Citation Nr: 18146269 Decision Date: 10/31/18 Archive Date: 10/30/18 DOCKET NO. 16-25 576 DATE: October 31, 2018 ORDER Entitlement to service connection for right wrist sprain is denied. Entitlement to service connection for an upper back disability is denied. Entitlement to service connection for a right ankle sprain is denied. Entitlement to service connection for sinusitis is denied. Entitlement to service connection for abdominal pain is denied. Entitlement to service connection for dry skin is denied. FINDINGS OF FACT 1. The Veteran does not have a current right wrist disability and has not had one during the pendency of her claim. 2. The Veteran does not have a current upper back disability and has not had one during the pendency of her claim. 3. The Veteran does not have a right ankle sprain related to service. 4. The Veteran does not have a current chronic sinusitis and has not had chronic sinusitis during the pendency of her claim. 5. The Veteran does not have abdominal pain related to active service. 6. The Veteran does not have dry skin related to active service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for right wrist sprain have not all been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 2. The criteria for entitlement to service connection for an upper back disability have not all been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 3. The criteria for entitlement to service connection for a right ankle sprain have not all been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 4. The criteria for entitlement to service connection for sinusitis have not all been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 5. The criteria for entitlement to service connection for abdominal pain have not all been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 6. The criteria for entitlement to service connection for dry skin have not all been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 2007 to January 2013. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). “To establish a right to compensation for a present disability, a Veteran must show: “(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”- the so-called “nexus” requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). 1. Entitlement to service connection for right wrist sprain The Veteran contends that her claimed right wrist sprain is related to 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 the Veteran does not have a current diagnosis of a right wrist disability and has not had one during the pendency of her 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); 38 C.F.R. § 3.303(a),(d). Service treatment records (STRs) indicate an assessment of a right wrist sprain and joint pain, localized in the wrist in 2010. The Veteran underwent a VA examination in May 2016. The examination report indicates a diagnosis of wrist sprain, resolved. The report indicates that that the Veteran reported a wrist sprain in 2008, which healed fairly well, with the exception of some pain with cold weather and with pushups. The Veteran denied any significant functional loss and reported no current treatment. The report indicates that neither pain, weakness, fatigability, nor incoordination significantly limit functional ability. The examiner opined that the Veteran’s claimed right wrist sprain was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. He stated that “per the current HPI and [examination], there is no current objective evidence with which to make a diagnosis of a continuing and chronic condition associated with the right wrist this time.” While the Veteran believes she has a right wrist disability, she is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The record indicates no post-service treatment for a wrist disability, and the VA examination indicates that her previous right wrist sprain fully resolved. Consequently, the Board gives more probative weight to the competent medical evidence. For the foregoing reasons, the Board finds that the preponderance of evidence is against the Veteran’s claim of entitlement to service connection for a right wrist sprain; consequently, the claim must be denied. The preponderance of the evidence is against the claim; therefore, the benefit of the doubt doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 2. Entitlement to service connection for an upper back disability The Veteran contends that her claimed upper back disability is related to service. The Board notes that the Veteran’s low back condition is service-connected as of January 2013. 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 the Veteran does not have a current upper back disability and has not had one during the pendency of her 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); 38 C.F.R. § 3.303(a),(d). STRs indicate complaints of upper back pain in July 2011. The Veteran underwent a VA examination in May 2016. The examination report indicates a diagnosis of chronic lumbar strain, and the examiner opined that the condition was at least as likely as not incurred in or caused by service. The examiner noted that in the September 11, 2012 STR, the Veteran reported continued, chronic, low back pain. The examination report indicates that the Veteran reported difficulty picking up her kids and poor tolerance for long walks, with increased pain with running. While the Veteran believes she has an upper back condition, she is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The record indicates no post-service treatment for an upper back condition, and the VA examination report, while indicating that her low back condition is related to service does not indicate an upper back condition. Thus, the Board gives more probative weight to the competent medical evidence. For the foregoing reasons, the Board finds that the preponderance of evidence is against the Veteran’s claim of entitlement to service connection for an upper back condition; consequently, the claim must be denied. The preponderance of the evidence is against the claim; therefore, the benefit of the doubt doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 3. Entitlement to service connection for a right ankle sprain The Veteran contends that she has a right ankle disability related to 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 lateral collateral ligament sprain on the right, and evidence shows that the Veteran complained of right ankle pain in STRs, the preponderance of the evidence weighs against finding that the Veteran’s right ankle sprain began during service or is otherwise 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). The Veteran underwent a VA examination in May 2016. The examiner opined that the Veteran’s claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner noted that the April 7, 2010 STRs indicates a visit for right ankle pain, and the May 3, 2010 record indicates right ankle pain lasting 10 weeks, with a negative x-ray. However, the examiner stated, the examination associated with the May 3, 2010 visit was normal. The examiner stated there were no additional records regarding ankle problems which would indicate chronicity of the condition during service. 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). While the Veteran believes that her right ankle condition is related to service, she is not competent to provide a nexus opinion in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The record indicates no post-service treatment for a right ankle condition, and the VA examiner found no connection between her current ankle condition and her in-service complaints. Consequently, the Board gives more probative weight to the competent medical evidence. For the foregoing reasons, the Board finds that the preponderance of evidence is against the Veteran’s claim of entitlement to service connection for a right ankle condition; consequently, the claim must be denied. The preponderance of the evidence is against the claim; therefore, the benefit of the doubt doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 4. Entitlement to service connection for sinusitis The Veteran contends that her claimed sinusitis is related to 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 the Veteran does not have chronic sinusitis and has not had the disability during the pendency of her 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); 38 C.F.R. § 3.303(a), (d). STRs indicate treatment in March, June, and November 2011 for acute episodes of sinusitis. The Veteran underwent a VA examination in May 2016. The report indicates a diagnosis of chronic sinusitis, resolved, and a diagnosis of allergic rhinitis. The examiner opined that the Veteran’s claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner noted that March 19, 2011 and November 28, 2011 STRs report acute sinusitis but that there are no further records found to indicate chronicity. While the Veteran believes she currently has chronic sinusitis, she is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The record indicates no post-service treatment for sinusitis, and the VA examination report indicates that the Veteran’s chronic sinusitis in 2011 was resolved. Consequently, the Board gives more probative weight to the competent medical evidence. For the foregoing reasons, the Board finds that the preponderance of evidence is against the Veteran’s claim of entitlement to service connection for an upper back condition; consequently, the claim must be denied. The preponderance of the evidence is against the claim; therefore, the benefit of the doubt doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 5. Entitlement to service connection for abdominal pain The Veteran contends that her abdominal pain is related to 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 dysmenorrhea, and evidence shows that the Veteran complained of abdominal pain and dysmenorrhea throughout service, the preponderance of the evidence weighs against finding that the Veteran’s condition began during service or is otherwise 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). The Veteran underwent a VA examination in May 2016. The report indicates a diagnosis of dysmenorrhea in 2006. The examiner stated that the Veteran reported a C-section during service, with lingering scarring and some pain with sit-ups, but no scar pain and no other significant related problems. The Veteran reported menorrhagia and dysmenorrhea persistently problematic since around 2010, but that the only records found related to that is a single 2-month long episode occurring in 2006. The examiner stated that she does not report present symptoms of this, which do fit the historical expected findings, and do fit for a diagnosis of present dysmenorrhea. The examiner stated that the condition has resolved per a review of the record but that she now reports continued episodes of cramping, pain, and heavy periods. The report indicates no continuous treatment and no functional impact. The examiner opined that the Veteran’s claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner stated that the July 27, 2006 STR indicates dysmenorrhea poorly relieved by AcipHex, and a September 14, 2006 STR reports dysmenorrhea poorly relieved by Motrin, with the additional prescription of T3. The examiner stated, however, that no additional records are found to indicate chronicity of this disorder during service, and that a review of systems in 2008 indicates a denial of dysmenorrhea. The examiner stated that while the present HPI does indicate findings consistent with a diagnosis of dysmenorrhea, records connecting her present symptoms with the symptoms experienced in 2006 are lacking. 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). While the Veteran believes that her abdominal pain, diagnosed as dysmenorrhea, is related to service, she is not competent to provide a nexus opinion in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The record indicates no post-service treatment for abdominal pain, and the VA examiner found no connection between her abdominal pain and her in-service complaints. Thus, the Board gives more probative weight to the competent medical evidence. For the foregoing reasons, the Board finds that the preponderance of evidence is against the Veteran’s claim of entitlement to service connection for abdominal pain; consequently, the claim must be denied. The preponderance of the evidence is against the claim; therefore, the benefit of the doubt doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 6. Entitlement to service connection for dry skin The Veteran contends that her skin condition is related to 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 acne vulgaris, an infectious skin condition, and evidence shows that the Veteran complained of dry skin in service, the preponderance of the evidence weighs against finding that the Veteran’s skin condition began during service or is otherwise 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). STRs indicate that the Veteran complained of dry skin during service and received a diagnosis of xerosis cutis. The Veteran underwent a VA examination in May 2016. The examiner opined that the Veteran’s claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner stated that a January 4, 2010 STR reports the diagnosis of xerosis cutis, treated with topical steroids, and that the diagnosis is parroted into subsequent problem lists, but that there is no finding of additional visits for this problem to indicate chronicity during service. Also, there is no current examination evidence of the existence of the condition. 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). While the Veteran believes that her skin condition is related to service, she is not competent to provide a nexus opinion in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The record indicates no post-service treatment for a skin condition, and the VA examiner found no connection between her current skin condition and her in-service complaints. Consequently, the Board gives more probative weight to the competent medical evidence. (Continued on the next page)   For the foregoing reasons, the Board finds that the preponderance of evidence is against the Veteran’s claim of entitlement to service connection for dry skin; consequently, the claim must be denied. The preponderance of the evidence is against the claim; therefore, the benefit of the doubt doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. JAMES G. REINHART Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Labi, Associate Counsel