Citation Nr: 1323085 Decision Date: 07/19/13 Archive Date: 07/24/13 DOCKET NO. 10-00 005A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Chicago, Illinois THE ISSUES 1. Entitlement to service connection for a back disorder. 2. Entitlement to service connection for an eye disorder. 3. Entitlement to service connection for a respiratory disorder. 4. Entitlement to service connection for a dental disorder for Department of Veterans Affairs (VA) compensation purposes or outpatient dental treatment. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD L. Barstow, Counsel INTRODUCTION The Veteran had active military service from June 1973 to August 1977. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2008 rating decision of the VA Regional Office (RO) in Chicago, Illinois. The Board notes that the Veteran requested a hearing before a Decision Review Officer, but withdrew his request in January 2010. The Veteran having withdrawn his hearing request, the Board will proceed to adjudicate the case based on the evidence of record. See 38 C.F.R. § 20.704 (e) (2012). FINDINGS OF FACT 1. A back disorder not present during service, arthritis was not manifest within one year of discharge from service, and a currently diagnosed back disorder did not develop as a result of any incident during service. 2. The Veteran's presbyopia is a refractive error that is congenital and developmental in nature; other (superimposed) disability of the eyes is not shown. 3. An eye disorder was not present during service and a currently diagnosed eye disorder did not develop as a result of any incident during service. 4. A respiratory disorder was not present during service, active tuberculosis has not been shown, and a currently diagnosed respiratory disorder did not develop as a result of any incident during service. 5. The Veteran did not incur dental trauma during service. 6. The Veteran does not have a service-connected dental disability, he was not a prisoner of war during military service, he has not filed a previous application for dental treatment, a dental disorder is not aggravating a service-connected disability, he is not in receipt of a 100 percent disability rating for service-connected disabilities, he is not participating in a rehabilitation program and he is not receiving care or service under 38 U.S.C.A. chapter 17. CONCLUSIONS OF LAW 1. A back disorder 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, 3.307, 3.309 (2012). 2. An eye disorder 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 (2012). 3. A respiratory disorder 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, 3.307, 3.309 (2012). 4. The criteria for service connection for a dental disorder for VA compensation purposes or outpatient dental treatment are not met. 38 U.S.C.A. §§ 1110, 1131, 1712, 5107 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.303, 3.381, 4.150, 17.161 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. VA's Duties to Notify and Assist The VA has duties to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159 & 3.326(a) (2012). Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant and his representative 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). The 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. Such notice should be provided to a claimant before the initial unfavorable agency of original jurisdiction (AOJ) decision on a claim. Pelegrini v. Principi, 18 Vet. App. 112 (2004). A letter dated in December 2007 complied with VA's duty to notify the Veteran with regards to the issues adjudicated herein. Specifically, this letter apprised the Veteran of what the evidence must show to establish entitlement to the benefits, what evidence and/or information was already in the RO's possession, what additional evidence and/or information was needed from the Veteran, what evidence VA was responsible for getting, and what information VA would assist in obtaining on the Veteran's behalf. It also notified the Veteran of the criteria for assigning a disability rating and an effective date. See Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). Regarding VA's duty to assist, VA obtained the Veteran's service treatment records (STRs), personnel records and post-service medical records. The Board finds that medical opinions on the questions of service connection for a back, eye, respiratory and dental disorders are not required because opinions are only necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but contains: 1) competent evidence of diagnosed disability or symptoms of disability, 2) establishes that the veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and 3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159(c)(4); see McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this case, as described in detail below, there is insufficient evidence establishing that the Veteran suffered an event, injury or disease in service or during any pertinent presumptive period, or that any currently diagnosed disorders are related to his military service. See Duenas v. Principi, 18 Vet. App. 512 (2004). Consequently, given the standard of the regulation, the Board finds that VA did not have a duty to assist that was unmet. II. Analysis Service connection may be granted for disability resulting from disease or injury incurred or aggravated during active military service. 38 U.S.C.A. §§ 1110, 1131. Generally, service connection requires (1) the existence of a present disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Pursuant to 38 C.F.R. § 3.303(b), when a chronic condition is present, a claimant may establish the second and third elements by demonstrating continuity of symptomatology. The term "chronic disease," whether as shown during service or manifest to a compensable degree within a presumptive window following service, applies only to those disabilities listed in 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Arthritis and active tuberculosis are included in 38 C.F.R. § 3.309. Lay assertions may serve to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C.A. § 1153(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see Buchanan v. Nicholson, 451 F. 3d 1331, 1336 (Fed. Cir. 2006) (addressing lay evidence as potentially competent to support presence of disability even where not corroborated by contemporaneous medical evidence). For purposes of entitlement to benefits, refractive errors of the eyes are congenital or developmental defects and are not a disease or injury within the meaning of applicable legislation. 38 C.F.R. §§ 3.303(c), 4.9 (2012); VA ADJUDICATION PROCEDURE MANUAL (M21-1MR), PART III, Subpart iv, Ch. 4, Section B, para. 10.d. In the absence of a superimposed disease or injury, service connection may not be allowed for refractive error of the eyes, including myopia, presbyopia and astigmatism, even if visual acuity decreased in service, as this is not a disease or injury within the meaning of applicable legislation relating to service connection. 38 C.F.R. §§ 3.303(c), 4.9. Thus, VA regulations do not contemplate service connection for refractive error of the eyes unless such defect was subjected to a superimposed disease or injury, which created additional disability. See VAOPGCPREC 82-90 (July 18, 1990) (cited at 55 Fed. Reg. 45,711 ) (Oct. 30, 1990) (service connection may not be granted for defects of congenital, developmental or familial origin, unless the defect was subject to a superimposed disease or injury). 1. Back Disorder The Veteran contends that he has a back disorder that is related to his military service. See, e.g., October 2007 claim. However, in his claim, he reported that the onset of his back disorder was in 1992, 15 years after he was discharged from service. A review of the Veteran's STRs shows no treatment for, or diagnosis of, a back disorder. A report of medical history dated in October 1972 showed that he denied symptoms such as arthritis, rheumatism or bursitis; bone, joint or other deformity; and recurrent back pain. His January 1973 enlistment examination showed a clinically normal spine. There is no indication in the Veteran's STRs that he incurred any event, injury or disease to his back in service. In this regard, although the Veteran's period of active service was from June 1973 to August 1977, it appears that a large portion of his service was spent incarcerated. The Veteran's personnel records reflect that he was charged with a crime in December 1974 to which he subsequently pled guilty in February 1976. His DD 214 shows that he had a total of 1,217 days lost between February 1974, April 1974 to August 1974 and September 1974 to August 1977. The Veteran's statements indicate that he was incarcerated between October 1973 through September 1977. See, e.g., October 2008 notice of disagreement. According to post-service medical records, the Veteran has complained of back pain since February 1999. At that time, he reported a history of chronic low back pain with mild degenerative joint disease. In June 2002, he complained of low back spasms with no known trauma. Records beginning in September 2002 reveal that he reported having a history of low back pain since a stabbing in 1994. In September 2006, the Veteran was shown to have a history of chronic back pain seen that day with severe back pain. His back pain was of unclear etiology. However, in that record, he did report that episodic back pains started after he was stabbed in the back almost ten years ago. None of the Veteran's treatment records indicate that he reported an in-service event, injury, or disease to his back nor did he relate the onset of his back complaints to his military service. Additionally, he did not report having arthritis within one year of discharge. Furthermore, none of his records contain any medical opinion relating a back disorder to his military service. Based on a review of the evidence, the Board concludes that service connection for a back disorder is not warranted. Although post-service records show repeated complaints of back pain and a reported diagnosis of mild degenerative joint disease, the Board finds that the evidence does not support a finding that an in-service incurrence or aggravation of an event, injury or disease to his back actually occurred. In reaching this conclusion, the Veteran himself has not actually reported incurring a back injury in service. Rather, in his claim, he reported that the onset of his back problems began in 1992, 15 years after his active duty. Furthermore, his treatment records show that he reported that having back problems since a stabbing in 1994. The Veteran's STRs do not show the incurrence of any event, injury or disease to his spine in service. His STRs are silent for any back complaints. In this case, the contemporaneous service records, the Veteran's post-service statements and post-service treatment records all fail to show that he incurred an event, injury or disease to his spine in service. Therefore, the evidence does not support a finding that the in-service incurrence or aggravation of an event, injury or disease to his spine actually occurred. Absent an in-service event, injury or disease, there is no nexus evidence to support a finding of service connection. In this case, the first evidence of back complaints is the Veteran's claim of the onset of his disability being in 1992. The United States Court of Appeals for Veterans Claims (Court) has indicated that normal medical findings at the time of separation from service, as well as the absence of any medical records of a diagnosis or treatment for many years after service is probative evidence against the claim. See Mense v. Derwinski, 1 Vet. App. 354, 356 (1991) (affirming Board where it found that veteran failed to account for the lengthy time period after service for which there was no clinical documentation of low back condition). See also Maxson v. Gober, 230 F.3d 1330, 1333 (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 a disease was incurred in service which resulted in any chronic or persistent disability). Thus, the lack of any evidence of back complaints, symptoms, or findings for over a decade between the period of active service and the Veteran's reported onset is itself evidence which tends to show that a back disorder did not have its onset in service or for many years thereafter. Furthermore, the claims folder contains no competent evidence of a back disorder being associated with the Veteran's active duty. In reaching this conclusion, the Board observes that none of the Veteran's post-service treatment records indicate that any diagnosed back disorder is related to his military service. Without evidence of an in-service event, injury, or disease to the Veteran's spine or competent evidence of an association between a current back disorder and his active duty, service connection for a back disorder is not warranted. Additionally, the evidence does not show that the Veteran's degenerative joint disease was manifest to a degree of 10 percent or more within discharge from service. Consequently, service connection on a presumptive basis is not warranted. See 38 C.F.R. § 3.307, 3.309. Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet.App. 428, 435 (2011), as to the specific issue in this case, the etiology of a back disorder falls outside the realm of common knowledge of a lay person. See Jandreau at 1377 n.4 (lay persons not competent to diagnose cancer). The Veteran's own assertions as to etiology have no probative value. Without evidence of the onset of a back disorder in service, or competent evidence of an association between a currently diagnosed back disorder and the Veteran's active duty, service connection for a back disorder is not warranted. Based on this evidentiary posture, the Board concludes that the preponderance of the evidence is against the Veteran's claim for service connection for a back disorder. As the preponderance of the evidence is against this issue, the benefit-of-the-doubt rule does not apply, and the Veteran's claim of entitlement to service connection for a back disorder is denied. See 38 U.S.C.A §5107 (West 2002 & Supp. 2012). 2. Eye Disorder The Veteran contends that he has an eye disorder that is related to his military service. See, e.g., October 2007 claim. However, in his claim, he reported that the onset of his eye disorder was in 2002, over 20 years after he was discharged from service. A review of the Veteran's STRs shows no treatment for, or diagnosis of, an eye disorder. A report of medical history dated in October 1972 showed that he denied symptoms such as eye trouble. His January 1973 enlistment examination showed clinically normal eyes and ocular motility; ophthalmoscopic examination was also normal. The Veteran had distant vision of 20/20 bilaterally. There is no indication in the Veteran's STRs that he incurred any event, injury or disease to his eyes in service. According to post-service medical records, the earliest record of eye treatment is in February 2004. At that time, he reported a history of being hit in the left eye ten years ago with residual left upper lid ptosis. He complained of gradually decreased visual acuity at near over the last year and no change in the ptosis. The Veteran was diagnosed with latent hyperope; presbyopia; and left upper lid involutional ptosis. A record dated in April 2007 again shows the Veteran's reported history of a post-service left eye injury with residual left upper lid ptosis. He again reported gradually decreasing visual acuity at near over the last year. In addition to his prior diagnoses in February 2004, he was also diagnosed with trichiasis. In November 2007, the Veteran had diplopia when seen for a severe headache. None of the Veteran's treatment records indicate that he reported an in-service event, injury or disease, nor did he relate the onset of his eye complaints to his military service. Furthermore, none of his records contain any medical opinion relating an eye disorder to his military service. Based on a review of the evidence, the Board concludes that service connection for an eye disorder is not warranted. Although post-service records show diagnoses of latent hyperope; presbyopia; left upper lid involutional ptosis; and trichiasis, the Board finds that the evidence does not support a finding that an in-service incurrence or aggravation of an event, injury or disease to his eyes actually occurred. In reaching this conclusion, the Veteran himself has not actually reported incurring an eye injury in service. Rather, in his claim, he reported that the onset of his eye problems began in 2002, over 20 years after his active duty. Furthermore, his treatment records show that he reported a left eye injury post-service. The Veteran's STRs do not show the incurrence of any event, injury or disease to his eyes in service. His STRs are silent for any eye or vision complaints. In this case, the contemporaneous service records, the Veteran's post-service statements and post-service treatment records all fail to show that he incurred an event, injury or disease to his eyes in service. Therefore, the evidence does not support a finding that the in-service incurrence or aggravation of an event, injury or disease to his eyes actually occurred. In finding that the evidence does not support a finding of an in-service injury, with regards to the Veteran's presbyopia, in the absence of a superimposed disease or injury, service connection may not be allowed for refractive error of the eyes, including presbyopia, even if visual acuity decreased in service, as this is not a disease or injury within the meaning of applicable legislation relating to service connection. 38 C.F.R. §§ 3.303(c), 4.9. No medical professional has provided any opinion indicating that the Veteran had an in-service superimposed injury to his eyes. Therefore, to the extent that the Veteran's currently diagnosed eye disorders includes refractive error, service connection for such refractive error cannot be granted as a matter of law as the evidence does not show a superimposed injury in service. Absent an in-service event, injury or disease, there is no nexus evidence to support a finding of service connection. In this case, the first evidence of eye complaints is the Veteran's report of a left eye injury ten years earlier in 2004, indicating an onset date of 1994. The Court has indicated that normal medical findings at the time of separation from service, as well as the absence of any medical records of a diagnosis or treatment for many years after service is probative evidence against the claim. See Mense at 356; see also Maxson at 1333. Thus, the lack of any evidence of eye complaints, symptoms, or findings for over one decade between the period of active service and the Veteran's report of an eye injury is itself evidence which tends to show that an eye disorder did not have its onset in service or for many years thereafter. Furthermore, the claims folder contains no competent evidence of an eye disorder being associated with the Veteran's active duty. In reaching this conclusion, the Board observes that none of the Veteran's post-service treatment records indicate that any diagnosed eye disorder is related to his military service. Without evidence of an in-service event, injury, or disease to the Veteran's eyes or competent evidence of an association between a current eye disorder and his active duty, service connection for an eye disorder is not warranted. Although lay persons are competent to provide opinions on some medical issues, see Kahana at 435, as to the specific issue in this case, the etiology of an eye disorder falls outside the realm of common knowledge of a lay person. See Jandreau at 1377 n.4. The Veteran's own assertions as to etiology have no probative value. Without evidence of the onset of an eye disorder in service, or competent evidence of an association between a currently diagnosed eye disorder and the Veteran's active duty, service connection for an eye disorder is not warranted. Based on this evidentiary posture, the Board concludes that the preponderance of the evidence is against the Veteran's claim for service connection for an eye disorder. As the preponderance of the evidence is against this issue, the benefit-of-the-doubt rule does not apply, and the Veteran's claim of entitlement to service connection for an eye disorder is denied. See 38 U.S.C.A §5107. 3. Respiratory Disorder The Veteran contends that he has a respiratory disorder, specifically tuberculosis, that is related to his military service. See, e.g., October 2007 claim. However, in his claim, he reported that the onset of his respiratory disorder was in 1994, over 15 years after he was discharged from service. A review of the Veteran's STRs shows no treatment for, or diagnosis of, a respiratory disorder. A report of medical history dated in October 1972 showed that he denied symptoms such as tuberculosis; asthma; shortness of breath; pain or pressure in chest; and chronic cough. His January 1973 enlistment examination showed clinically normal lungs and chest. There is no indication in the Veteran's STRs that he incurred any event, injury or disease to his respiratory system in service. The Veteran's STRs do not show the incurrence of tuberculosis, or any other respiratory disorder, in service. According to post-service medical records, the earliest record of a respiratory disorder is in September 1998. At that time, he reported a history of a positive skin test. The impression of chest X-rays in October 2003 was obliteration of the right costophrenic angle; negative exam, otherwise. In November 2003, a history of positive purified protein derivative (of tuberculin) (PPD) was noted. The Veteran reported being treated for one month in 1995. Another record in November 2003 reveals that tests showed that the Veteran did not meet the requirements for mycobacterium tuberculosis. A December 2003 record shows that the Veteran was never treated for latent tuberculosis. He began treatment at that time. A history of latent tuberculosis was noted in August 2004. None of the Veteran's treatment records indicate that he reported an in-service event, injury or disease, nor did he relate the onset of his respiratory complaints or tuberculosis to his military service. Furthermore, none of his records contain any medical opinion relating a respiratory disorder, including tuberculosis, to his military service. Based on a review of the evidence, the Board concludes that service connection for a respiratory disorder is not warranted. Although post-service records show treatment for latent tuberculosis and indicate a positive tuberculosis test, the Board finds that the evidence does not support a finding that an in-service incurrence or aggravation of an event, injury or disease to his respiratory actually occurred. In reaching this conclusion, the Veteran himself has not actually reported incurring an respiratory injury in service. Rather, in his claim, he reported that the onset of his respiratory problems began in 1994, over 15 years after his active duty. The Veteran's STRs do not show the incurrence of any event, injury or disease to his respiratory system in service. His STRs are silent for any respiratory complaints. In this case, the contemporaneous service records, the Veteran's post-service statements and post-service treatment records all fail to show that he incurred an event, injury or disease to his respiratory system in service. Therefore, the evidence does not support a finding that the in-service incurrence or aggravation of an event, injury or disease to his respiratory system actually occurred. Absent an in-service event, injury or disease, there is no nexus evidence to support a finding of service connection. In this case, the first evidence of respiratory complaints is the Veteran's claim of the onset of his disability being in 1994. The Court has indicated that normal medical findings at the time of separation from service, as well as the absence of any medical records of a diagnosis or treatment for many years after service is probative evidence against the claim. See Mense at 356; see also Maxson at 1333. Thus, the lack of any evidence of respiratory complaints, symptoms, or findings for over 15 decades between the period of active service and the Veteran's reported onset is itself evidence which tends to show that a respiratory disorder did not have its onset in service or for many years thereafter. Furthermore, the claims folder contains no competent evidence of a respiratory disorder being associated with the Veteran's active duty. In reaching this conclusion, the Board observes that none of the Veteran's post-service treatment records indicate that any diagnosed respiratory disorder is related to his military service. Without evidence of an in-service event, injury, or disease to the Veteran's respiratory system or competent evidence of an association between a current respiratory disorder, including tuberculosis, and his active duty, service connection for a respiratory disorder is not warranted. Additionally, the evidence does not show that the Veteran had active tuberculosis manifest to a degree of 10 percent or more within three years of discharge from service. Indeed, the evidence does not show whether he ever had active tuberculosis; rather, the Veteran was shown to have latent tuberculosis in the treatment records discussed above. Consequently, service connection on a presumptive basis is not warranted. See 38 C.F.R. § 3.307, 3.309. Although lay persons are competent to provide opinions on some medical issues, see Kahana at 435, as to the specific issue in this case, the etiology of a respiratory disorder falls outside the realm of common knowledge of a lay person. See Jandreau at 1377 n.4. The Veteran's own assertions as to etiology have no probative value. Without evidence of the onset of a respiratory disorder in service, or competent evidence of an association between a currently diagnosed respiratory disorder and the Veteran's active duty, service connection for a respiratory disorder is not warranted. Based on this evidentiary posture, the Board concludes that the preponderance of the evidence is against the Veteran's claim for service connection for a respiratory disorder. As the preponderance of the evidence is against this issue, the benefit-of-the-doubt rule does not apply, and the Veteran's claim of entitlement to service connection for a respiratory disorder is denied. See 38 U.S.C.A §5107. 4. Dental Disorder The Veteran contends that he has a dental disorder that is related to his military service. See, e.g., October 2007 claim. However, in his claim, he reported that the onset of his dental disorder was in 2000, over 20 years after he was discharged from service. Service connection for compensation purposes can only be established for certain types of dental and oral conditions listed under 38 C.F.R. § 4.150 (2012), such as impairment of the mandible, loss of a portion of the ramus and loss of a portion of the maxilla. Compensation is available for loss of teeth only if due to loss of substance of the body of the maxilla or mandible. See Simmington v. West, 11 Vet. App. 41 (1998). For loss of teeth, bone loss through trauma or disease such as to osteomyelitis must be shown for purposes of compensability. The loss of the alveolar process as a result of periodontal disease is not considered disabling. 38 C.F.R. § 4.150, Diagnostic Code 9913, Note (2012). It should be noted that for the purposes of determining whether a veteran has treatment eligibility, the term "service trauma" does not include the intended effects of treatment provided during the Veteran's military service. The regulations are intended to cover dental trauma involving external, sudden-force injury, such as a combat wound to the teeth and jaw. VAOPGCPREC 5-97 (1997); see also Nielson v. Shinseki, 23 Vet. App. 56, 60-61 [LEXIS Case Law Signal: Positive Treatment Indicated] (2009). A review of the Veteran's STRs shows no treatment for, or diagnosis of, a dental disorder. A report of medical history dated in October 1972 showed that he reported severe gum or tooth trouble; mild carious teeth were noted. His January 1973 enlistment examination showed no dental findings. There is no indication in the Veteran's STRs that he incurred any event, injury or disease to his teeth, gums or mouth in service. The Veteran's STRs do not show any dental treatment in service. According to post-service medical records, the earliest record of dental treatment is in January 2001. At that time, examination revealed that he was partially edentulous; varied degrees of decay; moderate plaque and calculus; and periapical pathology around tooth number nine. In December 2002, he had tooth number seven extracted. None of the Veteran's treatment records indicate that he reported an in-service event, injury or disease, nor did he relate the onset of his dental complaints to his military service. Furthermore, none of his records contain any medical opinion relating a dental disorder to his military service. Based on a review of the evidence, the Board concludes that service connection for a dental disorder for compensation purposes is not warranted. Although post-service records show dental treatment, including the extraction of a tooth, the Board finds that the evidence does not support a finding that the Veteran has been diagnosed with any of the dental and oral conditions listed in 38 C.F.R. § 4.150. Furthermore, the evidence fails to show the in-service incurrence or aggravation of an event, injury or disease to his mouth, teeth or gums actually occurred. In reaching this conclusion, the Veteran himself has not actually reported incurring dental trauma in service. Rather, in his claim, he reported that the onset of his dental problems began in 2000, over 20 years after his active duty. The Veteran's STRs do not show the incurrence of any in-service dental trauma. Although his STRs reflect dental caries prior to service, they fail to show that he incurred dental trauma in service. In this case, the contemporaneous service records, the Veteran's post-service statements and post-service treatment records all fail to show that he incurred dental trauma in service. Therefore, the evidence does not support a finding that the in-service incurrence or aggravation of dental trauma actually occurred. Absent in-service dental trauma to the maxilla (upper jaw bone) or mandible (lower jaw bone), or of any other impairment involving the mandible, ramus, or maxilla, there is no nexus evidence to support a finding of service connection. Without a demonstration of dental trauma, service connection may not be considered for compensation purposes, but service connection may be considered solely for the purpose of determining entitlement to dental examinations or outpatient dental treatment. See Woodson v. Brown, 8 Vet. App. 352, 354 (1995). The determination of whether service connection may be established for the purpose of outpatient dental treatment is based on the criteria set forth in 38 C.F.R. § 3.381 (2012). As provided by VA regulations, treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses and periodontal disease are not considered to be disabling conditions, but may be considered service connected solely for the purpose of establishing eligibility for VA outpatient dental treatment. See 38 U.S.C.A. § 1712 (West 2002); 38 C.F.R. § 3.381(a), 17.161 (2012). Service connection may be granted for a dental condition of each tooth and periodontal tissue shown by the evidence to have been incurred in or aggravated by service. When applicable, a determination will be made as to whether it is due to a combat wound or other service trauma, or whether the Veteran was interned as a prisoner of war (POW). 38 C.F.R. § 3.381(b). The significance of finding that a dental condition is due to service trauma is that a Veteran will be eligible for VA dental treatment for the condition, without the usual restrictions of timely application and one-time treatment. 38 C.F.R. § 17.161(c). The following principles apply to dental conditions noted at entry and treated during service: (1) teeth noted as normal at entry will be service connected if they were filled or extracted after 180 days or more of active service; (2) Teeth noted as filled at entry will be service connected if they were extracted or if the existing filling was replaced after 180 days or more of active service; (3) Teeth noted as carious but restorable at entry will not be service connected on the basis that they were filled during service. However, new caries that developed 180 days or more after such a tooth was filled will be service connected; (4) Teeth noted as carious but restorable at entry, whether or not filled, will be service connected if extraction was required after 180 days or more of active service; (5) Teeth noted at entry as nonrestorable will not be service connected regardless of treatment during service; (6) Teeth noted as missing at entry will not be service connected regardless of treatment during service. 38 C.F.R. § 3.381(d). In this case, the Veteran was shown to have mild carious teeth at entrance to service. However, the evidence fails to show that the Veteran was treated during service for any affected teeth. Therefore, the principles applying to dental conditions noted at entry and treated during service (emphasis added) do not apply. The following will not be service connected for treatment purposes: (1) calculus; (2) acute periodontal disease; (3) 3rd molars, unless disease or pathology of the tooth developed after 180 days or more of active service, or was due to combat or in-service trauma; (4) impacted or malposed teeth, and other developmental defects, unless disease or pathology of these teeth developed after 180 days or more of active service. 38 C.F.R. § 3.381(e). It is important to note that teeth extracted because of chronic periodontal disease will be service connected only if they were extracted after 180 days or more of active service. 38 C.F.R. § 3.381(e) . There are various categories of eligibility for VA outpatient dental treatment, including veterans having a compensable service-connected dental condition (Class I eligibility); one-time treatment for veterans having a noncompensable service-connected dental condition (Class II eligibility); those having a noncompensable service-connected dental condition adjudicated as resulting from a combat wound or other service trauma (Class II(a) eligibility); those who were detained as a POW (Class II(b) and Class II(c) eligibility); those who made prior applications for, and received, dental treatment from VA for noncompensable dental conditions but were denied replacement of missing teeth that were lost during any period of service prior to his or her last period of service (Class IIR (Retroactive) eligibility); those having a dental condition professionally determined to be aggravating disability from an associated service-connected condition or disability (Class III eligibility); those whose service-connected disabilities are rated at 100 percent by schedular evaluation or who are entitled to the 100 percent rating by reason of individual unemployability (Class IV eligibility); those who participate in a rehabilitation program under 38 U.S.C. chapter r 31 (Class V eligibility); and those who are scheduled for admission or who are otherwise receiving care and services under chapter 17 of 38 U.S.C. (Class VI eligibility). 38 U.S.C.A. § 1712; 38 C.F.R. § 17.161. The Board has examined all the classifications of dental disability under 38 C.F.R. §§ 3.381 and 17.161 and has found none that would apply to the Veteran. In this regard, the Veteran does not meet the requirements of class I because, as discussed in detail above, he does not have a service-connected compensable dental condition or disability. The Veteran also fails to establish eligibility for Class II treatment, one-time dental treatment for Veterans having a noncompensable service-connected dental condition or disability in existence at the time of discharge, because a review of the record on appeal shows that he waited until October 2007, 30 years after his separation from active duty service in August 1977, to apply for these benefits and such claims must be made within one year after a claimant's separation from active military service. The Veteran does not meet the requirements of class IIa because he does not have a dental condition or disability that is the result of combat wounds or other service trauma. Furthermore, the Veteran fails to establish eligibility for Class II(b), II(c), IIR, because he does not claim and the record does not show that he was ever a prisoner of war or that he filed a claim for dental treatment prior to the October 2007 claim. He does not meet the requirements of class III, because he does not have a dental condition or disability that has been medically determined to be aggravating a service-connected condition. The Veteran is not service-connected for any disability and therefore he is not in receipt of a 100 percent disability rating for a service-connected disability. Thus, the Veteran does not meet the requirements of class IV. The Veteran also fails to establish eligibility for Class V and VI treatment, as he does not claim and the record does not show that he participates in a rehabilitation program under 38 U.S.C. Chapter 31 or he is otherwise receiving care and services under 38 U.S.C. Chapter 17. See 38 C.F.R. § 17.161 (a). In conclusion, the Board finds that the preponderance of the evidence shows that the Veteran does not meet any of the classifications dental disability under 38 C.F.R. §§ 3.381 and 17.161. Accordingly, entitlement to service connection for a dental disorder for VA outpatient treatment purposes is not warranted. Based on this evidentiary posture, the Board concludes that the preponderance of the evidence is against the Veteran's claim for service connection for a dental disorder for compensation and/or VA outpatient treatment purposes. As the preponderance of the evidence is against this issue, the benefit-of-the-doubt rule does not apply, and the Veteran's claim of entitlement to service connection for a dental disorder for compensation and/or VA outpatient treatment purposes is denied. See 38 U.S.C.A §5107. ORDER Entitlement to service connection for a back disorder is denied. Entitlement to service connection for an eye disorder is denied. Entitlement to service connection for a respiratory disorder is denied. Entitlement to service connection for a dental disorder is denied. ____________________________________________ MILO H. HAWLEY Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs