 1110, 1116, 1131, 1154, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from November 1980 to July 1982, with confirmed service at Camp Lejeune. The Board thanks the Veteran for his service to our country.

The rating decision on appeal was issued in September 2021 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the September 2022 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on March 24,
307, 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from November 1980 to July 1982, with confirmed service at Camp Lejeune. The Board thanks the Veteran for his service to our country.

The rating decision on appeal was issued in September 2021 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the September 2022 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on March 24, 2026. At the time of the hearing, the undersigned advanced the matter on the docket due to the Veteran's serious illness (stage IV lung cancer). The Veteran explicitly waived the 90 day evidence submission period after his hearing. See BVA Hearing Transcript (T.) at 16.

Therefore, the Board may only consider the evidence of record at the time of the September 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran at the hearing (as he waived the remainder of the 90 day evidence window following the hearing). 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) any day following the day of the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 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.

Service Connection

Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Generally, the evidence must show: (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. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

Under 38 C.F.R. § 3.303(b), an alternative method of establishing the second and third Shedden element is through a demonstration of continuity of symptomatology if the disability claimed qualifies as a chronic disease listed in 38 C.F.R. §3.309(a). Regulations also provide that service connection may be granted for a disability diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability is due to disease or injury which was incurred in or aggravated by service. 38 C.F.R. § 3.303(d).

Additionally, for Veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including cardiovascular-renal disease, are presumed to have been incurred in service if manifested to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309.

Service connection may also be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995); Ward v. Wilkie, 31 Vet. App. 233, 239 (2019). Further, service connection may not be awarded on the basis of aggravation without establishing a pre-aggravation baseline level of disability and comparing it to the current level of disability. 38 C.F
. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995); Ward v. Wilkie, 31 Vet. App. 233, 239 (2019). Further, service connection may not be awarded on the basis of aggravation without establishing a pre-aggravation baseline level of disability and comparing it to the current level of disability. 38 C.F.R. § 3.310(b).

Finally, 38 U.S.C. § 1154(a) requires that VA give "due consideration" to "all pertinent medical and lay evidence" in evaluating a claim for disability or death benefits. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Specifically, "[l]ay evidence can 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." Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006).

1. Entitlement to service connection for asthma, also claimed as shortness of breath and/or bronchitis.

2. Entitlement to service connection for COPD.

3. Entitlement to service connection for pancreatitis.

4. Entitlement to service connection for stroke.

5. Entitlement to service connection for left arm weakness, claimed as secondary to stroke.

The Veteran maintains that his asthma, COPD, pancreatitis and stroke are related to service, to exposure to contaminants while stationed at Camp Lejune. He specifically asserts that his left arm weakness is secondary to his stroke disability.

The Board finds the evidence is persuasively against a finding that service connection for asthma, COPD, pancreatitis, stroke and a left arm weakness disability, including as due to in-service exposure to contaminated water at Camp Lejeune, is warranted.

The Board will first address the Veteran's contentions either that in-service exposure to contaminated water at Camp Lejeune caused or aggravated his claimed disabilities. See BVA Hearing T. at 12-13. The Board will next address his contentions that he incurred these disabilities during active service. Additionally, the Board will address why service connection for left arm weakness, as secondary to a stroke disability is not warranted.

Service Connection Based on Presumptive Disability due to Camp LeJeune toxic exposure

With respect to the assertion of in-service exposure to contaminated water at Camp Lejeune, the Board also observes that the available service personnel records document that the Veteran served at Camp Lejeune during an applicable presumptive period for such exposure for no less than 30 days. Thus, his in-service exposure to contaminated water at Camp Lejeune is presumed. See 38 C.F.R. § 3.307(a)(7).

Although the Veteran's in-service exposures to contaminated water at Camp Lejeune are presumed, the record evidence does not support granting service connection for asthma, COPD, pancreatitis, stroke or a left arm weakness, based on this presumed in-service exposure.

