Hoag v. Brown, 4 Vet. App. 209 (1993) — Service connection granted where the record showed in-service diagnosis of fibromyalgia/myofascial pain syndrome

Brian D. Hoag appealed a Board decision denying service connection for myofascial pain syndrome, service connection for depression, and an increased rating for residuals of a right-hand injury. The Court reviewed extensive service treatment and post-service evidence showing repeated complaints of widespread pain, in-service diagnoses of fibromyalgia, myofascial pain syndrome, musculoskeletal pain syndrome, and related musculoskeletal findings. On the myofascial pain syndrome issue, the Court held that the Board’s finding that the condition was not manifested in service had no plausible basis in the record. Because the evidence included multiple in-service diagnoses and a post-service VA examiner’s observations, the Court reversed and ordered service connection to be awarded, with a rating to be assigned on remand. For depression, the Court agreed that the Board had not adequately addressed secondary service connection and instructed the Board to consider direct service connection, the presumption of soundness, and aggravation if the condition preexisted service. On the right-hand rating issue, the Court found no clear error and held that the Board’s reasons or bases were adequate, so it affirmed.

A Board finding is clearly erroneous when the record contains no plausible basis for rejecting in-service evidence establishing the claimed disability; in such circumstances, the Court may reverse and direct an award of service connection. The Board must also consider reasonably raised secondary service connection, presumption of soundness, and aggravation theories when adjudicating related claims.

Hoag is a strong reversal case when the service records themselves document the claimed condition. It also is useful for arguing that the Board must address secondary theories and presumption/aggravation issues when the record raises them.

The case shows that a veteran can win outright on appeal when service records and medical findings make the Board’s contrary conclusion implausible. It also provides practical guidance for remand litigation: if a condition may be secondary to a newly service-connected disability, the Board must address that theory and any preexistence/aggravation questions.

Failing to recognize in-service diagnoses and failing to address reasonably raised secondary service connection and aggravation theories.

A veteran’s service records repeatedly diagnose fibromyalgia-like or chronic pain syndrome, but the Board denies service connection by calling the condition non-pathologic or unrelated. Hoag supports reversal if the denial lacks a plausible evidentiary basis and the record establishes in-service manifestation.

Use Hoag to argue for reversal where service treatment records contain direct diagnoses of the claimed disability and the Board’s contrary finding cannot be squared with the record. It is also useful to demand readjudication of secondary service connection and aggravation when a related disability becomes service connected.

Gilbert v. Derwinski, Mingo v. Derwinski, Lovelace v. Derwinski