Citation Nr: 18148869 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 14-40 457 DATE: November 8, 2018 ORDER Entitlement to service connection for a lower back disability is denied. Entitlement to service connection for a shaving rash is denied. Entitlement to service connection for a left eye disability, to include pinguecula, is denied. Entitlement to service connection for a skin disability, claimed as a body rash, is denied. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a lower back disability. 2. The preponderance of the evidence is against finding that the Veteran has a shaving rash that first manifested during service and then continued since service, or that is due to a disease or injury in service. 3. The preponderance of the evidence is against finding that the Veteran has a left eye disability that first manifested during service and then continued since service, or that is due to a disease or injury in service. 4. The preponderance of the evidence is against finding that the Veteran has a skin disability due to a disease or injury in service, to include a reported skin rash during service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a lower back disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for entitlement to service connection for a shaving rash have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 3. The criteria for entitlement to service connection for a left eye disability, to include pinguecula, have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 4. The criteria for entitlement to service connection for a skin disability, claimed as a body rash, have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1973 to December 1975. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision by the Department of Veterans Affairs (VA). On the Veteran’s substantive appeal, VA Form 9, he did not indicate whether or not he wanted a hearing. However, he has made no indication that he desires a hearing since that time. Moreover, the representative’s most recent statement requested adjudication based on the evidence already of record. Therefore, the Board finds that the Veteran does not want a hearing. Service Connection 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. Generally, the evidence 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. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). VA must give due consideration to all pertinent medical and lay evidence in a case where a veteran is seeking service connection. 38 U.S.C. § 1154(a). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the veteran. 38 U.S.C. § 5107(b). 1. Entitlement to service connection for a lower back disability The Veteran asserts that he has a lower back disability that is related to military 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 lower back disability 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, 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 August 2013 VA examiner evaluated the Veteran and determined that, while the Veteran claimed a chronic back condition related to an April 1975 sprain in service, he reported no known condition nor any treatment for his back. Testing revealed normal range of motion, muscle strength, reflexes, and nerves. Consequently, the examiner determined that the Veteran did not have a diagnosis of a lower back disability. Further, despite VA treatment for other conditions, he only complained of back pain on a single occasion in October 2012. VA and private treatment records do not contain a diagnosis of a lower back disability. While the Veteran believes he has a current diagnosis of a lower back disability, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education and knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Moreover, while the Veteran may be competent to report having pain or soreness in a certain region, the evidentiary record does not reflect any resulting disability or functional impairment, to include his ability to function under the ordinary conditions of daily life. See Saunders v. Wilkie, No. 886 F.3d. 1356 (Fed. Cir. 2018) (indicating that the term “disability” refers to the functional impairment of earning capacity, rather than the underlying cause of the impairment, and pain alone may be a functional impairment). Consequently, the Board gives more probative weight to the competent medical evidence and finds that the Veteran does not have a current back disability. Therefore, the Board finds that the requirements for service connection for a lower back disability have not been met. In reaching the above conclusion, the Board has considered the doctrine of reasonable doubt; however, as the most probative evidence is against the claim, the doctrine is not applicable. See Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 2. Entitlement to service connection for a shaving rash 3. Entitlement to service connection for a left eye disability, to include pinguecula The Veteran contends that he suffers from a shaving rash and left eye disability that manifested during military 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 a shaving rash and a left eye disability, and evidence shows that he reported a shaving rash and eye irritation during service, the preponderance of the evidence weighs against finding that the Veteran’s current disabilities began during service or are 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). With regards to the Veteran’s shaving rash, he reported a shaving rash during service in September 1973. However, his December 1975 separation examination makes no mention of any skin abnormalities, including a shaving rash. The first indication of a shaving rash after service is when the Veteran filed his claim in October 2012, more than three decades after his separation from service. The Board acknowledges that the Veteran is competent to report having experienced a shaving rash. For that reason, the Board does find that the Veteran has a current disability despite his shaving rash not being active during the August 2013 VA examination. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007) (the current disability requirement is fulfilled when the veteran has a disorder during a pendency of the claim even if it has resolved). With regards to the Veteran’s left eye disability, he suffered eye trouble during service when he had rust in his left eye in December 2013. Two days later, a medical provider noted that his eye was inflamed. However, his December 1975 separation examination makes no mention of any eye abnormalities. The first indication of an eye abnormality after service is when the Veteran filed his claim in October 2012, more than three decades after his separation from service. Additionally, the July 2013 VA examiner, who also submitted a September 2013 addendum opinion, opined against a connection between the Veteran’s current eye disability of pinguecula and the reports of eye trouble during service. The examiner saw no evidence that would lead them to believe that the current eye disability is related to the reports of eye trouble during service. The Board determines that the Veteran’s reported history of continued symptomatology since service is insufficient by itself to warrant service connection. The Board notes that the Veteran filed a claim for a foot disability in December 2009. The fact that he filed a claim for a foot disability, but not for a shaving rash or a left eye disability, weighs against the provided timeline. The Board also cannot ignore the significant gap in time between when the Veteran left service and when he filed his claim for benefits. See Forshey v. Principi, 284 F.3d 1335, 1358 (Fed. Cir. 2002) (en banc) (the Board may consider in its assessment of a service connection claim the passage of a lengthy period of time wherein the veteran has not complained of the malady at issue). The Board notes that there are no treatment records establishing that the Veteran’s shaving rash or left eye disability are related to active duty, nor has any physician asserted that such a relationship exists. While the Veteran believes his disabilities are related to an in-service injury, event, or disease, including a shaving rash and eye trouble during service, he is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it requires advanced medical knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the medical evidence. Therefore, the Board finds that the weight of the competent evidence does not attribute the Veteran’s shaving rash or left eye disability to his military service. In reaching the above conclusion, the Board has considered the doctrine of reasonable doubt; however, as the most probative evidence is against the claims, the doctrine is not applicable. See Ortiz, 274 F. 3d 1361; Gilbert, 1 Vet. App. 49. 4. Entitlement to service connection for a skin disability, claimed as a body rash The Veteran contends that he suffers from a skin rash which first manifested during military 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 dermatitis, and evidence shows that he suffered from a rash during service, the preponderance of the evidence weighs against finding that the Veteran’s dermatitis 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). Initially, the Board notes that the Veteran’s current claim on appeal does not address his foot rash, which has been diagnosed as tinea pedis. He was previously denied service connection for “athletes feet” and did not file a substantive appeal with respect to that issue. VA treatment records show that the Veteran was prescribed medication for severe contact dermatitis in July 2011. However, VA and private treatment records do not show a diagnosis prior to that date, which is several decades after his separation from service. Rather, the Veteran has stated that his rash has not affected him since military service. Specifically, during an August 2013 VA medical appointment, he stated that his extensive rash had started three years prior. At his VA examination during that same day, he repeated that his symptoms began in 2010. The August 2013 VA examiner opined that the Veteran’s dermatitis is not at least as likely as not related to an in-service injury, event, or disease, including his rash during service. The examiner found no evidence of a chronic condition in service to link to his contact dermatitis. The examiner noted that the Veteran’s duties as a cemetery caretaker expose him to irritants. The examiner specifically cited a July 2011 dermatology evaluation by the Veteran’s private physician, which diagnosed him with contact dermatitis, as demonstrating a link of etiology to his current employment. 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 his dermatitis is related to an in-service injury, event, or disease, including his rash during service, he is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it requires specialized medical knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the medical evidence, including the VA examiner’s probative opinion. Therefore, the Board finds that the weight of the competent evidence does not attribute the Veteran’s skin disability to military service. In reaching the above conclusion, the Board also considered the doctrine of reasonable doubt; however, as the most probative evidence is against the claim, the doctrine is not applicable. See Ortiz, 274 F. 3d 1361; Gilbert, 1 Vet. App. 49. Lindsey M. Connor Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Borman, Associate Counsel