The Board notes that these claimed disabilities are not among the diseases for which service connection is available on a presumptive basis due to in-service exposure to contaminated water at Camp Lejeune. See 38 C.F.R. § 3.309(f). Under 38 C.F.R. § 3.309(f), diseases including kidney cancer, liver cancer, non-Hodgkin's lymphoma, adult leukemia, multiple myeloma, Parkinson's disease, aplastic anemia and other myelodysplastic syndromes, and bladder cancer shall be service connected if the Veteran served at Camp Lejeune during the specified time frame. Accordingly, service connection on a presumptive basis based on exposures at Camp Lejeune is not warranted.

Where a veteran served continuously for ninety days or more during a period of war, or during peacetime service after December 31, 1946, as here, and certain disabilities become manifest to a degree of 10 percent within one year from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even
kin's lymphoma, adult leukemia, multiple myeloma, Parkinson's disease, aplastic anemia and other myelodysplastic syndromes, and bladder cancer shall be service connected if the Veteran served at Camp Lejeune during the specified time frame. Accordingly, service connection on a presumptive basis based on exposures at Camp Lejeune is not warranted.

Where a veteran served continuously for ninety days or more during a period of war, or during peacetime service after December 31, 1946, as here, and certain disabilities become manifest to a degree of 10 percent within one year from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1110, 1111,1133; 38 C.F.R. §§ 3.307, 3.309. However, the Veteran's treatment records do not reflect a diagnosis of or treatment for a respiratory or cardiovascular disability listed under 38 C.F.R. § 3.309(a) for many years following separation from service. Thus, the evidence is persuasively against the claims under the chronic disease presumption.

Nevertheless, the Veteran may still provide evidence that his claimed conditions are directly due to exposure to contaminated water at Camp Lejeune, or service. However, as discussed below, the Board finds that evidence of record persuasively weighs against a finding that the Veteran's asthma, COPD, pancreatitis, stroke or a left arm weakness disabilities are related to his active service, to include as a result of exposure to contaminated water at Camp Lejeune.

Service Connection on a Direct Basis and on a Presumptive Basis due to Chronic Disease

The Board also considers the theory of entitlement to service connection for asthma, COPD, pancreatitis, stroke or a left arm weakness disabilities on a direct basis. Combee v. Brown, 34 F.3d 1039, 1041-42 (Fed. Cir. 1994).

With regard to the first element of service connection, the September 2021 rating decision on appeal made favorable findings that the Veteran has been diagnosed with asthma, COPD, chronic bronchitis, a stroke, left arm weakness, and pancreatitis. It was also noted that the Veteran's claimed left arm weakness is secondary to a nonservice-connected disability (stroke). Specific to his bronchitis, the AOJ found that the Veteran had been treated for a viral syndrome in service in January 1982. See September 2021 Rating Decision.

The available service treatment records show that, at his enlistment physical examination in August 1980, the clinical evaluation was within normal limits except for a small umbilical cord and identifying body marks. The Veteran was treated for a viral syndrome in January 1982. Symptoms including cough and chest congestion were noted. See January 1982 Service Treatment Records.

The post-service evidence reflects that the Veteran was treated for bronchitis and COPD around 2018. See October 2018 private treatment record. A May 2021 VA respiratory examination noted a diagnosis of asthma from 2018. A May 2020 VA treatment record reflects a history of pancreatitis, 10 years prior, indicating treatment as early as 2010. A February 2020 VA treatment record noted that the Veteran had had a stroke and that the MRI "showed large right parietal lobe infarct plus multiple small infarcts noted bilaterally, which suggests thromboembolic etiology." A May 2020 VA treatment record noted left side weakness associated with a stroke.

Upon consideration of the above, it is not in dispute that the Veteran has had a stroke and that the medical evidence relates it to cardiovascular disease. However, the stroke did not become manifest within one year following separation from service. As the stroke was not initially shown until years after service, service connection on a chronic disease presumptive basis for cardiovascular disability (stroke) (under 38 U.S.C. § 1112; 38 C.F.R. § 3.309(a)) is not warranted.

