Citation Nr: 18150078 Decision Date: 11/14/18 Archive Date: 11/14/18 DOCKET NO. 14-20 319 DATE: November 14, 2018 ORDER Entitlement to service connection for sciatica of the bilateral lower extremities is granted. Entitlement to service connection for left ankle sprain is denied. FINDINGS OF FACT 1. The Veteran’s sciatica of the bilateral lower extremities is related to her active duty service. 2. 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 left ankle sprain. CONCLUSIONS OF LAW 1. The criteria for service connection for sciatica of the bilateral lower extremities are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for ankle sprain 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 April 2008 to May 2010. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a January 2012 rating decision by the Department of Veteran Affairs (VA) Regional Office (RO) in Phoenix, Arizona. Service Connection Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1101, 1110; 38 C.F.R. § 3.303. In general, to establish service connection there must be evidence showing (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or “medical nexus” between the current disability and the disease or injury incurred or aggravated during service. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010); 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. See 38 C.F.R. § 3.303 (d). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. See Baldwin v. West, 13 Vet. App. 1, 8 (1999). The Veteran is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Thus, when the evidence supports the claim or is in relative equipoise, the Veteran prevails; however, if the preponderance of the evidence is against the claim, then the claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 1. Entitlement to direct service connection for sciatica of the bilateral lower extremities. The Veteran contends that she developed sciatica of the bilateral lower extremities while on active duty. After reviewing the evidence of record, the Board agrees and finds that service connection is warranted. Upon review, the Veteran’s service treatment records document repeated complaints of low back pain with pain radiating into her lower extremities. Moreover, medical treatment records created during the Veteran’s last month of active duty service include multiple diagnoses of bilateral sciatica. These records continue after her separation from service and continue to note the diagnosis of bilateral sciatica. The Veteran filed her claim for service connection while still on active duty by using VA form 21-526c, “Pre-Discharge Compensation Claim.” As a result, the record indicates that she was diagnosed bilateral sciatica while on active duty and that this disability has continued after she separated and into the appeal period. While the Board is cognizant of the January 2011 VA medical opinion which says that the Veteran does not have sciatica, the examiner did not comment on the conflicting evidence of record. After resolving doubt in the Veteran’s favor, the Board finds that she had sciatica during the pendency of appeal. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). In view of the foregoing, the Board finds that the evidence is, at the very least, in equipoise. As such, the benefit of the doubt in resolving the issue on appeal is given to the Veteran and, therefore, service connection for sciatica of the bilateral lower extremities is warranted. 2. Entitlement to service connection for left ankle sprain. The Veteran contends that she sprained her left ankle while on active duty. 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 left ankle sprain 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); 38 C.F.R. § 3.303(a), (d); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013). The January 2011 VA examiner evaluated the Veteran and determined that, while she experienced foot pain and swelling, she did not have a diagnosis of left ankle sprain. An examination revealed that the Veteran’s left foot and ankle did not reveal any clinical abnormalities or functional impairment. With respect to the Veteran’s complaints of foot pain and swelling, the Veteran was granted service connection for idiopathic lymphedema of the left lower extremity in the January 2012 rating decision on appeal. A 10 percent disability rating was assigned. The rating decision notes that it has considered the Veteran’s complaints of pain, swelling, weakness, and fatigability when granting service connection and assigning a disability rating for that disability. The Veteran has not disagreed with the disability rating assigned to her service-connected left lower extremity disability. In a January 2013 letter, the Veteran’s private physician, Dr. P.S., noted that the Veteran was “active in cheerleading through high school” and “had multiple sprains.” However, these letters and treatment records did not identify an ankle sprain during the appeal period. In fact, a March 2012 MRI noted “no fractures or stress reactions.” The Board has considered the private medical records and letters from Dr. P.S., however while these records document the ongoing swelling, and pain, they do not indicate that the had left ankle fracture or fracture residuals during the appeal period. While the Veteran believes that she has a current diagnosis of left ankle sprain or sprain residuals, she is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education and the ability to interpret complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. In the absence of a competent medical to establish a diagnosis of left ankle sprain at any time during the appeal period, service connection may not be granted. In conclusion, for the reasons and bases expressed above, the Board finds that the preponderance of the evidence is against the Veteran’s claims of service connection for a left ankle sprain. The benefit sought on appeal is accordingly denied. M. Donohue Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Vaughn, Associate Counsel