Entitlement to service connection for right arm inflammation is denied.

Citation Nr: A26069932 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 250715-564878 DATE: July 30, 2026 ORDER Entitlement to service connection for right arm inflammation is denied. FINDING OF FACT The Veterans right arm inflammation is not a result of her military service and did not permanently worsen beyond normal progression during or as a result of her military service. CONCLUSION OF LAW The criteria for entitlement to service connection for right arm inflammation have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the Army from June 2016 to November 2017. This case is before the Board of Veterans' Appeals (Board) on appeal from a July 2025 Regional Office (RO) rating decision. In the August 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the July 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], 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 The law provides that service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.304. 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. 38 C.F.R. § 3.303(d). Generally, establishing service connection requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999). 1. Entitlement to service connection for right arm inflammation The Veteran is seeking entitlement to service connection for her right arm inflammation. In the July 2025 rating decision, the AOJ made the following favorable findings: 1. The Veteran has been diagnosed with a disability as the VA examination dated March 2025 showed diagnosis of right arm inflammation; and, 2. The claimed issue existed prior to military service. The Veteran reported that she fell and fractured elbow at 3 years of age. These are favorable findings by the AOJ, and the Board will not disturb these findings. See 38 U.S.C. § 5104A; 38 C.F.R. § 3.104 (c). A Veteran is presumed to have been sound upon entry into the military, except as to conditions noted at the time of the acceptance, examination, or enrollment, or where clear and unmistakable evidence demonstrates that the condition existed before acceptance and enrollment and was not aggravated by such service. 38 U.S.C. § 1111; Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004). The presumption of soundness applies only when a disease or injury not noted upon entry to service manifest in service, and a question arises as to whether it preexisted service. Gilbert v. Shinseki, 26 Vet. App. 48, 55 (2012), aff'd 749 F.3d 1370 (Fed. Cir. 2014). The burden falls on VA to rebut the presumption of soundness by clear and unmistakable evidence that an injury or disease manifested in service was both preexisting and not aggravated by service. See 38 U.S.C. § 1111; Wagner v. Principi, 370 F.3d 1089, 1096 (Fed.Cir.2004). Clear and unmistakable evidence means that the evidence cannot be misinterpreted and misunderstood, i.e., it is undebatable. Quirin v. Shinseki, 22 Vet. App. 390, 396 (2009). Clear and unmistakable evidence can consist of the Veteran's own admissions of a pre-service disability. Horn v. Shinseki, 25 Vet. App. 231, 237 (2012). If there is clear and unmistakable evidence to show that the Veteran's disability was both preexisting and not aggravated by service, then the Veteran is not entitled to service-connected benefits for the preexisting condition. Wagner,370 F.3d at 1096. The most competent and credible evidence of record shows that there is clear and unmistakable evidence that the Veteran's right arm inflammation preexisted service. Specifically, the Veteran reported that she fell and fractured elbow at 3 years of age. The Board finds the presumption of soundness is not applicable in the instant case as the evidence clearly and unmistakably demonstrates that the Veteran's right arm inflammation preexisted service. A review of the Veterans service treatment records shows that the Veteran was seen for complaints severe pain in her right arm in March 2017. She was seen again in May 2017 for right elbow pain and reported that she began having issues during PT. She reported going to occupational therapy for two months, but noted it did not help much. During her July 2017 separation examination, the Veteran selected "yes" for swollen or painful joints and noted a right elbow inflamed tendon. The Veteran underwent a March 2025 disability benefit questionnaire. The Veteran reported right arm pain with inflammation with any lifting or anything that may be causing sudden movements. She reported having a lot of pain in her right elbow. She further reported she fell and fractured her elbow at 3 years of age. The Veteran reported current symptoms of a lot of pain in right elbow. She denied any current treatment and reported no flare-ups. The examiner noted that her functional loss included right arm pain with any lifting or anything that may be causing sudden movements. On range of motion testing, the Veteran exhibited flexion endpoint to 170 degrees and abduction endpoint to 165 degrees. The examiner noted pain with active and passive motion that causes functional loss. No muscle atrophy or ankylosis was noted. The March 2025 examiner provided the following opinion and rationale: based on review of the available evidence, it is less likely than not that the claimed condition is due to service as there is a lack of substantiating evidence supporting a nexus between the current diagnosis of right arm inflammation and military service. Therefore, without chronicity during service or after service, a post-service event, illness, or injury is considered to be a more likely etiology. A May 2025 examiner opined that the Veterans right arm inflammation, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness. In support of her opinion, the examiner provided the following rationale: right arm inflammation is considered a symptom, not a medical condition. Inflammation in the right arm can result from a wide range of underlying etiologies, including trauma, infection, autoimmune disease, or localized overuse. The presence of inflammation (manifesting as pain, swelling, erythema, or warmth) is a clinical finding that prompts further evaluation to determine the underlying cause, which may be a specific medical condition such as arthritis, bursitis, or vasculitis. The medical literature emphasizes that inflammation is a pathophysiological process and a presenting feature, rather than a diagnosis in itself. For example, in the context of musculoskeletal complaints, the evaluation focuses on identifying the underlying disease-such as polymyalgia rheumatica, rheumatoid arthritis, or infection-based on the pattern, location, and associated features of inflammation. The American Heart Association, in its guideline on acute rheumatic fever, also treats joint inflammation as a symptom that requires further diagnostic workup to identify the specific disease entity. The examiner concluded that the Veterans right arm inflammation should be regarded as a clinical symptom that necessitates further investigation to establish the underlying medical condition responsible for the inflammatory process. The Veteran underwent another disability benefits questionnaire in July 2025. The Veteran reported that she had the same issue prior to service. She reported symptoms of inflammation to the right arm and treated with Tylenol if needed. The examiner noted no reports of flare-ups or functional loss. On examination, the Veterans range of motion was normal with no evidence of pain. The examiner noted additional factors of swelling due to pain. No muscle atrophy or ankylosis was noted. The July 2025 examiner opined that the Veterans claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale provided by the examiner is as follows: the Veteran has claimed right arm inflammation as being directly related to military service. Based on review of the available evidence, it is less likely than not that the claimed condition is due to service as there is a lack of substantiating evidence supporting a nexus between the current diagnosis of right arm pain while in service and military service. Without chronicity during service or after service, a post-service event, illness, or injury is considered to be a more likely etiology. The Veteran believes that her right arm inflammation was either caused by her military service or was aggravated by service. However, the Board finds the persuasive weight of the evidence is against a finding of either direct causation or aggravation. Although the Veteran may report things that she observes and experiences with her own senses, she has not demonstrated that she possesses the medical knowledge and training to provide an opinion regarding whether her right arm inflammation was a result of her military service and/or aggravated beyond its natural progression. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465, 470 (1994). In view of the above, the weight of the evidence is against the claim for service connection for right arm inflammation. Accordingly, the claim is denied. Martin T. Mitchell Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Vample, Erica 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.