One TERA Memo, Seven Reopened Claims, and a $1,678 Rating: Inside BVA 24018149

Case Citation: 24018149 | Decision Year: 2024 | Judge: Thomas English

A Marine filed for seven different conditions. VA denied all of them in 2015. He didn't appeal. Under the appeal-period rule that makes prior rating decisions final, that decision should have been the end of the road for those seven claims.

Eight years later, the Board reopened all seven of them in a single decision.

Not because he found a new doctor. Not because he hired a lawyer who knew a trick. Because three things happened in the intervening years that, taken together, cleared the "new and material" bar for every one of those claims at once. I want to walk through exactly what those three things were, because if you have a final denial sitting in your past, this is the playbook.

The Hook

Here's what's striking about BVA 24018149. The veteran served in the Marines from March 1987 to July 1991. He filed for service connection on a long list of conditions: heart disorder, sleep disorder, head disorder, diabetes, colon polyps, right shoulder, right knee, and a left hand index finger issue. In May 2015, the Regional Office denied every one of them. He did not file a Notice of Disagreement. The decision became final.

In December 2016, he asked VA to reopen the claims. In April 2017, the RO denied the reopens. He appealed that denial, and the case sat in the appellate pipeline for the better part of seven years before it landed in front of Veterans Law Judge Thomas English in April 2024.

In that seven-year window, three things changed. First, in March 2020, VA granted service connection for his left ankle. Second, in June 2022, VA granted service connection for his left knee. Third, in January 2024, VA generated a memorandum determining that he had participated in a Toxic Exposure Risk Activity (TERA) during his service in the Persian Gulf War theater.

Each of those three events, by itself, would have been useful. Combined, they did something powerful: they triggered VA's duty to assist on seven separate claims, all of which the RO had denied in 2015 specifically because there was no nexus and no current diagnosis on file. The Board reopened all seven. It also bumped his bilateral dry eye rating from 0 percent to 20 percent in the same decision. Then it remanded the seven reopened claims back to the RO with explicit instructions: schedule the exams you should have scheduled in the first place.

This is a reopen-and-remand case, not a grant case. But for a veteran sitting on a stack of old denials, this decision is closer to a roadmap than almost anything else in the BVA dataset.

What Happened (The Quick Version)

• Service: United States Marine Corps, March 1987 to July 1991. MOS as a Wireman and later a Drill Instructor.
• Initial claims: Service connection for heart disorder, sleep disorder, head disorder, diabetes, colon polyps, right shoulder, right knee, and left hand index finger.
• First decision: May 2015. RO denied all of them. Heart and left hand finger were denied for no current diagnosis. The rest were denied for no nexus to service or to a service-connected condition. He did not appeal. Decision became final.
• Reopen request: December 2016.
• Second denial: April 2017. RO denied the reopens, finding no new and material evidence.
• Intervening events that mattered:
• March 2020 rating decision: service connection granted for left ankle.
• June 2022 rating decision: service connection granted for left knee.
• January 2024 VA memorandum: TERA participation confirmed for service in the Persian Gulf War theater.
• March 2023 lay correspondence from the veteran himself describing the physical strain of his MOS and the overcompensation pattern with his right knee.
• Board outcome (April 2024):
• Seven claims reopened (heart, sleep, head, diabetes, colon polyps, right shoulder, right knee).
• One claim reopen denied (left hand index finger, because medical records still showed no diagnosis).
• Bilateral dry eye syndrome rating increased from 0 percent to 20 percent under Diagnostic Code 6099-6025.
• All seven reopened claims remanded for VA examinations the RO never ordered.
• Connection theory: Mix of direct (Persian Gulf TERA exposure, in-service MOS strain) and secondary (right knee via service-connected left knee and left ankle, secondary obesity theory raised but not fully developed).
• Nexus quality: Adequate to reopen and trigger duty to assist. Not yet sufficient to grant.

Why This Matters to You

If you have a final denial sitting in your past and you've been wondering whether it's worth trying to reopen it, this case is the answer to that question. The Board is telling you, in writing, that the threshold to reopen is low, that intervening grants on related conditions count, that a TERA memo counts, and that even your own well-written lay statement years after the fact can count. What you'll walk away with from this breakdown is a specific list of what kinds of new evidence move the needle on a reopen, and how to think about whether your own situation has produced any of them since your denial.

Why This Case Matters

• The "low threshold" language in Shade v. Shinseki is not a slogan. This decision proves the Board takes it literally. Seven claims got past the new-and-material gate on evidence that, taken individually, would not have won any of them outright.
• A TERA memo is a force multiplier across multiple claims at once. One document, generated by VA itself, opened up seven different exam orders. If you have any Persian Gulf, Southwest Asia, burn pit, or other toxic-exposure service, a TERA determination is the single most efficient piece of evidence you can pursue.
• Later grants on related conditions can resurrect old denials. When VA granted his left ankle in 2020 and left knee in 2022, those grants didn't just give him those ratings. They created a secondary service connection theory for his right knee that didn't exist in 2015.
• A noncompensable rating is not a closed file. While the Board was reopening seven claims, it also bumped his bilateral dry eye rating from 0 to 20 percent based on the same exam record the RO had already reviewed. The RO read the regulation wrong. The Board fixed it.

What the Board Said

On the new-and-material standard:

To reopen a claim which has been denied by a final decision, new and material evidence must be received. New and material evidence means evidence not previously submitted to agency decision makers; which relates, either by itself or when considered with previous evidence of record, to an unestablished fact necessary to substantiate the claim.

That's the rule. Read it twice and notice what it doesn't say. It does not say the new evidence must prove the claim. It does not say the new evidence must be a medical opinion. It does not say it has to be from a specialist. It just has to relate to an unestablished fact.

On what cleared that bar in this case:

Evidence added to the claims file subsequent to the May 2015 rating decision includes post-service VA and private treatment records, VA examinations, lay statements from the Veteran, a March 2020 rating decision granting service connection for left ankle disability, a June 2022 rating decision granting service connection for left knee disability, and a January 2024 VA memorandum that determined the Veteran participated in toxic exposure risk activity (TERA) while serving in the Persian Gulf War.

That paragraph is the engine of the entire decision. Six different categories of new evidence, none of them medical nexus opinions.

On the secondary obesity theory for sleep disorder, diabetes, and colon polyps:

Service connection may be granted on a secondary basis where the claimed disability would not have occurred but for obesity caused or aggravated by a service-connected disability. To reasonably raise the theory of secondary service connection via obesity as an intermediate step, there must be some evidence in the record that draws an association or suggests a relationship between the veteran's obesity, or weight gain resulting in obesity, and a service connected disability.

This is a doctrine many veterans have never heard of. Obesity itself cannot be service-connected as a disability. But obesity caused by a service-connected condition can be an intermediate step that connects that condition to a downstream disability like sleep apnea or diabetes. The Board flagged this theory as one the RO has to develop on remand.

On the heart claim specifically:

Post-service VA treatment records reflect treatment during the period on appeal for sinus bradycardia and hypertension...the evidence tends to show a current diagnosed disability. Moreover, this evidence triggers VA's duty to assist the Veteran in obtaining a VA examination to determine the nature and etiology of the Veteran's diagnosed sinus bradycardia and hypertension, as his service treatment records (STRs) note high levels of cholesterol upon separation from service.

Read that one carefully. The original 2015 denial was based on "no current diagnosis." VA treatment records from 2015 forward documented two cardiac diagnoses. That alone cleared the no-current-diagnosis problem. And the cholesterol notation in his separation STRs, which was already in the file in 2015, suddenly became relevant in-service evidence the moment a current diagnosis existed.

The First Precedent: Shade v. Shinseki (2010). The Low Threshold Rule

Shade v. Shinseki, 24 Vet. App. 110 (2010) is the case that defines how easy it is supposed to be to reopen a final denial. The rule in plain English: when VA is deciding whether new evidence raises a "reasonable possibility of substantiating the claim," it cannot ask whether the new evidence actually proves the claim. It must ask whether the new evidence, combined with what's already in the file, could substantiate the claim if VA actually developed it (for example, by ordering an exam).

This is a fundamentally different question. The first question is high bar. The second question is low bar.

In BVA 24018149, the Board relied on Shade explicitly to reopen the heart claim. The TERA memo by itself does not prove a heart condition was caused by Gulf War service. Treatment records showing hypertension and sinus bradycardia do not prove the conditions started in service. But put them together with the cholesterol notation at separation, and you have something that could substantiate the claim if VA ordered an exam. Under Shade, that's enough.

The practical impact: if you have a final denial and you've gathered any new evidence at all that points toward a diagnosis, an in-service event, or a nexus pathway, you are very likely past the Shade threshold. Whether you can ultimately win the claim is a separate question. But the door opens easier than most veterans think.

The Second Precedent: Barnett v. Brown (Fed. Cir. 1996). The Board Has to Decide Reopening First

Barnett v. Brown, 83 F.3d 1380 (Fed. Cir. 1996) stands for a procedural rule that's simple but important: before the Board can address the merits of a claim that was previously denied and not appealed, it has to make its own determination that new and material evidence was received. The Board cannot just skip past the reopen question and decide the merits.

That sounds technical, but it matters here because it explains why this decision is structured the way it is. Judge English does not order grants on the seven claims. He does not even reach the merits. He reopens them under Barnett and Shade, then remands them for development. The merits come later.

If you're reading a Board decision that addresses a reopened claim, expect this two-step. Reopen first, merits second. If the Board reopens but remands instead of granting, that's not a loss. That's the procedural sequence working correctly.

The Third Precedent: McLendon v. Nicholson (2006). When VA Owes You an Exam

McLendon v. Nicholson, 20 Vet. App. 79 (2006) is the case that tells VA when it has to order a C&P exam. The McLendon test has four parts: (1) there is competent evidence of a current diagnosis or persistent symptoms, (2) there is evidence of an in-service event, injury, or disease, (3) there is an indication that the current condition may be associated with that in-service event, and (4) the existing record is insufficient to decide the claim.

When all four are met, VA has a duty to assist by ordering an exam. When VA fails to order an exam in a situation where McLendon required one, that's not a discretionary call. That's a duty-to-assist error, and the Board will remand for the exam.

This decision is essentially a McLendon enforcement order on seven claims. The Board found, for each of the seven, that the threshold for ordering an exam was met. The RO had never ordered the exams. So the Board remanded all seven with specific instructions: get the exams done.

The lesson for you: if VA denied your claim without ever sending you to a C&P exam, and the four McLendon factors look like they were satisfied, that is a procedural error you can attack. The Board takes this seriously.

The Fourth Precedent: Grantham v. Brown (Fed. Cir. 1997). A Granted Issue Is Off the Table

Grantham v. Brown, 114 F. 3d 1156, 1158 (Fed. Cir. 1997) is the rule that once VA grants service connection on an issue, the issue is no longer in appellate status. The Board mentions Grantham here because of the left ankle grant in March 2020. That grant removed the left ankle from the appeal, but it did something more important. It created a service-connected condition that the veteran could then use as the predicate for a secondary service connection claim on his right knee.

This is the chain reaction worth understanding. Original denial of right knee in 2015 (no nexus to service). Grant of left ankle in 2020 (Grantham removes ankle from appeal). Grant of left knee in 2022. Veteran's 2023 lay letter describing overcompensation. Suddenly the right knee has a new theory: secondary to two service-connected lower-extremity disabilities. That theory did not exist in 2015. It exists now. New and material.

The Seven VA Examiner Failures, In Detail

The Board did not call them examiner failures, because the RO never ordered the exams. That's actually the failure. Each of the seven remanded claims came back with the same fundamental problem: the duty to assist required a VA examination, and VA never scheduled one. Here's what the Board ordered the RO to fix:

• Heart disorder. No exam ordered, despite VA treatment records showing sinus bradycardia and hypertension and despite STRs documenting high cholesterol at separation.
• Head disorder (headaches). No exam ordered, despite the TERA memo suggesting a possible nexus to Persian Gulf War exposure.
• Sleep disorder (obstructive sleep apnea). No exam ordered. Same TERA basis. Plus the secondary obesity theory the RO never developed.
• Diabetes. No exam ordered. Same TERA basis. Plus the secondary obesity theory.
• Colon polyps. No exam ordered. Same TERA basis. Plus the secondary obesity theory.
• Right shoulder disorder. No exam ordered, despite the veteran's March 2023 lay statement describing the physical strain of his Wireman and Drill Instructor duties and despite a current diagnosis of degenerative joint disease.
• Right knee disorder. No exam ordered, despite the veteran's overcompensation statement and despite intervening service connection grants for the left ankle and left knee.

The remand instructions are explicit:

On remand, the RO should obtain and associate with the claims file any outstanding VA treatment records. Thereafter, schedule the Veteran for VA examinations by examiners with appropriate expertise to determine the nature and etiology of any diagnosed heart disorder, head disorder, sleep disorder, diabetes, colon polyps, right shoulder disorder, and right knee disorder. The Veteran's electronic claims file must be accessible for review by the VA examiners in conjunction with the examinations. A complete history from the Veteran should be obtained and recorded. All testing deemed necessary by the examiners should be performed and the results reported in detail. A detailed rationale for all opinions should be provided.

Pay attention to the language "examiners with appropriate expertise." That's plural, and that's deliberate. The Board is not asking for one generalist to bang out seven cursory opinions. It is asking for specialists matched to each condition. If the cardiology question goes to a cardiologist, the sleep question goes to a sleep medicine examiner, and the orthopedic questions go to an orthopedist, the exams will be far harder to attack later.

The one claim that did not survive the reopen test was the left hand index finger. The Board denied that reopen because the post-service treatment records were silent for any diagnosis. No diagnosis means the McLendon test fails on the first prong. No exam ordered, no remand, no reopen.

That contrast matters. Six of seven claims had at least one current diagnosis in the post-service records. One did not. The one without a diagnosis stayed dead. If you have an old denial and you've never been diagnosed with the condition, your reopen has a structural problem before you start.

A grounded reset before the lessons

Everything above is what happened to one Marine over the course of nine years. Here's what it means for you, in your file, on your timeline.

Lesson #1: A Single TERA Memo Can Reopen Multiple Claims at Once

The January 2024 VA memorandum is the most efficient piece of evidence in this entire file. One document, generated internally by VA, provided the predicate for reopening four separate claims (sleep disorder, head disorder, diabetes, colon polyps). It did not prove any of them. It just suggested a possible nexus between the veteran's Persian Gulf War service and downstream conditions, which under Shade was enough.

If you served in any environment with documented toxic exposure (Persian Gulf, Southwest Asia, Vietnam, burn pits, contaminated water at Camp Lejeune, ionizing radiation, herbicide locations beyond Vietnam), pursue a TERA determination. It is not a claim. It is a finding by VA that you participated in a qualifying exposure activity. That finding then becomes evidence in every subsequent claim where exposure could plausibly be relevant.

Under the PACT Act, VA is supposed to be performing TERA evaluations as part of standard claim development for veterans with qualifying service. But "supposed to" and "did" are different things. If you've never seen a TERA memo in your file and you have qualifying service, ask for one explicitly.

Lesson #2: Intervening Grants Create New Theories on Old Claims

Every time VA grants service connection for any condition, you should be running the secondary analysis on every other condition you have. The grant of the left ankle in 2020 did not just give this veteran an ankle rating. It gave him a service-connected weight-bearing joint, which is the predicate for any secondary claim involving overcompensation, gait alteration, or biomechanical chain effects.

In this case, the chain reaction went left ankle (granted 2020) → left knee (granted 2022) → right knee (reopened 2024 under a secondary theory that did not exist before either prior grant).

If you have a final denial on a condition that could plausibly be secondary to something VA has since granted, the new grant itself is new and material evidence. You do not need a doctor to write you a new nexus letter just to reopen. You need to file the reopen with a clear statement explaining the secondary pathway, and let the duty to assist trigger the exam.

Lesson #3: A Well-Written Lay Letter Is Force-Multiplier Evidence

The veteran's March 2023 correspondence is doing serious work in this decision. It accomplished three different things in three different claims:

1. For the right shoulder, it described the physical demands of his MOS as a Wireman and a Drill Instructor, which the Board accepted as evidence of in-service strain.
2. For the heart claim, it cited Mayo Clinic medical literature explaining how high cholesterol increases heart disease risk, which the Board accepted as a nexus theory connecting his separation cholesterol notation to his later cardiac diagnoses.
3. For the right knee, it described overcompensation for his service-connected left knee and left ankle, which the Board accepted as the basis for the secondary connection theory.

One letter. Three different evidentiary functions. None of it required a doctor.

Lay statements are competent evidence for things the veteran has personally observed: what his job duties involved, what symptoms he experiences, how one body part affects another in his daily life. Lay statements are not competent for medical conclusions about etiology, but you can cite medical literature to point the examiner in a direction. That's what this veteran did with the Mayo Clinic reference, and the Board accepted it.

Write the letter. Be specific. Use dates. Use job titles. Describe physical activities concretely. If you can cite a credible medical source (Mayo Clinic, NIH, peer-reviewed studies) for the general proposition that X is associated with Y, do it. You are not pretending to be a doctor. You are pointing at a question the doctor should answer.

Lesson #4: Read Your Own Rating Schedule, Because the RO Sometimes Doesn't

While the Board was busy reopening seven claims, it also bumped this veteran's bilateral dry eye syndrome from 0 percent to 20 percent. The RO had rated him at noncompensable. The Board read the same evidence and rated him at 20 percent.

The reason is simple. Diagnostic Code 6025 assigns 10 percent for a lacrimal apparatus disorder affecting one eye and 20 percent for the same disorder affecting both eyes. His condition was bilateral. The 2020 VA examiner specifically found his condition was a disorder of the lacrimal apparatus. He used artificial tears regularly. Every criterion for the 20 percent rating was satisfied on the existing exam record.

A 20 percent rating for bilateral dry eye at 2024 rates is $338.49 per month for a veteran with no dependents, or $4,061.88 per year, tax-free. Going from 0 to 20 in this single decision is not life-changing money, but it is money that should have been on his check starting from the original claim date. The Board awarded it as an initial rating, meaning the back pay traces to the original effective date.

The lesson: if you have a noncompensable rating, pull up 38 C.F.R. § 4.79 (or whichever rating schedule applies to your condition) and read the actual criteria. If you read the criteria and your exam record meets the criteria for a compensable rating, the RO got it wrong and you have a clean appeal.

Lesson #5: The Reopen Threshold Is Low, But Diagnosis Is Non-Negotiable

Six of seven reopens succeeded. One failed. The one that failed (left hand index finger) failed because there was no current diagnosis in the post-service records. Everything else about the file was identical to the other six claims.

If you are looking at an old denial and the issue was "no current diagnosis," you need to get diagnosed before you reopen. That can mean a VA primary care visit, a private specialist evaluation, or whatever's appropriate for the condition. Without a current diagnosis, the McLendon test fails on the first prong, the duty to assist is not triggered, and your reopen will be denied at the gate.

Diagnosis is the floor. Everything else (in-service event, nexus theory, secondary pathway) is a separate question. But without diagnosis, you cannot get to those questions.

Lesson #6: Reopen-and-Remand Is the Most Common Path, Not the Loss It Looks Like

Reading this decision quickly, a veteran might see "seven claims remanded" and feel like nothing happened. In reality, this is a near-best-case outcome on a reopen request.

The reopens were granted. The merits will be decided after exams. The veteran now has a Board decision, in writing, instructing the RO to schedule exams with appropriately qualified specialists, to provide the claims file for review, and to obtain detailed rationale. The RO cannot quietly deny these claims again without doing that work.

Most reopen-and-remand cases will eventually produce grants on at least some of the underlying claims, especially when (as here) the Board has flagged specific theories the RO must develop. The TERA memo, the secondary obesity theory, the overcompensation argument for the right knee. These are the questions the examiners will be asked. Each one is a plausible path to grant.

One more grounded reset before the action steps

If your case looks anything like this one, the next part is what matters most. Not the case law. The list of things to do this week.

What If This Was You

If you have a final denial sitting in your past and you think your situation is similar, here is the order of operations.

1. Pull your last denial. Read the specific reason VA gave. Was it no current diagnosis? No in-service event? No nexus? The answer determines what evidence you need.
2. If the issue was no diagnosis, get diagnosed. Schedule a VA primary care visit or a private evaluation. Get the diagnosis on paper before anything else.
3. List every condition VA has granted since the denial. For each one, ask: is there a plausible secondary pathway from this granted condition to my denied condition? If yes, that grant is potentially new and material evidence.
4. Check for TERA eligibility. If you served in any qualifying exposure environment, request a TERA determination through your VSO or directly through VA. The memo itself becomes evidence across multiple potential claims.
5. Write the lay letter. Be specific about your MOS duties, your symptoms, the timeline, and how granted conditions affect the denied condition. Cite credible medical sources for general propositions if relevant. Date and sign it.
6. File the supplemental claim (the modern equivalent of a reopen) on VA Form 20-0995. Identify the new evidence explicitly. Cite the Shade low-threshold standard if you're comfortable doing so, or have an accredited representative do it.
7. Expect a remand if the Board gets involved. Reopen-and-remand is normal. The exam is where the real fight happens. Prepare for the C&P exam carefully. Bring documentation. Be ready to describe symptoms, history, and functional impact in detail.

What the Data Can't Tell Me

I want to be careful about what I can and can't conclude from a single Board decision.

I don't have this veteran's actual medical records. I have the Board's summary of what those records contained. The Board sometimes characterizes records in ways the records themselves might not fully support. I am taking Judge English's description at face value.

I also don't know how the remanded claims ultimately resolved. As of the April 2024 decision date, the exams hadn't happened yet. Any of the seven reopened claims could still come back denied if the examiners conclude there's no nexus. The Board reopening a claim is not the same as the Board granting a claim. It just opens the door to development.

I don't know why the RO denied all seven of these claims in 2015 without ordering a single C&P exam. The post-service treatment records that the Board found dispositive in 2024 (the hypertension and bradycardia diagnoses) existed when the 2015 decision came down. Either the RO didn't review them, or it concluded they didn't satisfy McLendon. The Board, looking at the same records, disagreed.

And I can't tell you whether your situation matches this one closely enough for the same pattern to work. Every claim file is different. The patterns the data reveals are real, but individual outcomes depend on facts I cannot see from outside.

Bottom Line

The central lesson of BVA 24018149 is that a final denial is not as final as it feels. The "new and material" threshold is genuinely low, and the kinds of evidence that clear it are broader than most veterans realize. A TERA memo. A later grant on a related condition. A well-drafted lay letter. None of these require a doctor's nexus opinion. Any one of them can be enough to trigger VA's duty to assist and pry the door back open.

For this Marine, three changes over eight years (two intervening grants and one TERA memo) reopened seven claims simultaneously and produced a 20 percent rating bump as a bonus. He's not done. The remanded claims still have to survive the exams. But he's in a fundamentally different position than he was in 2015 or 2017.

If you have an old denial, ask yourself what has changed in your file since then. If anything material has changed (new diagnosis, new grant on a related condition, new exposure determination, new lay evidence), the door may already be open. You just have to walk through it.

Methodology and Limitations

• Data source: Claim Raven's analysis of BVA citation 24018149, a single Board of Veterans' Appeals decision dated April 29, 2024, written by Veterans Law Judge Thomas English.
• Verbatim quotes: All blockquoted passages come from the structured key_quotes field of the decision and from the verbatim remand instructions in the Board's order. I have not paraphrased the Board's reasoning.
• Aggregate context: This is a single-case breakdown. Where I reference broader patterns, those patterns come from Claim Raven's larger dataset of 101,518 condition records drawn from 49,876 Board decisions. Individual case outcomes vary substantially and cannot be predicted from aggregate data alone.

Disclaimer

I'm not accredited by VA, not a lawyer, not a VSO. This is data analysis, not claim advice. These are patterns from cases that made it to the BVA, they don't predict individual outcomes. If you need help with your claim, work with an accredited representative.

Where to go next

• Related article: Supplemental Claim vs HLR vs Board Appeal: Which Lane to Pick Under AMA
• Relevant tool: Evidence Checklists, the supplemental-claim evidence pattern these reopens depend on
• More analysis: /blog
• Disclaimer: Claim Raven is data analysis, not legal, medical, or VA-accredited advice.

-Landon Founder, Claim Raven | U.S. Army Veteran