Citation Nr: 22017359 Decision Date: 03/24/22 Archive Date: 03/24/22 DOCKET NO. 17-28 839 DATE: March 24, 2022 ORDER Entitlement to service connection for night sweats is denied. FINDING OF FACT The Veteran does not have a current separately diagnosed disability manifested by night sweats. CONCLUSION OF LAW The criteria for service connection for night sweats have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1986 to September 1991, January 2003 to July 2003, and February 2008 to February 2009. These matters come to the Board of Veterans' Appeals (Board) on appeal from a June 2013 Department of Veterans Affairs (VA) regional office (RO) rating decision. In May 2016 and September 2021, the Board remanded this claim for further development. Namely, the September 2021 remand directed VA to obtain another VA examination. The Veteran participated in a hearing before the undersigned in May 2021; a transcript is associated with the claims file. Service Connection Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Generally, the evidence 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). Service connection is also warranted for a disability which is caused or aggravated by service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995); 38 C.F.R. § 3.310. Aggravation of a non-service-connected disability pursuant to 38 C.F.R. § 3.310 does not require a permanent worsening of the disability. Rather, aggravation in this context is any incremental increase in disability attributable to service-connected disability (i.e., any additional impairment of earning capacity that is above the degree of disability existing before the increase, regardless of its permanence). Ward v. Wilkie, 31 Vet. App. 233, 240-41 (2019). Entitlement to service connection for night sweats The Veteran contends that he is entitled to service connection for a disability manifested by night sweats. He is already service connected for posttraumatic stress disorder (PTSD) with panic attacks. The Board concludes that the Veteran does not have a separate and distinct night sweat disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Service connection is therefore not warranted. 38 C.F.R. § 3.303(a), (d); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). At his May 2021 hearing, the Veteran stated that while his night sweats currently manifest as part and parcel to his panic attacks associated with his service-connected psychiatric disability, "the night sweats were there before." The Board notes that this claim has been pending since July 2012 and that the Veteran only became service-connected for a psychiatric disability effective December 31, 2019. As stated by the Board in its September 2021 remand, the July 2018 VA examination was deemed inadequate as it was conclusory and failed to address all of the Veteran's theories of causation. As such, it is afforded no probative weight. A December 2021 VA medical opinion was obtained pursuant to the Board's remand. Therein, the VA examiner first opined that there was "no independent diagnosis of night sweats." The examiner noted that the Veteran had a diagnosis of PTSD with panic attacks and that the Veteran's claimed night sweats are "subsumed" by his PTSD diagnosis as PTSD "can involve excessive sweating." Second, the examiner opined that the Veteran's night sweats were not caused or aggravated by his service-connected Lyme Disease. The examiner indicated that a September 2015 VA examination showed his Lyme Disease was "inactive" and that his night sweats "are still ongoing." The examiner explained that "this would indicate that their night sweats are not due or have been aggravated by their Lyme disease as both would become inactive or lessen in degree at the same time if related." Third, the examiner again noted that the Veteran's night sweats are a symptom of PTSD, and stated that PTSD has a "clear and specific diagnosis, etiology, and pathophysiology. PTSD is due to exposure to trauma." After a review of the evidence of record, the Board finds that the most persuasive evidence is against the Veteran's claims for service connection for night sweats. While the Board finds the Veteran credible in his statements that he experiences night sweats, these statements are simply descriptive of the Veteran's symptoms and do not meet the necessary threshold to be considered a "disability" per Shedden. Put simply, night sweats are not themselves a disability for VA purposes. A disability is required in order to warrant service connection. See Gilpin v. Brown, 155 F.3d 1353 (Fed. Cir. 1998) (service connection may not be granted unless a current disability exists). Furthermore, to the extent that the Veteran is seeking compensation for his night sweats, such symptoms are already "subsumed" and associated with his service-connected PTSD with panic attacks, which has been rated at 30 percent disabling. In reaching this conclusion, the Board finds compelling the fact that the December 2021 VA examiner provided an adequate rationale linking these items as PTSD "can involve excessive sweating." The Board thus finds that the symptom of night sweats is appropriately considered in the rating assigned for the Veteran's PTSD with panic attacks. For this same reason, the Veteran's night sweats cannot stand as an "independent diagnosis" warranting service connection due to the Veteran's status as a Persian Gulf War Veteran. The Board acknowledges the August 2018 VA examiner's conclusion that the "etiology of his reported night sweats . . . is unknown." However, the August 2018 VA examiner failed to include a rationale while the December 2021 VA examiner thoroughly explained that the night sweats' underlying disability, PTSD, "is due to exposure to trauma." As such, the December 2021 VA medical opinion is afforded more probative weight than the August 2018 VA examination. The Board thus finds that the Veteran does not have a separate qualifying chronic disability and thus holds that the provisions under 38 C.F.R. § 3.317 do not warrant application. The Board has additionally considered the Veteran's belief that he suffers from an independent disability resulting in night sweats; however, he does not have the medical knowledge or training to provide competent evidence of an underlying disability resulting in night sweats. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Moreover, this belief is outweighed by the medical evidence of record, especially the December 2021 VA medical opinion, that does not show an "independent diagnosis" of night sweats. The Board notes that the Veteran was exposed to trauma in service and is service-connected for Lyme disease. However, even given the satisfaction of the second Shedden and Wallin elements here, "in the absence of proof of a present disability, there can be no valid claim." Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). As discussed in detail above, the most persuasive evidence is against finding that the Veteran has a current independent diagnosis of a disability manifested by night sweats during the appeal period or close in time to the appeal period. In sum, an independent diagnosis of night sweats has not been shown, but instead, the Veteran's night sweats have been identified as a symptom of his service-connected PTSD with panic attacks, which "is due to exposure to trauma." Accordingly, service connection for a disability manifested by night sweats is denied. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Caroline B. Fleming Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Finelli, 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.