Citation Nr: 0814791 Decision Date: 05/05/08 Archive Date: 05/12/08 DOCKET NO. 05-39 410 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Roanoke, Virginia THE ISSUES 1. Whether the character of the veteran's discharge from his period of service from December 13, 1989 to November 9, 1993 is a bar to certain VA benefits, to include compensation. 2. Entitlement to service connection for costochondritis. 3. Entitlement to service connection for irritable bowel syndrome (IBS). 4. Entitlement to service connection for arthritis of the right knee. 5. Entitlement to service connection for a left knee disability, to include arthritis and patellar femoral syndrome. ATTORNEY FOR THE BOARD M. Donovan, Associate Counsel INTRODUCTION The veteran had honorable military service in August 1981 and from March 1982 to December 12, 1989. He had a period of military service from December 13, 1989 to November 9, 1993 from which he was discharged under other than honorable conditions. This appeal to the Board of Veterans' Appeals (Board) arose from a July 2003 administrative decision and a January 2004 rating decision. In the July 2003 administrative decision, the RO found that the veteran's discharge for the period of service from March 25, 1990 to November 9, 1993 was considered to have been under dishonorable conditions for VA purposes and was a bar to VA benefits. In July 2003, the veteran filed a notice of disagreement (NOD) with this decision. In a September 2003 administrative decision, the RO found that there was clear and unmistakable error in the July 2003 administrative decision, and that the veteran's discharge for the period of service from December 13, 1989 to November 9, 1993 was considered to have been under dishonorable conditions for VA purposes and was a bar to VA benefits. In the January 2004 rating decision, the RO, inter alia, denied service connection for athlete's foot, IBS, arthritis in the knees, and costochondritis. The veteran filed an NOD with these denials of service connection in December 2004. A statement of the case (SOC) regarding the character of discharge for the period of service from December 13, 1989 to November 9, 1993 and the denials of entitlement to service connection was issued in November 2005, and the veteran filed a substantive appeal (via a VA Form 9, Appeal to the Board of Veterans' Appeals) in December 2005. In the current appeal, the veteran has consistently requested service connection for arthritis of the left knee, and the RO has consistently characterized the issue as entitlement to service connection for arthritis of the left knee. However, the Board notes that an August 2007 VA examination included a diagnosis of patellar femoral syndrome of the left knee. The RO considered this diagnosis, and the relationship between this knee condition and the veteran's military service in a February 2008 supplemental SOC (SSOC). Hence, the Board has characterized this claim as reflected on the title page. As the RO has already considered entitlement to service connection for a left knee disability, to include arthritis and patellar femoral syndrome (as reflected in the February 2008 SSOC) the veteran is not prejudiced by recharacterization of the issue in this manner. See Bernard v. Brown, 4 Vet. App. 384, 394 (1993). In a February 2008 rating decision, the RO, inter alia, granted service connection for tinea pedis (claimed as athlete's foot), evaluated as noncompensable, effective July 17, 2003. This rating decision constitutes a full grant of the benefit sought in connection with the claim for service connection. FINDINGS OF FACT 1. All notification and development actions needed to fairly adjudicate each claim on appeal have been accomplished. 2. In November 1993, the veteran was discharged under other than honorable conditions due to a civil conviction for felony offenses; there is no evidence or allegation of insanity at the time of commission of the felony offenses. 3. The competent medical evidence does not persuasively establish that the veteran has current costochondritis, and the only medical opinion to address the relationship between any current costochondritis and service weighs against the claim. 4. There is no competent medical evidence of a nexus between the veteran's current IBS and service. 5. There is no competent medical evidence that the veteran has current arthritis of the right knee. 6. There is no competent medical evidence of arthritis of the left knee and the only medical opinion to address the relationship between current patellar femoral syndrome and service weighs against the claim.. CONCLUSIONS OF LAW 1. The character of the veteran's November 1993 discharge is a bar to receiving certain VA benefits, to include compensation, for his period of service from December 13, 1989 to November 9, 1993. 38 U.S.C.A. §§ 101(2), 5303 (West 2002); 38 C.F.R. § 3.312(d) (2007). 2. The criteria for service connection for costochondritis are not met. 38 U.S.C.A. §§ 1131, 5103, 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2007). 3. The criteria for service connection for IBS are not met. 38 U.S.C.A. §§ 1131, 5103, 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2007). 4. The criteria for service connection for arthritis of the right knee are not met. 38 U.S.C.A. §§ 1112, 1113, 1131, 5103, 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2007). 5. The criteria for service connection for a left knee disability, to include arthritis and patellar femoral syndrome, are not met. 38 U.S.C.A. §§ 1112, 1113, 1131, 5103, 5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Duties to Notify and Assist The Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096 (Nov. 9, 2000) (codified at 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107, and 5126 (West 2002 & Supp. 2007)) includes enhanced duties to notify and assist claimants for VA benefits. VA regulations implementing the VCAA have been codified, as amended at 38 C.F.R. §§ 3.102, 3.156(a), 3.159, and 3.326(a) (2007). Notice requirements under the VCAA essentially require VA to notify a claimant of any evidence that is necessary to substantiate the claim(s), as well as the evidence that VA will attempt to obtain and which evidence he or she is responsible for providing. See, e.g., Quartuccio v. Principi, 16 Vet. App. 183 (2002) (addressing the duties imposed by 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b)). As delineated in Pelegrini v. Principi, 18 Vet. App. 112 (2004), after a substantially complete application for benefits is received, proper VCAA notice must inform the claimant of any information and evidence not of record (1) that is necessary to substantiate the claim(s); (2) that VA will seek to provide; (3) that the claimant is expected to provide; and (4) must ask the claimant to provide any evidence in her or his possession that pertains to the claim(s), in accordance with 38 C.F.R. § 3.159(b)(1). VA's notice requirements apply to all five elements of a service connection claim: veteran status, existence of a disability, a connection between the veteran's service and the disability, degree of disability, and effective date of the disability. Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). VCAA-compliant notice must be provided to a claimant before the initial unfavorable decision on a claim for VA benefits by the agency of original jurisdiction (in this case, the RO). Id.; Pelegrini, 18 Vet. App. at 112. See also Disabled American Veterans v. Secretary of Veterans Affairs, 327 F.3d 1339 (Fed. Cir. 2003). However, the VCAA notice requirements may, nonetheless, be satisfied if any errors in the timing or content of such notice are not prejudicial to the claimant. Id. Regarding the character of the veteran's discharge for his period of service from December 13, 1989 to November 9, 1993, a November 2002 pre-rating letter informed the veteran that anytime a veteran receives a discharge that is not "honorable," VA must decide if he is eligible for VA benefits. The letter added that, as long as VA decided that his service was not "dishonorable," he would still be eligible for VA benefits. The letter advised the veteran of evidence and information he should submit regarding his character of discharge, informed him where and when to send such information and evidence. Enclosed with the November 2002 letter was an excerpt from 38 C.F.R. § 3.12, regarding character of discharge. The July 2003 RO administrative decision reflects the initial adjudication of the claim regarding the veteran's character of discharge after issuance of the November 2002 letter. Regarding the claims for service connection, in an October 2002 pre-rating letter, the RO provided notice to the appellant regarding what information and evidence was needed to substantiate the claims for service connection for IBS and arthritis in the knees. A September 2003 pre-rating letter provided notice regarding what information and evidence was needed to substantiate the claim for service connection for costochondritis. A June 2006 post-rating letter provided notice regarding the information and evidence needed to substantiate the claims for service connection for costochondritis, IBS, arthritis of the right knee, and arthritis of the left knee. These letters also provided notice regarding what information and evidence must be submitted by the appellant, and what information and evidence would be obtained by VA. The June 2006 letter specifically informed the veteran to submit any evidence in his possession pertinent to the claims on appeal and provided the veteran with information pertaining to the assignment of disability ratings and effective dates, as well as the type of evidence that impacts those determinations, consistent with Dingess/Hartman. The January 2004 RO rating decision reflects the initial adjudication of the claims for service connection after issuance of the October 2002 and September 2003 letters. After issuance of the June 2006 letter, and opportunity for the veteran to respond, the February 2008 supplemental SOC (SSOC) reflects readjudication of the claims for service connection for costochondritis and arthritis of the left knee. Hence, the veteran is not shown to be prejudiced by the timing of the latter notice on these claims. See Mayfield v. Nicholson, 20 Vet. App. 537, 543 2006); see also Prickett v. Nicholson, 20 Vet. App. 370, 376 (2006) (the issuance of a fully compliant VCAA notification followed by readjudication of the claim, such as in an SOC or SSOC, is sufficient to cure a timing defect). Moreover, although the RO did not readjudicate the claims for service connection for IBS or arthritis of the right knee after issuance of the June 2006 letter, as no evidence was thereafter identified or submitted; hence, readjudication was not , The Board notes that the RO has not explicitly requested that the veteran furnish evidence in his possession; however, the claims file reflects that he has, in fact, submitted evidence in support of his claims. Given that fact, as well as the RO's instructions to him, the Board finds that the veteran is not prejudiced by the RO's omission in this regard. See Mayfield, 20 Vet. App. at 543 . The record also reflects that VA has made reasonable efforts to obtain or to assist in obtaining all relevant records pertinent to the claims on appeal. Pertinent medical evidence associated with the claims file consists of the veteran's service medical records, service personnel records, post-service records of treatment from the Virginia Department of Corrections, and the report of an August 2007 VA examination. Also of record and considered in connection with the appeal are various statements submitted by the veteran. The Board notes that no further development of the evidence is warranted in this appeal. In this regard, the Board has considered the veteran's assertions, advanced in both his NOD and substantive appeal, that he should be afforded VA examinations. While he was afforded a VA examination in August 2007, this examiner did not address the claims for service connection for IBS or arthritis of the right knee. The Board emphasizes, however, in this appeal, there is no medical evidence whatsoever to support these claims, particularly on the matters of whether the veteran has current IBS that had its onset in service, as alleged, or whether the veteran has current arthritis of the right knee. As the current record does not reflect even prima facie claims for service connection for IBS or arthritis of the right knee, VA is not required to obtain any medical opinion commenting upon the etiology of these claimed disabilities. See 38 U.S.C.A. § 5103A(d); Wells v. Principi, 326 F. 3d. 1381, 1384 (Fed. Cir. 2003). See also Duenas v. Principi, 18 Vet. App. 512 (2004) (per curium). In summary, the duties imposed by the VCAA have been considered and satisfied. Through various notices of the RO, the veteran has been notified and made aware of the evidence needed to substantiate these claims, the avenues through which he might obtain such evidence, and the allocation of responsibilities between himself and VA in obtaining such evidence. There is no additional notice that should be provided, nor is there any indication that there is additional existing evidence to obtain or development required to create any additional evidence to be considered in connection with any of the claims. Consequently, any error in the sequence of events or content of the notice is not shown to prejudice the veteran or to have any effect on the appeal. Any such error is deemed harmless and does not preclude appellate consideration of the claims, at this juncture. See Mayfield, 20 Vet. App. at 543. See also ATD Corp. v. Lydall, Inc., 159 F.3d 534, 549 (Fed. Cir. 1998). II. Character of Discharge The term "veteran" means a person who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable. See 38 C.F.R. § 3.1(d). If the former service member did not die in service, pension, compensation, or dependency and indemnity compensation is not payable unless the period of service on which the claim was based was terminated by a discharge or release under conditions other than dishonorable. See 38 U.S.C.A. § 101(2); 38 C.F.R. § 3.12. A discharge based on an offense involving moral turpitude is considered to have been issued under dishonorable conditions. An offense involving moral turpitude includes, generally, a felony. See 38 C.F.R. § 3.12(d)(3). A discharge or release from service under dishonorable conditions is a bar to the payment of benefits unless, however, it is found that the person was insane at the time of committing the offenses causing the discharge. See 38 C.F.R. § 3.12(b). In this case, the veteran had several periods of service. A outlined by a response from the National Personnel Records Center received in March 2003, the veteran enlisted on March 25, 1982 for four years, with a scheduled discharge date of March 24, 1986. He received an honorable discharge on December 12, 1985 and reenlisted on December 13, 1985 for four years, with a scheduled discharge date of December 12, 1989. He received an honorable discharge on June 29, 1989, and reenlisted for four years on June 30, 1989, with a scheduled discharge date of June 29, 1993. He received an other than honorable discharge on November 9, 1993. The veteran's service personnel records reflect that he was discharged in November 1993 by reason of misconduct due to civil conviction. A felony trial order from the Circuit Court of the City of Norfolk dated in October 1992 reflects that the veteran was found guilty of sodomy, rape, and statutory rape. In a December 2002 statement, the veteran indicated that he took full responsibility for his crime as he immediately plead guilty and was currently serving time. Given the evidence as outlined above, the Board finds that, during the period of service from December 13, 1989 to November 9, 1993, the veteran committed an offense involving moral turpitude, as reflected in the October 1992 felony trial order from the Circuit Court of the City of Norfolk. The veteran has not asserted, and the record does not reflect, that he was insane