Citation Nr: 0738910 Decision Date: 12/11/07 Archive Date: 12/19/07 DOCKET NO. 06-32 224 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in No. Little Rock, Arkansas THE ISSUES 1. Entitlement to an initial compensable evaluation for migraine headaches. 2. Entitlement to service connection for a viral syndrome/viral gastritis. 3. Entitlement to service connection for lymphadenopathy and swollen glands. 4. Entitlement to service connection for a chest disability. 5. Entitlement to service connection for stress, emotional problems, and depression. 6. Entitlement to service connection for rashes, to include as due to asbestos exposure. 7. Entitlement to service connection for dehydration. 8. Entitlement to service connection for urinary trouble. 9. Entitlement to service connection for blurred vision. 10. Entitlement to service connection for trouble breathing, to include as due to asbestos exposure. 11. Entitlement to service connection for a hearing loss disability. ATTORNEY FOR THE BOARD L. M. Barnard, Counsel INTRODUCTION The veteran had active service from October 1983 to January 1987. This appeal arose before the Board of Veterans' Appeals (Board) from a February 2006 rating decision of the above Department of Veterans Affairs (VA) Regional Office (RO). FINDINGS OF FACT 1. The veteran's headaches are manifested by complaints of left-side headaches associated with nausea, photophobia, and phonophobia which occur two to three times per day. 2. The veteran does not have a chronic viral syndrome/viral gastritis that is related to his period of active military service. 3. The veteran does not have chronic lymphadenopathy that is related to his period of service. 4. The veteran does not have a chest disability that is related to his period of service. 5. The veteran does not have stress, emotional problems, or depression that are related to his period of service. 6. The veteran does not have a skin rash that is related to his period of service, to include to any asbestos exposure. 7. The veteran does not have residuals of dehydration related to his period of service. 8. The veteran does not have any urinary trouble that is related to his period of service. 9. The veteran does not have any visual problems that are related to his period of service. 10. The veteran does not have any breathing trouble that is related to his period of service, to include to any asbestos exposure. 11. The veteran does not have a chronic hearing loss disability that is related to his period of service. CONCLUSIONS OF LAW 1. The criteria for a compensable evaluation for headaches have not been. 38 U.S.C.A. §§ 1155, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.159, 3.321, 4.1, 4.2, 4.7, Diagnostic Code (DC) 8100 (2007). 2. A chronic viral syndrome/viral gastritis was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.159, 3.303(b) (2007). 3. Chronic lymphadenopathy was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.159, 3.303(b) (2007). 4. A chest disability was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. § 3.159 (2007). 5. Currently claimed stress, emotional problems, and depression were not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. § 3.159 (2007). 6. Skin rashes were not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. § 3.159 (2007). 7. Chronic dehydration residuals were not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.159, 3.303(b) (2007). 8. Urinary trouble was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. § 3.159 (2007). 9. Blurred vision was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. § 3.159 (2007). 10. Trouble breathing was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. § 3.159 (2007). 11. A bilateral hearing loss disability was not incurred in or aggravated by service, nor may such a hearing loss disability be presumed to have been so incurred. 38 U.S.C.A. §§ 1101, 1112, 1113, 1131, 5103(a), 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.159, 3.307, 3.309, 3.385 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Duty to Notify and Assist The Veterans Claims Assistance Act of 2000 (VCAA) enhanced VA's duty to notify and assist claimants in substantiating their claims for VA benefits, as codified in pertinent part at 38 U.S.C.A. §§ 5103, 5103A (West 2002 & Supp. 2007); 38 C.F.R. § 3.159, 3.326(a) (2007). Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant of the information and evidence not of record that is necessary to substantiate the claim; to indicate which information and evidence VA will obtain and which information and evidence the claimant is expected to provide; and to request that the claimant provide any evidence in the claimant's possession that pertains to the claim. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b). The U.S. Court of Appeals for Veterans Claims has held that VCAA notice should be provided to a claimant before the initial RO decision on a claim. Pelegrini v. Principi, 18 Vet. App. 112 (2004). However, if VCAA notice is provided after the initial decision, such a timing error can be cured by subsequent readjudication of the claim, as in a Statement of the Case (SOC) or Supplemental SOC (SSOC). Mayfield v. Nicholson, 20 Vet. App. 537, 543 (2006). The VCAA notice requirements apply to all five elements of a service connection claim: (1) veteran status; (2) existence of disability; (3) connection between service and the disability; (4) degree of disability; and (5) effective date of benefits where a claim is granted. Dingess v. Nicholson, 19 Vet. App. 473, 484 (2006). The U.S. Court of Appeals for the Federal Circuit recently held that any error in a VCAA notice should be presumed prejudicial. The claimant bears the burden of demonstrating such error. VA then bears the burden of rebutting the presumption, by showing that the essential fairness of the adjudication has not been affected because, for example, actual knowledge by the claimant cured the notice defect, a reasonable person would have understood what was needed, or the benefits sought cannot be granted as a matter of law. Sanders v. Nicholson, 487 F.3d 881 (2007). In September 2005 and January 2006, the RO sent the veteran letters informing him of the types of evidence needed to substantiate his claims and its duty to assist him in substantiating his claims under the VCAA. These letters informed the veteran that VA would assist him in obtaining evidence necessary to support his claims, such as records in the custody of a Federal department or agency, including VA, the service department, the Social Security Administration, and other pertinent agencies. He was advised that it was his responsibility to send medical records showing he has a current disability as well as records showing a relationship between his claimed disabilities and service, as well as information concerning how to substantiate his claim for an increased evaluation, or to provide a properly executed release so that VA could request the records for him. The veteran was also specifically asked to provide to provide any evidence in his possession that pertained to his claim. The Board finds that the content of these letters provided to the veteran complied with the requirements of 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b) regarding VA's duty to notify and assist. He was advised of his opportunities to submit additional evidence. Subsequently, an August 2006 SOC provided him with an additional 60 days to submit more evidence. Thus, the Board finds that the purpose behind the notice requirement has been satisfied because the veteran has been afforded a meaningful opportunity to participate effectively in the processing of his claims. In addition, it appears that all obtainable evidence identified by the veteran relative to his claim has been obtained and associated with the claims file, and that he has not identified any other pertinent evidence, not already of record, which would need to be obtained for a fair disposition of this appeal. It is therefore the Board's conclusion that the veteran has been provided with every opportunity to submit evidence and argument in support of his claims, and to respond to VA notices. Moreover, the claimant has not demonstrated any error in VCAA notice, and therefore the presumption of prejudicial error as to such notice does not arise in this case. See Sanders v. Nicholson, supra. Accordingly, we find that VA has satisfied its duty to assist the veteran in apprising him as to the evidence needed, and in obtaining evidence pertinent to his claim under the VCAA. Therefore, no useful purpose would be served in remanding this matter for yet more development. Such a remand would result in unnecessarily imposing additional burdens on VA, with no additional benefit flowing to the veteran. The Court of Appeals for Veterans Claims has held that such remands are to be avoided. Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). In addition, to whatever extent the decision of the Court in Dingess v. Nicholson, supra, requires more extensive notice in claims for compensation, e.g., as to potential downstream issues such as disability rating and effective date, the Board notes that he was provided with the provisions of the Dingess case in May 2007. II. Applicable laws and regulations A. Increased evaluation Disability evaluations are determined by the application of a schedule of ratings which is based on the average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C.A. § 1155 (West 2002 & Supp. 2007); 38 C.F.R. Part 4 (2007). When a question arises as to which of two evaluations shall be assigned, the higher evaluation will be assigned of 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. In determining the disability evaluation, the VA has a duty to acknowledge and consider all regulations which are potentially applicable based upon the assertions and issues raised in the record and to explain the reasons used to support the conclusion. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). These regulations include, but are not limited to, 38 C.F.R. § 4.1, which requires that each disability be viewed in relation to its history and that there be an emphasis placed upon the limitation of activity imposed by the disabling condition, and 38 C.F.R. § 4.2, which requires that medical reports be interpreted in light of the whole recorded history, and that each disability must be considered from the point of view of the veteran working or seeking work. These requirements for the evaluation of the complete medical history of the claimant's condition operate to protect claimants against adverse decision based upon a single, incomplete, or inaccurate report, and to enable VA to make a more precise evaluation of the disability level and any changes in the condition. In general, when an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). However, when the current appeal arose from the initially assigned rating, consideration must be given as to whether staged ratings should be assigned to reflect entitlement to a higher rating at any point during the pendency of the claim. Fenderson v. West, 12 Vet. App. 119 (1999). Moreover, staged ratings are appropriate in any increased-rating claim in which distinct time periods with different ratable symptoms can be identified. Hart v. Mansfield, No. 05-2424 (Vet. App. Nov. 19, 2007). B. Service connection Service connection may be granted for disability resulting from personal injury suffered or disease contracted during active military service, or for aggravation of a pre-existing injury suffered, or disease contracted, during such service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. §§ 3.303(a), 3.304. Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disability. See Caluza v. Brown, 7 Vet. App. 498, 506 (1995); aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996) (table); see also Hickson v. West, 12 Vet. App. 247, 253 (1999); 38 C.F.R. § 3.303. Under section 3.303(b), an alternative method of establishing the second and/or third Caluza element is through a demonstration of continuity of symptomatology. See Savage v. Gober, 10 Vet. App. 488 (1997); see also Clyburn v. West, 12 Vet. App. 296, 302 (1999). Continuity of symptomatology may be established if a claimant can demonstrate (1) that a condition was "noted" during service; (2) evidence of post- service continuity of the same symptomatology; and (3) medical or, in certain circumstances lay evidence of a nexus between the present disability and the post-service symptomatology. Savage, 10 Vet. App. at 495-96; see Hickson, 12 Vet. App. at 253 (lay evidence of in-service incurrence sufficient in some circumstances for purposes of establishing service connection); 38 C.F.R. § 3.303(b). Significant in case law is that lay persons are not competent to opine as to medical etiology or to render medical opinions. See Grover v. West, 12 Vet. App. 109, 112 (1999); Espiritu v. Derwinski, 2 Vet. App. 492 (1992). Lay testimony is competent, however, to establish that observable symptomatology and "may provide sufficient support for a claim of service connection." Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Falzone v. Brown, 8 Vet. App. 398, 405 (1995) (lay person may provide eyewitness account of medical symptoms). The Court of Appeals for Veterans Claims (CAVC) has emphasized that "symptoms, not treatment, are the essence of any evidence of continuity of symptomatology." Savage, 10 Vet. App. at 496 (citing Wilson v. Derwinski, 2 Vet. App. 16, 19 (1991)). Once evidence is determined to be competent, the Board must determine whether such evidence is also credible. See Layno, supra (distinguishing between competency ("a legal concept determining whether testimony may be heard and considered") and credibility ("a factual determination going to the probative value of the evidence to be made after the evidence has been admitted.")). Barr v. Nicholson, 20 Vet. App. 528 (2007). Medical evidence is generally required to establish a medical diagnosis or to address questions of medical causation; lay assertions of medical status do not constitute competent medical evidence for these purposes. Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992). However, lay assertions may serve to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C.A. § 1153(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see Buchanan v. Nicholson, 451 F. 3d 1331, 1336 (Fed. Cir. 2006) (addressing lay evidence as potentially competent to support presence of disability even where not corroborated by contemporaneous medical evidence). For the showing of a chronic disease in service there is required a 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 diagnosis including the word "chronic." Continuity of symptomatology is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. 3.303(b). Service connection for a hearing loss disability may be granted if the disability results from disease or injury incurred in or aggravated by service, or if a sensorineural- type hearing loss disability was demonstrated to a compensable degree within one year thereafter. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1131; 38 C.F.R. §§ 3.303, 3.307, 3.309. For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000 or 4000 hertz (Hz) is 40 decibels or greater; or when the auditory thresholds for at least three of frequencies 500, 1000, 2000, 3000 or 4000 Hz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. There is no specific statutory or regulatory guidance with regard to claims for service connection for asbestosis or other asbestos-related diseases. However, in 1988, VA issued a circular on asbestos-related diseases which provided guidelines for considering asbestos compensation claims. See Department of Veterans Benefits, Veterans Administration, DVB Circular 21-88-8, Asbestos-Related Diseases (May 11, 1988). The information and instructions contained in the DVB Circular have since been included in VA Adjudication Procedure Manual, M21-1, part VI, para. 7.21 (October 3, 1997) (hereinafter "M21-1"). Also, an opinion by VA's Office of General Counsel discussed the development of asbestos claims. VAOPGCPREC 4-00 (April 13, 2000). The Board notes that the aforementioned provisions of M21-1 have been rescinded and reissued as amended in a manual rewrite (MR) in 2005. See M21-1MR, Part IV, Subpart ii, Chap. 1, Sec. H, Para. 29, entitled "Developing Claims for Service Connection for Asbestos-Related Diseases," and Part IV, Subpart ii, Chap. 2, Sec. C, Para. 9, entitled "Service Connection for Disabilities Resulting from Exposure to Asbestos." VA must analyze the veteran's claim of entitlement to service connection for asbestosis under these administrative protocols using the following criteria. Ennis v. Brown, 4 Vet. App. 523, 527 (1993); McGinty v. Brown, 4 Vet. App. 428, 432 (1993). The latency period for asbestos-related diseases varies from 10 to 45 or more years between first exposure and development of disease. The exposure may have been direct or indirect, and the extent or duration of exposure is not a factor. M21-1MR, Part IV, Subpart ii, Chap. 1, Sec. H, Para. 29a. The manual provisions acknowledge that inhalation of asbestos fibers and/or particles can result in fibrosis and tumors, and produce pleural effusions and fibrosis, pleural plaques, mesotheliomas of the pleura and peritoneum, and cancer of the lung, gastrointestinal tract, larynx, pharynx and urogenital system (except the prostate), with the most common resulting disease being interstitial pulmonary fibrosis (asbestosis). Also noted is the increased risk of bronchial cancer in individuals who smoke cigarettes and have had prior asbestos exposure. As to occupational exposure, exposure to asbestos has been shown in insulation and shipyard workers, and others. The clinical diagnosis of asbestosis requires a history of exposure and radiographic evidence of parenchymal lung disease. M21-1MR, Part IV, Subpart ii, Chap. 2, Sec. C, Para. 9a-f. The manual further provides that VA must determine whether military records demonstrate evidence of asbestos exposure in service; whether there is pre-service and/or post-service evidence of occupational or other asbestos exposure; and then make a determination as to the relationship between asbestos exposure and the claimed diseases, keeping in mind the latency and exposure information pertinent to the veteran. M21-1MR, Part IV, Subpart ii, Chap. 2, Sec. C, Para. 9h. It is the Board's responsibility to evaluate the entire record on appeal. See 38 U.S.C.A. § 7104(a). When there is an approximate balance in the evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102. In Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the Court of Appeals for Veterans Claims held that an appellant need only demonstrate that there is an "approximate balance of positive and negative evidence" in order to prevail. The Court has also stated, "It is clear that to deny a claim on its merits, the evidence must preponderate against the claim." Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert. III. Factual background and analysis A. Increased evaluation for migraines Review of the veteran's service medical records (SMRs) records shows that he sustained a head injury in service in February 1985. He had a small hematoma, although he denied any loss of consciousness. He sustained another injury in April 1985, resulting in a deep laceration which bled profusely and caused varying levels of consciousness, from groggy to sleepy. However, his service separation examination, performed in October 1986, was silent as to any complaints or findings of headaches. A VA examination was conducted in February 2006. The veteran said he had suffered headaches since service. He denied any aura. He said that he had left-side headaches, with nausea, photophobia, and phonophobia. This would be relieved by lying down. He stated that the headaches would occur about two to three times a day and would last from 5 minutes to all day. Stress and fatigue would trigger these headaches. The objective examination found that he was not in any acute distress. The examination of the head was normocephalic and atraumatic. There was some tenderness over the right tempomandibular joint. He was found to have headaches that could be post-traumatic in nature. Pursuant to 38 C.F.R. Part 4, DC 8100 (2007), a 10 percent evaluation is warranted for migraine headaches with characteristic prostrating attacks averaging one in two months over the last several months. A noncompensable (zero percent) evaluation is assigned for headaches with less frequent attacks. After a careful review of the evidence of record, the Board finds that entitlement to a compensable evaluation for migraine headaches has not been established. The objective evidence of record does not indicate that the veteran has experienced characteristic prostrating attacks averaging one in two months over the last several months. In this regard, the Board notes that it is significant that the veteran has sought no treatment for any such prostrating attacks since his release from service. Therefore, the preponderance of the evidence is against the veteran's claim for a compensable evaluation for migraine headaches. B. Service connection 1. Viral syndrome/viral gastritis The veteran's SMRs show that on September 7, 1984, he complained of nausea and vomiting. His bowel sounds were normal, and there were no masses or organomegaly. He displayed tenderness over the entire abdomen, worse over the left lower quadrant. The assessment was food poisoning versus viral gastritis. On August 13, 1985, he presented with complaints of nausea, vomiting, and stomach cramps which he said had been present for one and one-half weeks. The abdomen was soft and tender along the left upper quadrant, with no guarding. Bowel sounds were present, and there was no organomegaly. The clinical assessment was "rule out" dehydration. By the following day, this condition was resolving. On August 22, 1985, a viral syndrome was diagnosed based on his complaints of nausea and vomiting; this had been accompanied by a brief syncopal episode. Bowel sounds were normal, and the abdomen was soft and nontender, with no rebound. At the time of the October 1986 separation examination, the abdomen was within normal limits. VA outpatient treatment records developed between 2004 and 2007 show the veteran's report that ingesting milk caused diarrhea. In October 2004, his abdomen was soft, nontender, and without masses. In October 2005, he complained of nausea and vomiting of six weeks duration. However, the veteran abruptly ended the clinical interview, and no physical examination was conducted. No further complaints were made or are documented in the record. Upon careful review of the evidence of record, it is found that service connection for a viral syndrome/viral gastritis has not been established. The SMRs do show complaints of viral illnesses in service, but there is no indication that those complaints resulted in the development of a chronic disorder. This conclusion is supported by the normal separation examination of 1986 and the subsequent silence of the evidentiary record between 1986 and 2004. While he had complained of nausea and vomiting in 2005, he left before an examination could be conducted. In summary, there is no objective evidence that suggests a connection between any current complaint and the remote, acute illnesses which were treated during service. As a result, service connection cannot be awarded. 2. Lymphadenopathy and swollen glands The veteran's SMRs demonstrate that he was seen on November 11, 1983, with complaints of swollen glands. He was diagnosed with pharyngitis. In September 1984, at the time that he complained of nausea and vomiting, he was found to have mild lymphadenopathy. The October 1986 separation examination was negative. The post-service VA treatment records noted that, during a May to June 1994 stay at a domiciliary facility and in October 2004 clinical notes, the veteran was noted to have no lymphadenopathy. After a careful review of the evidence of record, the Board finds that service connection for lymphadenopathy has not been established. While lymphadenopathy related to viral illnesses was noted in service, there is no indication that these complaints resulted in the development of a chronic disability. This finding is supported by the silence of the October 1986 separation examination and the normal treatment records developed since his release from service. There is simply no evidence that the veteran has any current disability that could be related to the remote and acute episodes of lymphadenopathy noted in service. 3. Chest disability The service medical records show that the veteran had a brief syncopal episode in August 1985, related to a viral illness. However, no disorder of the chest was noted. The October 1986 separation examination was within normal limits. The post-service treatment records are all silent as to any chest disability. In 1994 and in 2004, his respiration was normal and chest X-rays were negative. After careful review of the evidence of record, it is found that service connection for a chest disability is not established. There is no suggestion in the record before the Board that the veteran had any disorder of the chest in service, and no indication that such a disorder currently exists. Therefore, there is no basis for an award of service connection. 4. Stress, emotional problems, depression The veteran's SMRs are completely negative for any complaints of or treatment for any psychiatric complaints. The April 1983 entrance examination and the October 1986 separation examination were entirely normal. Post-service treatment records from VA show extensive treatment for polysubstance abuse, mainly identified as cocaine and marijuana. He was noted to have feelings of guilt, depression, and anxiety. In January 2006, the diagnoses were anxiety, depression, and a drug-induced mood disorder. VA examined the veteran in February 2006. He was found to have a history of memory problems and sleep disturbances, which the examiner felt could be related to either an underlying psychiatric disorder or to his drug abuse. A VA outpatient treatment record from February 2006 noted that he had a history of significant polysubstance abuse. He was taking medication for the treatment of depression and nightmares. His mood was less depressed, and there was an improvement in his feelings of guilt and helplessness. The mental status examination found that his mood was better, but that his affect was dysphoric and irritated. There were no delusions or hallucinations. The Axis I diagnoses were polysubstance abuse in early remission and minor depression. Upon careful review of the evidence of record, the Board finds that service connection for stress, emotional problems, and depression has not been established. While the veteran has recently been diagnosed with anxiety and depression, there is no indication that these disorders were present in service. There is also no suggestion in the record that these disorders are in any way related to his remote period of service. Therefore, service connection cannot be awarded. 5. Skin rashes The veteran's service medical records do not show that he had any skin rashes in service. The April 1983 entrance examination and the October 1986 separation examination both showed that his skin was normal. The post-service treatment records show that in 2005, VA placed him on Citalpram. He subsequently developed a rash in the bilateral groin area, diagnosed as tinea. After carefully reviewing the evidence of record, the Board finds that entitlement to service connection for skin rashes has not been established. Initially, there is no indication that the veteran had any rashes in service to which his recent groin rash could be attributed. He has also asserte, however, that the claimed rash is related to in-service exposure to asbestos. The record indicates that the veteran served in the Navy as a fireman and in the boiler room of various vessels. This type of service would make it probable that he was exposed to asbestos in service. However, there is no suggestion in the medical evidence of record that any recently diagnosed tinea is causally or etiologically related to such exposure. To the contrary, this rash has been related to medication that he was taking; this medication was discontinued and there was no further mention of any rash. Therefore, there is no basis upon which to award service connection. 6. Residuals of dehydration The SMRs demonstrate that the veteran was seen on August 13, 1985, with complaints of nausea and vomiting. He stated that his lips felt dry. The examiner noted that his lips and mouth were moist. He had a slight decrease in urinary output. The assessment was "rule out" dehydration. The following day, the assessment was "rule out" resolving dehydration. His October 1986 separation examination was within normal limits. The post-service records do not reflect any treatment for any residual disabilities that have been related to dehydration. After careful review of the evidence of record, it is found that service connection for residuals of dehydration has not been established. While the veteran was treated on one occasion for suspected dehydration in service, there is no suggestion in the record that this acute and remote incident resulted in any chronic residual disability. This conclusion is supported by the normal separation examination and the silence of the post-service treatment records. As a consequence, service connection cannot be awarded. 7. Urinary trouble As noted above, in August 1985, the veteran was noted to have had a slight decrease in urinary output that was related to suspected dehydration. His October 1986 separation examination was negative. In May and June 1994, the veteran was admitted to a domiciliary facility for the treatment of drug abuse. He was noted to have had a urinary tract infection. In September 2004, he denied any genitourinary problems. Upon careful review of the evidence of record, it is determined that service connection for urinary trouble has not been established. The Board acknowledges that the veteran did have a slight decrease in urinary output in service; however, this had been related to an acute episode of dehydration and not to any underlying urinary disorder or disease. In addition, the post-service treatment records also do not demonstrate that the veteran has been diagnosed with any underlying urinary disability. Based upon this evidence, service connection cannot be awarded. 8. Blurred vision The veteran's service medical records include the April 1983 entrance examination, an October 1983 examination, and the October 1986 separation examination. These all showed normal bilateral visual acuity. VA treatment records developed after service do not show any complaints of or treatment for blurred vision. At the time of the February 2006 VA examination, his visual fields were noted to be full to confrontation. His eyes were equal and reactive to light, and the extraocular measurements were full. After a careful review of the evidence of record, the Board finds that service connection for blurred vision has not been established. There is no indication in either the service medical records or the post-service treatment records that any disability of the eyes, to include blurred vision, has been diagnosed. As a consequence, service connection is not justified. 9. Breathing trouble The SMRs are completely silent as to any complaints of or treatment for breathing problems. The April 1983 entrance examination and the October 1986 separation examination noted that his respiratory system was within normal limits. The post-service VA treatment records demonstrate this his lungs were normal during a May to June 1994 Domiciliary stay. A chest X-ray was negative. These records did show that he was provided prophylactic treatment following a positive tuberculosis test in the mid-1990's; however, there were no other lung problems noted. In October 2004, his respiratory system was normal. After a careful review of the evidence of record, it is determined that service connection for breathing problems has not been established. Initially, there is no suggestion that any breathing disorder was present in service. Nor is there any indication of any currently diagnosed breathing disorder. The Board notes that the veteran has contended that he has lung problems due to exposure to asbestos in service. As noted above, it is probable, given the nature of his service, that he was exposed to asbestos in service. However, there is no indication of the presence of asbestosis or of any other lung disorders that have been either causally or etiologically related to such exposure. Therefore, it is concluded that service connection cannot be awarded based upon this evidence. 10. Hearing loss Numerous audiological examinations were conducted during the veteran's period of service. On the authorized audiological evaluation conducted as part of the April 1983 entrance examination, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 10 5 5 10 20 LEFT 5 10 0 15 15 On the authorized audiological evaluation in October 1983, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 30 10 0 10 15 LEFT 20 15 0 10 10 On the authorized audiological evaluation in December 1985, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 10 15 15 30 10 LEFT 50 25 10 25 10 On the authorized audiological evaluation in March 1986, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 10 15 10 15 5 LEFT 20 10 10 10 10 On the authorized audiological evaluation conducted as part of the October 1986 separation examination, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 25 15 10 10 0 LEFT 20 25 10 10 10 The post-service records make no mention of any hearing deficit. This was specifically noted during a May to June 1994 Domiciliary stay. In 2004, his ears were noted to be normal, and no hearing loss was complained of. After careful review of the evidence of record, it is found that service connection for a bilateral hearing loss disability has not been established. There is no suggestion in the record that any hearing deficit was noted either in service or in the post-service treatment records. Therefore, there is no hearing loss disability that could be related to his period of service. Therefore, service connection cannot be granted. It is true that the veteran's lay statements may be competent to support the claims for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C.A. § 1153(a); 38 C.F.R. §§ 3.159, 3.303(a); Jandreau; Buchanan, supra. In the instant case, however, the evidence of record does not demonstrate that the veteran, who is competent to comment on his post-service symptoms, has the requisite expertise to render a medical diagnosis or to comment on a question of medical causation or aggravation. While the veteran's various contentions have been carefully and sympathetically considered, these contentions are outweighed by the absence of any medical evidence to support the veteran's claims. Therefore, the preponderance of the evidence is against the claims for service connection, and, therefore, the benefit-of-the-doubt doctrine does not apply. 38 U.S.C.A. § 5107(b); 38 C.F.R. §§ 3.102, 3.303; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). ORDER Entitlement to an initial compensable evaluation for migraine headaches is denied. Entitlement to service connection for a viral syndrome/viral gastritis is denied. Entitlement to service connection for lymphadenopathy and swollen glands is denied. Entitlement to service connection for a chest disability is denied. Entitlement to service connection for stress, emotional problems, and depression is denied. [Continued on Next Page] Entitlement to service connection for rashes, to include as due to asbestos exposure, is denied. Entitlement to service connection for dehydration is denied. Entitlement to service connection for urinary trouble is denied. Entitlement to service connection for blurred vision is denied. Entitlement to service connection for trouble breathing, to include as due to asbestos exposure, is denied. Entitlement to service connection for a hearing loss disability is denied. _________________________________ ANDREW J. MULLEN Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs