Citation Nr: 0723298 Decision Date: 07/30/07 Archive Date: 08/14/07 DOCKET NO. 03-29 122 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Jackson, Mississippi THE ISSUES 1. Entitlement to a disability evaluation greater than 10 percent for hemorrhoids. 2. Entitlement to a compensable disability evaluation for a history of renal calculus. 3. Entitlement to service connection for shortness of breath to include as secondary to asbestos exposure. 4. Entitlement to service connection for colon cancer to include as secondary to exposure to herbicides and ionizing radiation. 5. Entitlement to service connection for degenerative arthritis of the low back. 6. Entitlement to service connection for a degenerative arthritis of the left knee. 7. Entitlement to service connection for an iron deficiency. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Veteran ATTORNEY FOR THE BOARD D. M. Ames, Associate Counsel INTRODUCTION The veteran had active service from June 1959 to June 1963 and from November 1963 to July 1984, including service in the Republic of Vietnam. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2003 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Jackson, Mississippi. FINDINGS OF FACT 1. The veteran's hemorrhoids do not cause persistent bleeding with secondary anemia or fissures. 2. The veteran does not have recurrent kidney stone formation requiring one or more of the following: diet therapy, drug therapy, or invasive or non-invasive procedures more than two times a year. The veteran also does not have an occasional attack of colic, not infected and not requiring catheter drainage. 3. The veteran's colon cancer, degenerative arthritis of the low back and left knee, shortness of breath, and iron deficiency were not caused by his active military service from June 1959 to June 1963 and from November 1963 to July 1984. CONCLUSIONS OF LAW 1. The criteria for a 20 percent rating for hemorrhoids have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 2002); 38 C.F.R. §§ 4.1-4.7, 4.21, 4.114, Diagnostic Code (DC) 7336 (2006). 2. The criteria for a compensable rating for a history of renal calculus have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 2002); 38 C.F.R. §§ 4.1-4.7, 4.21, 4.115b, DCs 7508, 7509 (2006). 3. Service connection for shortness of breath is not established. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 2002); 38 C.F.R. § 3.303 (2006). 4. Service connection for colon cancer is not established. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 2002); 38 C.F.R. § 3.303, 3.307, 3.309(d), (e), 3.311 (2006). 5. Service connection for degenerative arthritis of the low back, degenerative arthritis of the left knee, and an iron deficiency is not established. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 2002); 38 C.F.R. § 3.303, (2006). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Increased evaluation claims Disability ratings are determined by applying the criteria established in VA's Schedule for Rating Disabilities, which is based upon the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C.A. § 1155 (West 2002); 38 C.F.R. §§ 4.1, 4.20 (2006). Where an increase in an existing disability rating based upon established entitlement to compensation is at issue, the present level of disability is the primary concern. Francisco v. Brown, 7 Vet. App. 55 (1994). If two evaluations are potentially applicable, the higher one will be assigned if the disability picture more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. When reasonable doubt arises as to the degree of disability, such doubt will be resolved in the veteran's favor. 38 C.F.R. § 4.3. Pertinent regulations do not require that all cases show all findings specified by the Rating Schedule, but that findings sufficiently characteristic to identify the disease and the resulting disability and above all, coordination of rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21. Therefore, the Board has considered the potential application of various other provisions of the regulations governing VA benefits, whether or not they were raised by the veteran, as well as the entire history of the veteran's disability in reaching its decision. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). The veteran asserts that he is entitled to a higher rating for his service-connected hemorrhoids, currently evaluated as 10 percent disabling under DC 7336, external or internal hemorrhoids. 38 C.F.R. § 4.114. Under DC 7336, a 10 percent rating is warranted when hemorrhoids are large or thrombotic, irreducible, with excessive redundant tissue, evidencing frequent recurrences. A 20 percent evaluation is warranted when the hemorrhoids cause persistent bleeding with secondary anemia or fissures. At his April 2004 RO hearing, the veteran testified that he had to push the hemorrhoids back into his rectum after every bowel movement. He also stated that the hemorrhoids bled, but not every day. In September 2003, the veteran underwent a colonoscopy that revealed moderately large hemorrhoids. In August 2003, the veteran underwent a VA anus and rectum examination. The examiner did not detect external hemorrhoids or the presence of any skin change perianally. On digital examination, there were tender, internal hemorrhoids. Rectal tone was normal and there was no evidence of blood, providing evidence against this claim. The Board finds that the facts and examination above are entitled to great probative weight and that they provide evidence against the claim. The evidence discussed above does not show that the veteran's hemorrhoids bled persistently with secondary anemia or fissures. The Board considered the veteran's VA and private medical treatment records, which also did not show fissures or persistent bleeding with secondary anemia. Reviewing the evidence, the Board finds that the overall disability picture for the veteran's hemorrhoids does not more closely approximate a 20 percent rating because there is no persistent bleeding with secondary anemia or fissures. 38 C.F.R. § 4.7. Therefore, the preponderance of the evidence against this claim. 38 C.F.R. § 4.3. The veteran also asserts that he is entitled to a compensable evaluation for a history of renal calculus. He is currently assigned a noncompensable evaluation under DC 7508, nephrolithiasis. Under DC 7508, the rater is instructed to rate nephrolithiasis as hydronephrosis, DC 7509, unless there is recurrent stone formation requiring one or more of the following: diet therapy, drug therapy, or invasive or non- invasive procedures more than twice a year. The veteran does not have recurrent stone formation. Therefore, the criteria of DC 7509 are warranted. Under DC 7509, a 10 percent evaluation is warranted when there is only an occasional attack of colic, not infected and not requiring catheter drainage. The veteran underwent a VA renal examination in August 2003. The examiner sated that the veteran had not had a kidney stone since 1984, and had been asymptomatic for almost 20 years, providing factual evidence against this claim. The veteran's renal function was normal. The Board finds that the VA examination report provides highly probative evidence against the claim. The veteran's private and VA medical records do not provide evidence in favor of his claim, as they do not show that the veteran has had an episode of colic. Reviewing the evidence, the Board finds that the overall disability picture for the veteran's history of renal calculus does not more closely approximate a compensable rating. 38 C.F.R. § 4.7. Therefore, the preponderance of the evidence against this claim. 38 C.F.R. § 4.3. Finally, the Board finds no reason to refer the case to the Compensation and Pension Service for consideration of an extra-schedular evaluation under 38 C.F.R. § 3.321(b). That is, there is no evidence of exceptional or unusual circumstances, such as frequent hospitalization or marked interference with employment, to suggest that the veteran is not adequately compensated by the regular rating schedule. VAOPGCPREC 6-96. Accordingly, the Board finds that the preponderance of the evidence is against entitlement to a rating greater than 10 percent for hemorrhoids and a noncompensable evaluation for a history of renal calculus. 38 C.F.R. § 4.3. Service connection claims Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease that was incurred or aggravated during active military service. 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. § 3.303(a) (2006). Service connection may be demonstrated either by showing direct service incurrence or aggravation or by using applicable presumptions, if available. Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994). Direct service connection generally requires evidence of a current disability with a relationship or connection to an injury or disease or some other manifestation of the disability during service. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000). A disorder may be service connected if the evidence of record reveals that the veteran currently has a disorder that was chronic in service or, if not chronic, that was seen in service with continuity of symptomatology demonstrated subsequent to service. 38 C.F.R. § 3.303(b); Savage v. Gober, 10 Vet. App. 488, 494-97 (1997). Evidence that relates the current disorder to service must be medical unless it relates to a disorder that may be competently demonstrated by lay observation. Savage, 10 Vet. App. at 495-97. For the showing of chronic disease in service, there is a required combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "chronic." 38 C.F.R. § 3.303(b). Disorders diagnosed after discharge may still be service connected if all the evidence, including relevant service records, establishes that the disorder was incurred in service. 38 C.F.R. § 3.303(d). Where the determinative issue involves medical causation or a medical diagnosis, there must be competent medical evidence to the effect that the claim is plausible; lay assertions of medical evidence do not constitute competent medical evidence. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993); Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is resolved in favor of the veteran. 38 U.S.C.A. § 5107(b). A layperson is generally not capable of opining on matters requiring medical knowledge. Routen v. Brown, 10 Vet. App. 183, 186 (1997). See also Bostain v. West, 11 Vet. App. 124, 127 (1998) citing Espiritu v. Derwinski, 2 Vet. App. 492 (1992) (a layperson without the appropriate medical training and expertise is not competent to provide a probative opinion on a medical matter, to include a diagnosis of a specific disability and a determination of the origins of a specific disorder). Lay testimony is competent, however, to establish the presence of observable symptomatology and "may provide sufficient support for a claim of service connection." Layno v. Brown, 6 Vet. App. 465, 469 (1994). When a condition may be diagnosed by its unique and readily identifiable features, the presence of the disorder is not a determination "medical in nature" and is capable of lay observation. In such cases, the Board is within its province to weigh that testimony and to make a credibility determination as to whether that evidence supports a finding of service incurrence and continuity of symptomatology sufficient to establish service connection. See Barr v. Nicholson, No. 04-0534 (Vet. App. June 15, 2007). The first requirement for any service connection claim is competent evidence of existence of a current disability. Boyer, 210 F.3d at 1353; Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The veteran has diagnoses of colon cancer, degenerative arthritis of the low back and left knee, and microcytic anemia. He does not have a diagnosis of shortness of breath. A post-service treatment record indicates that the veteran had possible chronic obstructive pulmonary disease, but no diagnosis was given. As the veteran does not have a current diagnosis of shortness of breath or another respiratory condition, that claim must be denied. Even if the Board were to assume that the veteran had a respiratory condition, service connection could not be granted. There is no specific statutory guidance with regard to asbestos-related claims, nor has the Secretary promulgated any regulations in regard to such claims. However, VA has issued a circular on asbestos-related diseases. DVB Circular 21-88-8, Asbestos-Related Diseases (May 11, 1988) provides guidelines for considering compensation claims based on exposure to asbestos. The information and instructions from the DVB Circular were included in the VA Adjudication Procedure Manual, M21-1 (M21-1), Part VI, § 7.21. In December 2005, M21-1, Part VI was rescinded and replaced with a new manual, M21-1MR, which contains the same asbestos- related information as M21-1, Part VI. The U.S. Court of Appeals for Veterans Claims (Court) has held that VA must analyze an appellant's claim to entitlement to service connection for asbestosis or asbestos-related disabilities under the administrative protocols under the DVB Circular guidelines. See Ennis v. Brown, 4 Vet. App. 523 (1993); McGinty v. Brown, 4 Vet. App. 428 (1993). The applicable section of M21-1MR is Part IV, Subpart ii, Chapter 1, Section H, Topic 29. It lists some of the major occupations involving exposure to asbestos, including mining, milling, work in shipyards, insulation work, demolition of old buildings, carpentry and construction, manufacture and servicing of friction products such as clutch facings and brake linings, manufacture and installation of roofing and flooring materials, asbestos cement and pipe products, and military equipment. High exposure to respirable asbestos and a high prevalence of disease have been noted in insulation and shipyard workers, and this is significant considering that, during World War II, U.S. Navy veterans were exposed to chrysotile, amosite, and crocidolite that were used extensively in military ship construction. Furthermore, it was revealed that many of these shipyard workers had only recently come to medical attention because the latent period for asbestos-related diseases varies from 10 to 45 or more years between first exposure and development of disease. Also of significance is that the exposure to asbestos may be brief (as little as a month or two) or indirect (bystander disease). M21-1MR, Part IV Subpart ii, Chapter 2, Section C, Topic 9, see also M21-1MR Part IV, Subpart ii, Chapter 1, Section H, Topic 29. In short, with respect to claims involving asbestos exposure, VA must determine whether or not military records demonstrate evidence of asbestos exposure during service, develop whether or not there was pre-service and/or post-service occupational or other asbestos exposure, and determine whether there is a relationship between asbestos exposure and the claimed disease. M21-1MR, Part IV, Subpart ii, Chapter 1, Section H, Topic 29; DVB Circular 21-88-8, Asbestos-Related Diseases (May 11, 1988). In this case, the veteran claims that he was exposed to asbestos during active duty. He contended that the protective clothing he wore while servicing liquid oxygen on B52 and KC135 aircraft contained asbestos, which caused his shortness of breath. The RO obtained the veteran's service personnel records, and they contained no evidence of the exposure to asbestos or indications that the veteran's work during service would have lead him to extensive exposure to asbestos. Additionally, the veteran's service medical records (SMRs) show no complaints, findings, or diagnoses of any lung disorders. Evaluations of the veteran during service make no reference to any such disorders, or indications of such disorders. His induction and separation examinations are negative for lung disorders. Clearly, the service records provide evidence against this claim. The veteran's post-service medical records do not provide a link between a respiratory disorder and his period of active military service, nor do they suggest that the veteran was exposed to asbestos in service. The Board finds that the service and post-service medical records provides very negative evidence against this claim, indicating a minimal (at best) condition that began many years after service. As the preponderance of the evidence is against the claim for service connection for shortness of breath, claimed as due to asbestos exposure, the benefit-of-the-doubt rule does not apply, and the claim for service connection must be denied. 38 U.S.C.A. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). With regard to the veteran's claim that he has a disability related to radar radiation exposure or unexploded nuclear weapons (the veteran contends that he worked on B-52s with nuclear weapons onboard), presumptive service connection for a disability based upon exposure to radiation can be awarded on two different legal bases. The first basis is a presumptive basis for diseases specific to radiation-exposed veterans under 38 C.F.R. § 3.309(d). The second basis is based on exposure to ionizing radiation with the subsequent development of a radiogenic disease under 38 C.F.R. § 3.311. There are certain diseases, including colon cancer, that are presumptively service-connected specific to radiation-exposed veterans. 38 U.S.C.A. § 1112(c)(2); 38 C.F.R. § 3.309(d)(2)(xix). However, the presumption of 3.309(d) does not apply to the veteran because he is not a radiation- exposed veteran as defined in 38 C.F.R. § 3.309(d)(3). Radiogenic diseases may also be service-connected pursuant to 38 C.F.R. § 3.311. Colon cancer is among the diseases identified as potentially radiogenic. 38 C.F.R. § 3.311. For purposes of 38 C.F.R. § 3.311, a "radiogenic disease" is defined as a disease that may be induced by ionizing radiation, and specifically includes, among other diseases, all types of cancers, which must become manifest five years or more after exposure. 38 C.F.R. § 3.311(b)(2)(i)-(xxiv), (b)(5)(iv) (2006). The veteran was diagnosed with colon cancer in July 2002, more than five years after leaving service. 38 C.F.R. § 3.311 provides for development of claims based upon a contention of radiation exposure during active service and post-service development of a radiogenic disease. These provisions do not give rise to a presumption of service connection, but rather establish a procedure for handling claims brought by radiation exposed veterans or their survivors. See Ramey v. Gober, 120 F.3d 1239, 1244 (Fed. Cir. 1997). The governing regulation states that, in all claims in which it is established that a radiogenic disease first became manifest after service, and it is contended that the disease resulted from radiation exposure, a dose assessment will be made. 38 C.F.R. § 3.311(a)(2). The Board considered remanding this case so that a dose estimate could be obtained. In order to submit the veteran's case for a dose estimate, the RO must request all available information pertaining to the veteran's exposure to radiation. The RO requested the veteran's service personnel records and any other records that could show that the veteran was exposed to radiation. The veteran's service personnel records did not show radiation exposure, and the service department did not submit any additional records that could show radiation exposure. A DD Form 1141 was not present in his SMRs or service personnel records. Therefore, the RO had no records to submit for a dose estimate and such a request would not be feasible in the absence of records showing radiation exposure. At his April 2004 RO hearing, the veteran stated that he carried a dosimeter, but that it was never checked. The veteran's service records to not refer to a dosimeter. Assuming that the veteran did wear a dosimeter, there is no information pertaining to it in the veteran's record, and therefore nothing that can be submitted for a dose estimate. Simply stated, the service record does not provide a basis to send this case for a dose estimate as any request, based on the record, would clearly not provide a basis to grant this claim. Simply stated, based on the evidence in the record at this time, an additional development effort would serve no useful purpose. See Soyini v. Derwinski, 1 Vet. App. 540, 546 (1991); Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). The veteran also contends that his colon cancer is due to exposure to herbicides. A veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the Vietnam era shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. 38 U.S.C.A. § 1116(f); 38 C.F.R. § 3.307. The following diseases are deemed associated with herbicide exposure, under VA law: chloracne or other acneform diseases consistent with chloracne, Hodgkin's disease, multiple myeloma, non-Hodgkin's lymphoma, acute and subacute peripheral neuropathy, porphyria cutanea tarda, prostate cancer, respiratory cancers (cancer of the lung, bronchus, larynx, or trachea), soft-tissue sarcomas (other than osteosarcoma, chondrosarcoma, Kaposi's sarcoma, or mesothelioma), and diabetes mellitus (Type 2). 38 U.S.C.A. § 1116; 38 C.F.R. § 3.307(a)(6)(iii); 38 C.F.R. § 3.309. While the veteran served in the Republic of Vietnam during the Vietnam era, colon cancer is not a disease deemed associated with herbicide exposure under VA law. Therefore, the presumption does not apply. As the presumptions and procedures for radiation exposure and the presumption for herbicide exposure do not apply to the veteran's colon cancer claim, the Board will address service connection on a direct basis. The veteran's SMRs are negative for any diagnosis of or treatment for colon cancer and the veteran's post-service treatment records do not provide a link between the veteran's colon cancer and his period of active service. Therefore, the Board finds that the preponderance of the evidence is against service connection for colon cancer. 38 U.S.C.A. § 5107(b). The appeal is denied. The veteran was diagnosed with degenerative arthritis of the low back in 1990, more than one year after leaving military service. The veteran's SMRs show that he complained of back pain once in November 1983. The SMRs are otherwise negative for any diagnosis of or treatment for a back disorder. The Board finds that the veteran's November 1983 back pain was acute and transitory, not chronic. There is no post-service medical evidence to provide a link between the veteran's degenerative arthritis of the low back and his period of military service. The Board must note the lapse of many years between the veteran's separation from service and the first treatment for the claimed disorder. The United States Court of Appeals for the Federal Circuit has determined that such a lapse of time is a factor for consideration in deciding a service connection claim. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). The Board finds that the service and post-service medical evidence provides evidence against this claim, indicating a disorder that began many years after service. The Board finds that the preponderance of the evidence is against service connection for degenerative arthritis. 38 U.S.C.A. § 5107(b). The appeal is denied. The veteran was first treated for a left knee strain and possible left knee cartilage tear in the late 1990s for an injury that occurred in December 1997, more than ten years after the veteran left service. The veteran contended that he was diagnosed with left knee arthritis in 1981. However, his SMRs are negative for any diagnosis of or treatment for any kind of left knee disorder. The veteran's post-service medical records do not provide a link between his period of active service and his degenerative arthritis of the left knee. The Board finds that the preponderance of the evidence is against service connection for a left knee disability. 38 U.S.C.A. § 5107(b). The appeal is denied. A July 2002 private medical treatment record shows that the veteran had microcytic anemia, suggesting the possibility of an iron deficiency. This is the first finding of an iron deficiency in the veteran's treatment records. The Board must again note the lapse of many years between the veteran's separation from service and the first treatment for the claimed disorder. The veteran's SMRs are completely negative for any diagnosis of or treatment for anemia or an iron deficiency. His post- service medical treatment records do not provide a link between his microcytic anemia and his period of active service. The Board finds that the preponderance of the evidence is against service connection for iron deficiency. 38 U.S.C.A. § 5107(b). The appeal is denied. The Duty to Notify and the Duty to Assist Review of the claims folder reveals compliance with the Veterans Claims Assistance Act of 2000 (VCAA), 38 U.S.C.A. § 5100 et seq. See 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a). That is, by a letter dated in October 2002, the RO advised the veteran of the evidence needed to substantiate his claims and explained what evidence VA was obligated to obtain or to assist the veteran in obtaining and what information or evidence the veteran was responsible for providing. Thus, the Board finds that the RO has provided all notice required by the VCAA. 38 U.S.C.A. § 5103(a). See Quartuccio v. Principi, 16 Vet. App. 183 (2002). The Board observes that the RO issued a VCAA notice letter prior to the adverse determination on appeal. Pelegrini v. Principi, 18 Vet. App. 112, 120 (2004). The October 2002 VCAA letter does not specifically ask the veteran to provide any evidence in his possession that pertains to the claim. Id. at 120-21. However, the May 2005 VCAA follow-up letter did make the specific request. As discussed above, the Board finds that the RO has ultimately provided all notice required by § 5103(a). Therefore, any failure to make the specific request in the October 2002 VCAA letter is non-prejudicial, harmless error. Bernard v. Brown, 4 Vet. App. 384, 392-94 (1993). See Sutton v. Brown, 9 Vet. App. 553 (1996); see also 38 C.F.R. § 20.1102 (harmless error). Moreover, neither the veteran nor his representative has made any showing or allegation that the content of the VCAA notice resulted in any prejudice to the veteran. In any event, the Board finds that any deficiency in the notice to the veteran or the timing of these notices is harmless error. See Overton v. Nicholson, 20 Vet. App. 427, 435 (2006) (finding that the Board erred by relying on various postdecisional documents to conclude that adequate 38 U.S.C.A. § 5103(a) notice had been provided to the appellant, the Court found that the evidence established that the veteran was afforded a meaningful opportunity to participate in the adjudication of his claims, and found that the error was harmless, as the Board has done in this case). If there was any deficiency in the notice to the veteran, the Board finds that the presumption of prejudice on the VA's part has been rebutted in this case by the following: (1) based on the communications sent to the veteran over the course of this appeal, the veteran clearly has actual knowledge of the evidence he is required to submit in this case; and (2) in this case, based on the veteran's contentions and the communications provided to the veteran by the VA over the course of this appeal, he is found to be reasonably expected to understand from the notices provided what was needed. The Board notes that in a June 2006 letter, the veteran was informed that a disability rating and effective date would be assigned if his claim was granted. See Dingess v. Nicholson, 19 Vet. App. 473 (2006). With respect to the duty to assist, the RO has secured the veteran's service medical records, service personnel records, VA medical records, private medical records, Social Security Administration records, and VA examinations. As there is no other indication or allegation that relevant evidence remains outstanding, the Board finds that the duty to assist has been met. 38 U.S.C.A. § 5103A. The Board notes that an etiological opinion has not been obtained for the veteran's service connection claims. However, the Board finds that the evidence, discussed above, which indicates that the veteran did not receive treatment for the claimed disorders during service or that there is any competent medical evidence showing or indicating a nexus between service and the disorders at issue, warrants the conclusion that a remand for an examination and/or opinion is not necessary to decide the claim. See 38 C.F.R. § 3.159 (c)(4) (2005). As service and post-service medical records provide no basis to grant this claims, and provides evidence against the claims, the Board finds no basis for a VA examination to be obtained. Under McLendon v. Nicholson, 20 Vet. App. 79 (2006), in disability compensation (service connection) claims, the VA must provide a VA medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence on file for the VA to make a decision on the claim. Simply stated, the standards of McLendon are not met in this case. With the exception of a claim for shortness of breath, the first element is met. However, as the Board has found that the presumptions of exposure to ionizing radiation, herbicides, and asbestos do not apply, the second and third elements are not met because there is no evidence providing a link between the claimed disabilities and the veteran's period of active service ORDER A disability evaluation greater than 10 percent for hemorrhoids is denied. A compensable disability evaluation for a history of renal calculus is denied. Service connection for shortness of breath to include as secondary to asbestos exposure is denied. Service connection for colon cancer to include as secondary to exposure to herbicides and ionizing radiation is denied. Service connection for degenerative arthritis of the low back is denied. Service connection for a degenerative arthritis of the left knee is denied. Service connection for an iron deficiency is denied. ______________________________________________ JOHN J. CROWLEY Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs