Citation Nr: 18143348 Decision Date: 10/18/18 Archive Date: 10/18/18 DOCKET NO. 16-28 714 DATE: October 18, 2018 ORDER Service connection for nonspecific urethritis is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has nonspecific urethritis due to a disease or injury in service, to include specific in-service event, injury, or disease. CONCLUSION OF LAW The criteria for service connection for nonspecific urethritis have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran, who is the appellant, served on active duty from October 1965 to July 1968. 1. Service connection for nonspecific urethritis Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). 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 shown 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 a condition, as identified in 38 C.F.R. § 3.309(a), noted during service is not shown to be chronic, then generally, a showing of continuity of symptoms after service is required for service connection. 38 C.F.R. § 3.303(b). Service connection may also be granted for any disease 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). In order to prevail on the issue of service connection, there must be medical evidence of current disability; medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and medical evidence of a nexus between the claimed in-service disease or injury and the present disease or injury. See Hickson v. West, 12 Vet. App. 247 (1990). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and an evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1990); 38 C.F.R. § 3.303(a). The Board 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). Hence, the Board will summarize the relevant evidence where appropriate and the analysis below will focus specifically on what the evidence shows, or fails to show, as to the claim. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. When all of the evidence is assembled, 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 fair preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). The Veteran contends that service connection is warranted for nonspecific urethritis. He asserts that he was treated for this in service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current diagnosis of nonspecific urethritis, and evidence shows that he was treated for urethral discharge on several occasions during service, the preponderance of the evidence weighs against finding that the Veteran’s current diagnosis of nonspecific urethritis began during service or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). The record includes the result of a VA general medical examination in April 1973, which showed no gross abnormality of the genitourinary system; and VA and private treatment records that have been reviewed and do not show that the Veteran has been diagnosed with nonspecific urethritis that has been found to be related to his military service. While the Veteran is competent to report having experienced symptoms of urethritis since service, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of a chronic disability that is related to service. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body or the interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Further, an August 2013 VA examiner opined that the Veteran’s nonspecific urethritis is not at least as likely as not related to an in-service injury, event, or disease, including the treatment rendered while he was on active duty. The rationale was that there was insufficient evidence to support a clinical correlation between the Veteran’s nonspecific urethritis and treatment for venereal disease in 1967 and 1968. In addition, there was contradictory evidence in the form of a December 2010 urology consultation. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for chronic nonspecific urethritis, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Joseph P. Gervasio