Service connection for temporomandibular joint disorder (TMJ) is granted.

Citation Nr: A26069989 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 250707-562015 DATE: July 30, 2026 ORDER Service connection for temporomandibular joint disorder (TMJ) is granted. Service connection for chronic respiratory disorder is denied. Service connection for chronic sinusitis is denied. Service connection for chronic rhinitis is denied. Service connection for diabetes mellitus type II (DM II) is denied. Service connection for hypertension is denied. REMANDED Service connection for a renal disability is remanded. FINDINGS OF FACT 1. The Veteran is diagnosed with TMJ which had its onset during service. 2. There is no indication of a diagnosis of a chronic respiratory disorder other than rhinitis close in proximity to, or during, the pendency of the claim. 3. There is no indication of a diagnosis of sinusitis close in proximity to, or during, the pendency of the claim. 4. The Veteran's diagnosed chronic rhinitis did not have its onset during service and is not otherwise related to service or any incident therein. 5. The Veteran's diagnosed DM II did not have its clinical onset during service and is not otherwise related to service or any incident therein. 6. The Veteran's diagnosed hypertension did not have its clinical onset during service and is not otherwise related to service or any incident therein. CONCLUSIONS OF LAW 1. The criteria for service connection for chronic respiratory disorder are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for chronic sinusitis are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for chronic rhinitis are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for DM II are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 5. The criteria for service connection for hypertension are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1983 to May 1987. The rating decision on appeal was issued in June 2025 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. By way of history, the Veteran filed a new September 2024 claim seeking service connection for, as relevant here, a chronic respiratory issue, chronic sinusitis, chronic rhinitis, DM II, hypertension, and chronic kidney issues to include surgeries. The agency of original jurisdiction (AOJ) issued a January 2025 rating decision denying the claim. In March 2025 the Veteran sought higher level review. The AOJ conducted a de novo review and issued a June 2025 rating decision denying the claim. 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 June 2025 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, 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. However, because the Board is remanding the claims of service connection for a renal disability, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii). Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38?U.S.C. §?1110; 38?C.F.R. §?3.303. Service connection is also warranted for disability proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Such secondary service connection is warranted for any increase in severity of a nonservice-connected disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(b). Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). 1. Service connection for TMJ The Veteran contends that he has TMJ due to his service. Specifically, the Veteran contends that he started grinding his teeth while in charge of recovery of torpedoes during his service. See February 2025 VA Examination Report. The Board is bound by the AOJ's favorable finding that the Veteran has a current diagnosis of TMJ. 38 CFR § 3.104(c); See June 2025 Rating Decision. The Board found a military personnel record which indicated that on September 5, 1985, the Veteran completed torpedo recovery training. Although a February 2025 VA examiner rendered a negative nexus opinion, the opinion is inadequate for adjudicative purposes in that it relies solely on the absence of evidence in service treatment records. The entire rationale for the provided opinion is "I can find no STR of TMJ being recorded." Id. However, the Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). In addition, the examiner recorded the Veteran's lay statement that he started to grind his teeth during torpedo recovery, impermissibly did not consider whether it was sufficient evidence of the etiology of the Veteran's disability such that his claim could be proven without contemporaneous medical evidence. See Buchanan v. Nicholson, 451 F.3d 1331, 1336, n. 1 (Fed. Cir. 2006). As such, the Board has afforded low probative weight to the opinion. Lay evidence is competent if it is provided by a person who has knowledge of the facts or circumstances and conveys matters that can be observed and described by a lay person. See Layno v. Brown, 6 Vet. App. 465, 470 (1994); 38 C.F.R. § 3.159(a)(2). Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience. Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience. Id. Competent lay evidence can be sufficient on its own to establish any element of a claim. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). Here, the Board finds that the Veteran is competent to report symptoms of grinding his teeth during service, which caused an eventual TMJ diagnosis. The Board did not find any evidence to impugn the Veteran's character. Therefore, the Board finds that the evidence is at least in approximate balance as to whether the Veteran's TMJ had its onset during service. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). 2. Service connection for chronic respiratory issues 3. Service connection for chronic sinusitis 4. Service connection for chronic rhinitis The Veteran contends that he has chronic respiratory issues, including chronic sinusitis and chronic rhinitis due to his service. Specifically, the Veteran contends that he has these conditions due to toxic exposures in service. See September 2024 Claim. The Board is bound by the AOJ's favorable finding that the Veteran was exposed to the following toxins during his service: asbestos, ionizing radiation, exposure to paints, fumes, and diesel during service. 38 C.F.R. § 3.104(c); See January 2025 Rating Decision. The Board is also bound by the AOJ's favorable finding that the Veteran has a chronic rhinitis diagnosis. 38 C.F.R. § 3.104(c); See January 2025 Rating Decision. A January 2025 VA examiner found that the Veteran did not have a diagnosis for a chronic respiratory issue or for sinusitis. The examiner only diagnosed the Veteran with allergic rhinitis, for which she rendered a negative nexus opinion. The Board finds the opinion of the January 2025 examiner adequate for adjudicative purposes, as it is based on consideration of the Veteran's medical history, described the criteria for the Veteran's claimed conditions and explained why the Veteran did not meet the criteria for a diagnosis of a chronic respiratory condition and sinusitis, namely, that there was no pathology to render a diagnosis for either one. In addition, examiner explained that the U.S. Department of Veterans Affairs and The Agency for Toxic Substances and Disease Registry do not support allergic rhinitis as a known condition for exposure to asbestos, ionizing radiation, diesel fuel, paints, or fumes. The examiner found that at that time, there was no medical or scientific evidence available that provided any indication of a relationship between the development of allergic rhinitis and the asbestos, ionizing radiation, exposure to paints, fumes, and diesel during service. Id. The January 2025 VA examiner made reference to relevant treatment records and medical literature. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). The Board finds that, because of the explanations offered and the reference to the relevant medical literature, the opinions of the examiner are entitled to high probative weight. Id. The Board did not find any other relevant medical evidence or medical opinion in the evidence of record. The existence of a current disability is the cornerstone of a claim for VA disability compensation. See Degmetich v. Brown, 104 F. 3d 1328 (1997). In the absence of proof of a present disability there can be no valid claim. While the Board recognizes the Veteran's general contention that a separate chronic respiratory issue and sinusitis had their onset during service, the record does not show, nor does the claimant contend that he has the specialized education, training, or experience that would qualify him to diagnose himself with a chronic respiratory issue or sinusitis. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). Therefore, the Board has no competent evidence of record to support a grant of service connection for a chronic respiratory issue or chronic sinusitis. And, because the only competent evidence of record concerning chronic rhinitis is the negative nexus opinion of the January VA examiner, the appeals must be denied at this time. In denying the claims for service connection, the Board concludes that the evidence is neither evenly nor approximately balanced. Rather, it persuasively weighs against service connection. The benefit of the doubt doctrine (U.S.C. § 5107(b)) is therefore not applicable. Lynch v. McDonough, 21 F.4th 776. 5. DM II 6. Hypertension The Veteran contends that he has DM II and hypertension due to his service. Specifically, the Veteran contends that he has these conditions due to toxic exposures in service. See September 2024 Claim. The Veteran also claims that the hypertension should be presumptively service connected. Id. The Board is bound by the AOJ's favorable findings that the Veteran has a diagnosis for DM II and for hypertension. 38 C.F.R. § 3.104(c); See January 2025 Rating Decision. The Board found that the Veteran's recorded blood pressure when entering service was 150/86, and at separation it was 120/78, demonstrating an improved reading during service. See An October 2024 VA examiner rendered a negative nexus opinion for both DM II and hypertension. The Board finds the opinion of the October 2024 examiner adequate for adjudicative purposes, as it is based on consideration of the Veteran's medical history, described the criteria for the Veteran's claimed conditions and explained why the Veteran did not meet the criteria for a diagnosis of a chronic respiratory condition and sinusitis, namely, that there was no medical evidence to support the development of either condition due to exposures to asbestos, ionizing radiation, paints, fumes, and diesel. The October 2024 VA examiner made reference to relevant treatment records and medical literature. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). The Board finds that, because of the explanations offered and the reference to the relevant medical literature, the opinions of the examiner are entitled to high probative weight. Id. Both DM II and hypertension are considered chronic condition under 38 C.F.R. § 3.309(a). Therefore, the Board has considered whether the conditions warrant presumptive service connection. However, under 38 C.F.R. § 3.307(a)(3), to qualify for service connection the chronic diseases must have must have become manifest to a degree of 10 percent or more within one year. Here, after thoroughly reviewing the evidence of record, the Board did not find evidence to support a contention that the Veteran developed either condition to a degree of 10 percent or more within one year. Therefore, the Board has no basis on which to grant presumptive service connection for either DM II or hypertension. The Board also considered whether the Veteran's lay statements were competent to establish the etiology of the DM II and hypertension. However, while the Board recognizes the Veteran's general contention that the DM II and hypertension had their clinical onset during service, the record does not show, nor does he contend that he has the specialized education, training, or experience that would qualify him to provide the etiology of DM II or hypertension. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). Having not found any competent evidence of record besides the October 2024 VA Examination Report to establish service connection, the Board has no basis on which to grant it. In denying the claim for service connection, the Board concludes that the evidence in this case is neither evenly nor approximately balanced. Rather, it persuasively weighs against service connection. The benefit of the doubt doctrine (U.S.C. § 5107(b)) is therefore not applicable. Lynch v. McDonough, 21 F.4th 776. The Board would like to point out that is the Veteran's "general evidentiary burden" to establish all elements of his claim, including the nexus requirement." See Fagan v. Shinseki, 573 F.3d 1282 (2009). The Board reminds the Veteran that, as stated in the introductory section of the instant opinion, if he has new and relevant information as regards any of the five denied claims above, he may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. The Board is grateful for the Veteran's honorable service and regrets that a more favorable outcome could not be reached at this time. REASONS FOR REMAND 1. Service connection for a renal disorder The Veteran contends that he has a renal disorder due to his service. Specifically, he contends that his "stomach problems started after..." service on the USS Ohio. See September 2024 Claim. In addition, the Veteran contends that that he was "seen multiple times for fever, feeling weak, abdominal pain and urinary symptoms and was told of having UTI. Was given antibiotics without improvement. Eventually went to ER and had work up and found to have a kidney stone." See October 2024 VA Examination Report. Post-service treatment records note that the Veteran was diagnosed with and has a history of Stage 3 Chronic Kidney Disease. See, e.g., January 25, 2025 VA Treatment Record. Prior to the issuance of the June rating decision on appeal, post service treatment records note that the Veteran was diagnosed with and had a history of Stage 2 Chronic Kidney Disease. See, e.g., May 30, 2024 VA Treatment Record. Additionally, the Veteran had surgery to remove a renal cyst, i.e., kidney stone. See, e.g., September 6, 2024 VA Treatment Record. And on June 18, 2024, a VA treatment record finds that the kidney is now atrophic. Although an October 2024 VA examiner rendered a negative nexus opinion, the opinion is inadequate in that it fails to consider whether the Veteran's descriptions of his symptoms was sufficient evidence of the etiology of the Veteran's disability such that his claim could be proven without contemporaneous medical evidence. In fact, the rendered opinion impermissibly ignores the Veteran's lay statements, instead basing the opinion on a lack of connection between a renal disorder and the Veteran's conceded toxic exposures, as discussed above. See Buchanan v. Nicholson, 451 F.3d 1331, 1336, n. 1 (Fed. Cir. 2006); Dalton v. Nicholson, 21 Vet. App. 23, 39 (2007). In addition, the examiner found that the Veteran's only renal diagnosis was of Staghorn kidney stone (resolved), without addressing the post service medical records that he has Stage 2 Chronic Kidney Disease, as noted above. As such, the opinion is also based on an inaccurate factual premise. See Reonal v. Brown, 5 Vet. App. 458. Accordingly, the Board has assigned no probative weight to this opinion. The Board did not find any other competent nexus evidence of record as regards the Veteran's renal disorder. In the June 2025 rating decision, the AOJ denied the claim without seeking an addendum medical opinion. This is a duty to assist error. A remand is required to cure the deficiencies noted above. The matters are REMANDED for the following action: Obtain an addendum medical opinion from a NEW and appropriate clinician. The clinician must determine which renal disorder diagnoses the Veteran has, to include surgery and any residuals. For each diagnosis the clinician must determine whether it is at least as likely as not (meaning the favorable and unfavorable evidence is in approximate balance or is nearly equal) that the Veteran's renal condition had its clinical onset during service. In doing so, the clinician must at least consider the following: (A) The Veteran's lay statement that "he was seen multiple times for fever, feeling weak, abdominal pain and urinary symptoms and was told of having UTI. Was given antibiotics without improvement. Eventually went to ER and had work up and found to have a kidney stone." (B) The May 30, 2024 VA Treatment Record noting that the Veteran has a history of Stage 2 Chronic Kidney Disease AND the January 25, 2025 VA Treatment Record noting that the Veteran has Stage 3 Chronic Kidney disease. (C) A June 18, 2024 VA Treatment Record finding that a CT scan reviewed from May 29, 2024 showed "hemorrhagic/infected cyst anterior to the kidney with stranding and retroperitoneal inflammation. The kidney is now atrophic." The claims file, including a copy of this Remand, must be made available to and be reviewed by the clinician in conjunction with the examination. The clinician is asked to explain the reasons behind all opinions expressed and conclusions reached. Note that the lack of documented treatment in service, or a long period after, while probative, cannot serve as the sole basis for a negative finding. The Veteran's lay contentions must be considered and weighed in making the determination. The medical opinion must support the conclusions reached with an analysis that is adequate to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. In ordering?a?remand in the instant case, the Board is not making a preliminary formal finding as to the credibility of the Veteran's lay reports.?Rather, the Board is merely requesting that the?examiner?on remand consider the Veteran's own descriptions of the history of his disabilities.?See Smith v. Wilkie, 32 Vet. App. 332, 338-39 (2020). S. C. Krembs Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jackson, Atossa K. 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.