What remains then is the question of whether, in the absence of a showing of onset in service and continuity since, the Veteran's asthma, COPD, pancreatitis, stroke or a left arm weakness disabilities may otherwise be related to his service. Notably, aside from claiming his current asthma, COPD, pancreatitis, stroke and left arm weakness disabilities related to his military service, the Veteran has not argued that these disability symptoms have persisted from service to the present. In fact,
shown until years after service, service connection on a chronic disease presumptive basis for cardiovascular disability (stroke) (under 38 U.S.C. § 1112; 38 C.F.R. § 3.309(a)) is not warranted.

What remains then is the question of whether, in the absence of a showing of onset in service and continuity since, the Veteran's asthma, COPD, pancreatitis, stroke or a left arm weakness disabilities may otherwise be related to his service. Notably, aside from claiming his current asthma, COPD, pancreatitis, stroke and left arm weakness disabilities related to his military service, the Veteran has not argued that these disability symptoms have persisted from service to the present. In fact, at his Board hearing the Veteran self-reported symptomatology beginning years following service. See Walker v. Shinseki, 708 F.3d 1331, 1338-40 (Fed. Cir. 2013).

Whether there is a nexus between his current asthma, COPD, pancreatitis, stroke or a left arm weakness disability and service, is a medical question that requires medical expertise, which the Veteran has not been shown to possess. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Kahana v. Shinseki, 24 Vet. App. 428 (2011). Therefore, the Veteran's opinions that his current asthma, COPD, pancreatitis, stroke or left arm weakness disabilities are related to service are merely lay speculations and are not competent evidence. They are without probative value in this matter.

The Veteran underwent a May 2021 VA respiratory conditions examination. He was diagnosed with asthma, COPD, chronic bronchitis, and pneumonia. The VA examiner opined that the Veteran's asthma and bronchitis were less likely than not incurred in or caused by the claimed in-service injury, event or illness. The examiner rationalized that the Veteran and his wife state that the Veteran did not begin having difficulty with breathing or asthma or bronchitis until 2006. The examiner noted that asthma and bronchitis were not identified while the Veteran was in the military. He noted that the Veteran stated that he never used oxygen while in the military and was not required to use oxygen other than his two hospitalizations for pneumonia in 2018 and 2020. Therefore, he concluded that the Veteran's asthma and also bronchitis are less likely than not incurred in or caused by his military service.

With respect to COPD, the VA examiner opined that it was less likely than not incurred in or caused by service. The examiner noted that the Veteran and his wife report that he did not have COPD until 2018 and 2020. He noted that a review of the records did not reflect COPD while he was in the military. He considered that the Veteran reported no use of oxygen while in the military and it was not required other than his two hospitalizations for pneumonia in 2018 and 2020. The examiner concluded that the Veteran's COPD is less likely than not incurred in or caused by his military service.

A May 2021 central nervous system and neuromuscular disease VA examination was completed. The Veteran was diagnosed with a stroke. The Veteran reported that in February 2020 he became disoriented at work and was taken to the hospital at which time a diagnosis of a stroke was established. The VA examiner opined that the claimed condition is less likely as not incurred in or caused by service. The examiner noted that there was no stroke condition while the Veteran was performing his military service.

The only medical opinions as to whether there is a nexus between the Veteran's current asthma (shortness of breath/bronchitis), COPD and stroke and his service have been outlined above. Together, these VA opinions warrant substantial probative weight because they incorporate statements made by the Veteran throughout the pendency of his claim as well as his STRs and post-service treatment records and explain why the complaints and findings shown do not support a nexus between any currently diagnosed asthma (shortness of breath/bronchitis), COPD and stroke disabilities and his service. These opinions are based on detailed examinations and thorough review of the record and include rationales that point to factual data, including the Veteran's self-reports provided in clinical settings. These opinions are probative evidence as to the claims of service connection for asthma (shortness of breath/bronchitis), COPD and stroke disabilities and, in the absence of probative evidence to the contrary, are persuasive.

The Board also acknowledges that VA has not provided the Veteran an examination and/or sought a medical opinion concerning his claimed pancreatitis or left arm weakness disabilities. The medical evidence of record identifies the
do not support a nexus between any currently diagnosed asthma (shortness of breath/bronchitis), COPD and stroke disabilities and his service. These opinions are based on detailed examinations and thorough review of the record and include rationales that point to factual data, including the Veteran's self-reports provided in clinical settings. These opinions are probative evidence as to the claims of service connection for asthma (shortness of breath/bronchitis), COPD and stroke disabilities and, in the absence of probative evidence to the contrary, are persuasive.

The Board also acknowledges that VA has not provided the Veteran an examination and/or sought a medical opinion concerning his claimed pancreatitis or left arm weakness disabilities. The medical evidence of record identifies the Veteran's left arm weakness as a residual of his stroke. As there is no probative indication that the Veteran's pancreatitis or left arm weakness disabilities may be associated with an established event, injury, or disease, a VA examination or a medical opinion is not warranted. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Generalized lay allegations are not sufficient to meet the McLendon standard, even though medical evidence is not necessarily required. Waters v. Shinseki, 601 F.3d 1274, 1276 (2010).

The Veteran also has not identified or submitted any evidence demonstrating his entitlement to service connection for asthma, COPD, pancreatitis, stroke or left arm weakness disabilities, as due to in-service exposure to contaminated water at Camp Lejeune.

On August 10, 2022, the President signed into law the PACT Act of 2022 which, in relevant part, expands the presumptions of service connection for diseases associated with exposures to burn pits and other toxins. Pub. L. 117-168, 136 Stat. 1759 (2022) (to be codified under 38 U.S.C. § 1120). The Board observes that the Veteran had service at Camp Lejeune. The PACT Act included changes to medical examination requirements where there is documented toxic exposure risk activity (TERA).

The Board has considered the PACT Act with respect to the claims for asthma, COPD, pancreatitis, stroke or a left arm weakness disabilities and cannot grant any of the claims at this time on that basis as for each, there is no connection between any current disability and exposures in service to contaminated water in the record available for review by the Board at this time. As the rating decision on appeal was issued prior to the effective date of the PACT Act, a remand for development under the PACT Act is not possible as the AMA does not permit remand in the absence of error and there was no pre-decisional error in this case (as the PACT Act was not passed at the time of the rating decision on appeal).

The Board finds that the weight of the competent and credible evidence of record is against the Veteran's claims under the theory of direct service connection or under the theory of presumptive service connection for chronic disease with respect to the stroke claim.

Secondary Service Connection

The Board will next address the Veteran's contentions that he has a left arm weakness disability secondary to a stroke.

Service connection is also warranted for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury. 38?C.F.R. §?3.310. Any additional impairment of earning capacity resulting from an already service-connected condition, regardless of whether or not the additional impairment is itself a separate disease or injury caused by the service-connected condition, should also be compensated. Allen v. Brown, 7?Vet. App.?439 (1995). When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. Id.

However, as noted above, service connection for a stroke is not warranted. Where the primary condition that is the alleged etiological source of the claimed secondary condition is not service-connected, service-connection on a secondary basis must be denied by the operation of law. 38 C.F.R. § 3.310. Accordingly, in the absence of service connection for the underlying diagnosis of stroke, the Board must deny entitlement to service connection for weakness of the left arm as secondary to a stroke disability.

In conclusion, the Board finds that the evidence weighs against the entitlement to service connection for asthma, COPD, pancreatitis, stroke and a left arm weakness disability, to include as due to his in-service contaminated water exposure, or his left arm weakness disability as secondary to a service-connected disability. As such, the appeal is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see
by the operation of law. 38 C.F.R. § 3.310. Accordingly, in the absence of service connection for the underlying diagnosis of stroke, the Board must deny entitlement to service connection for weakness of the left arm as secondary to a stroke disability.

M. C. GRAHAM

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board A. M. Clark, 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.

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