Citation Nr: 21027487 Decision Date: 05/05/21 Archive Date: 05/05/21 DOCKET NO. 16-28 692 DATE: May 5, 2021 ORDER Entitlement to service connection for a disability manifested by chronic fatigue is granted. FINDING OF FACT Resolving reasonable doubt in his favor, the Veteran's chronic fatigue is caused or aggravated by his service-connected posttraumatic stress disorder (PTSD) and major depression. CONCLUSION OF LAW The criteria for service connection for chronic fatigue are met. 38 U.S.C. §§ 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from January 1992 to August 1995 in the United States Marine Corps (USMC). He had qualifying service in the Southwest Asia theater of operations during the Persian Gulf War. This case initially came before the Board of Veterans' Appeals (Board) on appeal of a June 2015 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). In June 2017, the Veteran withdrew his request for a Board hearing. In October 2018 and October 2019, the Board remanded the claim for additional development. The case has since been returned to the Board for further appellate review. Service Connection Chronic Fatigue The Veteran maintains that he has chronic fatigue syndrome related to exposure to environmental hazards during his service in the Persian Gulf. The report of a June 2015 VA examination indicated that the Veteran meet the criteria for a diagnosis of chronic fatigue syndrome. No explanation or rationale was provided. During a March 2019 VA examination, the Veteran complained of poor sleep and waking up tired. He reported that a 2014 sleep study was inconclusive. He stated that after becoming sober in 2015/2016, he noted feeling tired a lot and that he did not have the same energy he used to have. The examiner indicated that the Veteran did not meet the criteria for a diagnosis of chronic fatigue syndrome, but provided no rationale or explanation. In July 2020, a VA examiner reviewed the claims file and provided an opinion. She indicated that the Veteran's fatigue was chronic in nature and was attributable to his sleep issues, which were primarily related to his mental health conditions but also to a lesser degree his musculoskeletal conditions and headaches. She indicated that fatigue was not the primary diagnosis, but a secondary symptom. She indicated that his fatigue was less likely than not related to chemical exposure in Southwest Asia, noting again that it was attributable to his sleep issues. Initially, the Board notes that the evidence indicates that the Veteran has a current disability manifested by chronic fatigue, which results in functional impairment. Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). In this regard, the Veteran has described feeling tired a lot and lacking energy. In addition, the Veteran is service connected for PTSD and major depression, which has been rated at 100 percent since March 2017. The July 2020 VA examiner indicated that his chronic fatigue was related to sleep issues that were primarily attributable to his mental health conditions. Although she also noted some sleep impairment related to nonservice-connected musculoskeletal conditions and headaches, she noted that this was to a lesser degree. In this case, the Board finds that the evidence is at least in equipoise as to whether the Veteran's chronic fatigue was caused or aggravated by his service-connected PTSD and major depression. 38 C.F.R. § 3.310. Therefore, resolving reasonable doubt in his favor, the claim for service connection for chronic fatigue is granted. 38 U.S.C. § 5107(b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Mishalanie, 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.