Citation Nr: 18150301 Decision Date: 11/15/18 Archive Date: 11/14/18 DOCKET NO. 16-37 783 DATE: November 15, 2018 ORDER Service connection for a respiratory disorder is denied. Service connection for an irregular bowel disorder is denied. Service connection for a hernia is denied. Service connection for a kidney disorder is denied. FINDINGS OF FACT 1. The Veteran does not have a diagnosed respiratory disorder that is related to active duty service. 2. The Veteran does not have a diagnosed irregular bowel disorder that is related to active duty service. 3. The Veteran does not have a diagnosed hernia that is related to active duty service. 4. The Veteran does not have a diagnosed kidney disorder that is related to active duty service. CONCLUSIONS OF LAW 1. The criteria for service connection for a respiratory disorder have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, (2017). 2. The criteria for service connection for an irregular bowel disorder have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). 3. The criteria for service connection for a hernia have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). 4. The criteria for service connection for a kidney disorder have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty service from July 1982 to July 1985. This appeal is before the Board of Veterans’ Appeals (Board) from a May 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. Service Connection Service connection may be granted for current disability arising from disease or injury incurred or aggravated by active service. 38 U.S.C. § 1110. Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Lay evidence is one type of evidence that must be considered, and competent lay evidence can be sufficient in and of itself. The Board, however, retains the discretion to make credibility determinations and otherwise weigh the evidence submitted, including lay evidence. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006). Laypersons are considered competent to provide a medical diagnosis only if (1) the condition is simple to identify (such as a broken leg), (2) he or she is reporting a contemporaneous medical diagnosis, or (3) his or her description of symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicolson, 492 F.3d 1372 (Fed. Cir. 2007). 1. Respiratory disorder The Veteran’s service treatment records are silent for complaints, treatment, or diagnoses of a respiratory disorder. In May 2013, the Veteran underwent a VA examination. The examiner concluded that the Veteran had never been assigned a diagnosis of a respiratory disorder, nor was there any objective evidence that the Veteran had a current respiratory condition. The Veteran did not require the use of oral, parenteral corticosteroid, or inhaled medications; oral bronchodilators; or oxygen therapy for a respiratory disorder. After reviewing the Veteran’s April 2013 pulmonary function tests and chest x-rays, the examiner determined that the Veteran did not have a pulmonary disorder. With regard to the Veteran’s contentions, in which he attributes his claimed disability to his active duty service, to include as a residual of his in-service appendectomy, the Veteran is competent to report shortness of breath. Layno v. Brown, 6 Vet. App. 465, 467-69 (1994). However, the Veteran has not shown that he is competent (meaning medically trained) to make a complex medical determination involving the etiology of his purported respiratory disorder. Jandreau. There is no competent evidence indicating a diagnosis of a respiratory disorder. The preponderance of the evidence is against the claim, and the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Entitlement to service connection for a respiratory disorder is therefore not warranted and the claim must be denied. 2. Irregular bowel disorder The Veteran’s service treatment records are silent for complaints, treatment, or diagnoses of an irregular bowel or intestinal disorder. The evidence is silent for any complaints or treatment of an intestinal disorder until October 2009, when the Veteran underwent a colonoscopy at the North Shore University Hospital. The treating physician indicated that the Veteran had an inflamed and ulcerated mucosa, and mild inflammation of the gastric antrum. The findings of the biopsy were not conclusive but suggested the possibility of a lymphoproliferative disorder. No diagnosis was assigned. June 2011 VA treatment records indicated that the Veteran denied a history of constipation, ulcers, bleeding, colitis, or stones. He reported bowel movements every one to two days, with no change in frequency or caliber of stools. Later in June 2011, VA emergency department treatment records showed complaints of abdomen pain, however the treating physician noted normal bowel gas patterns. The Veteran denied abdomen pain on palpitation. November 2011 VA treatment records showed an abdomen examination indicating a soft abdomen which was neither tender nor distended, with good bowel sounds. January 2012 VA treatment records showed the Veteran’s complaints of constipation lasting two days and left flank discomfort without dysuria. The abdomen was protuberant and soft. There was no voluntary nor involuntary guarding, tenderness, rebound or rigidity. His bowel sounds were normal. April 2012 VA treatment records showed that the Veteran presented with a soft abdomen with normoactive bowel sounds. There was no indication of distention or tenderness. In October 2012, the Veteran underwent a VA examination which noted his appendectomy surgery. The Veteran reported diarrhea and constipation since his appendectomy in 1984. He stated that he had a colonoscopy and that although he had some small polyps, they were not removed. The examiner did not indicate the Veteran was assigned an intestinal condition diagnosis. The examiner also noted that the Veteran’s claims file was not available for review. In May 2013, the Veteran underwent a VA examination. The examiner concluded that the Veteran had never been diagnosed with an intestinal disorder, nor was there objective evidence that the Veteran had a current intestinal disorder. The examiner noted the Veteran’s reports of constipation and his 2009 colonoscopy, but noted that the Veteran was not diagnosed with a specific intestinal or bowel disorder. The Veteran did not use medications for an intestinal disorder, nor did he have any signs or symptoms attributable to any non-surgical non-infectious intestinal disorder. The examiner reported that the Veteran did not have episodes of bowel disturbances with abdominal stress or exacerbations or attacks of an intestinal disorder. The Veteran did not experience weight loss due to an intestinal disorder, nor were there signs of malnutrition, complications, or other general health affects attributable to an intestinal disorder. The examiner also noted that the Veteran’s April 2013 laboratory testing did not indicate an intestinal disorder. Regarding the Veteran’s contentions, in which he attributes his claimed disability to his active duty service, to include as a residual of his in-service appendectomy, the Veteran is competent to report uncomfortable or irregular bowel movements. Layno v. Brown, 6 Vet. App. 465, 467-69 (1994). However, the Veteran has not shown that he is competent (meaning medically trained) to make a complex medical determination involving the etiology of his purported uncomfortable or irregular bowel movements. Jandreau. There is no competent evidence indicating a diagnosis of an irregular bowel or intestinal disorder. The preponderance of the evidence is against the claim, and the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Entitlement to service connection for an irregular bowel disorder is therefore not warranted and the claim must be denied. 3. Hernia The Veteran’s service treatment records are silent for complaints, treatment, or diagnoses of a hernia. In October 2009, the Veteran underwent an endoscopy at the North Shore University Hospital. The treating physician indicated that a medium-sized hiatus hernia was present. In September 2012, the Veteran was evaluated at the Texas Health Harris Methodist Hospital for an acute exacerbation of chronic left side abdominal pain, dehydration, nausea, vomiting, and diarrhea. Several small low density hepatic masses were identified, but they were too small to characterize. The physician opined that they were likely tiny cysts, but no diagnosis was assigned. There was no acute abnormality noted in the abdomen or pelvis. In May 2013, the Veteran underwent a VA examination. The examiner noted the Veteran’s 1983 appendectomy, but concluded that the Veteran had never been diagnosed with a hernia, nor was there objective evidence that the Veteran had a current hernia. The Veteran did not have any other pertinent physical findings, complications, conditions, signs and/or symptoms related to the claimed disorder. As to the May 2013 VA examiner’s determination that the Veteran never had a hernia, the Board finds this statement has little probative weight. The evidence shows that the Veteran was diagnosed with a hiatus hernia in October 2009. Service treatment records do not demonstrate complaints, treatment, signs, or symptoms of a hernia. The evidence is devoid of any documented symptoms or complaints of a hernia until October 2009, over 23 years after the Veteran’s active duty service. The evidence demonstrates that the Veteran had a medium-sized hiatal hernia diagnosis in October 2009, although the evidence is silent for any treatment of a hernia following the October 2009 diagnosis. The May 2013 VA examiner concluded that the Veteran did not have a then-current hernia diagnosis. Service connection requires a current diagnosis of a disability, linked by competent evidence to service. The evidence does not demonstrate that the Veteran had a hernia at any point during the appeal period. The preponderance of the evidence is against the claim, and the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Therefore, service connection for a hernia is not warranted and the claim must be denied. 4. Kidney disorder The Veteran’s service treatment and VA treatment records are silent for complaints, treatment, symptoms, or diagnoses of a kidney disorder. In May 2013, the Veteran underwent a VA examination. The examiner concluded that the Veteran had never been assigned a diagnosis of a kidney disorder or renal dysfunction, nor was there any objective evidence that the Veteran had a current kidney disorder. In 1983, the Veteran had an appendectomy, followed with pain that resolved. The Veteran did not have kidney, ureteral, or bladder calculi. He did not have a history of or recurrent urinary tract or kidney infections. (Continued on the next page)   The evidence is silent for a diagnosis of a kidney disorder. The preponderance of the evidence is therefore against the claim, and the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Therefore, entitlement to service connection for a kidney disorder is not warranted and the claim must be denied. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Carolyn Colley, Associate Counsel