Citation Nr: 18142273 Decision Date: 10/15/18 Archive Date: 10/15/18 DOCKET NO. 16-42 782 DATE: October 15, 2018 ORDER 1. Entitlement to service connection for a bilateral knee disability is denied. 2. Entitlement to service connection for a bilateral foot disability is denied. 3. Entitlement to service connection for a lower back disability is denied. FINDINGS OF FACT 1. The Veteran does not have a current bilateral knee disability. 2. The preponderance of the evidence shows that the Veteran’s bilateral foot disability is not related to his military service. 3. The preponderance of the evidence shows that the Veteran’s lower back disability is not related to his military service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a bilateral knee disability have not been met. 38 U.S.C. §§ 1101, 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). 2. The criteria for service connection for a bilateral foot disability have not been met. 38 U.S.C. §§, 5107 (2012); 38 C.F.R. §§ 3.303 (2017). 3. The criteria for service connection for a lower back disability have not been met. 38 U.S.C. §§, 5107 (2012); 38 C.F.R. §§ 3.303 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1978 to November 1978. These matters come before the Board of Veterans’ Appeals (BVA or Board) on appeal from a February 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. A May 2016 rating decision reconsidered the previous denial of service connection for these disabilities and continued the denial of the claims. Service Connection Under the relevant laws and regulations, service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated in active military service. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (a) (2017). In general, service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; 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, 1167 (Fed. Cir. 2004). Additionally, where symptoms are capable of lay observation, a lay witness is competent to testify to a lack of symptoms prior to service, continuity of symptoms after in-service injury or disease, and receipt of medical treatment for such symptoms. Charles v. Principi, 16 Vet. App 370, 374 (2002). When considering whether lay evidence is competent, the Board must determine, on a case by case basis, whether the Veteran’s particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011). However, although the Veteran is competent in certain situations to provide a diagnosis of a simple condition, the Veteran is not competent to provide evidence as to more complex medical questions. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Some chronic diseases, including arthritis, may be presumed to have been incurred in service, if they become manifest to a degree of ten percent or more within the applicable presumptive period. 38 U.S.C. §§ 1101 (3), 1112(a); 38 C.F.R. §§ 3.307 (a), 3.309(a). For those listed chronic conditions, a showing of continuity of symptoms affords an alternative route to service connection. 38 C.F.R. § 3.303 (b); Walker v. Shinseki, 708 F. 3d 1331 (Fed. Cir. 2013). Here, there is no showing or allegation that any form of arthritis manifested to a degree of ten percent or more within one year of service. Furthermore, in determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of matter, the benefit of the doubt will be given to the Veteran. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. 1. Entitlement to service connection for a bilateral knee disability is denied. Service treatment records are silent regarding any in-service injury or treatment of the Veteran’s knees. Additionally, post-service treatment records do not document any complaints or treatment related to a bilateral knee disability, other than reports of pain. See VA Treatment Record dated December 29, 2015. Although the Veteran may experience knee pain, the evidence shows no current bilateral knee disability. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (service connection requires a current disability). A current disability is one shown at some time during the period beginning proximate to the date of claim. Romanowsky v. Shinseki, 26 Vet. App. 303 (2013). In this case there is no evidence of a knee disability since separation from service and there is no documentation of an injury to either knee during service. Additionally, the Veteran has not reported any pertinent symptomatology or treatment during the current appeal. There is no evidence of any post-service treatment, nor is there any other evidence to show a current underlying disability. There is also no persuasive evidence showing symptoms that result in any functional impairment. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (holding that a “disability” under 38 U.S.C. § 1110 refers to functional impairment of earning capacity). Although the Veteran is competent to report observable complaints, he is not competent to provide a diagnosis to account for such complaints. Rather this question requires medical expertise due to the complex nature of the musculoskeletal system. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). As such, the preponderance of the evidence is against service connection for a bilateral knee disability. Reasonable doubt does not arise, and the benefit-of-the-doubt doctrine does not apply; the Veteran’s claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 2. Entitlement to service connection for a bilateral foot disability is denied. The Veteran seeks entitlement to service connection for a bilateral foot disability as a result of his military service. He has current diagnoses of degenerative arthritis and calcaneal spurs of the bilateral feet. See February 2016 VA Examination Report. The Board acknowledges that the Veteran believes his foot disabilities are related to service. However, no diagnosis of arthritis or calcaneal spurs was rendered in service, and there are no probative medical opinions in favor of the claim. The Board notes that a service treatment record documented the Veteran’s reports of heel pain, but no diagnosis was rendered at that time. See Service Treatment Record dated October 3, 1978. Additionally, there is no evidence of record linking this incident to his current diagnoses. The Veteran underwent a VA examination for his feet in February 2016. The examiner opined that the bilateral foot disability was less likely than not related to his military service. He acknowledged the report of heel pain during service, but noted that there was no definitive link between the in-service symptomatology and the current diagnoses. The examiner further noted that the Veteran reported being active for many years following separation, and that the foot disabilities did not become severe until a year prior to the examination. Ultimately, the examiner concluded that the bilateral foot disability occurred gradually and did not worsen until recently. Based on the foregoing, the Board finds that the preponderance of the evidence is against the Veteran’s claim for service connection for a bilateral foot disability. In this regard, the Board places great probative weight on the February 2016 examiner’s opinion that the Veteran’s bilateral foot disability is less likely than not related to his military service. The examiner clearly reviewed the claims file and thoroughly summarized pertinent clinical records, indicating that he was fully aware of the extent of the Veteran’s claimed condition, as well as his medical history and reported symptomatology. He offered a discussion analyzing the pertinent evidence of record and explaining the basis for the opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). As there have been no opinions submitted in favor of the Veteran’s claim, the February 2016 VA opinion is the only probative medical opinion of record. The Veteran has contended on his own behalf that his bilateral foot disability is related to his military service. The Board appreciates that the Veteran believes that his current disability is related to service, and that he is competent to report his personal observations. Layno v. Brown, 6 Vet. App. 465, 469 (1994). However, the Board affords the lay opinion no probative value. Although lay persons are competent to provide opinions on some medical issues, see Kahana, supra, as to the specific issue in this case, determining whether musculoskeletal disorders, such as calcaneal spurs or degenerative arthritis, are due to in-service heel pain, falls outside the realm of common knowledge of a lay person. See Jandreau; supra. As such, the preponderance of the evidence is against entitlement to service connection for a bilateral foot disability. Reasonable doubt does not arise, and the benefit-of-the-doubt doctrine does not apply; the Veteran’s claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 3. Entitlement to service connection for a lower back disability is denied. The Veteran seeks entitlement to service connection for a lumbar spine disability as a result of his military service. He has a current diagnosis of intervertebral disc syndrome (IVDS). See May 2016 VA Examination Report. The Board acknowledges that the Veteran contends that he developed a back disability during service. However, he has not specifically described the nature of the alleged in-service injury. A diagnosis of IVDS was not rendered in service, and there are no probative medical opinions in favor of the claim. Indeed, service treatment records do not reflect any treatment or symptomatology related to the Veteran’s lower back. The Veteran underwent a VA examination for his lower back in May 2016. The examiner explained that there was no evidence of a recurrent back condition during service. He further noted that the Veteran was not diagnosed with IVDS during service. Based on the foregoing, the Board finds that the preponderance of the evidence is against the Veteran’s claim for service connection for a lower back disability. In this regard, the Board places great probative weight on the May 2016 examination report, which noted that the Veteran did not have a back disability during his military service. The examiner clearly reviewed the claims file and thoroughly summarized pertinent clinical records, indicating that he was fully aware of the extent of the Veteran’s claimed condition, as well as his medical history and reported symptomatology. As there have been no opinions submitted in favor of the claim, and the Veteran has not provided information regarding an in-service injury, the May 2016 VA opinion is the only probative evidence of record. The Veteran has contended on his own behalf that his lower back disability is related to his military service. The Board appreciates that the Veteran believes that his current disability is related to service, and that he is competent to report his personal observations. See Layno; supra. However, the Board affords the lay opinion no probative value. Although lay persons are competent to provide opinions on some medical issues, see Kahana, supra, as to the specific issue in this case, determining whether a musculoskeletal disorder, such as IVDS, is due to military service, falls outside the realm of common knowledge of a lay person. Jandreau; supra. As such, the preponderance of the evidence is against entitlement to service connection for a lower back disability. Reasonable doubt does not arise, and the benefit-of-the-doubt doctrine does not apply; the Veteran’s claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Erin J. Trojanowski, Associate Counsel