Citation Nr: 25005015 Decision Date: 04/14/25 Archive Date: 04/14/25 DOCKET NO. 20-27 086 DATE: April 14, 2025 ORDER Entitlement to service connection for restless leg syndrome is denied. FINDING OF FACT The evidence of record persuasively weighs against finding that the Veteran has had restless leg syndrome at any time during or approximate to the pendency of the claim. CONCLUSION OF LAW The criteria for service connection for restless leg syndrome are not 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 had periods of active service from June 1983 to May 1986, from March 3, 1992, to March 19, 1992, and from January 1996 to August 1996. However, additional documents attest to additional periods of service that are cognizable as active service for VA purposes. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in December 2017. This matter was previously before the Board in March 2024 and remanded by the Board for a VA examination concerning the Veteran's restless leg syndrome. A VA examination was provided in April 2024. As will be discussed in further detail below, the Board finds there has been substantial compliance with the previous remand directives. Stegall v. West, 11 Vet.App. 268, 271 (1998). 1. Entitlement to service connection for restless leg syndrome The Veteran has been inexact in his contentions regarding the nature and source of his restless leg syndrome. In the March 2024 Board remand, the Board stated that its best understanding of the Veteran's claim was that his restless leg syndrome claim was predicated on findings from his November 2010 and April 2011 sleep studies that documented mild periodic leg movements during sleep. As these findings were contained in sleep studies, the Board understood this claim to be a facet of his asserted sleep disorder, obstructive sleep apnea (OSA), that the Veteran had alleged was related to his psychiatric disorder. Thus, the Board also concluded at that time that the Veteran's contention was that the claimed restless leg syndrome was related to his psychiatric condition. Broadly speaking, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (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). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. Whether a condition is directly related to a claimant's service or caused or aggravated by another service-connected condition, it is always a requirement that the disability for which service connection is being sought be present. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current diagnosis of restless leg syndrome and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The April 2024 Compensation and Pension (C&P) examiner determined the Veteran did not have a diagnosis of restless leg syndrome and noted that despite a long and extensive medical record, no such diagnosis appears in the record at all. Even when asked about the condition during the examination, the Veteran complained of no symptoms that he himself had noticed. He stated that he had had sleep studies done and that he had been told that he had restless leg syndrome after those sleep studies. The Veteran also reported that had it not been for these sleep studies he would not have known he had this condition. As discussed above, the Veteran appears to be referring to the sleep studies conducted in November 2010 and April 2011. Both of these sleep studies provided evidence of periodic leg movements during sleep. However, neither sleep study made a diagnosis of restless leg syndrome. Consequently, based on the Veteran's explanation of his condition, where he reported no noticeable symptoms, the best evidence appears to be that the Veteran has misunderstood the findings of these sleep studies. The Veteran has never sought treatment for this condition despite a long and extensive medical record where the Veteran has sought treatment for a variety of other conditions. The April 2024 examination indicated that no diagnosis of this condition was present at the examination or throughout the record. Thus, the Board finds that the evidence of record is persuasively against a finding that that the Veteran has this condition. The Board recognizes that a diagnosis is not necessarily required. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). However, even in circumstances where VA might be able to grant benefits in the absence of a diagnosis, the claimed condition must still reach a level of functional impairment of earning capacity. Id. at 1367-69. As discussed above, the Veteran's description of his symptoms is not congruent with a finding that the Veteran's condition has reached this level of functional impairment. The Veteran does not describe any particular symptoms and has stated to the examiner that he would not be aware of this condition if he had not been "told" that he had this condition. Thus, the Board finds that the evidence of record is persuasively against a finding that the Veteran has a condition he describes as restless leg syndrome that is a cognizable disability for VA benefits purposes. The Board recognizes the Veteran's argument that the April 2024 examination was inadequate because the Board had determined that this condition had been diagnosed in the March 2024 Board decision. However, this appears to be a misunderstanding of the March 2024 decision. As discussed above, in March 2024, the Board stated that it appeared to the Board that the Veteran's restless leg syndrome claim was based on the movement of his legs during sleep documented during sleep studies. That was the Board's understanding of the nature of the Veteran's claim, and it remains the Board's understanding of the nature of the Veteran's claim. However, this is not intended as a finding that the Veteran in fact had restless leg syndrome. The only other action taken by the Board in March 2024 was to request an examination and opinion regarding the claimed restless leg syndrome. This also was not a finding that the Veteran had restless leg syndrome, it was a request for an examination to determine if this condition existed and, if so, whether this condition was related to the Veteran's psychiatric condition. Therefore, the Board finds that the C&P examination is adequate and is not in conflict with any finding of the Board because it made no finding. For the reasons set forth above, the Board finds that the evidence of record is persuasively against the Veteran's claim. As the evidence is persuasively against the Veteran's claim, the benefit-of-the-doubt rule does not provide an independent basis for granting the requested relief. 38 U.S.C. § 501; 38 C.F.R. § 3.102. Therefore, the claim for service connection for restless leg syndrome is denied. Paul R. Casey Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Steven H. Johnston, 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.