Citation Nr: 21027249 Decision Date: 05/05/21 Archive Date: 05/05/21 DOCKET NO. 12-34 253 DATE: May 5, 2021 ORDER Entitlement to service connection for multiple sclerosis is granted. FINDING OF FACT Multiple sclerosis was manifest during active service. CONCLUSION OF LAW Multiple sclerosis was incurred in service. 38 U.S.C. §§ 1101, 1110; 38 C.F.R. §§ 3.303, 3.304, 3.306, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1968 to February 1969. This case was previously before the Board in January 2021, at which time it was remanded for further development. The directives having been substantially complied with, the matter again is before the Board. D'Aries v. Peake, 22 Vet. App. 97, 105 (2008); Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Entitlement to service connection for multiple sclerosis To establish service connection a Veteran must generally 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, 1167 (Fed. Cir. 2004). Service connection may also 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). Certain chronic diseases may be presumed to have been incurred during service if manifested to a compensable degree within one year of separation from active military service, even though there is no evidence of such disease during the period of service. 38 C.F.R. § 3.309 (a). Multiple sclerosis is a listed disease subject to presumptive service connection under 38 C.F.R. § 3.309; however, multiple sclerosis has a seven (7) year presumptive period. 38 C.F.R. § 3.307 (a)(3). The Veteran has reported that his multiple sclerosis was first manifest while he was on active duty. Specifically, he recounted that during service he woke up one morning and was unable to walk due to severe pain. He has also reported optic neuritis in 1976, seven years after his discharge. Medical treatment records show that the Veteran has consistently reported these incidents and symptoms. Service treatment records show that the Veteran reported swollen or painful joints, arthritis or rheumatism, and recurrent back pain. At separation his physician noted the Veteran was diagnosed with gout in November 1969. The Veteran had VA examinations in January 2018 and June 2020. The January 2018 examiner opined that the Veteran's MS was less likely than not related to his service because of a lack of documentation of the Veteran's reported symptoms and a 37 year gap between service and MS diagnosis. The June 2020 examiner likewise opined that the Veteran's MS was less likely than not related to his service. He stated that the Veteran's report of optic neuritis is not documented by objective evidence in the file. An addendum opinion provided in February 2021 again provides a negative nexus, stating that the Veteran's reports of optic neuritis cannot be verified, and there is no other evidence of MS symptoms in service or within 7 years. The Veteran's private physician submitted a positive nexus opinion in June 2020, stating that the Veteran's first symptoms were most likely the weakness he reported in 1969. Further, he stated that treatment notes from 2007 and 2009 support the Veteran's report of optic neuritis, as well as the ophthalmological exam which showed optic atrophy. The Board finds the June 2020 opinion from the Veteran's private physician to be most probative, as it considers all relevant evidence. The VA opinions all fail to address the Veteran's reports of weakness during service and in the years immediately thereafter. They further discount his consistent reports of optic neuritis due to a lack of medical documentation in the file. Therefore, they are of limited probative value. In reaching this determination, we have considered the June opinion from a VA physician with expertise in this field. This document reflects a review of the record. Accordingly, the Board finds that the Veteran's MS was manifest during active duty. Service connection for MS is granted. H. N. SCHWARTZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Creegan 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.