Service connection for acute bronchitis is granted.

Citation Nr: A26069954 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 250903-582119 DATE: July 30, 2026 ORDER Service connection for acute bronchitis is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, there is an approximate balance of positive and negative evidence as to whether the Veteran's acute bronchitis is related to his active service. CONCLUSION OF LAW The criteria for service connection for acute bronchitis have been met. 38 U.S.C. §§ 1101, 1110, 1310, 1154(b), 5107(b) 38 C.F.R. § 3.303 REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from March 2003 to August 2003. This matter is before the Board of Veterans' Appeals (Board) on appeal of a July 2025 Appeals Modernization Act (AMA) rating decision that considered the evidence of record on that date. In September 2025 the Veteran submitted a Decision Review Request (Notice of Disagreement) to the Board and selected the Direct Review option by a Veterans Law Judge. As the Veteran selected the direct review docket, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. Service Connection Generally, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303 (d). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each issue shall be given to the claimant. See 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3. 1. Service connection for acute bronchitis is granted. The Veteran asserts that entitlement to service connection for acute bronchitis is warranted because the claimed disability was caused by in-service toxic exposure risk activity (TERA) while serving in Kuwait and Afghanistan. Pursuant to the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxins Act of 2022 (PACT Act), exposure to burn pits and other toxins (BPOT) is presumed for "covered veterans," i.e., those who served in specific locations on or after specific dates. 38 U.S.C. § 1119. Any veteran who, on or after August 2, 1990, performed active military, naval, air, or space service while assigned to a duty station in and/or airspace above Bahrain; Iraq; Kuwait; Oman; Qatar; Saudi Arabia; Somalia; the United Arab Emirates; the neutral zone between Iraq and Saudi Arabia; the Gulf of Aden; the Gulf of Oman; the Persian Gulf; the Arabian Sea; or the Red Sea will be presumed BPOT exposed, as will any veteran who, on or after September 11, 2001, performed active military, naval, air, or space service while assigned to a duty station in and/or airspace above Afghanistan; Djibouti; Egypt; Jordan; Lebanon; Syria; Yemen; or Uzbekistan. 38 U.S.C. § 1119; VBA Letter 20-22-10 at 7, Processing Claims Involving the PACT Act, 87 Fed. Reg. 78,543 (Dec. 22, 2022). Certain diseases will be presumed related to service for veterans with in-service toxic exposure, including BPOT exposure. 38 U.S.C. § 1120. Initially, the Board notes that the July 2025 rating decision on appeal includes the favorable finding that the Veteran has been diagnosed with a disability, as he has been diagnosed with acute bronchitis. That rating decision also found that the Veteran had been exposed to particulate matter during military service, as he had verified service in Kuwait in May 2003, and in Afghanistan from March 2003 to August 2003. Thus, the Board is bound by these favorable findings, and the Veteran meets the current disability and in-service event requirements. See 38 C.F.R. § 3.104(c). Accordingly, the Veteran is a "covered veteran" with presumed BPOT exposure under 38 U.S.C. § 1119. As such, presumptive service connection will be warranted for diseases enumerated in 38 U.S.C. § 1120. However, the Veteran's acute bronchitis is not among those diseases which can be presumed due to BPOT exposure pursuant to 38 U.S.C. § 1119. Therefore, presumptive service connection due to BPOT exposure is not warranted under 38 U.S.C. § 1120. A claimant is not, however, precluded from establishing service connection with proof of actual direct causation. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). In other words, the fact that a veteran does not meet the requirements for service connection on a presumptive basis does not in and of itself preclude the establishment of service connection, as entitlement may alternatively be established on a direct basis. Turning to the evidence of record, in August 2023 a private letter from the Veteran's primary care physician, Dr. J.M. was added to the claims file. In that letter, Dr. J.M. noted that he had been seeing the Veteran since at least 2014. The physician stated that over the course of his care, the Veteran had been seen multiple times for respiratory symptoms and had been diagnosed with acute bronchitis. Dr. J.M. opined that "it was possible" that the current respiratory condition was related to the Veteran's military deployment and exposure to burn pits. The Board notes, however, that the opinion is flawed as it appears speculative in linking the current respiratory condition to the Veteran's active service. Bloom v. West, 12 Vet. App. 185, 187 (1999) (stating that medical opinions that are equivocal in nature, such as those expressed in speculative language (e.g., "could have caused", etc.), do not provide the degree of certainty required for medical nexus evidence); Black v. Brown, 5 Vet. App. 177, 180 (1993); Reonal v. Brown, 5 Vet. App. 458, 460 (1993). In May 2025 Dr. G.G., a treatment provider at a VA medical center provided a nexus letter. Dr. G.G. indicated in the letter that the Veteran received care at the VA medical center and that the Veteran requested that she provide the statement. The clinician noted that based on the information available in the Veteran's medical records at the VA medical center, the Veteran had been seen at least two times a year with bronchial infection. She stated that the Veteran had been seen by medical providers since 2003, when serving in the military. She also wrote that the Veteran's symptoms began with burn pit exposure in the military. The examiner concluded that it was her professional opinion that it was more likely than not that the Veteran's symptoms were related to his military exposures to burn pits. While the Board recognizes that Dr. G.G. provided a positive etiological opinion, the opinion was conclusory and did not provide further rationale for this medical finding. The examiner did not directly reference any in-service treatment records or provide any discussion on how the burn pit exposure caused his current respiratory condition. The Veteran was afforded a VA medical examination and opinion in July 2025. At that time, the Veteran reported onset of symptoms for his acute bronchitis as beginning in 2004. He stated that he had been evaluated and treated on numerous occasions to resolve bronchitis. He reported ongoing issues with intermittent episodes of chronic bronchitis 1-2 times annually which had increased in frequency and severity over time. In a related medical opinion, the examiner provided a negative TERA opinion. In providing a rationale, the examiner explained that while a review of records supported that the Veteran was treated for bronchitis, the records reviewed did not support the condition being diagnosed as chronic bronchitis, but rather acute bronchitis. The examiner concluded that as the condition was not chronic in nature, the claimed condition was less likely than not caused by the in-service TERA. The Board notes, however, that the examiner's rationale hinged on the finding that the condition was not chronic in nature, but failed to provide any discussion on whether there was a relationship between the Veteran's TERA, and his current diagnosed respiratory condition. The examiner failed to specifically address the positive evidence of record, including the prior medical opinions and the Veteran's lay statements, linking the onset of recurrent treatment of the condition as having its onset from the Veteran's period of active duty service. Thus, the Board is presented with a mix of conflicting opinions which are insufficient in different ways. In such circumstances, as noted above, the Board is reminded that reasonable doubt and evidentiary equipoise is resolved in the favor of the Veteran and that seeking to obtain negative evidence against the Veteran is prohibited by VA law. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003). Furthermore, the Board will afford more probative weight to the May 2025 opinion, as Dr. G.G. not only took into account a review of the Veteran's treatment records, but also his lay statements of symptoms into consideration. Thus, the Board finds that the Veteran has recurrent acute bronchitis which has been credibly related to his active-duty service. The criteria for service connection, then, have been met and service connection for acute bronchitis loss is granted. Ardie A. Bland Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Nettey, 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.