at the time of the offenses committed during this period of service. Rather, as indicated in his December 2002 statement, he took full responsibility for those offenses. The Board has considered the veteran's assertions, also made in his December 2002 statement, that his entire period of service was honorable, as reflected by his letters of commendation and appreciation and his performance evaluations. Despite the veteran's statement, the circumstances of service and entitlement are determined by the character of the final termination of such active service. See 38 C.F.R. § 3.13(b). A discharge to reenlist is a conditional discharge if it was issued during peacetime service prior to the date the person was eligible for an unconditional discharge. See 38 C.F.R. § 3.13(a); see also 38 U.S.C.A. § 101(18). Despite the fact that no unconditional discharge may have been issued, a person shall be considered to have been unconditionally discharged or released from active military, naval, or air service when (1) the person served in the active military, naval, or air service for the period of time the person was obligated to serve at the time of entry into service; (2) the person was not discharged or released from such service at the time of completing that period of obligation due to an intervening enlistment or reenlistment; and (3) the person would have been eligible for a discharge or release under conditions other than dishonorable at that time except for the intervening enlistment or reenlistment. See 38 C.F.R. § 3.13(c). In this case, as outlined above, the veteran's service included a four-year period of reenlistment which began on December 13, 1985. As such, his scheduled discharge date was December 12, 1989. He reenlisted on June 30, 1989, however, the June 29, 1989 discharge was a conditional discharge as it was a discharge to reenlist prior to the date the veteran was eligible for an unconditional discharge. Although no unconditional discharge was issued, the veteran was considered to have been unconditionally discharged on December 12, 1989, as the criteria outlined in 38 C.F.R. § 3.13(c) were met. As such, the RO properly found that the veteran's service prior to December 13, 1989 was honorable, but, in light of felonious offenses committed in 1992, his period of service from December 13, 1989 to November 9, 1993 was dishonorable. For all the foregoing reasons, the Board finds that the veteran's discharge from his period of service from December 13, 1989 to November 9, 1993 is considered to have been issued under dishonorable conditions. Because the discharge was not under conditions other than dishonorable, it serves as a bar to the receipt of certain VA benefits, to include compensation for disabilities incurred or aggravated during that period of service. See 38 C.F.R. § 3.12. III. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. § 1131; 38 C.F.R. § 3.303. Service connection may be granted for any disease diagnosed after discharge from service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Where a veteran served 90 days or more during a period of war or after December 31, 1946, and arthritis becomes manifest to a degree of l0 percent within 1 year from date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C.A. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. After a full review of the record, including the medical evidence and statements made by the veteran, the Board finds that all the claims for service connection must be denied. A. Costochondritis The veteran asserts that he has costochondritis that is related to service. Service medical records reflect complaints of chest pain in August 1987. The assessment was fit for PRT. The veteran again presented in June 1991 with complaints of chest pain, and the assessment was costochondritis. The Board notes, however, that this diagnosis of costochondritis is during the veteran's period of service from December 13, 1989 to November 9, 1993, and that the veteran has no legal entitlement to VA benefits based on disease or injury incurred during that period. The Board further notes, in any event, that, even if the veteran claimed service connection in connection with a period of honorable service, the claim for service connection for costochondritis must fail on the basis of current disability and/or nexus to service.. Records of post-service treatment from April 1993 to October 2002 are negative for complaints regarding or findings of costochondritis. In his July 2003 claim for service connection, the veteran reported that he was diagnosed with costochondritis in June 1991 and still had intermittent pains. He reported that he took Motrin quite often, and that coughing, sneezing, hard breathing, and anxiety brought about the pain. On VA examination in August 2007, the veteran described chest pain which lasted a few minutes and would then resolve. He indicated that he had undergone cardiac workups to rule out heart problems. The veteran added that, when he experienced the chest pain, by the time he was able to get to sick call, the pain had subsided. The veteran described the pain as occasional and located between the 3rd and 4th rib. He reported that the pain had centralized more over the past year towards the mid-sternum, and added that, at times, the pain was so bad it could take his breath away. On examination, the veteran was having no chest pain with movement and breathing. There was no chest tightness. The veteran had mild complaints of pain on deep palpation over the second through fifth costal cartilage, but the examiner indicated that these complaints were not significant enough for a diagnosis. Chest X-ray revealed that the lungs were clear, heart size was normal, and regional bones were unremarkable. With respect to costochondritis, the examiner was no pathology to render a diagnosis; none found on examination. The examiner opined that it was less likely than not that the veteran's current costochondritis was related to his chest pain while in the military. The stated rationale for the opinion was that the costochondritis was self-limiting and that the veteran's original complaints were after running, but that no diagnosis was officially made. The examiner added that, in the rare instances that one has reoccurring costochondritis, one does not have long periods between attacks, rather, such individuals are often hospitalized and have to remain on medication for long periods of time. The veteran's complaints of pain, however, were sharp but not long lasting. In this case, the Board finds that the competent medical evidence does not clearly support a finding of current costochondritis. Notwithstanding the evidence of current complaints of chest pain, as indicated in the veteran's July 2003 claim for service connection and during the August 2007 VA examination, there are no medical findings or diagnoses to support the existence of underlying pathology for that pain. Rather, the diagnosis rendered by the VA examiner was no pathology to render a diagnosis; none found on examination. Pain alone, without a diagnosed or identifiable underlying malady or condition, does not constitute a disability for which service connection can be granted. Sanchez-Benitez v. West, 13 Vet. App. 282, 285 (1999), vacated in part and remanded on other grounds sub. nom. Sanchez-Benitez v. Principi, 239 F. 3d 1356 (Fed. Cir. 2001); see Evans v. West, 12 Vet. App. 22 (1998). Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability. See 38 U.S.C.A. § 1131. Thus, where the competent and persuasive medical evidence does not establish a current disability upon which to predicate a grant of service connection, there can be no valid claim for service connection. See Gilpin v. West, 155 F. 3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The Board further notes that, although the VA examiner specifically found no costochondritis on examination, the etiological opinion referred to the veteran's "current costochondritis." Assuming, arguendo, that this reference could constitute medical evidence of current costochondritis, the service connection claim would still fail, as there is no competent medical evidence or opinion linking costochondritis to service. Rather, the only medical opinion on the question of etiology weighs against the claim, as the same examiner specifically opined that current costochondritis was less likely than not related to chest pain in service, and provided a thorough rationale for this opinion. Significantly, there is no contrary medical evidence or opinion on this point. In addition to the medical evidence, in adjudicating the claim, the Board has considered the veteran's written assertions; however, none of this evidence provides a basis for allowance of the claim. As indicated above, the claim turns on the medical matter matters of diagnosis and etiology-matters within the province of trained medical professionals. See Jones v. Brown, 7 Vet. App. 134, 137-38 (1994). As the veteran is not shown to be other than a layperson without the appropriate medical training and expertise, he is not competent to render a probative opinion on a medical matter. See, e.g., Bostain v. West, 11 Vet. App. 124, 127 (1998), citing Espiritu v. Derwinski, 2 Vet. App. 492 (1992). See also Routen v. Brown, 10 Vet. App. 183, 186 (1997) ("a layperson is generally not capable of opining on matters requiring medical knowledge"). Hence, the lay assertions in this regard have no probative value. The Board has also considered the veteran's argument, made in his December 2004 NOD, that the claim for service connection for costochondritis should be considered in accordance with 38 U.S.C.A. § 1117. Under 38 U.S.C.A. § 1117(a)(1), compensation is warranted for a Persian Gulf veteran who exhibits objective indications of a "qualifying chronic disability" that became manifest during service on active duty in the Armed Forces in the Southwest Asia theater of operations during the Persian Gulf War, or to a degree of 10 percent during the presumptive period prescribed by the Secretary. The Board notes that the period within which such disabilities must become manifest to a compensable degree in order for entitlement to compensation to be established is December 31, 2011. 38 C.F.R. § 3.317(a)(1)(i). Furthermore, the chronic disability must not be attributed to any known clinical disease by history, physical examination, or laboratory tests. 38 U.S.C.A. § 1117; 38 C.F.R. § 3.317(a), (b). A Persian Gulf veteran is defined as a veteran who served on active duty in the Armed Forces in the Southwest Asia Theater of operations during the Persian Gulf War. 38 U.S.C.A. § 1117(f). "Qualifying chronic disability" includes (a) undiagnosed illness, (b) a medically unexplained chronic multi-symptom illness (such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome) that is defined by a cluster of signs or symptoms, or (c) any diagnosed illness that the Secretary determines, in regulations, warrants a presumption of service connection. 38 C.F.R. § 3.317(a)(2). While the veteran's service personnel records reflect that he was awarded the Southwest Asia Service Medal with two bronze stars and the Kuwait Liberation Medal, as indicated above, the veteran has no legal entitlement to VA benefits based on disease or injury incurred during the period from December 13, 1989 to November 9, 1993, during which time he served in the Persian Gulf. As such, consideration of entitlement to service connection in accordance with 38 U.S.C.A. § 1117 is not warranted. In adjudicating the claim, the Board also has considered the applicability of the benefit-of-the-doubt doctrine; however, as the preponderance of the evidence is against the claim, that doctrine is not applicable. See 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53- 56 (1990). B. IBS The veteran asserts that he has current IBS that is related to service. Service medical records are negative for complaints regarding or findings of IBS. Therefore, IBS was not shown in service. Records of post-service treatment from April 1993 to October 2002 reflect diagnoses of and treatment for IBS. During treatment in January 1996, the veteran complained of chronic gaseousness, cramps and urgency to defecate after each meal, and described a history of bad abdominal cramps while in the Navy. While the post-service records of treatment confirm the presence of current IBS, and despite the veteran's complaints of abdominal cramps in the Navy, none of these medical records include any comment or opinion regarding etiology of current IBS. In short, there is simply no medical evidence or opinion of a nexus between current IBS and the veteran's service, and the veteran has not presented or identified any such existing medical evidence or opinion that would, in fact, support the claim. The Board has considered the veteran's argument, made in his December 2004 NOD, that the claim for service connection for IBS should be considered in accordance with 38 U.S.C.A. § 1117. Although IBS is a medically unexplained chronic multi-symptom illness as described in 38 C.F.R. § 3.317(a)(2), as noted above, the veteran has no legal entitlement to VA benefits based on disease or injury incurred during the period of service from December 13, 1989 to November 9, 1993, during which he served in Southeast Asia. As such, consideration of entitlement to service connection in accordance with 38 U.S.C.A. § 1117 is not warranted. In addition to the medical evidence, in adjudicating this claim, the Board has considered the appellant's written assertions. However, this claim turns on the matter of whether there exists a medical relationship between claimed disability and an injury or disease during service-a matter about which the appellant is not competent to render a persuasive opinion. See Bostain, 11 Vet. App. at 127; Routen, 10 Vet. App. at 186. Hence, he cannot support the claim on the basis of such lay assertions, alone. Under these circumstances, the claim for service connection for IBS must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the- doubt doctrine. However, as no competent, persuasive evidence supports the claim, that doctrine is not applicable. See 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53-56. C. Arthritis of the Right Knee The veteran asserts that he has arthritis of the right knee that is related to service. Service medical records reflect complaints of left knee pain, but are negative for complaints regarding or treatment for the right knee. Records of post-service treatment from April 1993 to October 2002 include complaints of bilateral knee pain. A June 2002 X-ray report indicates that multiple views of the right knee failed to demonstrate evidence of acute fracture, dislocation, or other bony pathology. A July 2002 record of treatment noted that X-ray of both knees was normal. In this case, the Board finds that the service connection claim must fail, as there is no competent and persuasive medical evidence of current arthritis of the right knee for which service connection can be granted. Notwithstanding the evidence of current complaints of pain, as indicated in the post-service treatment records, there are no medical findings or diagnoses to support the existence of underlying pathology for that pain. Pain alone, without a diagnosed or identifiable underlying malady or condition, does not constitute a disability for which service connection can be granted. See Sanchez-Benitez, 13 Vet. App. at 285; Evans, 12 Vet. App. 22. Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability. See 38 U.S.C.A. § 1131. Thus, where, as here, competent and persuasive medical evidence does not establish a current disability upon which to predicate a grant of service connection, there can be no valid claim for service connection. See Gilpin, 155 F. 3d 1353; Brammer, 3 Vet. App. at 225. In addition to the medical evidence, in adjudicating this claim, the Board has considered the appellant's written assertions. However, this claim turns on the medical matter of current disability,, a matter within the province of trained medical professionals. See Bostain, 11 Vet. App. at 127; Routen, 10 Vet. App. at 186. Hence, he cannot support the claim on the basis of such lay assertions, alone. Under these circumstances, the Board finds that the claim for service connection for arthritis of the right knee must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as no competent, persuasive evidence supports the claim, that doctrine is not applicable. See 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53-56. D. Left Knee Disability The veteran asserts that he has a left knee disability that is related to service. While service medical records reflect complaints of left knee pain in May 1987, no significant abnormality was demonstrated on X-ray. Post-service records of treatment reflect complaints regarding and treatment for the left knee. The veteran complained of popping and locking of the left knee in November 1995, and an X-ray that month revealed a normal left knee. The report of a June 2002 X-ray indicates that multiple views of the left knee failed to demonstrate evidence of acute fracture, dislocation, or other bony pathology. A July 2002 record of treatment notes that X-ray of both knees was normal. The veteran's left knee was evaluated during VA examination in August 2007. The veteran then reported that he injured his left knee in the military. He stated that he believed that the wear and tear of working on the flight decks was the cause of his left knee pain. The veteran denied instability and giving way, but described grinding. He reported pain, in that he described the feeling of a sharp needle sticking under his patella. He also described stiffness and weakness. He denied decreased speed of joint motion, dislocation, subluxation, locking, effusions, symptoms of inflammation, or effects on range of motion. The veteran reported that he had an elastic knee brace for his left knee that he would wear on occasion when his knee was aggravated. On examination, the left knee was not swollen. There was no laxity, but there was mild crepitus. Range of motion of the left knee revealed extension to +5 degrees actively and to 0 degrees passively, and flexion to 140 degrees actively and passively. There were no complaints of pain on range of motion. Repetitively moving the knee caused no pain and no change in range of motion. X-ray of the left knee revealed no fracture or dislocation and was essentially normal. The pertinent diagnosis was left patellar femoral syndrome. The examiner opined that it was less likely than not that the veteran's left knee was related to his knee pain while in the military. In providing a rationale for this opinion, the examiner noted that a review of the medical files revealed no consistent medical treatment for chronic left knee pain. The examiner added that the veteran's symptoms and negative X-ray would be age related. He further noted that the veteran had no significant arthritis and that, had the left knee condition been caused by a chronic condition while in the military, there would have been more flare-ups and some arthritis noted. The Board notes that, as discussed above, the veteran initially claimed service connection for arthritis of the left knee. However, as the foregoing medical evidence clearly demonstrates, there is no competent medical evidence of current arthritis of the left knee, as November 1995, June 2002, and August 2007 X-rays of the left knee were all normal. In the absence of current medical evidence of arthritis, there is no basis for a grant of service connection for any such disability. See Gilpin, 155 F. 3d 1353; Brammer, 3 Vet. App. at 225. Moreover, while the August 2007 VA examination report does confirm the presence of a current left knee disability- specifically, patellar femoral syndrome-the record does not support a grant of service connection for such disability, as the only medical opinion on the question of etiology weighs against the claim. In this regard, the VA examiner specifically opined that the veteran's current left knee disability was less likely than not related to his knee pain while in the military, and provided a thorough rationale for this opinion. In addition to the medical evidence, in adjudicating this claim, the Board has considered the appellant's written assertions. However, this claim turns on the matter of whether there exists a medical relationship between claimed disability and an injury or disease during service-a matter about which the appellant is not competent to render a persuasive opinion. See Bostain, 11 Vet. App. at 127; Routen, 10 Vet. App. at 186. Hence, he cannot support the claim on the basis of such lay assertions, alone. Under these circumstances, the Board finds that the claim for service connection for a left knee disability must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim, that doctrine is not applicable. See 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53-56. ORDER The character of the veteran's discharge from his period of service from December 13, 1989 to November 9, 1993 is a bar to certain VA benefits, to include compensation. Service connection for costochondritis is denied. Service connection for IBS is denied. Service connection for arthritis of the right knee is denied. Service connection for arthritis of the left knee is denied. ____________________________________________ JACQUELINE E. MONROE Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs