Citation Nr: 18145814 Decision Date: 10/30/18 Archive Date: 10/30/18 DOCKET NO. 16-01 786 DATE: October 30, 2018 ORDER Entitlement to service connection for a back disorder is denied. Entitlement to service connection for a left hand disorder is denied. Entitlement to service connection for a left ankle disorder is denied. Entitlement to service connection for a right ankle disorder is denied. Entitlement to service connection for a left knee disorder, identified as patellofemoral pain syndrome is denied. Entitlement to service connection for a right knee disorder, currently identified as patellofemoral pain syndrome is denied. Entitlement to service connection for a left hip disorder is denied. Entitlement to service connection for a vision disorder is denied. REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for a sinus disorder is remanded. Entitlement to service connection for allergy disorder is remanded. Entitlement to service connection for a respiratory disorder is remanded. Entitlement to service connection for a skin disorder involving the hands is remanded. FINDINGS OF FACT 1. The preponderance of the competent evidence of record does not demonstrate that the Veteran has a current back disability that is a result of his period of service. 2. The preponderance of the competent evidence does not demonstrate that the Veteran has a current disability due to residuals from left third digit fracture and nail bed repair. 3. The preponderance of the competent evidence of record does not demonstrate that the Veteran’s currently diagnosed left hand disorder, involving residual scar and limitation of motion in the left thumb, was incurred in service or otherwise a result of his period of service. 4. The preponderance of the competent evidence of record does not demonstrate that the Veteran has a current right ankle disability that is a result of his period of service. 5. The preponderance of the competent evidence of record does not demonstrate that the Veteran has a current left ankle disability that is a result of his period of service. 6. The preponderance of the competent evidence of record does not demonstrate that the Veteran’s current bilateral knee disorder, patellofemoral syndrome, was incurred during service or is otherwise a result of his period of service. 7. The preponderance of the competent evidence of record does not demonstrate that the Veteran has a current left hip disability that is a result of his period of service. 8. The preponderance of the competent evidence of record does not demonstrate that the Veteran has a current vision disability that is a result of his period of service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a back disorder have not been met. 38 U.S.C. §§ 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). 2. The criteria for entitlement to service connection for a left hand disorder have not been met. 38 U.S.C. §§ 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). 3. The criteria for entitlement to service connection for a right ankle disorder have not been met. 38 U.S.C. §§ 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). 4. The criteria for entitlement to service connection for a left ankle disorder have not been met. 38 U.S.C. §§ 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). 5. The criteria for entitlement to service connection for a left knee disorder have not been met. 38 U.S.C. §§ 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). 6. The criteria for entitlement to service connection for a right knee disorder have not been met. 38 U.S.C. §§ 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). 7. The criteria for entitlement to service connection for a left hip disorder have not been met. 38 U.S.C. §§ 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). 8. The criteria for entitlement to service connection for a vision disorder have not been met. 38 U.S.C. §§ 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from November 1977 to July 1981. Service Connection 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 (2012); 38 C.F.R. § 3.303 (a) (2017). Service connection may 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) (2017). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004); see also Hickson v. West, 12 Vet. App. 247, 253 (1999), citing Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff’d, 78 F.3d 604 (Fed. Cir. 1996). In rendering a decision on appeal, the Board must analyze the credibility and probative value of all medical and lay evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the veteran. 38 U.S.C. § 1154 (a) (2012); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Radiation Exposure The Board notes that the Veteran has generally asserted that entitlement to service connection is warranted because of his exposure to radiation during service when he worked in close proximity to radar towers at drone test facility at Roosevelt Roads and worked adjacent to microwave towers on Diego Garcia, British Indian Ocean Territory (B.I.O.T.). However, the Veteran has not specified which of his claimed conditions he believes is associated with such exposure. Regardless, the Veteran does not qualify as a “radiation-exposed veteran” as defined by 38 C.F.R. § 3.309 (d) (201y), as he did not participate in a radiation-risk activity. 38 C.F.R. § 3.309 (b) (I), (ii) (2017). Accordingly, he cannot take advantage of the presumptive provisions of 38 C.F.R. § 3.309 (d) (2017). Further, he does not have a “radiogenic diseases”, which would be subject to special development procedures. 38 C.F.R. § 3.311 (2017). Moreover, the U.S. Court of Appeals for Veterans Claims (CAVC) has taken judicial notice that radar equipment emits microwave-type non-ionizing radiation, which is not subject to review under the ionizing radiation statute and regulations. Rucker v. Brown, 10 Vet. App. 67 (1997) citing The Microwave Problem, Scientific American, September 1986; Effects upon Health of Occupational Exposure to Microwave Radiation (RADAR), American Journal of Epidemiology, Vol. 112, 1980; and Biological Effects of Radiofrequency Radiation, United States Environmental Protection Agency, September 1984. The Veteran has not provided any medical evidence that associates any of his claimed conditions with his exposure to microwave-type radiation, nor does he have the medical expertise to provide competent opinion that his claimed conditions are a result of such exposure. There is no competent evidence to support such assertions and the Veteran’s generalized statements in this regard are not sufficient to trigger VA’s duty to provide a medical opinion to further explore a possible link. 38 C.F.R. § 3.159 (c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006); see Waters v. Shinseki, 601 F.3d 1274, 1278-79 (Fed. Cir. 2010). Accordingly, further consideration of the Veteran’s general assertion of entitlement to service connection based on exposure to microwave-type non-ionizing radiation is not warranted. 1. Entitlement to service connection for a back disorder The Veteran seeks entitlement to service connection for a back disorder. The Veteran believes he has spinal degeneration as result of injury sustained from heavy lifting while working in heavy construction as a steel worker during service. See March 2013 statement in support of the case and January 2016 substantive appeal. A review of the Veteran’s service treatment records shows he presented in March 1978 with complaints of back pain and he was assessed with muscle strain. There was no subsequent treatment for back problems. His July 1981 examination prior to separation shows his spine was evaluated as normal. An associated report of medical history is not available. There are no post-service medical records of back problems, and the Veteran has not identified any outstanding records of pertinent treatment. The report of a December 2013 VA examination shows that the Veteran did not have a currently diagnosed back disorder. The Veteran reported he experienced episodes of low back pain every three months that kept him off his feet for about two weeks, but he has not sought treatment for any back problems after his separation from service. The findings from clinical examination showed the Veteran had a normal back examination and the VA examiner found that the Veteran did not have a diagnosed back disability. Based on a review of the claims folder, the December 2013 VA examiner concluded it was less likely than not that the Veteran’s claimed back disorder was a result of service. In support of the medical conclusion, the VA examiner noted that there was no evidence of a current back condition given his normal examination. The VA examiner further noted that there was no evidence of chronic back condition in the military as the Veteran had a normal examination at separation. After a review of all the lay and medical evidence of record, the Board finds that the weight of the evidence is against a finding that the Veteran has a current back disability as result of his period of service. As indicated above, although service treatment records do show a single complaint of back problems in March 1978, there is no evidence of chronic back disorder as the Veteran had a normal spine examination at the time of his separation examination. The record also does not contain any post-service treatment records pertaining to back problems, and the 2013 VA examiner found that the Veteran had a normal back examination. There is no credible persuasive evidence that the Veteran suffers from a current back disability productive of chronic functional impairment. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (holding that pain resulting in functional impairment constitutes a disability as contemplated in 38 U.S.C. § 1110, even in the absence of a presently-diagnosed condition). Here, the medical evidence of record neither verifies the Veteran’s reports of a current back disorder, document treatment related to a current back disorder, nor substantiated any functional limitations associated with any back signs or symptoms. Rather, the December 2013 VA examination report shows a normal back examination and the VA examiner concluded that the Veteran did not have a current back disability. In the absence of proof of a current disability at any point during the pendency of the appeal, there can be no valid claim for service connection. See 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303 (a), (d). The Veteran has not submitted any medical evidence that shows he has a diagnosed back disability during the appellate period or a back disability close in time to the appeal period. The Board has considered the Veteran’s statements with regard to his reports of episodic back pain. The Veteran is competent to report that which he has personally experienced, such as pain. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the record does not show he has the medical training or expertise to provide an opinion on a diagnose a back condition or the etiology of such condition. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Veteran’s lay statements, although acknowledged, are outweighed by the more probative clinical evaluation conducted by the December 2013 VA examiner which showed that the Veteran had a normal back examination and there was no evidence of a current back disability. Moreover, there is no persuasive evidence linking the Veteran’s claimed back disorder to his period of service. Rather, the only competent medical opinion of record heavily weighs against the Veteran’s claim. Here, the December 2013 VA examiner opined that the Veteran’s current claimed back problems were less likely than not a result of his period of service as he had a normal spine examination at separation and there was no evidence of back disorder on current physical examination. Overall, the Board finds the VA examiner’s conclusion based on the normal physical examination to be more probative, and demonstrates that the Veteran does not have a current back disability as a result of his period of service. In sum, the evidentiary requirements of demonstrating a current disability and a nexus to service have not been satisfied. There is no doubt of material fact to be resolved in the Veteran’s favor, and the claim of service connection for a back disorder must be denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53. 2. Entitlement to service connection for left hand disorder, to include residuals of third digit fracture The Veteran seeks entitlement to service connection for a left hand disorder. The Veteran reports that he has suffered several laceration injuries to left hand from sharp objects and his middle finger was smashed by a closing car door during his period of service. He reported that his left thumb was barely functional. See March 2013 statement in support of the case and January 2016 substantive appeal. A review of the Veteran’s service treatment records shows in August 1978, he suffered an injury to his third digit on his left hand when it was slammed by a closing car door. X-ray film revealed findings of finger distal phalanx tuft fracture and he required left third finger nail bed laceration repair. An October 1978 service orthopedic consultation note showed that the Veteran’s injury to his left middle finger was considered healing. There are no subsequent complaints of left hand or left middle finger problems. His July 1981 examination prior to separation shows that his left hand was evaluated as normal. The report of a December 2013 VA examination shows that no left hand disorder was diagnosed, other than residuals of a left thumb deep laceration injury, which the Veteran reported had occurred years after service. The VA examiner noted that the Veteran reported no chronic left hand condition originating from military service. Although his service treatment records show the Veteran had suffered a left third digit fracture and he required nail bed repair, he did not report any current symptoms or limitations regarding his left third finger. On clinical examination, the Veteran’s left thumb had a residual laceration scar and he was unable to fully extend his left thumb. There was no other abnormal finding pertaining to the Veteran’s left hand observed on clinical evaluation. Based on a review of the claims folder, the VA examiner concluded that it was less likely than not that the Veteran had a current claimed left hand disorder as a result of service. In support of this medical conclusion, the VA examiner noted that the only abnormalities of left hand found on examination was the Veteran’s inability to fully extend left thumb, which by his own admission and lack of service treatment records, was a post-service injury. Initially, the Board notes that the competent medical evidence demonstrates that the Veteran has a current left hand disability that is manifested by residuals of left thumb laceration injury, which included limitation of motion and laceration scar of the thumb. Although the Veteran’s service treatment records show he injured his left middle finger, the competent evidence does not demonstrate that he has current residuals from that in-service injury. Rather, the VA examiner found that the Veteran had a normal left hand examination, other than his left thumb abnormalities, and the Veteran specifically denied any current symptoms or limitations regarding his left third finger. There is no competent evidence of disability involving the Veteran’s left third finger. See Saunders, 886 F.3d at 1356. After a review of all the evidence of record, lay and medical, the Board finds that the weight of the competent evidence demonstrates there is no relationship between the Veteran’s current left hand disability and his military service. There is no evidence of a left thumb laceration injury during service, and the Veteran specifically reported he suffered the left thumb laceration injury after his separation from service. In addition, there is evidence of recurrent symptoms of left hand problems during service or since service. Moreover, there is no competent medical opinion that links the Veteran’s current left hand disorder to his period of service. Rather, the December 2013 VA examiner provided a medical opinion that goes against such a relationship. The Board finds that the VA examiner’s medical opinion is highly probative in this matter, because it is based on a review of the claims folder, including the Veteran’s reported medical history and service treatment records. The VA examiner’s medical conclusion heavily weighs against the Veteran’s claim for service connection. There is no contrary medical opinion of record. While the Veteran believes he had a current left hand disorder that is related to an in-service injury, he is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it requires knowledge of musculoskeletal conditions. Jandreau, 492 F.3d at 1377 n.4. Consequently, the Board gives more probative weight to the VA examiner’s medical opinion that weighs heavily against the claim. Accordingly, a medical nexus between the Veteran’s current diagnosis and his period of service has not been shown. In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, the preponderance of the evidence is against the Veteran’s claims of entitlement to service connection for a left hand disorder. As such, that doctrine is not applicable in the instant appeal, and his claim must be denied. 38 U.S.C. § 5107 (2012); 38 C.F.R. § 3.102 (2017); Gilbert, supra. 3. Entitlement to service connection for a right ankle disorder 4. Entitlement to service connection for a left ankle disorder The Veteran seeks entitlement to service connection for bilateral ankle disorder. The Veteran reports that he experiences generalized ankle pain with extended weight bearing activities. The Veteran believes that his current bilateral ankle problems are a result of injuries sustained while performing heavy construction such as a steel work during service. The Veteran reports that during service, he was constantly climbing and lifting as well as standing in awkward positions on structures for long periods of time, which he believes has caused his current bilateral ankle problems. See March 2013 statement in support of the case and January 2016 substantive appeal. A review of the Veteran’s service treatment records shows that the Veteran sought treatment for his right ankle, but not his left ankle during service. He presented in March 1979 with complaints of sore right ankle for the past week. He had slight discomfort range of motion, and assessed with a muscle strain. In September 1979, the Veteran reported that he twisted his right ankle while playing basketball. On clinical evaluation, there was pain on palpitation, but no discoloration or swelling, and he had good range of motion. An impression of sprained right ankle was given. There are no subsequent treatment records for complaints of ankle problems. His July 1981 examination prior to separation shows his lower extremities were evaluated as normal. An associated report of medical history is not available. There is no post-service medical evidence of ankle problems, and the Veteran has not identified any outstanding records of pertinent treatment. The report of a December 2013 VA examination shows that the VA examiner found that the Veteran did not have a currently diagnosed ankle disorder. The Veteran complained of occasional generalized ankle pain with extended weight bearing activities, but he has not sought treatment for any ankle problems since service. The findings from clinical examination show that the Veteran had a normal bilateral ankle examination and no ankle disability was identified. Based on a review of the claims folder, the December 2013 VA examiner concluded that it was less likely than not that the Veteran’s claimed right ankle disorder was a result of service, to include in-service treatment for right ankle problems. In support of this medical conclusion, the VA examiner noted that there was no evidence of chronic right ankle condition in the military as he had a normal examination at separation and there was no evidence of a current diagnosed disorder based on the current examination. Based on a review of the claims folder, the Board concludes that the Veteran does not have a current diagnosis of a right and/or left ankle disability, and has not had one at any time during the pendency of the appeal. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303 (a), (d). While the Veteran reported he experiences generalized ankle pain during the December 2013 VA examination, there is no credible persuasive evidence that the Veteran’s reported ankle pain has been so severe as to cause a functional impairment to support a finding of a current left or right ankle disability. See Saunders, 886 F.3d at 1356. Although the Veteran believes that he has a current ankle disability due to pain, he is not competent diagnose an ankle disability. A medical diagnosis of a current disability in this instance requires medical expertise which the Veteran has not been shown to possess. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Rather, the Veteran’s lay complaints, although acknowledged, are outweighed by the more probative clinical evaluation conducted by the December 2013 VA examiner which showed the Veteran had a normal bilateral ankle examination. Moreover, the December 2013 VA examiner opined that the Veteran’s claimed right ankle problem was less likely than not a result of his period of service as he had a normal examination at separation and there was no evidence of ankle disorder on current physical examination. Overall, the Board finds the VA examiner’s conclusion based on the normal physical examinations for bilateral ankles to be more probative, and demonstrates that the Veteran does not have a current right or left ankle disability as a result of his period of service. In sum, the evidentiary requirements of demonstrating a current disability and a nexus to service have not been satisfied. There is no doubt of material fact to be resolved in the Veteran’s favor, and the claim of service connection for right and left ankles disorder must be denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53. 5. Entitlement to service connection for a left knee disorder, identified as patellofemoral pain syndrome 6. Entitlement to service connection for a right knee disorder, currently identified as patellofemoral pain syndrome The Veteran seeks entitlement to service connection for a bilateral knee disorder. He reports that he has weakened knees. The Veteran believes that he has current bilateral knee disorder as a result of injury from heavy lifting and kneeling for prolong periods during his service. See March 2013 statement in support of the case and January 2016 substantive appeal. A review of the Veteran’s service treatment records shows complaints of left and right knee problems. In January 1979, the Veteran complained of left knee pain for the past two weeks, mostly when sitting. He had normal range of motion with no tenderness on clinical examination. It was felt that he had sore muscle from a past trauma which occurred two weeks earlier. In February 1981, the Veteran presented with complaints of bilateral knee pain for the past day. He reported that the knee pain began while he was playing basketball. Clinical examination revealed some knee pain on bending and impression knee trauma was given. He was advised to avoid squatting. His July 1981 examination prior to separation shows his lower extremities were evaluated as normal. An associated report of medical history is not available. There is no post-service medical evidence of knee problems, and the Veteran has not identified any outstanding records of pertinent treatment. In December 2013, the Veteran was afforded a VA examination in conjunction with his claim. The examination report shows a current diagnosis of patellofemoral pain syndrome, bilateral knees. The Veteran reported a medical history of the bilateral knee pain, which was worse on left than right, that began approximately 3-4 years ago. He reports increased knee pain triggered by prolonged kneeling and weightbearing activities. He did not report any acute knee trauma in service. Based on a review of the claims folder, the VA examiner concluded it was less likely than not that the Veteran’s bilateral knee patellofemoral syndrome was a result of his period service. The VA examiner noted that the current diagnosis was first established on the current examination and there was no evidence of patellofemoral syndrome in service treatment records. The VA examiner had further noted that although his service treatment records showed visits for sport-related injuries, mostly sore muscles or contusions, there was no evidence of a chronic knee condition and his separation examination showed knee normal evaluation. While the evidence of record shows that the Veteran has current diagnosed left and right knees disorder, namely patellofemoral syndrome, the probative evidence of record demonstrates that such is not related to his service. In this regard, the Board places great probative weight on the opinion of the December 2013VA examiner that the current bilateral knee disorder was less likely than not related to service. The Board finds that the VA examiner’s medical opinion is highly probative in this matter, because it is based on a review of the claims folder, including the Veteran’s reported medical history and service treatment records. The VA examiner’s medical conclusion heavily weighs against the Veteran’s claim for service connection. There is no contrary medical opinion of record. Moreover, the Veteran has not asserted, and the record does not demonstrate, a continuity of bilateral knee symptoms since his period of service. Rather, the Veteran reported an onset of 2009 or 2010 for his current bilateral knee problems during the 2013 VA examination. Service connection based on continuity of symptomatology has not been demonstrated by the record. The Board has considered the Veteran’s assertions that his current bilateral knee disorder is related to his service. Again, the Veteran is competent to provide lay evidence relating to symptoms within the realm of his personal knowledge, such as knee pain and weakness, but he not competent to establish that which would require specialized knowledge or training, such as medical expertise. Layno v. Brown, 6 Vet. App. 465, 469-70 (1994). While the Veteran is competent to describe the current manifestations of his bilateral knee disorder and to describe any claimed knee complaints in service, the Board accords such statements regarding the etiology of such disorder little probative value as he is not competent to opine on such a complex medical question. Specifically, where the determinative issue is one of medical causation, only those with specialized medical knowledge, training, or experience are competent to provide evidence on the issue. See Jones v. Brown, 7 Vet. App. 134, 137 (1994). The Veteran has offered only conclusory statements regarding the relationship between his in-service knee injuries and his current bilateral knee disorder. In contrast, the VA examiner took into consideration all the relevant facts in providing an opinion, to include the Veteran’s contended in-service injury as well as the current nature of his bilateral knee disorder. Therefore, the Board accords greater probative weight to the VA examiner’s opinion. In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, the preponderance of the evidence is against the Veteran’s claims of entitlement to service connection for left and right knees disorder. As such, that doctrine is not applicable in the instant appeal, and his claim must be denied. 38 U.S.C. § 5107 (2012); 38 C.F.R. § 3.102 (2017); Gilbert, supra. 7. Entitlement to service connection for a left hip disorder The Veteran seeks entitlement to service connection for a left hip disorder. He reports that he feels his left hip constantly popping out of joint. He believes that he has a current left hip disorder is a result of injuries sustained from heavy lifting and carrying while working in heavy construction as a steel worker during his period of service. See March 2013 statement in support of the case and January 2016 substantive appeal. A review of the Veteran’s service treatment records does not show any complaints, treatment or diagnosis of left hip problems. His July 1981 examination prior to separation shows that his left lower extremity was evaluated as normal. An associated report of medical history is not available. There is no post-service medical evidence of hip problems, and the Veteran has not identified any outstanding records of pertinent treatment. The Board is cognizant that the Veteran has not been afforded a VA examination concerning his left hip, and that a nexus opinion has not been obtained. In this case, the Board finds that such development is not necessary as there is no competent evidence indicating that this disability may be associated with service. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). To the extent that the Veteran has asserted that he has a left hip as a result of his service, such a conclusory generalized lay statement alleging nexus between a current disability and service does not meet the standard to warrant a VA examination. Waters v. Shinseki, 601 F.3d 1274, 1278-79 (Fed. Cir. 2010). The evidence does not show that the Veteran has a current left hip disorder that was incurred in service, or show a medical nexus between the presently diagnosed disorder and the Veteran’s service, service connection for left hip disorder cannot be granted on a direct basis. The Board acknowledges the Veteran’s assertions that he has a current left hip disorder manifested by sensation of popping out of joint. However, there is no credible persuasive evidence that the Veteran’s reported left hip symptoms have been so severe as to cause a functional impairment to support a finding of a current left hip disability. See Saunders, 886 F.3d at 1356. Further, the Veteran is not competent to provide opinions on diagnosis and etiology of a specific musculoskeletal condition which outside the realm of common knowledge of a lay person. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Thus, the Veteran’s general statements regarding any such link are not competent. In summary, the Veteran’s service treatment records do not show any hip problems in service, and there is no evidence of any post-service treatment for left hip problems. Beyond the Veteran’s lay statements of left hip symptoms, there is no persuasive evidence of a current diagnosed left hip disability. See 38 U.S.C. § 1110; Rabideau, supra. Moreover, no medical professional has ever attributed the Veteran’s claimed conditions to his active duty service, nor is the Veteran competent to make such a link. Based on the foregoing, service connection on a direct basis is not warranted. Accordingly, the Board finds that the preponderance of the evidence is against the claim for service connection for left hip disorder, and the claim must be denied. 38 U.S.C. § 5107 (West 2014); 38 C.F.R. § 3.102 (2016); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 8. Entitlement to service connection for a vision disorder The Veteran seeks entitlement to service connection for a vision disorder. The Veteran reports that he suffers from a degeneration of visual acuity which has progressively worsened over the years. He believes that he has loss of vision as a result of flash burn injuries to his eyes during service while working as a steel worker. He reports that eye protection issued during service was not adequate, and he experienced flash burns frequently. See March 2013 statement in support of the case and January 2016 substantive appeal. A review of the Veteran’s service treatment records does not show complaints or findings pertaining to any eye injury or diagnosed eye condition. His November 1977 enlistment examination report shows his vision was 20/20 bilaterally, and his July 1981 examination prior to separation shows his vision was evaluated as 20/20 in the left and 20/15 in the right eye. There are no post-service treatment records that treatment for a diagnosed eye disorder. The Veteran has not identified any outstanding records of pertinent treatment for his eyes. Here, the competent medical evidence of record does not show that the Veteran has a currently diagnosed vision disability. Although the Veteran contends that he has vision problems that warrants service connection, the Veteran’s service treatment records do not show any diagnosis of, or treatment for, an eye disability or eye injury while in service. Moreover, the Veteran has not identified any post-service treatment for an eye disability. There is no medical diagnosis of record to rely on, either contemporaneously to service or at any time. Indeed, while the Veteran is competent to report experiencing loss of vision, he lacks the requisite medical training, expertise, or credentials needed to render a diagnosis of a specific eye disability. Such a question is complex, and requires knowledge of the ocular system, as well as training in conducting and understanding tests that demonstrate the presence of a disability or injury. He has made no such allegations regarding his complaints of loss of vision. A current disability has not been established either through the clinical record or the lay evidence. In sum, the record does not show the Veteran has had a diagnosed vision disorder at any time during the period under review. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Accordingly, the first element of service connection has not been established, and therefore, the claim must be denied. REASONS FOR REMAND 1. Entitlement to service connection for bilateral hearing loss is remanded. A remand is needed to obtain an addendum VA medical opinion on whether the Veteran’s current bilateral hearing loss disability is a result of his in-service acoustic trauma. While the record contains the medical opinion in the December 2013 VA audiology examination, the VA examiner did not address the significance of the shift in the pure tone thresholds between the Veteran’s enlistment and separation audiometric results. Accordingly, the Board finds that an addendum VA medical opinion is needed prior to adjudication of the claim. 2. Entitlement to service connection for a sinus disorder is remanded. 3. Entitlement to service connection for allergy disorder is remanded. 4. Entitlement to service connection for a respiratory disorder is remanded. The Veteran contends that he has current sinus, allergy, and respiratory disorders as result of his period of service, to include his exposure to dusty and fumes while working heavy construction. A review of his service treatment records shows complaints of sinus problems, allergies, and asthma. He has not yet been afforded with VA examination to obtain medical opinions on these issues. A remand is needed to afford the Veteran with a VA examination in conjunction with his claims for sinus disorder, allergies, and respiratory disorder. 5. Entitlement to service connection for a skin disorder involving the hands is remanded. The Veteran contends that he has a current skin disorder involving his hands as a result of his period of service, to include repeated exposure to lime without the use of proper hand protection, while working heavy construction during service. He has not yet been afforded with VA examination to obtain medical opinions on these issues. A remand is needed to afford the Veteran with a VA examination in conjunction with this claim. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s bilateral hearing loss is at least as likely as not related to his in-service acoustic trauma, which includes a discussion of the shift in the Veteran’s audiometric results between his enlistment and separation examinations. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any sinus, allergy, or respiratory disorder. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including in-service complaints of sinus, allergy, and respiratory problems, as well as exposure to dust and fumes from working heavy construction. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any skin disorder involving his hands. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including exposure to lime and other solvent and chemicals while working in heavy construction during service. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Department of Veterans Affairs