Citation Nr: 1319837 Decision Date: 06/19/13 Archive Date: 06/27/13 DOCKET NO. 08-36 339 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Louis, Missouri THE ISSUES 1. Entitlement to service connection for left ear hearing loss disability. 2. Entitlement to service connection for tinnitus. 3. Entitlement to service connection for diabetes mellitus, type II. REPRESENTATION Appellant represented by: Missouri Veterans Commission ATTORNEY FOR THE BOARD K. R. Fletcher, Counsel INTRODUCTION The Veteran had active military service from January 1955 to December 1958. He also had subsequent periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) with the Air National Guard. This matter comes before the Board of Veterans' Appeals (Board) on appeal from April and August 2008 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri. This case was most recently before the Board in April 2012 when it was remanded for additional development. The purpose of that remand was to: request copies of the Veteran's service treatment records (STRs) from the Minnesota Air National Guard; request verification of the Veteran's claimed herbicide exposure in Guam from the Compensation and Pension (C&P) Service; request verification of the Veteran's claimed herbicide exposure in Guam from the US Army and Joint Services Records Research Center (JSRRC); and arrange for a VA examination to determine the nature, extent, and etiology of the Veteran's diabetes mellitus, type II. Negative responses were received from the Minnesota Air National Guard, the C&P Service and the JSRRC in April 2012, August 2011 and August 2012. The Veteran underwent a VA examination in February 2013. As the requested development has been completed to the extent possible, there has been substantial compliance with the actions requested by the Board. See Stegall v. West, 11 Vet. App. 268 (1998). Accordingly, the Board may proceed with a final adjudication of the Veteran's claims. In addition to the paper claims file, there is a Virtual VA (VVA) electronic claims file associated with the Veteran's claims. The documents in the Veteran's VVA file are either duplicative of the evidence in the paper claims file or are irrelevant to the issues on appeal. Please note that this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). FINDINGS OF FACT 1. Left ear hearing loss disability and tinnitus were not shown during active duty service from January 1955 to December 1958 or for many years thereafter. 2. No current left ear hearing loss disability or tinnitus is etiologically related to service. 3. The Veteran did not become disabled due to an ear disease or injury incurred in the line of duty ACDUTRA, and did not become disabled due to an ear injury incurred in the line of duty during INACDUTRA. 4. It is not shown that the Veteran set foot on land in the Republic of Vietnam, or was otherwise exposed to an herbicide agent during service, including while serving in Guam from October 1955 to April 1957. 5. The Veteran's diabetes mellitus, type II, cannot be presumed to be due to exposure to herbicides in service, is not otherwise related to his service, and was not manifested until many years after his active service. CONCLUSIONS OF LAW 1. Left ear hearing loss disability was not incurred or aggravated in service, and left ear sensorineural hearing loss may not be presumed to have been so incurred. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1131, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.306, 3.307, 3.309, 3.385 (2012). 2. Tinnitus was not incurred or aggravated in service. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.306 (2012). 3. Diabetes mellitus, type II, was not incurred or aggravated in service, and may not be presumed to have been so incurred. 38 U.S.C.A. §§ 1110, 1116, 1131, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.306, 3.307, 3.309 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Veterans Claims Assistance Act of 2000 (VCAA) The VCAA, in part, describes VA's duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a). Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant and his or her representative, if any, of any information, and any medical or lay evidence, that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b); Quartuccio v. Principi, 16 Vet. App. 183 (2002). Proper VCAA notice must inform the claimant of any information and evidence not of record (1) that is necessary to substantiate the claim; (2) that VA will seek to provide; and (3) that the claimant is expected to provide. 38 C.F.R. § 3.159(b)(1) (including as amended effective May 30, 2008, 73 Fed. Reg. 23353 (Apr. 30, 2008)). VCAA notice should be provided to a claimant before the initial unfavorable agency of original jurisdiction decision on a claim. Pelegrini v. Principi, 18 Vet. App. 112 (2004). The Court has also held that that the VCAA notice requirements of 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b) apply to all five elements of a service connection claim. Those five elements include: 1) veteran status; 2) existence of a disability; 3) a connection between the veteran's service and the disability; 4) degree of disability; and 5) effective date of the disability. Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). Regarding the claims for service connection, the record reflects that the Veteran was mailed letters in April 2007, March 2008 and June 2008 advising him of what the evidence must show and the respective duties of VA and the claimant in obtaining evidence, as well as the appropriate notice with respect to the disability-rating and effective-date elements of the claims. The Veteran was provided complete notice prior to the adjudication of the claims. The Board also finds VA has complied with its duty to assist the Veteran in the development of his claims. In this regard, the Board notes that all available STRs, service personnel records and post-service treatment records were obtained. [In this regard, multiple searches for additional STRs were unsuccessful. However, the Board points out that there is a heightened obligation to explain findings and conclusions and to consider carefully the benefit of the doubt rule in cases, such as this, in which records are presumed to have been lost or destroyed while the file was in the possession of the government. See Pruitt v. Derwinski, 2 Vet. App. 83, 85 (1992); see also O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). The Board's analysis of the Veteran's claims has been undertaken with this duty in mind.] Neither the Veteran nor his representative has identified any outstanding evidence that could be obtained to substantiate the claims; the Board is also unaware of any such evidence. In addition, the Board finds that no additional development for medical opinions or examinations is necessary. In this regard, the Veteran has been afforded the appropriate VA examination to determine the etiology of his claimed diabetes mellitus, type II. As directed by the April 2012 Board remand, a VA examination was provided in February 2013 so as to ascertain whether any currently-diagnosed diabetes mellitus is etiologically-related to service. The examination included the requested opinion. Accordingly, the Board finds that there has been substantial compliance with its remand directives. See D'Aries v. Peake, 22 Vet. App. 97, 105 (2008). Moreover, pursuant to the Board's May 2010 Remand, the Veteran was scheduled for a VA examination in September 2010 to determine the etiology of his claimed left ear hearing loss disability and tinnitus. However, he failed to report. Statements from the Veteran show that he was provided timely notice, but chose not to report for this evaluation. See September 2010 statement from the Veteran. The December 2011 supplemental statement of the case (SSOC) also referenced the Veteran's failure to report for this examination. As such, it may be reasonably concluded that the Veteran was notified of his examination and of his obligation to participate in it. Thus, the Board finds that VA fulfilled its duty to assist in its attempt to afford the Veteran a VA examination, and, in the absence of a showing of good cause as to why he did not appear, the claim should instead be adjudicated based on the available evidence of record. 38 C.F.R. § 3.655 (2012); Wood v. Derwinski, 1 Vet. App. 190, 193 (1991) (which stipulates that the duty to assist is not always a "one-way street" and that a veteran may not "passively wait" for assistance). Evidentiary development is complete. As VA's duties to notify and assist are met, the Board will address the merits of the claims. II. Service Connection - Laws and Regulations The term "veteran" is defined in 38 U.S.C.A. § 101(2) as "a person who served in the active military, naval, or air service, and who was discharged or released therefrom under conditions other than dishonorable." The term "active military, naval, or air service" includes active duty, and "any period of active duty for training during which the individual concerned was disabled or died from a disease or injury incurred or aggravated in line of duty, and any period of inactive duty training during which the individual concerned was disabled or died from an injury incurred or aggravated in line of duty." 38 U.S.C.A. § 101(24); 38 C.F.R. § 3.6(a); see Biggins v. Derwinski, 1 Vet. App. 474, 477-478 (1991). ACDUTRA is defined, in part, as "full-time duty in the Armed Forces performed by reserves for training purposes." 38 U.S.C.A. § 101(22); 38 C.F.R. § 3.6(c). The term INACDUTRA is defined, in part, as duty, other than full- time duty, under sections 316, 502, 503, 504, or 505 of title 32 [U. S. Code] or the prior corresponding provisions of law. 38 U.S.C.A. § 101(23); 38 C.F.R. § 3.6(d). Service connection means that the facts establish that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated during service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303(a), 3.304. Every person employed in the active military, naval, or air service shall be taken to have been in sound condition when examined, accepted and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance and enrollment (the disease or injury need not be symptomatic, but only noted on entrance, Verdon v. Brown, 8 Vet. App. 529, 534-535 (1996)), or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service. See 38 U.S.C.A. §§ 1111, 1137. A preexisting injury or disease will be considered to have been aggravated by active military, naval, or air service where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease. 38 U.S.C.A. § 1153; 38 C.F.R. § 3.306. Clear and unmistakable evidence (obvious or manifest) is required to rebut the presumption of aggravation where the pre-service disability underwent an increase in severity during service. This includes medical facts and principles that may be considered to determine whether the increase is due to the natural progress of the condition. Aggravation may not be conceded where the disability underwent no increase in severity during service on the basis of all the evidence of record pertaining to the manifestations of the disability prior to, during and subsequent to service. See 38 C.F.R. § 3.306(b). The usual effects of medical and surgical treatment in service, having the effect of ameliorating disease or other conditions incurred before enlistment, including postoperative scars, absent or poorly functioning parts or organs, will also not be considered service connected unless the disease or injury is otherwise aggravated by service. See 38 C.F.R. § 3.306(b)(1). Intermittent or temporary flare-ups during service of a pre- existing injury or disease do not constitute aggravation; rather, the underlying condition, as contrasted with symptoms, must have worsened. Hunt v. Derwinski, 1 Vet. App. 292, 297 (1991). Accordingly, "a lasting worsening of the condition"-that is, a worsening that existed not only at the time of separation but one that still exists currently-is required. Routen v. Brown, 10 Vet. App. 183, 189 n. 2 (1997); Verdon, supra. In addition, certain chronic diseases, including type 2 diabetes mellitus and organic diseases of the nervous system such as sensorineural hearing loss, may be presumed to have been incurred during service if the disorder becomes manifest to a compensable degree within one year of separation from active duty. 38 U.S.C.A. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. If the condition at issue is not a "chronic disease" listed under 38 C.F.R. § 3.309(a), 38 C.F.R. § 3.303(b) does not apply. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With chronic disease as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. If there is no showing of a resulting chronic condition during service, then a showing of continuity of symptomatology after service is required to support a finding of chronicity. 38 C.F.R. § 3.303(b). Service connection may also be granted for any disease initially 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). For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. Veterans who, during active service, served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed to an herbicide agent, unless there is affirmative evidence of non-exposure. 38 U.S.C.A. §§ 1116; 38 C.F.R. § 3.307. If a veteran was exposed to a herbicide agent during active military, naval or air service and has contracted an enumerated disease (to include type 2 diabetes mellitus) to a degree of 10 percent or more at any time after service (except for chloracne and acute and subacute peripheral neuropathy which must be manifested within a year of the last exposure to an herbicide agent during service), the veteran is entitled to a presumption of service connection even though there is no record of such disease during service. 38 U.S.C.A. § 1112; 38 C.F.R. § 3.307, 3.309(e). 38 U.S.C.A. § 1116; 38 C.F.R. §§ 3.307(a)(6)(iii), 3.309(e), 3.313. The last date on which such a veteran shall be presumed to have been exposed to an herbicide agent shall be the last date on which he or she served in the Republic of Vietnam during the Vietnam era. "Service in the Republic of Vietnam" includes service in the waters offshore and service in other locations if the conditions of service involved duty or visitation in the Republic of Vietnam. 38 C.F.R. § 3.307(a)(6)(iii). VA General Counsel has determined that the regulatory definition of "service in the Republic of Vietnam" in 38 C.F.R. § 3.307(a)(6)(iii), requires that an individual actually have been present within the boundaries of the Republic of Vietnam to be considered to have served there, through inclusion of the requirement for duty or visitation in the Republic of Vietnam. VAOPGCPREC 27-97. In addition, the Department of Defense (DoD) has identified specific units that served in areas along the DMZ in Korea between April 1968 and July 1969, certain locations in Thailand, and Johnson Island between April 1972 and September 1977 as locations where herbicides were used. See MR21-1MR, Part IV, Subpart ii, Chapter 2, Section C, Paragraph 10. For all other locations where exposure to herbicides is alleged, the requirements for evidentiary development is outlined in M21-1MR, Part IV, Subpart ii, Chapter 2, Section C, para. 10(n). Notwithstanding the foregoing presumptive provisions, the Federal Circuit has determined that a claimant is not precluded from establishing service connection with proof of direct causation. Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). Brock v. Brown, 10 Vet. App. 155, 160-61 (1997). Thus, presumption is not the sole method for showing causation. In reviewing the evidence, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and continuity of current symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a veteran is competent to report on that of which he or she has personal knowledge). "Symptoms, not treatment, are the essence of any evidence of continuity of symptomatology." Savage v. Gober, 10 Vet. App. 488, 496 (1997), citing Wilson v. Derwinski, 2 Vet. App. 16, 19 (1991). Once evidence is determined to be competent, the Board must determine whether such evidence is also credible. See Layno, supra (distinguishing between competency ("a legal concept determining whether testimony may be heard and considered") and credibility ("a factual determination going to the probative value of the evidence to be made after the evidence has been admitted"). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional." Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed.Cir.2007). In fact, competent medical evidence is not necessarily required when the determinative issue involves either medical etiology or a medical diagnosis. Id. at 1376-77; see also Buchanan v. Nicholson, 451 F .3d 1331, 1337 (Fed.Cir.2006); Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. Sept 14, 2009). In evaluating a claim, the Board's duty is to assess the credibility and probative weight of the evidence. See Hayes v. Brown, 5 Vet. App. 60, 69-70 (1993). When a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated on the evidence of record. 38 C.F.R. § 3.655. Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C.A. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. III. Factual Background and Analysis The Board notes that it has reviewed all of the evidence in the Veteran's claims file, with an emphasis on the evidence relevant to this appeal. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that VA must review the entire record, but does not have to discuss each piece of evidence). Hence, the Board will summarize the relevant evidence where appropriate and the Board's analysis below will focus specifically on what the evidence shows, or fails to show, as to the claims. Left Ear Hearing Loss Disability and Tinnitus The Veteran claims entitlement to service connection for left ear hearing loss disability and tinnitus as due to noise exposure during service. However, based on the evidence of record, the Board finds that service connection is not warranted. STRs for the Veteran's period of active duty from January 1955 to December 1958 are negative for complaint or findings of left ear hearing loss disability or tinnitus. The Veteran denied any ear trouble on a December 1958 Report of Medical History. On examination in December 1958, whispered voice testing was 15/15. Prior to November 1967, service departments used ASA units to record pure tone sensitivity thresholds in audiometric measurement. VA currently uses ISO (ANSI) units. For purposes of comparison between the service audiometric data and more recent VA audiometric data, the table below shows the ASA measurements recorded in service, with the comparable ISO (ANSI) measurements in adjacent parentheses. Audiometric evaluation in December 1958 revealed: HERTZ 500 1000 2000 3000 4000 For ISO add (+15) (+10) (+10) (+10) (+5) LEFT 5(20) 0(10) -5(5) -5(5) 0(5) Service personnel records for the Veteran's active duty service show that the Veteran's military occupational specialty (MOS) was aircraft mechanic. Hearing conservation data obtained during the course of a June 1973 National Guard enlistment examination shows: HERTZ 500 1000 2000 3000 4000 LEFT 25 20 15 25 25 A May 1983 Report of Medical History notes that the Veteran reported having a tonsillectomy at age three; he denied any other surgical history. Hearing conservation data obtained during the course of a May 15, 1983 civilian National Guard examination shows: HERTZ 500 1000 2000 3000 4000 LEFT 35 5 0 50 45 A June 1984 STR notes that the Veteran was to be seen and examined for hearing loss because he complained that his hearing in his left ear had become significantly worse over the past year. Hearing conservation data obtained in September 1984 shows: HERTZ 500 1000 2000 3000 4000 LEFT 55 55 65 65 65 A June 1985 STR notes that the Veteran showed continued severe loss of hearing in the left ear since 1983. The Veteran was to see an ENT specialist to determine if the loss was irreversible due to noise or was due to some internal cause. It was recommended that the Veteran be removed from high noise areas until that work up was completed. Subsequent medical records, including April 1983 private audiology reports, show findings of left ear hearing loss disability. In February 2007 the Veteran filed a claim for service connection for left ear hearing loss. He stated that he was an airplane mechanic during his period of active duty, that he noticed a left ear hearing problem during his last two years of service, and that he had surgery on his left ear and is considered deaf in that ear now. A February 2008 VA examination report notes the Veteran's history of aircraft maintenance during active duty and current complaints of hearing loss and tinnitus. The Veteran reported that he underwent left ear reconstructive surgery in 1982, which reportedly resulted in a "dead" left ear. The Veteran also stated that he has had tinnitus since 1956. On the authorized audiological evaluation, pure tone thresholds, in decibels, revealed no response from 500 to 4000 decibels. Speech audiometry was not testable. The diagnoses included profound left ear hearing loss and tinnitus. After reviewing the claims file, the VA examiner stated that he cannot resolve the question of the etiology of the Veteran's left ear hearing loss and tinnitus without resorting to speculation, as the Veteran suffered profound left ear hearing loss following the 1982 ear surgery. The examiner further noted that any right ear hearing loss was likely due to a combination of both military and civilian noise exposure. In June 2008 the Veteran submitted a claim seeking service connection for tinnitus. In a March 2009 statement he maintained that his current bilateral tinnitus is the result of noise exposure in service. In a June 2010 statement, the Veteran maintained that his hearing loss began during his active duty. He reported that after his active duty, in January 1959, he saw a private physician for his complaints of hearing loss and was told that he had a small hole in his left inner ear drum. He indicated that records from this evaluation no longer exist. He further stated that he had surgery after his left ear got infected in 1982. Thereafter, he lost his hearing completely in his left ear. Records from this surgery no longer exist. The Board remanded this case to obtain an additional etiology opinion in this case; however, the Veteran failed to report (without good cause) for a September 2010 VA examination. Based on the aforementioned evidence, the Veteran is not shown to have left ear hearing loss disability or tinnitus during his period of service from 1955 to 1958. There is no evidence to indicate that he was diagnosed sensorineural hearing loss of the left ear within one year of his leaving active duty in 1958, so as to warrant service connection on a presumptive basis under 38 C.F.R. § 3.307 and 3.309. The first diagnosis of left ear hearing loss disability under 38 C.F.R. § 3.385 was on May 15, 1983. Personnel records show that the Veteran was on civilian status from May 2, 1980, to May 20, 1983, and was not performing ACDUTRA or INACDUTRA on in 1982 (the date of his alleged left ear surgery) or on May 15, 1983 (the date of the hearing loss disability diagnosis). The weight of the competent evidence does not attribute the Veteran's left ear hearing loss disability to his military service, despite his contentions to the contrary. None of the competent evidence establishes a relationship between his hearing loss disability and active duty, nor has any treating professional suggested such a conclusion. Specifically, the February 2008 VA examiner stated that he could not resolve the question of the etiology of left ear hearing loss disability without resorting to speculation. (As discussed above and in compliance with the statutory duty to assist, the AMC attempted to schedule a compensation and pension examination for the Veteran to ascertain the etiology of any current left ear hearing loss disability. However, he failed to cooperate with the development sought.) Therefore, the weight of the clinical evidence does not indicate that his left ear hearing loss disability is attributable to service. Moreover, there is no evidence to show that any pre-existing left ear hearing loss disability was aggravated beyond normal progression by any subsequent military (National Guard) service. Again, the Board notes that the AMC attempted to schedule an additional compensation and pension examination for the Veteran in September 2010; however, he failed to cooperate with the development sought. The Veteran first complained of tinnitus in 2008, long after his military service. See February 2008 VA examination and June 2008 statement from the Veteran. The weight of the competent evidence does not attribute the Veteran's tinnitus to his military service, despite his contentions to the contrary. Specifically, none of the competent evidence establishes a relationship between his tinnitus and military service, nor has any treating professional suggested such a conclusion. Specifically, the February 2008 VA examiner stated that he could not resolve the question of the etiology of tinnitus without resorting to speculation. (As discussed above and in compliance with the statutory duty to assist, the AMC attempted to schedule a compensation and pension examination for the Veteran in September 2010 to ascertain the etiology of any current tinnitus. However, he failed to cooperate with the development sought.) Therefore, the weight of the clinical evidence does not indicate that his tinnitus is attributable to service. The Board acknowledges the Veteran's statements asserting continuity of hearing loss and tinnitus symptomatology since his period of active duty. The Board is required to assess the credibility and probative weight of all relevant evidence, including the credibility of the Veteran's statements. McClain v. Nicholson, 21 Vet. App. 319, 325 (2007). Competency of evidence differs from weight and credibility. The former is a legal concept determining whether testimony may be heard and considered by the trier of fact, while the latter is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997). In this regard, the Veteran's lay testimony is competent to establish the presence of observable symptomatology and may provide sufficient support for a claim of service connection, if credible, regardless of the lack of contemporaneous medical evidence. Barr v. Nicholson, 21 Vet. App. 303, 307 (2007). Here, regarding the Veteran's claimed hearing loss disability, the Board concludes that the medical evidence is of greater probative value than the lay allegations. Considering the normal hearing on testing at discharge in 1958, and the absence of competent evidence of disabling hearing loss until nearly 25 years after service, the preponderance of the evidence is against service connection for the claimed disability. The Veteran himself believes that his current hearing loss disability was incurred during his active service. However, medical expertise is required to answer the question of whether the Veteran's hearing loss disability is related to service, to include noise exposure therein. The Veteran's lay opinion concerning this matter requiring medical expertise is of no probative value. Jandreau, supra. Moreover, the Board determines that any statements asserting a continuity of tinnitus since active service, while competent, are nonetheless not credible. In so concluding, the Board again notes that no complaints or findings of tinnitus were noted on medical records dated from 1955 to 1987. Therefore, continuity is not established based on the clinical evidence of record or the Veteran's statements. In light of the above discussion, the Board concludes that the preponderance of the evidence is against the claims for service connection for left ear hearing loss disability and tinnitus, and there is no doubt to be otherwise resolved. As such, the claims are denied. Diabetes Mellitus, Type II The Veteran contends that his type II diabetes mellitus is related to exposure to herbicides in service. Specifically, he claims his diabetes mellitus is due to exposure to herbicides (specifically Agent Purple) while serving at Andersen Air Base in Guam. See March 2008, June 2008 and June 2010 statements from the Veteran. STRs for the Veteran's period of active duty from January 1955 to December 1958, including a December 1958 separation examination report, show no treatment for, diagnosis of, or complaints consistent with, diabetes mellitus. Service personnel records show that the Veteran served at Andersen Air Base in Guam from October 1955 to April 1957. In periodic National Guard Reports of Medical History dated from 1975 to 1987 the Veteran denied any history of sugar in his urine. Periodic National Guard Reports of Medical Examination dated from 1973 to 1987 show that urinalysis was negative for sugar. Post-service medical evidence does not show precisely when the Veteran was diagnosed to have diabetes mellitus. However, a June 2000 private treatment record notes that the Veteran was being treated for diabetes mellitus. An April 2004 private treatment records states that the Veteran had been on diabetic medication for 6 years (since 1998). In February 2008 the Veteran submitted a claim seeking service connection for diabetes mellitus. A February 2013 VA examination report notes a diagnosis of diabetes mellitus, type II. After reviewing the claims file, the examiner opined that the Veteran's diabetes mellitus is less likely than not (less than 50 percent probability) to have been incurred in or caused by the claimed his military service. The examiner pointed out that there is no evidence in the STRs of any symptoms or signs of diabetes mellitus during service. The Veteran confirmed to the examiner that he did not have any symptoms of diabetes or suspicion of diabetes during service, and that it was not until much later, in the mid 1990's (as confirmed by his treatment records), that he developed diabetes. The examiner noted that the Veteran has a family history of diabetes in two of his brothers, which is a significant risk factor for himself. The evidence fails to demonstrate any direct etiological link between the Veteran's military service and his diabetes mellitus, type II. His STRs are silent with regard to any diabetes mellitus or symptoms related thereto. Furthermore, the earliest available post-service evidence of diabetes mellitus is 1998 (see April 2004 private treatment record), many years after his discharge from service. The weight of the competent evidence does not attribute the Veteran's diabetes mellitus to his military service, despite his contentions to the contrary. None of the competent evidence establishes a relationship between his diabetes mellitus and active duty, nor has any treating professional suggested such a conclusion. Specifically, the February 2013 VA examiner stated the Veteran's diabetes mellitus is less likely than not (less than 50 percent probability) to have been incurred in or caused by the claimed his military service, to include any alleged herbicide exposure therein. The examiner provided reasons and bases for the opinion, as noted above, including the Veteran's significant family history of diabetes mellitus. There is no medical evidence to the contrary. Consequently, the absence of any evidence of diabetes in service or for many years after service speaks against finding that service connection is warranted. See Maxson v. West, 12 Vet. App. 453 (1999), aff'd, 230 F.3d 1330 (Fed. Cir. 2000) (service incurrence may be rebutted by the absence of medical treatment for the claimed condition for many years after service). Moreover, regarding the Veteran's claim that he was exposed to herbicides in service which caused his diabetes mellitus, his service personnel records do not show (nor does he allege) that his "service involved duty or visitation in the Republic of Vietnam." Consequently, the Veteran's claim seeking service connection is not within the purview of 38 U.S.C.A. § 1116; 38 C.F.R. § 3.307 (which provides for establishing service connection for diseases, including diabetes mellitus, on a presumptive basis based on herbicide exposure therein for veterans who served on land in Vietnam). Rather, he maintains that he was exposed to herbicides (Agent Purple) during his service in Guam. For this type of alleged exposure, the requirements for evidentiary development is outlined in M21-1MR, Part IV, Subpart ii, Chapter 2, Section C, para. 10(n). Specifically, a detailed statement of the Veteran's claimed herbicide exposure is to be sent to the C&P Service via e-mail and a review be requested of the DoD's inventory of herbicide operations to determine whether herbicides were used or tested as alleged. If the exposure is not verified, a request is then to be sent to the JSRRC for verification. Here, the C&P was contacted and responded in August 2011 that that it had no information that herbicides were used, tested, or stored in Guam as alleged. Likewise, in November 2012, the JSRRC stated that there is no evidence that Agent Purple was stored on the Island of Guam during the period from 1955 through 1957. The Veteran was notified appropriately concerning these findings in a March 2013 SSOC. Consequently, the Board finds that all development necessary to the claim has been conducted. Therefore, the Veteran has not established actual exposure to herbicides while serving in Guam. In this regard, the Board finds that the Veteran is competent to report what he did and observed (storage barrels) while serving in Guam. See Layno, supra ("Competent lay evidence" is evidence provided by a person who has personal knowledge derived from his own senses); 38 C.F.R. § 3.159(a)(2) ("Competent lay evidence" is any evidence not requiring that the proponent have specialized education, training or experience, but is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person.). He is not, however, competent to report that he was exposed to tactical herbicides such as Agent Purple during his service in Guam. The Board further finds that the information from C&P and the JSRRC is more probative than the assertions contained in the Veteran's statements. The DoD has more comprehensive and accurate official records regarding its own use of herbicides and defoliants than do authors and organizations providing conflicting accounts. See, e.g., Soria v. Brown, 118 F.3d 747, 748 (Fed.Cir.1997); Duro v. Derwinski, 2 Vet. App. 530 (1992) (the service department's decisions on matters within its provenance are conclusive and binding on VA). Consequently, as the evidence fails to demonstrate that the Veteran had actual exposure to herbicides while serving in Guam, entitlement to service connection for type II diabetes mellitus is not warranted based upon the presumption in 38 C.F.R. §§ 3.307 and 3.309(e) that it is related to herbicides. For the foregoing reasons, the Board finds that the preponderance of the evidence is against finding that service connection for diabetes mellitus, type II, is warranted. Therefore, the benefit of the doubt doctrine is not applicable in the instant appeal. 38 U.S.C.A. § 5107(b); Gilbert, supra. As such, the Veteran's claim is denied. (CONTINUED ON NEXT PAGE) ORDER Service connection for left ear hearing loss disability is denied. Service connection for tinnitus is denied. Service connection for diabetes mellitus, type II, is denied. ____________________________________________ THERESA M. CATINO Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs