Citation Nr: 21040472 Decision Date: 07/03/21 Archive Date: 07/03/21 DOCKET NO. 16-50 585 DATE: July 3, 2021 ORDER Entitlement to service connection for polyarthritis palindromic rheumatism is granted. FINDING OF FACT The VA examiner opined that this Veteran's polyarthritis palindromic rheumatism is a medically unexplained chronic multi-symptom illness. CONCLUSION OF LAW The criteria for entitlement to service connection for polyarthritis palindromic rheumatism have been met. 38 U.S.C. §§ 1110, 1131, 1117, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.317. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1985 to November 1992. This matter comes before the Board of Veterans' Appeals (Board) from an August 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record. The case was last before the Board in October 2020 and has returned to the Board for further appellate review. 1. Entitlement to service connection for polyarthritis palindromic rheumatism The Veteran seeks service connection for polyarthritis palindromic rheumatism, which she asserts is related to her service in the Southwest Asia theater of operations. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Generally, to prove service connection there must be: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Additionally, under legislation specific to Persian Gulf War veterans, service connection may be established for a qualifying chronic disability resulting from an undiagnosed illness that became manifest during active service in the Southwest Asia theater of operations during the Persian Gulf War or to a degree of 10 percent or more no later than December 31, 2021. 38 U.S.C. § 1117; 38 C.F.R. § 3.317(a)(1). The term "qualifying chronic disability" means a chronic disability resulting from any of the following (or any combination of any of the following): (A) an undiagnosed illness; (B) a medically unexplained chronic multi-symptom illness (MUCMI) that is defined by a cluster of signs or symptoms, such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome; or (C) any diagnosed illness that the Secretary determines in regulations prescribed under subsection (d) warrants presumptive service-connection. 38 U.S.C. § 1117(a)(2); 38 C.F.R. § 3.317(a)(2)(i). Such chronic disability must not be attributed to any known clinical diagnosis by history, physical examination, or laboratory tests. 38 C.F.R. § 3.317(a)(1). Objective indications of a chronic disability include both "signs," in the medical sense of objective evidence perceptible to an examining physician, and other, non-medical indicators that are capable of independent verification. 38 C.F.R. § 3.317(a)(3). Disabilities that have existed for six months or more and disabilities that exhibit intermittent episodes of improvement and worsening over a six-month period will be considered chronic. 38 C.F.R. § 3.317(a)(4). Manifestations of an undiagnosed illness may include, among other things, gastrointestinal signs or symptoms. 38 C.F.R. § 3.317(b)(10). Compensation shall not be paid, however, if there is affirmative evidence that an undiagnosed illness was not incurred during active military, naval or air service in the Southwest Asia theater of operations during the Persian Gulf War; or if there is affirmative evidence that an undiagnosed illness was caused by a supervening condition or events that occurred between the appellant's most recent departure from active duty in the Southwest theater of operations during the Persian Gulf War and the onset of the illness; or if there is affirmative evidence that the illness is the result of the appellant's own willful misconduct or the abuse of alcohol or drugs. 38 U.S.C. § 1117; 38 C.F.R. § 3.317(c). Service personnel records confirm that the Veteran served in the Southwest Asia theatre of operations during the Persian Gulf War. 38 C.F.R. § 3.317(e); 38 U.S.C. § 101(33). Therefore, she qualifies for consideration for presumptive service connection for disabilities resulting from an undiagnosed illness or medically unexplained chronic multi-symptom illness. The Veteran underwent a VA examination in April 2021, at which time the examiner indicated the Veteran had a diagnosis of palindromic rheumatism of the bilateral hands and feet. Between attacks of joint pain and swelling, the symptoms disappear, and the affected joints go back to normal with no lasting damage. As such, the examiner opined that the Veteran's palindromic rheumatism is a diagnosable but medically unexplained chronic multi-symptom illness of unknown etiology. Although additional rationale would be helpful to understand the examiner's statement that the condition is a potential MUCMI, the Board may not develop for negative evidence. Thus, after resolving reasonable doubt in the Veteran's favor, the Board finds that this Veteran's currently diagnosed palindromic rheumatism manifested to a compensable degree at some point during the presumptive period under 3.317(a). See 38 C.F.R. § 4.71a, Diagnostic Code 5003. Accordingly, service connection for polyarthritis palindromic rheumatism is granted. K. A. BANFIELD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Lance, 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.