Citation Nr: 21010952 Decision Date: 02/26/21 Archive Date: 02/26/21 DOCKET NO. 17-17 638 DATE: February 26, 2021 ORDER Entitlement to service connection for sarcoidosis is granted. REMANDED Entitlement to service connection for an eye condition, including conjunctivitis, is remanded. FINDING OF FACT It is at least as likely as not that the Veteran’s sarcoidosis is etiologically related to her active duty service. CONCLUSION OF LAW The criteria for entitlement to service connection for sarcoidosis have been met. 38 U.S.C. §§ 1101, 1111, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1969 to April 1972. She received the National Defense Service Medal and Meritorious Mast. In September 2020, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. Service Connection for Sarcoidosis Direct service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 C.F.R. § 3.303(a). Direct service connection generally requires credible and competent evidence showing: (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. Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may also be granted for a disease first 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). The evidence shows that the Veteran has a current disability. Specifically, the Veteran’s treatment records show that she has been treated for sarcoidosis. See January 2011 VA Treatment Records, p. 4. Accordingly, the first element of service connection is established. See Holton, 557 F.3d at 1366. The Veteran has also presented sufficient evidence to establish the second element of service connection. Her service treatment records are unavailable for review, see September 2009 VA Memo, p. 1, but the Veteran competently testified to having a persistent cough, fatigue and joint pain in service. See September 2020 Hearing Transcript, pp. 7, 17. The Veteran’s testimony is corroborated by a statement from her former spouse who stated that he observed the Veteran coughing a lot during her active duty service. See December 2020 Correspondence, p. 1. The Board finds that there is sufficient evidence to establish the occurrence of an in-service injury. Accordingly, the second element of service connection is established. See Holton, 557 F.3d at 1366. Regarding nexus, the evidence is at least in equipoise. The Veteran submitted an opinion from her VA clinician which opined that it is as likely as not that the symptoms the Veteran experienced in service were due to sarcoidosis that was first diagnosed after service. See December 2020 VA Treatment Records, pp. 1-2; see also 38 C.F.R. § 3.303(d). The opinion is based on the facts as demonstrated by the record, including the Veteran’s statements and her corroborating buddy statements, and the Board finds the opinion to be probative. As there is no opinion to the contrary, the evidence regarding nexus is at least in equipoise. When the evidence for and against a claim is in relative equipoise, the Board has an obligation to resolve all reasonable doubt in favor of the claimant. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). In resolving all reasonable doubt in the Veteran’s favor, the Board finds that the third element of service connection is established. See Holton, 557 F.3d at 1366. Thus, service connection for sarcoidosis is warranted. REASONS FOR REMAND Service Connection for Conjunctivitis At the September 2020 hearing, the Veteran testified to experiencing symptoms of an eye condition, including persistent swelling, redness and discharge. See September 2020 Hearing Transcript, p. 9. The evidence also establishes that the Veteran had symptoms of an eye condition during her active duty service. See September 2020 Hearing Transcript, pp. 4-5; December 2020 Correspondence, p. 1. The Veteran has raised the theory that her current eye condition may be secondary to her now service-connected sarcoidosis. As there is no nexus opinion of record, the claim is remanded for an examination to ascertain the nature of the Veteran’s current eye complaints and a nexus opinion that considers both direct and secondary service connection. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The matter is REMANDED for the following action: Schedule the Veteran for an examination to ascertain the nature and etiology of her eye condition. Any indicated evaluations, studies, and tests deemed necessary by the examiner should be accomplished. The entire claims file, to include a complete copy of this REMAND, should be made available to the examiner designated to provide an opinion, and the examination report should include a discussion of the Veteran’s documented medical history and assertions. The examiner should offer comments, an opinion and a supporting rationale that address the following: (a) Identify all diagnoses that pertain to the Veteran’s current eye condition. (b) For any diagnosis identified, is it at least as likely as not (a 50 percent probability or greater) that the Veteran’s condition was incurred in, aggravated by, or is otherwise etiologically related to the Veteran’s active duty service? In providing this response, the examiner must consider the Veteran’s reports of an in-service diagnosis of conjunctivitis as well as persistent eye redness and discharge. See September 2020 Hearing Transcript, pp. 4-5; December 2020 Correspondence, p. 1. (c) For any diagnosis identified, is it at least as likely as not that the Veteran’s disability is caused by, aggravated by, or is otherwise etiologically related to the Veteran’s service-connected sarcoidosis? The examiner is advised that the Veteran is competent to report her symptoms and history, and such reports must be considered. If the examiner rejects the Veteran’s reports, the examiner must provide a reason for doing so. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board W.V. Walker, Associate 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.