Citation Nr: 0812553 Decision Date: 04/15/08 Archive Date: 05/01/08 DOCKET NO. 06-10 029 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Chicago, Illinois THE ISSUES 1. Entitlement to service connection for a low back disorder. 2. Entitlement to service connection for left leg disorder, to include as secondary to a low back disorder. 3. Entitlement to service connection for a lung disorder, to include as due to asbestos exposure. 4. Entitlement to service connection for hypertension, to include as secondary to a lung disorder and asbestos exposure. 5. Entitlement to service connection for a heart disorder, to include as secondary to a lung disorder and asbestos exposure. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESSES AT HEARING ON APPEAL Appellant, M. G. ATTORNEY FOR THE BOARD David S. Ames, Associate Counsel INTRODUCTION The veteran served on active duty from July 1951 to July 1955. This matter comes properly before the Board of Veterans' Appeals (Board) on appeal from a rating decision by the Department of Veterans Affairs (VA) Regional Office in Chicago, Illinois (RO). This case was remanded by the Board in April 2007 for additional development. FINDINGS OF FACT 1. The medical evidence of record does not show that the veteran's currently diagnosed low back disorder is related to military service. 2. The medical evidence of record does not show that the veteran's currently diagnosed left leg disorder is related to military service or to a service-connected disability. 3. The medical evidence of record does not show that the veteran's currently diagnosed lung disorder is related to military service, to include as due to asbestos exposure. 4. The medical evidence of record does not show that the veteran's currently diagnosed hypertension is related to military service, to include as due to asbestos exposure, or to a service-connected disability. 5. The medical evidence of record does not show that the veteran's currently diagnosed heart disorder is related to military service, to include as due to asbestos exposure, or to a service-connected disability. CONCLUSIONS OF LAW 1. A low back disorder was not incurred in, or aggravated by, active military service. 38 U.S.C.A. §§ 1110, 1131, 5103A, 5107 (West 2002); 38 C.F.R. § 3.303 (2007). 2. A left leg disorder was not incurred in, or aggravated by, active military service, nor is it proximately due to, or aggravated by, a service-connected disability. 38 U.S.C.A. §§ 1110, 1131, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.303, 3.310 (2007). 3. A lung disorder, was not incurred in, or aggravated by, active military service, to include as due to asbestos exposure. 38 U.S.C.A. §§ 1110, 1131, 5103A, 5107 (West 2002); 38 C.F.R. § 3.303 (2007). 4. Hypertension was not incurred in, or aggravated by, active military service, to include as due to asbestos exposure, nor is it proximately due to, or aggravated by, a service-connected disability. 38 U.S.C.A. §§ 1110, 1131, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310 (2007). 5. A heart disorder was not incurred in, or aggravated by, active military service, to include as due to asbestos exposure, nor is it proximately due to, or aggravated by, a service-connected disability. 38 U.S.C.A. §§ 1110, 1131, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS With respect to the veteran's claims, VA has met all statutory and regulatory notice and duty to assist provisions. See 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126 (West 2002 & Supp. 2006); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326 (2007). Prior to initial adjudication, letters dated in May 2004 and September 2004 satisfied the duty to notify provisions. An additional letter was also provided to the veteran in April 2007, after which the claims were readjudicated. See 38 C.F.R. § 3.159(b)(1); Overton v. Nicholson, 20 Vet. App. 427 (2006); see also Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). The veteran's service medical records, VA medical treatment records, and indicated private medical records have been obtained. VA examinations were provided to the veteran in connection with his claims. There is no indication in the record that additional evidence relevant to the issues decided herein is available and not part of the claims file. As there is no indication that any failure on the part of VA to provide additional notice or assistance reasonably affects the outcome of this case, the Board finds that any such failure is harmless. See Mayfield v. Nicholson, 20 Vet. App. 537 (2006); see also Dingess/Hartman, 19 Vet. App. 473. Further, 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, to include the opportunity to present pertinent evidence. Generally, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303(a). In addition, service connection may be granted for any disease diagnosed after discharge, when all the evidence including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In order to establish service connection for the claimed disorders, there must be (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 current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999). Service connection may be established on a secondary basis for a disability which is shown to be proximately due to or the result of a service connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) caused by a service connected disability or (b) aggravated by a service connected disability. Id.; Allen v. Brown, 7 Vet. App. 439, 488 (1995) (en banc). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. See Baldwin v. West, 13 Vet. App. 1, 8 (1999). Alternatively, under 38 C.F.R. § 3.303(b), service connection may be awarded for a "chronic" condition when (1) a chronic disease manifests itself and is identified as such in service, or within the presumptive period under 38 C.F.R. § 3.307, and the veteran presently has the same condition; or (2) a disease manifests itself during service, or during the presumptive period, but is not identified until later, and there is a showing of continuity of related symptomatology after discharge, and medical evidence relates that symptomatology to the veteran's present condition. Savage v. Gober, 10 Vet. App. 488, 495-98 (1997). For certain chronic disorders, including cardiovascular-renal disease and hypertension, service connection may be granted if the disease becomes manifest to a compensable degree within one year following separation from service. 38 U.S.C.A. §§ 1101, 1112, 1113 (West 2002); 38 C.F.R. §§ 3.307, 3.309. Low Back Disorder The veteran's service medical records show that he was treated in sick call with a complaint of a sore back in January 1953. He was treated with heat lamps and returned to duty. After separation from military service, a November 1993 VA x- ray examination report gave an impression of degenerative changes in the visualized thoracic spine and the lumbosacral spine. The medical evidence of record shows that various low back disorders have been consistently diagnosed since November 1993. An October 1998 VA outpatient medical report stated that the veteran's low back disorder was secondary to spinal stenosis. A December 1999 letter from a private physician stated that the veteran had a 1 month history of "rather severe left sided sciatica and an L5 radiculopathy. A recent [magnetic resonance imaging scan] shows an extruded disc fragment on that side." January 2000 and November 2000 VA outpatient medical reports, indicate that the veteran complained of back pain for the previous 20 years. In a November 2004 private back and neck pain history report, the veteran stated that he was injured on November 4, 1999 and his symptoms began on November 6, 1999. He stated that his current pain had existed for months and that he had experienced trouble with his neck, back, or legs for years. The veteran stated that he had experienced significant back problems prior to the current injury. He reported that in November 1999, he was unloading a cargo trailer when he tripped and fell backwards. An August 2007 VA general medical examination report stated that the veteran's claims file had been reviewed. After a review of the veteran's medical history and a physical examination, the examiner opined that the veteran's back disorder was not caused by or a result of military service. The examiner stated that the [v]eteran was asked whether he had back pain in the military. He stated that he had back pain in the military but did not seek medical care. Veteran did NOT offer history today that he injured [his] back when he fell on the deck while loading ammunition. In review of the military sick call treatment records, the veteran was seen on [January 22, 1953] for complaints of sore back, however I do not see any physician notes regarding the details o[r] circumstances for this condition. . . . Repeat [magnetic resonance imaging] in [February 2001] showed evidence of probably recurrent disc herniation at L4- 5 appeared to produce a mass effect [on] the thecal sac and L4 nerve root. This is likely the reason for the pain in the back and left leg today. . . . The x-ray also showed [diffuse idiopathic skeletal hyperostosis (DISH)]. This condition is seen in the aging population. DISH does not cause back pain and is unrelated to his radicular leg symptoms or claimed back injury in the military. The medical evidence of record does not show that the veteran's low back disorder is related to military service. Though the veteran complained of a sore back once during military service, no low back disorder was diagnosed at that time, nor was a chronic low back disorder shown in the remaining service medical records prior to service discharge. While the veteran has a current diagnosis of a low back disorder, there is no medical evidence of record that a low back disorder was diagnosed prior to November 1993, over 38 years after separation from military service. See Mense v. Derwinski, 1 Vet. App. 354, 356 (1991) (holding that VA did not err in denying service connection when the veteran failed to provide evidence which demonstrated continuity of symptomatology, and failed to account for the lengthy time period for which there is no clinical documentation of his low back condition). Furthermore, there is no medical evidence of record that relates the veteran's currently diagnosed low back disorder to military service. The only medical evidence of record that discusses the etiology of the veteran's low back disorder is the August 2007 VA general medical examination report, which found that the veteran's low back disorder was not related to military service. The veteran's statements alone are not sufficient to prove that his currently diagnosed low back disorder is related to military service. Medical diagnosis and causation involve questions that are beyond the range of common experience and common knowledge and require the special knowledge and experience of a trained physician. As he is not a physician, the veteran is not competent to make a determination that his currently diagnosed low back disorder is related to military service. Espiritu v. Derwinski, 2 Vet. App. 492, 495 (1992); Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). As such, there is no medical evidence of record that relates the veteran's currently diagnosed low back disorder to military service. Accordingly, service connection for a low back disorder is not warranted. In reaching this decision, the Board considered the doctrine of reasonable doubt. However, as there is no medical evidence of record that relates the veteran's currently diagnosed low back disorder to military service, the doctrine is not for application. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Left Leg Disorder The veteran's service medical records are negative for any complaints, symptoms, or diagnoses of a left lower extremity disorder. After separation from military service, in a March 2000 private medical report, the veteran complained of "a little leg discomfort." The medical evidence of record shows that a left leg disorder has been consistently noted or diagnosed since March 2000. In a May 2000 private medical report, the veteran complained of occasional pain radiation to the left leg. The examiner stated that "[t]he exact cause of his symptoms aren't clear." In a March 2002 VA outpatient medical report, the veteran complained of left leg pain and numbness. After physical examination, the assessment was failed back syndrome with neuropathic pain in the left leg. In a September 2002 VA outpatient medical report, the veteran complained of radiating left leg pain since a back operation 2 years before. After physical examination, the assessment was "chronic back pain due to failed back surgery syndrome and possibly S1 nerve root involvement." In a November 2002 VA outpatient medical report, the veteran complained of a history of left leg pain since a laminectomy 2 years before. After physical examination, the assessment was failed back surgery syndrome. In a March 2003 VA outpatient medical report, the veteran complained of a history of left leg pain since a laminectory 2 years before. After physical examination, the assessment was failed back surgery syndrome. A September 2003 VA outpatient medical report stated that the veteran had a history of left leg pain status post back surgery. The report stated that the pain had been present since the surgery 3 years before. In a February 2004 private medical report, the veteran reported that [h]e injured his left ankle when he was in the Navy [in] about 1953 and had surgery in the year 2000 . . . Since he had that surgery he has some numbness in his left foot by the toes and also has been subjected to intermittent swelling, especially worse towards the end of the day. . . . There is a very noticeable mass of bone both on the x-ray and with clinical palpation over the lateral malleolus. He received this injury in 1953 in the Navy when he slipped and fell from a ramp when he was loading ammunition. He has had this enlarged left lateral malleolus for all that time and it has not given him much trouble really, it just has been an enlargement that looks funny. In a February 2004 VA outpatient medical report, the veteran complained of left ankle pain and swelling since back surgery. The veteran reported that his left lateral malleolus had been enlarged "for years but was not painful." After physical examination, the assessment was failed back surgery syndrome. In a July 2004 VA outpatient medical report, the veteran complained of left leg pain for the previous 5 years. In an August 2004 VA outpatient medical report, the veteran complained of left leg pain. After physical examination, the assessment was chronic left lower extremity pain due to lumbar radiculopathy. A second August 2004 VA outpatient medical report stated that the veteran had a history of left lower extremity pain status post back surgery. After physical examination, the assessment was failed back surgery syndrome with exacerbation of pain. An August 2004 VA operative report stated that the veteran complained of left lower extremity pain. The preoperative and postoperative diagnoses were failed back surgery syndrome. An August 2007 VA general medical examination report stated that the veteran's claims file had been reviewed. After a review of the veteran's medical history and a physical examination, the examiner opined that the veteran's left leg disorder was not caused by or a result of military service. The examiner stated that [t]he veteran is claiming a LEFT lower fibula/ankle condition related to his milit[ar]y service. The veteran contends that he slipped on the deck while moving ammunition causing injury to the left fibula/ankle. He states that he spent several days in the sick bay. There are NO military medical records to verify this claim. The veteran states that he was seen several time[s] for the left distal leg condition during service. All of the military re[co]rds show that it was the RIGHT leg. The veteran states that the documentation was incorrect and that i[t] should have stated the LEFT leg. However, . . . most of the docu[me]ntation regards refere[nc]es to the right tibia/fibula fracture or right tibia callous and its effects which would make it seem that the correct leg was documented in the chart. The site of heterotropic bone formation is at the distal LEFT fibula. There are NO references in any physician military records regarding the claimed LEFT leg injury. The x[-]rays taken in the military are only of the RIGHT leg demonstrating the prior fracture of the tibia and fibula. There were no x[-]rays taken of the LEFT leg. . . . The x-rays taken today at the VA confirm the prior RIGHT leg fibula/tibia fracture. Due to the lack of evidence showing injury to the LEFT leg during his military service, I can not confirm the veteran's claimed injury to the LEFT leg fibula/ankle region as a result of his military service. The medical evidence of record does not show that the veteran's left leg disorder is related to military service or to a service-connected disability. The veteran has repeatedly stated that he experienced, and was treated for, a left leg injury during military service. However, his service medical records show repeated treatment for right leg complaints, not left leg complaints. The veteran claims that these reports erroneously identified the wrong leg. However, this contention is not substantiated by the evidence of record. The veteran's service medical records include many separate reports of right leg disorders on different dates and by different examiners throughout the course of the veteran's military service. It is unlikely that all of these examiners made the same error in each medical report, including x-ray examinations of the wrong leg. Furthermore, the veteran himself stated that he had experienced a broken leg prior to military service on his July 1951 report of medical history. This is consistent with a February 1954 medical report in which the veteran stated that he experienced a right leg fracture in 1949 after being run over by a truck. Furthermore, the medical evidence of record shows that post-service x-ray examinations have confirmed an old right leg fracture. Accordingly, the medical evidence of record shows that the service medical records were not erroneous in their identification of the right leg. As such, the veteran's service medical records are negative for any complaints, symptoms, or diagnoses of a left leg disorder. While the veteran has a current diagnosis of a left leg disorder, there is no medical evidence of record that it was diagnosed prior to March 2000, approximately 45 years after separation from military service. See Mense, 1 Vet. App. at 356. Furthermore, there is no competent medical evidence of record that relates the veteran's currently diagnosed left leg disorder to military service or to a service-connected disability. While a February 2004 private medical report stated that the veteran's left leg disorder was incurred during military service, these statements were based upon the veteran's reported history. See Elkins v. Brown, 5 Vet. App. 474, 478 (1993). Such evidence cannot enjoy the presumption of truthfulness, because a medical professional is not competent to opine as to matters outside the scope of his or her expertise, and a bare transcription of a lay history is not transformed into "competent medical evidence" merely because the transcriber happens to be a medical professional. See Layno v. Brown, 6 Vet. App. 465, 469 (1994) ("in order for any testimony to be probative of any fact, the witness must be competent to testify as to the facts under consideration"). The United States Court of Appeals for Veterans Claims has held that medical professionals are not competent to transform a lay history, unenhanced by medical comment, into competent medical evidence based on their status as medical professionals. LeShore v. Brown, 8 Vet. App. 406 (1995). Furthermore, as noted above, the veteran's service medical records show that the veteran experienced right leg symptoms during military service, not left leg symptoms. Accordingly, the February 2004 private medical report is not competent to show that the veteran's currently diagnosed left leg disorder is related to military service. In contrast, the August 2007 VA general medical examination report found that the veteran's left leg disorder was not related to military service based on the evidence of record. In addition, the medical evidence of record clearly shows that the veteran's left leg disorder is directly related to a failed back surgery in 2000. However, as noted above, service connection for a back disorder has been denied. Accordingly, the medical evidence of record does not show that the veteran's currently diagnosed left leg disorder is related to a service-connected disability. The veteran's statements alone are not sufficient to prove that his currently diagnosed left leg disorder is related to military service or to a service-connected disability. Espiritu, 2 Vet. App. at 495; Grottveit, 5 Vet. App. at 93. Accordingly, there is no competent medical evidence of record that relates the veteran's currently diagnosed left leg disorder to military service or to a service-connected disability. As such, service connection for a left leg disorder is not warranted. In reaching this decision, the Board considered the doctrine of reasonable doubt. However, as there is no competent medical evidence of record that relates the veteran's currently diagnosed left leg disorder to military service or to a service-connected disability, the doctrine is not for application. Gilbert, 1 Vet. App. 49. Lung Disorder VA has issued certain procedures on asbestos-related diseases which provide guidelines for use in the consideration of compensation claims based on exposure to asbestos. See VA Adjudication Procedure Manual, M21-1 MR, Part IV, Subpart ii, Chapter 2, Section C, para. 9 (September 29, 2006); see also McGinty v. Brown, 4 Vet. App. 428, 432 (1993). The aforementioned manual notes that the inhalation of asbestos fibers can produce fibrosis and tumors, with interstitial pulmonary fibrosis (asbestosis) being the most common disease. A clinical diagnosis of asbestosis requires a history of exposure and radiographic evidence of parenchymal lung disease. Symptoms and signs include dyspnea, end-respiratory rales over the lower lobes, compensatory emphysema, clubbing of the fingers at the late stages; and pulmonary function impairment and cor pulmonale which can be demonstrated by instrumental methods. Asbestos fibers may also produce pleural effusions and fibrosis, pleural plaques, mesotheliomas of the pleura and peritoneum, lung cancer, and cancers of the gastrointestinal tract. Cancers of the larynx and pharynx, as well as the urogenital system (except the prostate) are also associated with asbestos exposure. Persons with asbestos exposure have an increased incidence of bronchial, lung, pharyngolaryngeal, gastrointestinal, and urogenital cancer. Moreover, the risk of developing bronchial cancer is increased in current cigarette smokers who have had asbestos exposure. The veteran's service medical records are negative for any complaints, symptoms, or diagnoses of a lung disorder. After separation from military service, a March 1993 VA outpatient medical report stated that the veteran had previously had an upper respiratory infection and complained of shortness of breath. On physical examination, the veteran had a right-sided wheeze on inspiration. A March 1993 VA x- ray examination report stated that after views of the veteran's chest, the impression was elevation of the left hemidiaphragm with an associated atelectasis in the left base. The medical evidence of record shows that a lung disorder has been consistently diagnosed since March 1993. An April 1997 VA computed tomography (CT) examination report stated that the veteran had a history of chronic left chest pain. On x-ray examination, opacification in the left lower lobe was seen. After CT examination, the impression was "nodule in superior segment of lingual, etiology uncertain." An August 1998 VA CT examination report stated that the veteran had a history of asbestos exposure and smoking with a chronic elevated left hemidiaphragm. On observation, no changes were noted in a left lower lobe abnormality which "looks more like atelectasis than nodule." An August 1999 VA medical report stated that the veteran complained of atypical chest pain and increasing shortness of breath over the previous 6 to 12 months. The report stated that the veteran's "past medical history revealed calcified mediastinal nodes due to previous asbestos exposure." In a July 2004 VA general medical examination report, the veteran complained of a lack of energy, morning sputum production, and shortness of breath. He reported that he smoked from age 20 to age 34 and continued chewing tobacco from age 34 until 2 weeks prior to the examination. The veteran reported being exposed to asbestos during military service, as well as after service while working at a gas station. On x-ray examination, the veteran had an elevation of the left hemidiaphragm and a blunting of the left costophrenic angle, either representing mild pleural effusion or pleural thickening. No asbestos plaques were identified. The impression was mild shortness of breath with no evidence of asbestosis. A March 2005 VA medical examination report stated that the veteran's claims file had been reviewed. The veteran reported that he was exposed to asbestos during military service and after separation from military service. He reported that he smoked from age 15 to age 44. After physical examination, the impression was no evidence of asbestosis and obstructive lung disease. An August 2007 VA general medical examination report stated that the veteran's claims file had been reviewed. The veteran reported exposure to asbestos and lead during military service. He reported that he smoked from age 15 to age 44 and continued to chew tobacco. After a review of the veteran's medical history and a physical examination, the examiner stated that [t]he veteran reports exposure to asbestosis and lead in the military. Because the lead exposure was [over] 50 years, ago, lead levels were not obtained as lead levels in blood will be positive with recent exposure and not remote exposure. Hair and other tissue sampling evaluating for lead exposure are not reliable and not recommended for testing. The veteran does not demonstrate residual lead effects from his history or physical examination, therefore although he may have had lead exposure, I can not say that he is suffering from this condition currently. He did not have sy[m]ptoms of acute lead exposure when I reviewed his medical records. Therefore even if he was exposed to lead through the paint, it does not appear that he suffered any permanent effects. . . . Will refer to pulmonology to clarify whether the [veteran] has asbestos related lung disease. A September 2007 VA pulmonary examination report stated that the veteran had a history of asbestos exposure and abnormal CT findings. After physical examination, the impression was there is a small area of pleural calcification on the left lower posterior pleura; cannot exclude asbestos as a cause but this would be unlikely given that the changes are unilateral, small, paucity of symptoms, and could possibly [be] related to his previous [history] of [motor vehicle accident] with chest trauma. A September 2007 VA medical noted dated the next day stated that "[a]fter referral to pulmonol[o]gy and review of the CT scan there is NO EVIDENCE at this time to suggest a diagnosis of asbestosis." The medical evidence of record does not show that the veteran's currently diagnosed lung disorder is related to military service, to include as due to asbestos exposure. The veteran's service medical records are negative for any diagnosis of a lung disorder. While the veteran has a current diagnosis of a lung disorder, there is no medical evidence of record that it was diagnosed prior to March 1993, approximately 38 years after separation from military service. See Mense, 1 Vet. App. at 356. Furthermore, the preponderance of the medical evidence of record does not show that the veteran's currently diagnosed lung disorder is related to military service, to include as due to asbestos exposure. While the August 1999 VA medical report stated that the veteran had a lung disorder which was related to previous asbestos exposure, subsequent medical reports dated in July 2004, March 2005, and September 2007 stated that the veteran did not have a lung disorder that was related to asbestos exposure. In addition, there is no medical evidence of record that relates the veteran's lung disorder to military service in any other manner. The veteran's statements alone are not sufficient to prove that his currently diagnosed lung disorder is related to military service, to include as due to asbestos exposure. Espiritu, 2 Vet. App. at 495; Grottveit, 5 Vet. App. at 93. Accordingly, the preponderance of the medical evidence of record does not show that the veteran's currently diagnosed lung disorder is related to military service, to include as due to asbestos exposure. As such, service connection for a lung disorder is not warranted. In reaching this decision, the Board considered the doctrine of reasonable doubt. However, as the preponderance of the evidence is against the veteran's claim, the doctrine is not for application. Gilbert, 1 Vet. App. 49. Hypertension and Heart Disorder The veteran's service medical records are negative for any diagnosis of hypertension or a heart disorder. After separation from military service, a March 1993 VA x-ray examination report stated that the veteran had a history of hypertension. The medical evidence of record shows that hypertension has been consistently diagnosed since March 1993. An April 1997 VA outpatient medical report stated that the veteran had a previous medical history of coronary artery disease (CAD) status post percutaneous transluminal coronary angioplasty in 1989. The report also stated that the veteran had a medical history of hypertension for the previous 20 to 25 years and had a history of a myocardial infarction 20 years before. After physical examination, the assessment was history of CAD with systemic chest pain. The medical evidence of record shows that heart disorders have been consistently diagnosed since April 1997. A March 2005 VA medical examination report stated that the veteran's claims file had been reviewed. The veteran reported that he had a myocardial infarction in 1982 and received a diagnosis of hypertension in 1990. After physical examination, the impression was essential hypertension and CAD. The examiner stated that "[i]t is less likely as not that the veteran's essential hypertension nor his [CAD] are a complication of asbestos exposure." The medical evidence of record does not show that the veteran's currently diagnosed hypertension and heart disorder are related to military service, to include as due to asbestos exposure, or to a service-connected disability. The veteran's service medical records are negative for any diagnosis of hypertension or a heart disorder. Though the veteran has current diagnoses of hypertension and a heart disorder, there is no medical evidence of record that they were diagnosed prior to 1990 and 1982, respectively, which is approximately 35 and 27 years after separation from military service, respectively. See Mense, 1 Vet. App. at 356. In addition, there is no medical evidence of record that relates the veteran's currently diagnosed hypertension and heart disorder to military service or to a service-connected disability. The only medical evidence of record that discusses the etiology of the veteran's currently diagnosed hypertension and heart disorder is the March 2005 VA medical examination report, which stated that these disorders were not related to asbestos exposure. Furthermore, while the veteran claims these disorders are related to his currently diagnosed lung disorder, as noted above, service connection has not been established for a lung disorder. The veteran's statements alone are not sufficient to prove that his currently diagnosed hypertension and heart disorder are related to military service, to include as due to asbestos exposure, or to a service-connected disability. Espiritu, 2 Vet. App. at 495; Grottveit, 5 Vet. App. at 93. Accordingly, there is no medical evidence of record that relates the veteran's currently diagnosed hypertension and heart disorder to military service, to include as due to asbestos exposure, or to a service-connected disability. As such, service connection for hypertension and a heart disorder is not warranted. In reaching this decision, the Board considered the doctrine of reasonable doubt. However, as there is no medical evidence of record that relates the veteran's currently diagnosed hypertension and heart disorder to military service, to include as due to asbestos exposure, or to a service-connected disability, the doctrine is not for application. Gilbert, 1 Vet. App. 49. ORDER Service connection for a low back disorder is denied. Service connection for left leg disorder, to include as secondary to a low back disorder, is denied. Service connection for a lung disorder, to include as due to asbestos exposure, is denied. Service connection for hypertension, to include as due to asbestos exposure and as secondary to a lung disorder, is denied. Service connection for a heart disorder, to include as due to asbestos exposure and as secondary to a lung disorder, is denied. ____________________________________________ JOY A. MCDONALD Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs