Citation Nr: 1017253 Decision Date: 05/10/10 Archive Date: 05/26/10 DOCKET NO. 06-24 814A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Winston- Salem, North Carolina THE ISSUES 1. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and depression. 2. Entitlement to service connection for residuals of a head injury, to include chin and facial injuries, claimed as a result of a personal assault. 3. Entitlement to service connection for residuals of a back and body injury, claimed as a result of a personal assault. 4. Entitlement to service connection for a left knee disability. 5. Entitlement to service connection for a right knee disability. 6. Entitlement to service connection for a right hip disability. 7. Entitlement to service connection for frostbite of the left foot. 8. Entitlement to service connection for frostbite of the right foot. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Veteran INTRODUCTION The Veteran served on active duty from April 1980 to February 1987. This matter comes before the Board of Veterans' Appeals (BVA or Board) on appeal from a September 2005 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Roanoke, Virginia, which denied the benefits sought on appeal. The claims were previously before the Board in February 2009 wherein the matter was remanded for further development and adjudication. The claims have been returned to the Board and are now ready for appellate disposition. As the Board is obligated to construe a claim for an acquired psychiatric disorder liberally, the claim for PTSD has been recharacterized as it appears on the cover page of the instant decision. See Clemons v. Shinseki, 23 Vet. App. 1 (2009) (the scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by the claimant's description of the claim, reported symptoms, and the other information of record). The Board has also recharacterized other issues on appeal in order to afford the Veteran the broadest scope of review. During the pendency of the appeal, jurisdiction of the claims was transferred to the Winston-Salem RO. The Veteran presented testimony before the Board in March 2008. The transcript has been associated with the claims folder. FINDINGS OF FACT 1. The Veteran has been apprised of what evidence would substantiate the claims for benefits and the allocation of responsibility for obtaining such evidence; and all relevant medical and lay evidence obtainable and necessary to render a decision in these matters has been received. 2. The Veteran's asserted personal assault stressors are not credible and inconsistent with the evidence of record and thus, remain unverified. 3. The record does not contain a diagnosis of PTSD. 4. Depression was not shown during service or for years thereafter, and there is no competent medical evidence linking any currently diagnosed psychiatric condition to the Veteran's period of service or a verified stressor. 5. The competent evidence of record does not contain any head injury, to include chin and facial injuries, due to a verified personal assault in service or any currently diagnosed residuals thereof. 6. The competent evidence of record does not contain any evidence of injury to the Veteran's back or body during active military service due to a verified personal assault; arthritis of the lumbar spine was not incurred during the Veteran's active military service nor did it manifest in the year following his separation from such. 7. A chronic right knee disability was not incurred during the Veteran's active military service nor did minimal degenerative joint disease (DJD) manifest in the year following discharge from such. 8. A chronic left knee disability was not incurred during the Veteran's active military service nor did minimal DJD manifest in the year following discharge from such. 9. The competent evidence of record does not contain any frostbite of the right foot during the Veteran's active military service or any currently diagnosed residuals thereof. 10. The competent evidence of record does not contain any frostbite of the left foot during the Veteran's active military service or any currently diagnosed residuals thereof. 11. A right hip disability was not shown during service or for years thereafter, and there is no competent medical evidence linking any currently diagnosed minimal spurring to the Veteran's period of service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for an acquired psychiatric disorder, to include PTSD and depression, have not been met. 38 U.S.C.A. §§ 1101, 1131 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.307, 3.309 (2009). 2. The criteria for entitlement to service connection for residuals of a head injury, to include chin and facial injuries, have not been met. 38 U.S.C.A. §§ 1101, 1131 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2009). 3. The criteria for entitlement to service connection for residuals of a back and body injury have not been met. 38 U.S.C.A. §§ 1101, 1131 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2009). 4. The criteria for entitlement to service connection for a right knee disability have not been met. 38 U.S.C.A. §§ 1101, 1131 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2009). 5. The criteria for entitlement to service connection for a left knee disability have not been met. 38 U.S.C.A. §§ 1101, 1131 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2009). 6. The criteria for entitlement to service connection for frostbite of the right foot have not been met. 38 U.S.C.A. §§ 1101, 1131 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2009). 7. The criteria for entitlement to service connection for frostbite of the left foot have not been met. 38 U.S.C.A. §§ 1101, 1131 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2009). 8. The criteria for entitlement to service connection for a right hip disability have not been met. 38 U.S.C.A. §§ 1101, 1131 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2009). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Criteria Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303. Evidence of continuity of symptomatology from the time of service until the present is required where the chronicity of a condition manifested during service either has not been established or might reasonably be questioned. 38 C.F.R. § 3.303(b). Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Moreover, where a veteran served continuously for ninety (90) days or more during a period of war, or during peacetime service after December 31, 1946, and a psychosis and/or arthritis becomes manifest to a degree of at least 10 percent within one 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, 1137 (West 2002); 38 C.F.R. §§ 3.307, 3.309. In order to prevail on the issue of service connection there must be medical evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in- service occurrence or aggravation of a disease or injury; and medical evidence of a nexus between an in-service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999); see also Pond v. West, 12 Vet App. 341, 346 (1999). Analysis The Board has reviewed all the evidence in the Veteran's claims file. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the appellant or obtained on his behalf be discussed in detail. Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate each claim and what the evidence in the claims file shows, or fails to show, with respect to each claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-30 (2000). Acquired Psychiatric Disorder The Veteran contends that he is entitled to service connection for PTSD. Specifically, he asserts that he was the victim of a racially motivated beating (personal assault) by Military Police in Germany during his active duty service. In order for a claim for service connection for PTSD to be successful, there must be: (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); (2) a link, established by medical evidence, between the current symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). If a PTSD claim is based on in-service personal assault, evidence from sources other than the veteran's service records may corroborate the veteran's account of the stressor incident. Examples of such evidence include, but are not limited to: records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals or physicians, pregnancy tests or tests for sexually transmitted diseases, and statements from family members, roommates, fellow service members, or clergy. Evidence of behavior changes following the claimed assault is one type of relevant evidence that may be found in these sources. Examples of behavior changes that may constitute credible evidence of the stressor include, but are not limited to: a request for a transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifiable cause; or unexplained economic or social behavior changes. 38 C.F.R. § 3.304(f)(3). Having carefully considered the Veteran's contentions in light of the evidence of record and the applicable law, the Board finds that the preponderance of the evidence is against the claim for an acquired psychiatric disorder, to include PTSD and depression, and it must be denied. At the outset, the Board finds that the record does not contain a confirmed diagnosis of PTSD. Notably, VA outpatient treatment records dated in September 2005 show the Veteran had a negative PTSD screen. To the extent that the Veteran or his representative opines that he meets the criteria for a diagnosis of PTSD, as laymen, neither the veteran nor his representative are competent to render an opinion regarding diagnosis or etiology. Espiritu v. Derwinski, 2 Vet. App. 492, 494-95 (1992). Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability. See 38 U.S.C.A. §§ 1110; 1131. In the absence of proof of present disability there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); see also Degmetich v. Brown, 104 F.3d 1328 (1997) (38 U.S.C.A. § 1131 requires existence of present disability for VA compensation purposes); see also Wamhoff v. Brown, 8 Vet. App. 517, 521 (1996). Such is the case in the instant matter with regard to the PTSD aspect of the Veteran's claim. What is not in dispute is that the Veteran was diagnosed with depression in September 2005 and November 2005. However, what remains to be determined is whether depression is related to service or to a verified incident that occurred during service. It is noteworthy that service treatment records are negative for treatment or diagnosis of a psychiatric disorder, to include depression. The Veteran indicated that he did not desire a physical examination upon separation. However, he was informed that a medical records review was to be undertaken to determine if there was any condition warranting examination, which apparently there was not. An August 1987 report of medical history and examination were both negative for a psychiatric disorder, to include depression. The Veteran was discharged from service in 1987 and the first record of psychiatric treatment is dated in 2005, some 18 years after his discharge. This is well outside the one-year presumptive period for psychoses. 38 C.F.R. §§ 3.307, 3.309. This lengthy period without treatment weighs heavily against the claim because it tends to disprove that depression was the result of military service which in turn resulted in a chronic disability or persistent symptoms thereafter. See Maxson v. Gober, 230 F.3d 1330 (Fed. Cir. 2000) (A prolonged period without medical complaint can be considered, along with other factors concerning a claimant's health and medical treatment during and after military service, as evidence of whether an injury or disease was incurred in service, which resulted in any chronic or persistent disability.) The Board must consider all the evidence including the availability of medical records, the nature and course of the disease or disability, the amount of time that elapsed since military service, and any other relevant facts in considering a claim for service connection. Cf. Dambach v. Gober, 223 F.3d 1376, 1380-81 (Fed. Cir. 2000). Thus, when appropriate, the Board may consider the absence of evidence when engaging in a fact- finding role. See Jordan v. Principi, 17 Vet. App. 261 (2003) (Steinberg, J., writing separately) (noting that the absence of evidence may be considered as one factor in rebutting the aggravation part of the section 1111 presumption of soundness). The medical evidence of record does not indicate that the Veteran's depression either had its onset during service or was aggravated by service. With no treatment during service or for almost two decades thereafter, and no medical evidence linking the currently diagnosed depression to service, service connection for depression must be denied. The Board has considered, but decided against, remanding this matter for a medical examination with opinion. In so concluding, the Board notes that VA regulations provide that VA will assist the Veteran by providing a medical examination or obtaining a medical opinion based upon review of the evidence of record if VA determines that it is necessary to decide the claim. 38 C.F.R. § 3.159(c)(4)(i). The regulations further provide, in pertinent part, that a medical examination or medical opinion is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but: (A) Contains competent lay or medical evidence of a current diagnosed disability or persistent or recurrent symptoms of disability; (B) Establishes that the veteran suffered an event, injury, or disease in service; and (C) Indicates that the claimed disability or symptoms may be associated with the established event, injury, or disease in service. 38 C.F.R. § 3.159(c)(4)(i). Because requirements in subsections (B) or (C) are not met with regard to the claim for service connection for depression, it is not necessary to obtain a medical examination or medical opinion in order to decide this aspect of the claim in this case. 38 C.F.R. § 3.159(c)(4)(i); Duenas v. Principi, 18 Vet. App. 512, 517 (2004), citing Paralyzed Veterans of Am. V. Sec'y of Veterans Affairs, 345 F.3d 1334, 1355-57 (Fed. Cir. 2003) (noting that a medical examination conducted in connection with claim development could not aid in substantiating a claim when the record does not already contain evidence of an inservice event, injury, or disease). The Board also considered whether depression was related to the alleged personal assault, but it does not appear that there is any evidence available that can serve to verify the reported inservice stressor events. At this juncture, the Board would note even assuming the record contained a PTSD diagnosis, absent a verified stressor event, it would not be valid. The Veteran's claim with regard to the beating by the Military Police is not supported by any corroborating evidence. In his initial stressor report in April 2005, the Veteran indicated that in March 1981 at Grafenwoehr training area he was wrongfully arrested, assaulted and beaten by Military Police. He indicated that the Post Command Sergeant Major assured him that the culprits would be jailed and discharged from service. Next, in July 2005, the Veteran said that some time between January 1981 and February 1981, in Vilseck, Federal Republic of Germany, and not the Grafenwoehr Training Area, he was lying on his cot in tent city when he was awoken by a fellow troop and told that a private was looking for him. He indicated that he was heading towards the German cantina and that the Military Police told him to freeze. He was then handcuffed, placed in the jeep, and driven to an unknown location and beaten. He indicated he was then dragged in the mud from the jeep without his boots. He further stated that his Acting First Sergeant apologized to him and told him the assailants would be discharged from the military. He stated that a Private JD, Spec4. H, and CSM HB knew of the event, but provided no contact information. In May 2006, he indicated that the incident took place in July 1981 in Bamberg, Germany, and that an x-ray of the skull dated the same, showing that he was hit in the face by a club, was proof of the assault. During the March 2008 Board hearing, the Veteran testified that he was on kitchen duty and there was some incident about a guy taking his board hat, which was returned, and then he went to sleep. Thereafter, he indicated that "some" incident occurred and he was asked when he left his tent where he was going. He indicated that he was going "out there" to let them know that nothing had happened to him and he got his hat back, but the Military Police came and everyone ran. He was told to stop, which he did because his knees "were messed up" and then he was handcuffed and taken to a waiting point. He stated there were eight soldiers in three jeeps and he was hit with a club and that was it. He indicated he then woke up after this and could not walk because of his knees and the Military Police were mad because they had to carry him. BVA Transcript at pp. 38-41. He later testified that he was kicked repeatedly and thrown over the seat of the jeep and did a "whole flip." BVA Transcript at pp. 49-50. He testified that he did not need stitches. BVA Transcript at 51. He then indicated that he had butterfly stitches in his forehead after the attack. BVA Transcript at 54. Later during the hearing, the Veteran stated that the incident actually occurred in March, but that he began treating between May and July 1981. BVA Transcript at 63. He indicated that after the assault, his personality and behaviors change. BVA Transcript at 65. Finally, when asked if he could get in touch with any of the witnesses to the incident, the Veteran indicated that CSM HB was the only one, but that he just saw the name on a military web site and that was "where [he] got his name basically from." There is simply no evidence of record that can support verification of the claimed personal assault. 38 C.F.R. § 3.304(f)(3). The record does not include any lay statements from fellow service members or others that might have had contemporaneous knowledge of the alleged in-service personal assault nor does it contain any other corroborative evidence regarding the non-combat stressors that the Veteran has now reported. (Emphasis added.) In fact, the Board finds the Veteran lacks credibility associated with the reported stressors and thus, remand for attempted verification is not warranted. Gobber v. Derwinski, 2 Vet. App. 470, 472 (1992) (the duty to assist is not a license for a fishing expedition to determine if there might be some unspecified information which could possibly support a claim). First, as delineated above, the Veteran has provided conflicting accounts regarding the alleged incident and apparently, he basically got the name of the Command Sergeant Major off a military website. Service personnel records do show that the Veteran was charged with possession of marijuana in March 1981, as well as disorderly conduct, which he failed to mention. He received an Article 15 and was reduced to E1 (suspended 90 days), forfeited $130.00, and was given 14 days restriction and extra duty. He was again arrested in 1982 for driving under the influence; however, the Board is not convinced this constitutes a behavioral change as result of an alleged assault, as the Veteran was charged for criminal conduct, which were either conditionally discharged or discharged, even prior to his enlistment in the military. While the service treatment records do contain an x-ray dated in 1981 for the skull as a result of being hit by a club, there are no recorded reports that this was the result of a beating by the Military Police. In addition, there was no treatment for bruising or swelling to the body, back or face as claimed between May 1981 and July 1981. The only evidence in the record regarding the occurrence of a personal assault comes from the Veteran's own statements, which have not found to be credible. The Board is cognizant that the Veteran is competent to give testimony about what he experienced; for example, he is competent to report his in- service experiences. See, e.g., Layno v. Brown, 6 Vet. App. 465 (1994). Competency, however, must be distinguished from weight and credibility, which are factual determinations going to the probative value of the evidence. See Rucker v. Brown, 10 Vet. App. 67, 74 (1997). The Board can not give great weight and credibility to the Veteran's account of the personal assault for the reasons listed above. Based upon the evidence that has been submitted in this case, none of which has been found to establish that a personal assault occurred, the Board finds that the evidence is not in relative equipoise; thus, the Veteran may not be afforded the benefit of the doubt and his claim for an acquired psychiatric disorder, to include PTSD and depression, must be denied. 38 U.S.C.A. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). Residuals of Head (Including Chin and Face), Back, and Body Injuries The Veteran contends that he has residuals of head, back, and body injuries, including chin and facial injuries, with memory and anger problems, as a result of a personal assault in military service. He alternatively contends that the chin injury was the result of a moped accident. At the outset, the Board notes that it has previously determined that there is no credible evidence of the alleged personal assault. Thus, the Board shall consider the claims on a direction causation basis only. Having carefully considered the Veteran's claims in light of the record and the applicable law, the Board concludes that the preponderance of the evidence is against the claims for residuals of a head injury, as well as residuals of a back and body injury, and the appeal as to these issues will be denied. First, service treatment records are wholly devoid of treatment, complaints, or diagnoses of back, body, and chin injuries. While entries dated in July 1981 show his skull was x-rayed for being hit in the left side of the face with a club, the examination was negative. There were no corresponding treatment notes or any further complaints or treatment in service. In September 1984 the Veteran did wreck his moped, but he only sustained a scratch to his left index finger. He sought medical attention for Betadine pads and bandages. In February 1984, the Veteran had a superficial laceration to the forehead. There was no acute bleeding. The Veteran received sutures. The next morning he did complain of blurred vision and dizziness secondary to the laceration, but the examiner found no loss of consciousness, nausea or vomiting. There was no further treatment during service. The Veteran indicated that he did not desire a physical examination upon separation. However, he was informed that a medical records review was to be undertaken to determine if there was any condition warranting examination, which apparently there was not. An August 1987 report of medical history and examination were both negative for residuals of head, back, body, chin, or facial injuries. The mere fact that the Veteran was treated for a laceration to the forehead and x-rayed for being hit with a club is not enough to establish that the Veteran sustained a condition, specifically residuals of a head and facial injury, during his active duty service. 38 C.F.R. § 3.303(b). Post- service, the Veteran has not sought any treatment for claimed residuals of head, body, facial, or chin injuries. Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability. See 38 U.S.C.A. §§ 1110; 1131. In the absence of proof of present disability of the claimed disorders there can be no valid claims. 38 U.S.C.A. § 1131; see also Brammer, 3 Vet. App. at 225. Such is the case in the instant matter with regard to the Veteran's claims for residuals of head, body, chin, and facial injuries. With regard to the claim for residuals of a back injury, the Veteran was discharged from service in 1987 and the first record of low back pain is dated in 2002, some 15 years after his discharge. At this time, x-rays showed wedging of the L5-S1 disc, which is well outside the one-year presumptive period for arthritis. 38 C.F.R. §§ 3.307, 3.309. VA outpatient treatment records dated in September 2005 reveal the Veteran reported that he had low back pain for several years and that he had been hit by a truck in 2001. The Veteran has denied providing this information; however, it was further noted by his private provider, Sexton Family Chiropractic, in September 2002. Looking at documented diagnoses in the claims file, there is a 15-year evidentiary gap in this case between the Veteran's active service and the earliest objective medical evidence of arthritis of the lumbar spine in 2002, which weighs heavily against a finding of service incurrence especially in light of the absence of treatment for a back disorder in service and some suggestion the Veteran injured his back post- service. See Maxson, supra. As the Veteran's low back disorder was not shown during service or for years thereafter, service connection can only be granted if there is some medical evidence linking the current condition to service. Here, there is no such medical evidence. The Board has considered, but decided against, remanding the claims for a medical examination with opinion. With regard to the claim for chin and body injuries, none of the requirements of 38 C.F.R. § 3.159(c)(4)(i) were met; regarding the claim for head and facial injuries the requirements in subsections (A) or (C) were not met; and with regard to the claim for back injury the requirements in (B) or (C) were not met. Duenas, 18 Vet. App. at 512. The Board is cognizant that the Veteran maintains that he has had back, body, head, facial and chin problems since service, and that the Veteran is competent to report his symptoms. See, e.g., Layno, supra. However, the Board can not give great weight and credibility to the Veteran's account in light of the lack of evidence of: treatment in service for chin, body, or back injuries; no post-service treatment for residuals of facial, chin, head, or body injuries, to include any current diagnoses of such; and the 15 year gap between the Veteran's discharge from service and the diagnosis of arthritis of the lumbar spine and some suggestion of post- service injury to the back. See Rucker, 10 Vet. App. at 74. While the veteran contends that residuals of head, chin, facial, back, and body injuries have been present since his period of active military service and related thereto, his statements do not constitute competent evidence of a medical nexus opinion. Espiritu, 2 Vet. App. at 494-95. The evidence is not in relative equipoise. Accordingly, as the preponderance of the evidence is against the claims for entitlement to service connection for residuals of injury to the head (including the face and chin), back, and body, the appeals must therefore be denied. 38 U.S.C.A. § 5107(b); Ortiz, 274 F.3d at 1364; Gilbert, 1 Vet. App. at 55-57. Left and Right Knee Injuries The Veteran contends that he is entitled to service connection for left and knee right injuries. Specifically, the Veteran asserts that his current conditions, chondromalacia and minimal DJD, are the result of basic training. Notably, he maintains the weight of combat gear and equipment, as well as the running, walking, etc, caused wear and tear on his knees. Additionally, the Veteran maintained his knee injuries were aggravated during an alleged personal assault, which the Board has found no credible supporting evidence, to include the Veteran's own statements. As such, this aspect of the claim is rendered moot by the prior findings. After careful consideration of all procurable and assembled data, the Board finds that service connection is not warranted for either right or left knee injuries. In this regard, service treatment records do show the Veteran reported knee pain in May 1980. He denied any trauma or prior history of knee pain. He was diagnosed with bilateral patella pain syndrome. He again complained of knee pain in May 1980 with running. There was no edema, discoloration, deformity, or fluid. The Veteran had full range of motion and no tenderness to touch. He was diagnosed with unresolved bilateral knee pain. In November 1986, the Veteran complained of a right knee injury while playing ball. He indicated that his knees felt like sandpaper rubbing in the knee. He was diagnosed with chondromalacia. There were no further complaints in service. As noted previously, the Veteran declined a separation examination. The mere fact that the Veteran was treated for bilateral patella pain syndrome (1980) and chondromalacia (1986) is not enough to establish that the Veteran sustained a chronic bilateral knee condition during his active duty service. 38 C.F.R. § 3.303(b). An examination performed shortly after the Veteran's discharge in August 1987, was negative for complaints or diagnoses of a bilateral knee disorder in both the report of medical history and physical examination. The first complaints of knee pain are dated in April 2002. Records from North Carolina Disability Determination show the Veteran reported an injury in service. The provider indicated that the etiology of possible patellofemoral syndrome on the right was undetermined. Despite a notation by Dr. TDF in May 2002 that the Veteran had osteoarthritis of the knees, a radiographic report in May 2002 was negative for such. The first findings of minimal spurring of the knees are dated in September 2005, which is clearly outside the one year presumptive period for arthritis. 38 C.F.R. §§ 3.307, 3.309. As the Veteran's minimal DJD of the bilateral knees was not shown during service or for years thereafter, service connection can only be granted if there is some competent evidence linking the current disability to service. Here, there is no such competent evidence that establishes a relationship to an incident of service. Notably, the April 2006 examiner, after conducting a review of the service and post-service treatment records, physical examination of the Veteran, and notation of reported history as provided by the Veteran, found that the Veteran's bilateral knee pain and minimal DJD was not due to or aggravated by the Veteran's service. The examiner reasoned there were no knee problems at separation from service or for at least 16 years after his discharge from service. The Board notes that magnetic resonance imaging reports (MRI) dated in July 2007 and June 2008 show the Veteran had chondromalacia of the knees; however, there was no indication this was related to the Veteran's military service 20 years earlier. A remand for an addendum opinion is not necessary as there was no evidence of a chronic knee problem in service or until many years thereafter or that any current condition may be related to the Veteran's military service. Duenas, 18 Vet. App. at 512. The Board is cognizant that the Veteran maintains that he has had knee problems since service and that the Veteran is competent to report his symptoms. See, e.g., Layno, supra. However, the Board can not give great weight and credibility to the Veteran's account in light of the lack of evidence of a chronic knee condition in service, the lack of post-service treatment until many years after discharge, or any opinion that any currently diagnosed knee condition is related to the Veteran's military service. See Rucker, 10 Vet. App. at 74. Though the Veteran contends he has chronic knee problems that are related to his military service, there is simply no medical evidence on file supporting the Veteran's assertion, and his statements do not constitute competent evidence of a medical diagnosis or nexus opinion. See Espiritu, 2 Vet. App. at 494-95. As a final note, the Board acknowledges that the Veteran has provided medical treatise evidence in support of his claims, i.e. articles regarding chondromalacia. However, the principles discussed do not specifically refer specifically to this Veteran. Sacks v. West, 11 Vet. App. 314, 317 (1998)(citing Beausoleil v. Brown, 8 Vet. App. 459, 463 (1996)); Libertine v. Brown, 9 Vet. App. 521, 523 (1996); Wallin v. West, 11 Vet. App. 509 (1998). Further, while medical treatise evidence can provide important support when combined with an opinion of a medical professional, in the instant case, as discussed above, a probative nexus opinion is not of record. Mattern v. West, 12 Vet. App. 222, 228 (1999). In sum, the evidence is not in relative equipoise. The preponderance of the evidence is against the claims and the appeals involving service connection must therefore be denied. 38 U.S.C.A. § 5107(b); Ortiz, 274 F.3d at 1364; Gilbert, 1 Vet. App. at 55-57. Frostbite of the Right and Left Feet The Veteran contends that he is entitled to service connection for frostbite of the bilateral feet. Specifically, the Veteran testified that during service he was in a tank without heat while stationed in Germany, which caused frostbite of the toes especially and his current problems with ingrown toenails. After careful consideration of all procurable and assembled data, the Board finds that service connection is not warranted for frostbite of either the right or left foot. In this regard, service treatment records do show the Veteran reported ingrown toenails of a three year duration in March 1981. (Note: this would be prior to service.) The provider noted the Veteran trimmed his nails incorrectly. The Veteran complained of pain in his feet in November 1981. He indicated that his toes hurt when they got cold or he put pressure on them. The provider noted the toes were normal, but that the Veteran had ingrown toenails. Routine nail care and bigger boots were recommended. There were no further complaints in service. As noted previously, the Veteran declined a separation examination. The mere fact that the Veteran was treated for ingrown toenails and pain in the toes when they got cold or had pressure applied is not enough to establish that the Veteran sustained frostbite of the feet or a chronic foot condition during his active duty service. 38 C.F.R. § 3.303(b). An examination performed shortly after the Veteran's discharge in August 1987, was negative for complaints or diagnoses of frostbite of either foot. Post-service, the Veteran has not sought any treatment for residuals of frostbite of the feet nor has any such condition been diagnosed. In the absence of proof of present disability of the claimed disorders there can be no valid claims. 38 U.S.C.A. § 1131; see also Brammer, 3 Vet. App. at 225. Such is the case in the instant matter with regard to the Veteran's claims for frostbite of the right and left feet. The Board has considered, but decided against, remanding this matter for a medical examination with opinion. In so concluding, the Board notes that VA regulations provide that VA will assist the Veteran by providing a medical examination or obtaining a medical opinion based upon review of the evidence of record if VA determines that it is necessary to decide the claim. 38 C.F.R. § 3.159(c)(4)(i). In the absence of a cold weather injury in service or any current diagnosis thereof, an examination is not warranted in these matters. The Board is cognizant that the Veteran maintains that he has had feet problems since service and that the Veteran is competent to report his symptoms. See, e.g., Layno, supra. However, the Board can not give great weight and credibility to the Veteran's account in light of the lack of evidence of a cold weather injury in service or any current residuals thereof. See Rucker, 10 Vet. App. at 74. Though the Veteran contends he has residuals of frostbite of the bilateral feet that are related to his military service, there is simply no medical evidence on file supporting the Veteran's assertion, and his statements do not constitute competent evidence of a medical diagnosis or nexus opinion. See Espiritu, 2 Vet. App. at 494-95. In sum, the evidence is not in relative equipoise. The preponderance of the evidence is against the claims and the appeals involving service connection must therefore be denied. 38 U.S.C.A. § 5107(b); Ortiz, 274 F.3d at 1364; Gilbert, 1 Vet. App. at 55-57. Right Hip The Veteran contends that he is entitled to service connection for a right hip disability. Specifically, he testified that his current hips problems are the result of being hit by a battle tank truck while changing track in service. After careful consideration of all procurable and assembled data, the Board finds that service connection is not warranted for a right hip disability. In this regard, the Veteran's service treatment records are wholly devoid of complaints, diagnoses, or treatment for a right hip disability. As previously noted, the Veteran declined a separation examination, but an August 1987 report of medical history and examination contained within the service treatment records were similarly negative. Post-service, the first objective evidence pertaining to the right hip is contained in records from Sexton Family Chiropractic dated in September 2002. At that time the Veteran reported pain, but the etiology was undetermined. Despite notations by Dr. TDF in May 2002 that the Veteran had osteoarthritis of the hip, x-rays dated in the same month were negative. Minimal spurring of the right hip was not shown until September 2005, which is clearly outside the one- year presumptive period for arthritis. 38 C.F.R. §§ 3.307, 3.309. Looking at documented diagnoses in the claims file, there is a 18-year evidentiary gap in this case between the Veteran's active service and the earliest objective medical evidence of arthritis of the right hip in 2005, which weighs heavily against a finding of service incurrence especially in light of the absence of treatment for a right hip disorder in service. See Maxson, supra. As the Veteran's right hip disorder was not shown during service or for years thereafter, service connection can only be granted if there is some competent evidence linking the current disability to service. Here, there is no such competent evidence that establishes a relationship to an incident of service. The Board considered, but decided against, remanding this matter for a medical opinion. An opinion is not necessary in order to decide the claim in this case because the record does not contain any evidence that the Veteran suffered from a right hip disorder in service or until many years thereafter. Moreover, other than the Veteran's statements, there is no evidence that the claimed right hip disability may be associated with his period of military service. 38 C.F.R. § 3.159(c)(4)(i); Duena, 18 Vet. App. at 517. The Board is cognizant that the Veteran maintains that he has had right hip problems since service, and that the Veteran is competent to report his symptoms. See, e.g., Layno, supra. However, the Board can not give great weight and credibility to the Veteran's account in light of the evidence that a right hip disorder was not objectively demonstrated in service or until 18 years after the Veteran's separation from service, and has not been shown to be related thereto. See Rucker, 10 Vet. App. at 74. Though the Veteran contends his right hip disability is related to his military service, there is simply no medical evidence on file supporting the Veteran's assertion, and his statements do not constitute competent evidence of a medical nexus opinion as only those medically trained are competent to diagnose a condition and identify likely etiology. See Espiritu, 2 Vet. App. at 494-95. In sum, the evidence is not in relative equipoise. The preponderance of the evidence is against the claim and the appeal involving service connection must therefore be denied. 38 U.S.C.A. § 5107(b); Ortiz, 274 F.3d at 1364; Gilbert, 1 Vet. App. at 55-57. Duties To Notify And Assist The Veterans Claims Assistance Act of 2000 (VCAA), codified in part at 38 U.S.C.A. §§ 5103, 5103A, and implemented at 38 C.F.R. § 3.159, amended VA's duties to notify and assist a claimant in developing the information and evidence necessary to substantiate a claim. Under 38 U.S.C.A. § 5103, VA must notify the claimant of any information or evidence not of record that is necessary to substantiate the claim, as well as what parts of that information or evidence VA will seek to provide, and what parts VA expects the claimant to provide. 38 C.F.R. § 3.159(b) (2009). VA must provide such notice to a claimant prior to an initial unfavorable decision on a claim for VA benefits by the agency of original jurisdiction (AOJ), even if the adjudication occurred prior to the enactment of the VCAA. See Pelegrini v. Principi, 18 Vet. App. 112, 119-120 (2004). Furthermore, the VCAA requirements of 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b) apply to all elements of a claim for service connection, so that VA must specifically provide notice that a disability rating and an effective date will be assigned if service connection is awarded. Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006); aff'd sub nom. Hartman v. Nicholson, 483 F.3d 1311 (2007). VA complied with notification responsibilities in regards to the Veteran's claims for service connection in correspondence sent to the Veteran in February 2004, June 2004, February 2005, May 2005, June 2005, and April 2006. These letters notified the Veteran of VA's responsibilities in obtaining information to assist the Veteran in completing his claims and identified the Veteran's duties in obtaining information and evidence to substantiate his claims. Notice pursuant to the Dingess decision was sent in March 2006 and January 2007. VA has also made reasonable efforts to assist the Veteran in obtaining evidence necessary to substantiate his claims. 38 U.S.C.A. § 5103A (West 2002). The information and evidence currently associated with the claims file consists of the Veteran's service treatment and personnel records, post- service VA and private medical records, articles, a report of VA examination, and the transcript from March 2008 Board hearing. The Veteran has not identified any other evidence which has not been obtained. The RO attempted to obtain records from the Social Security Administration (SSA); however, they were notified in April 2009 that they were unable to locate the Veteran's medical record. The Veteran was notified in May 2009 that the RO was unable to locate SSA records. He was asked to submit any records in his possession, which he did in May 2009. The RO made a formal finding of the unavailability of SSA records in May 2009. Any further attempts to obtain these records would be futile. 38 C.F.R. § 3.159(c)(1). The Board would additionally note the Veteran testified in March 2008 that some of his service treatment records were missing as some records were removed because he was Special Forces in service. However, a review of the Veteran's service personnel records do not show that the Veteran was Special Forces. Efforts to obtain any additional service treatment records from the New York Army National Guard resulted in a negative response. Specifically, they indicated the Veteran's records were sent to the National Personnel Records Center (NPRC) in February 2004. The Veteran's service treatment records were sent to the RO in August 2004. They contain both reports of enlistment and separation examinations, as well as treatment records dated between 1980 and 1987. There is no indication that there are any missing records. Further, the Veteran's reports of such are not considered credible. Any further attempts to obtain "missing" records would be futile. 38 C.F.R. § 3.159(c)(1). Additional evidence was added to the claims file after the October 2009 supplemental statement of the case (SSOC) was issued. The Veteran waived initial RO adjudication of the newly submitted evidence and as such, remand for preparation of an SSOC is not necessary. 38 C.F.R. § 20.1304(c). For the foregoing reasons, the Board therefore finds that VA has satisfied its duty to notify and the duty to assist pursuant to the VCAA. See 38 U.S.C.A. §§ 5102 and 5103 (West 2002 & Supp. 2009); 38 C.F.R. §§ 3.159(b), 20.1102 (2009); Pelegrini, supra; Quartuccio, supra; Dingess, supra. Any error in the sequence of events or content of the notice is not shown to have any effect on the case or to cause injury to the claimant. Thus, any such error is harmless and does not prohibit consideration of this matter on the merits. See Dingess, supra; see also ATD Corp. v. Lydall, Inc., 159 F.3d 534, 549 (Fed. Cir. 1998). ORDER Entitlement to service connection for an acquired psychiatric disorder, to include PTSD and depression, claimed as a result of a personal assault, is denied. Entitlement to service connection for residuals of a head injury, to include chin and facial injuries, claimed as a result of a personal assault, is denied. Entitlement to service connection for residuals of a back and body injury, claimed as a result of a personal assault, is denied. Entitlement to service connection for a right hip disability is denied. Entitlement to service connection for frostbite of the left foot is denied. Entitlement to service connection for frostbite of the right foot is denied. Entitlement to service connection for a left knee injury is denied. Entitlement to service connection for a right knee injury is denied. ______________________________________________ MARY GALLAGHER Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs