Citation Nr: 21022779 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 15-33 669 DATE: April 19, 2021 ORDER Entitlement to service connection for a disorder characterized by fatigue is granted. FINDING OF FACT Resolving all reasonable doubt in the Veteran’s favor, his diagnosed hyperprolactinemia is manifested by fatigue and is attributable to his military service. CONCLUSION OF LAW The criteria for service connection for hyperprolactinemia are met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1993 and May 1997. The Board notes that the United States Court of Appeals for Veterans Claims (Court) has held that when a claimant makes a claim, he is seeking service connection for symptoms regardless of how those symptoms are diagnosed or labeled. See Brokowski v. Shinseki, 23 Vet. App. 79 (2009); see also Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). Here, the Veteran claimed service connection for chronic fatigue syndrome (CFS). However, as discussed below, the Board finds it necessary to recharacterize the issue to that of a disorder characterized by fatigue, which has been diagnosed as hyperprolactinemia, as it provides the most favorable adjudication for the Veteran. Service Connection The Veteran is seeking service connection for a disorder characterized by fatigue, initially claimed as CFS, that he believes is due to his military service. Specifically, the Veteran states he began to feel fatigued while he was in the service after deployment to Southwest Asia in 1997. The Veteran also stated that he was chronically fatigued and felt that it was due to his exposure to environmental hazards, such as burn pits, vaccines and various chemical contaminants. See July 2019 VA Chronic CFS Disability Benefits Questionnaire (DBQ). Alternatively, the Veteran believes his fatigue is due to or aggravated by his service-connected headaches disability. In order to establish entitlement to service connection for a disability, a veteran 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). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt shall be given to the claimant. 38 U.S.C. § 5107 (b). When a reasonable doubt arises regarding service origin, such doubt will be resolved in the favor of the claimant. Reasonable doubt is doubt which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. 38 C.F.R. § 3.102. The Board concludes that the Veteran has a disorder characterized by fatigue, diagnosed as hyperprolactinemia, that is attributable to his service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303 (a). See July 2019 VA Chronic CFS DBQ. As to the initial matter of a current diagnosis, the Board notes the June 2016 VA CFS DBQ examiner indicated there was a self-diagnosis of CFS. See June 2016 CFS DBQ. However, the VA examiner then found that self-diagnosed CFS is not consistent with CFS, and the Veteran’s fatigue is not a diagnosable chronic multi-symptoms illness, a symptom of such, or related to any specific exposure event during his service in Southwest Asia. Thereafter, the July 2019 VA examiner diagnosed the Veteran with hyperprolactinemia. The examiner noted that the Veteran’s symptoms are similar to those identified in people with CFS; however, in light of the current diagnosis of hyperprolactinemia noted in the claims file, the symptoms were attributed to the already diagnosed disorder. Thus, the question becomes whether the current disability is related to service. Here, the July 2019 VA examiner noted the Veteran’s report of fatigue in service and following his separation, up until his eventual diagnosis of hyperprolactinemia in 2012. The examiner then concluded that the in-service fatigue issues were the early manifestations of the later diagnosed hyperprolactinemia. Therefore, his hyperprolactinemia is at least as likely as not incurred in the service. There are no conflicting opinions of record. (Continued on the next page) As to any remaining arguments of entitlement to service connection on a presumptive basis under the provisions of 38 C.F.R. § 3.317, or on a secondary basis under the provisions of 38 C.F.R. § 3.310, the Board finds further discussion is not warranted as a grant on a direct incurrence basis is the greater benefit. Accordingly, the Board finds that service connection for hyperprolactinemia is warranted. Accordingly, the appeal is granted. YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Berry, 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.