Citation Nr: 18150642 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 14-33 305 DATE: November 15, 2018 ORDER Entitlement to service connection for acid reflux is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has acid reflux due to a disease or injury in service, to include specific in-service event, injury, or disease. CONCLUSION OF LAW The criteria for service connection for acid reflux are not met. 38 U.S.C. §§ 1110, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a) (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty from August 1985 through May 1988 and from February 1989 through January 1995. 1. Entitlement to service connection for acid reflux The Veteran claims entitlement to service connection for acid reflux. He asserts in his claims submissions that symptoms associated with an acid reflux condition were present at the time of his separation from service in January 1995 and that he was subsequently diagnosed with and treated for acid reflux in June 1995. He states that his acid reflux condition has remained chronic since that time. His claim is supported also by a September 2014 statement from his former work supervisor, P.L., who recalls that over the course of the Veteran's employment from 1995 through 1999, he noticed that the Veteran had a dry cough, hoarseness, regurgitation of food, and chest pains. According to P.L., he also had gastroesophageal reflux disease (GERD) and he therefore recognized those symptoms as being likely manifestations of GERD. In general, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110 (2012); 38 C.F.R. § 3.303 (a) (2017). Service connection requires evidence showing the following elements: (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, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Even in instances where the record does not contain affirmative evidence of the occurrence of a disease or injury during service, service connection may still be granted if all of the evidence, including that pertinent to service, establishes that the disability was incurred during service. See 38 U.S.C. § 1113 (b) (2012); 38 C.F.R. § 3.303 (d) (2017); Cosman v. Principi, 3 Vet. App. 503, 505 (1992). Service connection may also be granted for a disease that was first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred during service. 38 C.F.R. § 3.303 (d) (2017). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or alternatively, whether a preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. § 5107 (b) (2017). Although the Veteran has reported initial treatment for his acid reflux symptoms in June 1995 at Los Alamos Medical Center, VA was notified by the custodian of records at that facility in June 2011 that records for the Veteran do not exist. Still, assigning full weight to lay assertions raised by the Veteran and his former supervisor that the Veteran has had chronic acid reflux symptoms since his initial reported treatment in June 1995, the preponderance of the evidence shows that the Veteran's acid reflux was not incurred during active duty service or resulted from an in-service injury, illness, or event. Careful review of the service treatment records shows no evidence of the onset of acid reflux or other esophageal or gastrointestinal symptoms or conditions during the Veteran's active duty service. Notes and records pertaining to treatment received by the Veteran during service do not reflect any complaints or findings related to acid reflux. Repeated medical examinations of the Veteran's abdomen and viscera conducted throughout the course of his active duty service were normal. Indeed, Reports of Medical History completed by the Veteran during those examinations show that the Veteran did not report any history of acid reflux, and indeed, expressly denied such symptoms as shortness of breath; pain or pressure in his chest; chronic cough; frequent indigestion; stomach, liver, or intestinal trouble; gall bladder trouble or gallstones; rupture or hernia; piles or rectal disease; or recent gain or loss of weight. Post-service treatment records show that the Veteran has been followed for ongoing GERD since September 2012. Nonetheless, the post-service treatment records contain no opinions concerning the etiology or origin of the Veteran's GERD. During an August 2016 VA examination, the Veteran reported that he began having symptoms such as sore throat, difficulty swallowing, dry cough, hoarseness, regurgitation of fluids, and acid reflux while laying down since November 1985. As discussed above, however, that history is contradicted by contrary statements made by the Veteran during his in-service medical examinations and by contrary medical findings during those examinations. Based on the review of the records, the examiner diagnosed GERD but opined that it is less likely than not that the condition was incurred during service or is proximately due to an in-service injury, illness, or event. Consistent with the evidence in the record, the examiner noted that the Veteran's service treatment records do not indicate any in-service complaints, treatment, or diagnoses related to GERD or acid reflux. The examiner's negative opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting information. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Although the Board is mindful of the Veteran's various assertions that this acid reflux symptoms began at some point during his active duty service, those assertions are not entitled to any probative weight. In that regard, such assertions are contradicted by contrary statements made by the Veteran throughout service, where he expressly denied during repeated medical examinations that he had any gastrointestinal or esophageal symptoms or disorders. Given those inconsistencies, the Veteran's assertions that he has had chronic acid reflux symptoms that date back to his active duty service carry grave credibility concerns and are not entitled probative weight. For the reasons give above, the Board assigns far greater weight to the VA examiner's negative opinion and finds that opinion persuasive. The Board points out that even if the Veteran's assertions concerning in-service onset and subsequent chronicity did carry probative weight, he would not be competent to provide a nexus opinion in this case. That issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body and interpretation of complicated diagnostic medical testing and information. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). The Veteran is not entitled to service connection for acid reflux. This appeal is denied. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D.S. Lee, Counsel