Citation Nr: 18149006 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 17-07 407 DATE: November 8, 2018 ORDER Entitlement to service connection for hernia as secondary to service-connected post-operative left kidney cancer residuals is denied. FINDING OF FACT The weight of the evidence is against a finding of a currently diagnosed left hernia at any time during the appeal period. CONCLUSION OF LAW The requirements for entitlement to service connection for hernia as secondary to service-connected post-operative left kidney cancer residuals have not been met. 38 U.S.C. §§ 1110, 1131 (West 2012); 38 C.F.R. § 3.310 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION In the initial review of this appeal, the Board allowed entitlement to service connection for atelectasis as secondary to service-connected left kidney cancer, post-left nephroureterectomy. See 12/07/2017 Remand BVA. The Board also remanded the hernia claim for a medical review to determine if the Veteran has or had a hernia and, if so, a nexus opinion on any linkage with the kidney cancer residuals. Entitlement to service connection for hernia as secondary to service-connected left kidney cancer, post-left nephroureterectomy, residuals Governing Law and Regulations A disability which is proximately due to or the result of a service-connected injury or disease shall be service connected. 38 C.F.R. § 3.310. Further, a disability which is aggravated by a service-connected disorder may be service connected to the degree that the aggravation is shown. Allen v. Brown, 7 Vet. App. 439 (1995). To establish entitlement to secondary service connection, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a nexus between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). Discussion The Veteran was diagnosed with left renal cell carcinoma in 2001, and his left kidney was removed in 2002. See 08/10/2001 Medical Treatment-Non-Government Facility, P. 4; 09/10/2002 Government Facility). An August 2014 rating decision granted service connection for kidney cancer, effective in May 2008. See 08/29/2014 Rating Decision-Narrative. Hence, Wallin Element 2 is shown by the evidence. The Court of Appeals for Veterans Claims has held that the requirement of a current disability be present is satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of the claim, even though the disability resolves prior to the Secretary’s adjudication of the claim. See McClain v. Nicholson, 21 Vet. App. 319 (2007). Post-operative urology records dated in July 2002 reflect that a flank hernia developed as a result of the kidney surgery, and that a binder was provided. A July 2003 entry noted an incisional defect/hernia. An October 2007 CT scan of the chest revealed a small hiatal hernia. See 03/17/2008 Government Facility, P. 7, 34, 37. The December 2015 VA examination report reflects the opinion that the Veteran did not have an incisional or any other abdominal hernia. The examiner, thus, opined that it was not at least as less likely as not that the Veteran has an abdominal hernia, left flank, that is proximately due to or the result of his service-connected left nephroureterectomy. See 12/24/2015 C&P Exam, P. 2. The Board noted, however, that a May 2017 examination conducted in conjunction with a claim for an increased rating of the left kidney cancer residuals reflects a ventral hernia on the left. The examiner did not comment on any potential etiology. See 05/31/2017 C&P Exam, P. 8. Hence, the Board remanded for additional medical assessment. Pursuant to the Board remand, the AOJ requested an addendum examination report. The January 2018 addendum reflects that the examiner reviewed the claims file and the Veteran’s electronic records and opined that there was no left ventral hernia. See 01/10/2018 C&P Exam, 1st Entry; 03/23/2018 Email Correspondence. The examiner’s rationale was that the “hernia” noted in earlier entries was in fact an abdominal bulge due to retroperitoneal fat, and not a hernia. The examiner noted an April 2017 entry of the Veteran’s primary care physician that noted a bulge at the left aspect of the abdomen with no palpable defect of the abdominal musculature; and, that a CT scan with contrast revealed no evidence of a hernia. Hence, the examiner opined that there was no currently diagnosed hernia; and, therefore, no diagnosed disorder to cause or aggravate. Id. The Board finds that the examiner’s opinion is supported by the weight of the evidence of record. An October 2017 outpatient entry noted the Veteran’s history of complaints of incisional pain and bloating in May 2015 and again in August 2015 in the Urology Clinic, but noted an August 2015 CT of the abdomen and pelvis with contrast showing no evidence of an incisional hernia. A November 2016 entry noted the Veteran reported intermittent right lower quadrant pain. The examiner noted that examination of the Veteran was benign, and that a colonoscopy showed polyps but was otherwise within normal limits. The Veteran was reassured and instructed to continue to use an abdominal binder, as it relieved his symptoms. The absence of a hernia on CT was again noted. See 12/21/2017 CAPRI, P. 8, 45. Thus, the Board finds that the absence of Wallin Element 1, a currently diagnosed hernia, is shown by the preponderance of the evidence of record. Hence, there is no current disorder that may have been caused or aggravated by the service-connected disability. Therefore, the claim must be denied. 38 C.F.R. § 3.310. Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD W.T. Snyder