Citation Nr: 18146213 Decision Date: 10/31/18 Archive Date: 10/30/18 DOCKET NO. 14-38 119A DATE: October 31, 2018 ORDER Service connection for a bilateral knee disorder is denied. Service connection for glaucoma is denied. Service connection for bilateral hearing loss is denied. FINDINGS OF FACT 1. The Veteran’s bilateral knee disorder was not shown in service or for many years thereafter, and is not otherwise related to active duty service. 2. The Veteran’s glaucoma was not shown in service or for many years thereafter, and is not otherwise related to active duty service. 3. The Veteran does not have a current diagnosis of bilateral hearing loss for VA compensation purposes. CONCLUSIONS OF LAW 1. The criteria for service connection for a bilateral knee disorder are not met. 38 U.S.C. §§1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307. 3.309. 2. The criteria for service connection for glaucoma are not met. 38 U.S.C. §§1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307. 3.309. 3. The criteria for service connection for bilateral hearing loss are not met. 38 U.S.C. §§1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307. 3.309, 3.385. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from February 1985 to February 1988, and from September 1990 to October 1990. Service Connection 1. Entitlement to service connection for a bilateral knee disorder 2. Entitlement to service connection for glaucoma 3. Entitlement to service connection for bilateral hearing loss The Veteran generally asserts that his bilateral knee disorder, glaucoma, and bilateral hearing loss are related to his active 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. Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. §§ 3.303 (a), 3.304, 3.307, 3.309, 3.385. As a preliminary matter, the Board concludes that the Veteran does not have a current diagnosis of bilateral hearing loss for VA compensation purposes and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 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); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); 38 C.F.R. § 3.303(a), (d). In cases where a hearing loss disability is claimed, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the above frequencies are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. Here, the Board observes that the Veteran’s service treatment records do not include any diagnosis or findings of hearing loss. Further, in February 2012, a VA examiner found that the Veteran did not have auditory threshold over 25 decibels in the 500, 1000, 2000, 3000, and/or 4000 Hertz auditory frequencies. Moreover, the Veteran had speech recognition scores, using the Maryland CNC Word List, of 96 percent in his right ear, and 94 percent in his left ear. Therefore, the Board finds that the audiological testing of record shows that the Veteran has no current hearing loss disability for VA purposes, and, as such, there can be no valid claim for service connection for hearing loss. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000); Giplin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (indicating service connection presupposes a current diagnosis of the condition claimed). The Board acknowledges the Veteran’s assertions and belief that he has bilateral hearing loss, however, he is not competent to provide a diagnosis in this case. The issue is medically complex and requires specialized medical education and knowledge of the interaction between multiple systems in the body, as well as the ability to interpret complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Further, to the extent the Veteran is competent to report decreased hearing sensations, the medical evidence is not sufficient to demonstrate a diagnosed disability for VA purposes. As such, the preponderance of the evidence is against a finding that the Veteran has bilateral hearing loss at any point during the time on appeal. See 38 U.S.C. § 1110; Rabideau v. Derwinski, 2 Vet. App. 141 (1992). With respect to glaucoma and a bilateral knee eye disorder, the Board concludes that while the Veteran has a current diagnosis of these disorders, the preponderance of the evidence weighs against finding that these disorders began during service or are otherwise etiologically related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. §§ 3.303(a), (d), 3.304, 3.307, 3.309. Specifically, aside from a single report of acute bilateral knee pain without any evidence of an injury, the service treatment records are silent for any complaints, symptoms, or a diagnosis relating to a bilateral knee disorder. Further, while the Veteran had numerous eye complaints during service, the Veteran had several eye examinations in which the military ophthalmologist specifically ruled out glaucoma and/or a disorder related thereto. Moreover, the Veteran’s February 1988 separation examination did not report any signs or a diagnosis related to a bilateral knee disorder or glaucoma. In fact, the Veteran denied any symptoms of a knee or disorder in his November 1991 reserve examination and even stated that he was in “good health.” Next, while the Veteran’s post-service treatment records include statements to his medical providers regarding symptoms of these disorders since service, the objective medical evidence nevertheless does not demonstrate any symptoms of glaucoma and/or a knee disorder until 2005. Therefore, continuity of symptoms has not been shown based on the clinical evidence, including for purposes of the chronic disease presumption under 38 C.F.R. § 3.307(a)(3). The Board recognizes the statements from the Veteran regarding his history of symptoms since service. While the Veteran is competent to report that he experienced symptoms, including pain, limitation of motion, and blurry vision, since service, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of a particular disorder. See Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Nevertheless, to the extent the Veteran asserts that his disorders have persisted since service, the Board determines that the Veteran’s reported history of continued symptoms while competent, is nonetheless not sufficient by itself to establish a relationship between his complaints and active duty. As an initial matter, the large gap in treatment for these disorders weighs against the Veteran’s claims. Moreover, the Veteran’s November 1991 reserve examination and VA treatment records from April 1995 are inconsistent with the assertions that his symptoms have persisted since service. Additionally, the Board notes that the Veteran filed a claim for VA benefits many years prior to filing the claims on appeal. Therefore, the fact that the Veteran was aware of the VA benefits system and sought out a claim for other benefits, but made no reference to the disorders he now claims, weighs heavily against his credibility. Although the Veteran is not competent to diagnosis and provide etiological opinions related to the disorders on appeal, service connection may nonetheless be established if a relationship may be otherwise established by competent evidence, including medical evidence and opinions. In this case, the Board places significant probative value on the opinions from the VA examiners that performed a detailed review of the Veteran’s service and medical treatment records, as well as a comprehensive physical examination. In this case, the August and September 2012 VA examiners opined that the Veteran’s glaucoma was not related to service. In support, they noted that while Veteran’s eye cup to disc were “wide” in service, it was still within normal limits. Further, the Veteran’s eye pressures were normal and no glaucoma treatments were prescribed. Additionally, the Board can infer that based upon the nature of the Veteran’s current glaucoma described in the examination report, in conjunction with the fact that the Veteran’s in-service and April 1995 eye evaluations did not reveal symptoms or a diagnosis of glaucoma, there is no relationship between the Veteran’s active service and his glaucoma. With regard to the Veteran’s bilateral knee disorder, the February 2014 VA examiner opined that the Veteran’s disorder was not related to service. Specifically, the examiner noted that the Veteran had arthritis and a history of stress fractures and bilateral arthroscopies in the past few years. However, based upon the severity of these conditions, the examiner determined these disorders could not have been caused by the Veteran’s single complaint of pain during service, which as the Board observes, was not caused by an injury or resulted in any limitation of function. Thus, the Board can infer from the examiner’s findings that there is no nexus between the Veteran’s active service and his current bilateral knee disorder. Additionally, the Veteran has not provided sufficient evidence, including medical opinions, to demonstrate a relationship between his disorders and active service. As part of this claim, the Board recognizes the statements from the Veteran regarding the relationship between his disorders and active service. Nevertheless, while he is competent to provide testimony regarding observable symptomatology such as pain, limitation of motion, and blurry vision, he is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it requires knowledge of the interaction between multiple systems in the body and interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Therefore, the unsubstantiated statements regarding the claimed diagnosis and etiology of the Veteran’s disorders are found to lack competency.   In light of the above discussion, the Board concludes that the preponderance of the evidence is against his claims of service connection and there is no doubt to be otherwise resolved. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Therefore, the appeal is denied. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Meyer, Associate Counsel