Citation Nr: 18151361 Decision Date: 11/20/18 Archive Date: 11/16/18 DOCKET NO. 16-07 735 DATE: November 20, 2018 ORDER 1. Entitlement to service connection for a bilateral hearing loss disability is denied. 2. Entitlement to service connection for a lumbar spine disability, to include degenerative joint disease, is denied. 3. Entitlement to service connection for emphysema is denied. 4. Entitlement to service connection for obstructive sleep apnea (OSA) is denied. 5. Entitlement to service connection for diabetes mellitus, type II, is denied. 6. Entitlement to service connection for traumatic brain injury (TBI) is denied. 7. Entitlement to service connection for headaches, to include as secondary to a service-connected disability, is denied. 8. Entitlement to service connection for acquired psychiatric disorder, to include major depressive disorder, is denied. 9. The application to reopen the claim of entitlement to service connection for right first toe contusion is denied. 10. The application to reopen the claim of entitlement to service connection for loss of vision is denied. 11. The application to reopen the claim of entitlement to service connection for neurodermatitis is denied. REMANDED 12. Entitlement to service connection for hay fever is remanded. FINDINGS OF FACT 1. The Veteran does not currently have a hearing loss disability for VA purposes in either ear. 2. Lumbar spine disability was not shown in service, arthritis was not shown to a compensable degree within one year of service discharge, and is not otherwise related to service. 3. Emphysema was not incurred in service and is not otherwise related to service. 4. Obstructive sleep apnea was not incurred in service and it is not otherwise related to service. 5. Diabetes mellitus, type II, did not have its onset in during service or within one year of separation from service and is not otherwise related to service. 6. The Veteran did not experience a TBI in service. 7. Headaches were not shown to have been incurred in service, caused by or otherwise related to service; or shown to be caused by or aggravated by a service-connected disability. 8. The Veteran’s acquired psychiatric disorder, to include major depressive disorder, did not have its onset in service, is not otherwise related to active duty service, and is not secondary to a service-connected disability. 9. In a February 1998 rating decision, the regional office denied the claim of entitlement to service connection for right first toe contusion. The Veteran perfected an appeal, and in a May 2005 decision, the Board denied the claim, determining that the disability did not have its onset in service or was otherwise due to service. The Veteran did not initiate an appeal of the Board decision. 10. Evidence received since the May 2005 Board decision does not relate to an unestablished fact necessary to substantiate the claim of entitlement to service connection for right first toe contusion. 11. In a November 1998 rating decision, the regional office denied the claim of entitlement to service connection for loss of vision. The Veteran perfected an appeal, and in a May 2005 decision, the Board denied the claim, determining that the Veteran’s loss of vision was due to myopia, which is a form of refractive error and is not a disability for which service connection could be granted. The Veteran did not initiate an appeal of the Board decision. 12. Evidence received since the May 2005 Board decision does not relate to an unestablished fact necessary to substantiate the claim of entitlement to service connection for loss of vision. 13. The Veteran did not appeal the February 1998 rating decision denying entitlement to service connection for neurodermatitis after being notified of his appellate rights. 14. Evidence received since the February 1998 rating decision does not relate to an unestablished fact necessary to substantiate the claim of entitlement to service connection for neurodermatitis. CONCLUSIONS OF LAW 1. The criteria for service connection for a bilateral hearing loss disability have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385 (2017). 2. The criteria for service connection for a lumbar spine disability, to include degenerative joint disease, have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309 (2017). 3. The criteria for service connection for emphysema have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304. (2017). 4. The criteria for service connection for obstructive sleep apnea have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2017). 5. The criteria for service connection for diabetes mellitus, type II, have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.307, 3.309 (2017). 6. The criteria for service connection for TBI have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). 7. The criteria for service connection for headaches as secondary to a service-connected disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310 (2017). 8. The criteria for service connection for an acquired psychiatric, to include major depressive disorder, have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304 (2017). 9. The May 2005 Board decision denying service connection for right first toe contusion is final. New and material evidence has not been received to reopen the claim of entitlement to service connection for right first toe contusion. 38 U.S.C. §§ 5108, 7104(b) (2012); 38 C.F.R. §§ 3.156, 20.1100 (2017). 10. The May 2005 Board decision denying service connection for loss of vision is final. New and material evidence has not been received to reopen the claim of entitlement to service connection for loss of vision. 38 U.S.C. §§ 5108, 7104(b) (2012); 38 C.F.R. §§ 3.156, 20.1100 (2017). 11. The February 1998 rating decision is final. New and material evidence has not been received to reopen the claim of entitlement to service connection for neurodermatitis. 38 U.S.C. §§ 5108, 7105 (2012); 38 C.F.R. §§ 3.104, 3.156, 20.1103 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1982 to October 1991. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 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 was incurred in service. 38 C.F.R. § 3.303(d). Establishing service connection generally requires evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). In addition, service connection may also be established under 38 C.F.R. § 3.303(b) if a chronic disease is shown in service, and subsequent manifestations of the same chronic disease at any later date, however remote, are shown, unless clearly attributable to intercurrent causes. Arthritis, diabetes mellitus, type II, and hearing loss (as an organic disease of the nervous system) are chronic conditions listed under 38 C.F.R. § 3.309(a); and thus, 38 C.F.R. § 3.303(b) is applicable. Service connection may also be established based upon a legal presumption by showing that a disorder manifested itself to a degree of 10 percent disabling or more within one year from the date of separation from service. 38 U.S.C. § 1101; 38 C.F.R. §§ 3.307, 3.309(a). In deciding an appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence, which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material favorable to the claimant. Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994). Competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997). When considering whether lay evidence is competent, the Board must determine, on a case-by-case basis, whether a veteran’s particular disability is the type of disability for which lay evidence may be competent. A veteran is competent to report symptoms because this requires only personal knowledge, not medical expertise, as it comes to him through his senses. Lay testimony is competent to establish the presence of observable symptomatology, where the determination is not medical in nature and is capable of lay observation. Lay evidence may establish a diagnosis of a simple medical condition, a contemporaneous medical diagnosis, or symptoms that later support a diagnosis by a medical professional. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 1. Entitlement to service connection for a bilateral hearing loss disability. The Veteran contends that service connection for a bilateral hearing loss disability is warranted because it was caused by his in-service exposure to acoustic trauma. Specific to claims for service connection, impaired hearing is considered a disability for VA purposes when the auditory threshold in any of the frequencies of 500, 1,000, 2,000, 3,000, or 4,000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of these frequencies are 26 or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. In evaluating claims of service connection for hearing loss disability, it is observed that the threshold for normal hearing is from zero to 20 decibels, with higher threshold levels indicating some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). Service connection for a bilateral hearing loss disability is not warranted because the Veteran has does not have a current hearing loss disability in either ear for VA purposes. In April 2014, the Veteran underwent a VA audiological assessment which showed that the Veteran’s puretone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 25 25 25 25 30 LEFT 25 20 15 30 20 The assessment revealed a speech recognition score of 100 percent and 96 percent using the Maryland CNC Test for the right ear and left ear, respectfully. The audiologist found mild to moderate sensorineural hearing loss from 4-8 kHz for the right ear and mild sensorineural hearing loss at 3 kHz for the left ear. However, the Veteran does not have a current hearing loss disability in either ear for VA purposes. The auditory threshold is not 26 or greater in at least three, or 40 or greater in at least one, of the frequencies of 500, 1,000, 2,000, 3,000, or 4,000 Hertz for either ear. Speech recognition testing is not less than 94 percent using the Maryland CNC Test. 38 C.F.R. § 3.385. Therefore, the evidence does not support a finding that the Veteran has a current hearing loss disability in either ear for VA purposes and does not meet the first requirement of service connection. The Board has also considered lay statements from the Veteran; however, lay assertions do not constitute a competent clinical diagnosis of a hearing loss disability for VA purposes. Competent medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. See 38 C.F.R. § 3.159(a)(1). The Veteran’s lay assertions cannot constitute competent evidence in support of a current diagnosis of a right or left ear hearing loss disability for VA purposes. In the absence of a current diagnosis for a right or left ear hearing loss disability for VA purposes, service connection cannot be established. If the Veteran’s hearing loss worsens, he may submit a new claim for service connection for a hearing loss disability of either or both ears. The preponderance of the evidence is against the claim of service connection for a bilateral hearing loss disability, the benefit-of-the-doubt doctrine is not for application, and the claim for service connection is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 2. Entitlement to service connection for a lumbar spine disability. The Veteran contends that service connection for a lumbar spine disability is warranted because it was incurred in service or otherwise a result of service. Specifically, the Veteran asserts that his low back disability was due to heavy lifting in service and non-specific back pain. See 1) October 2014 Disability Benefits Questionnaire (DBQ) for back conditions and 2) January 2016 Decision Review Officer (DRO) hearing transcript. The Board has carefully reviewed the evidence of record and finds that service connection for a lumbar spine disability is not warranted because the preponderance of the evidence is against a finding that the Veteran has a lumbar spine disability that is related to service, which is explained below. As to evidence of a current disability, VA medical records, including a February 2016 record reflect chronic recurrent episodes of low back pain and degenerative joint disease (DJD) of the lumbar spine, which was shown by computed tomography (CT) scan in March 2015. A diagnosis of faucet joint arthropathy or DJD was also noted in the October 2014 Disability Benefits Questionnaire (DBQ) for back conditions. Thus, the Veteran meets the first element for service connection. As to an in-service disease or injury, the service treatment records and personnel records do not document low back complaints. For example, a November 1990 Report of Medical Examination for the purposes of Desert Shield reveal a normal clinical evaluation of all bodily systems including “upper extremities,” “lower extremities,” and “spine, other musculoskeletal.” This tends to show that he did not incur a lumbar spine disability in service. However, the Veteran’s Certificate of Release or Discharge (DD Form-214) indicates that the Veteran’s primary specialty was petroleum supply, and the Board finds that the Veteran is competent to report his duties while in service. Therefore, the Board concedes that the Veteran’s duties as a petroleum supply specialist includes heavy lifting. As to a nexus to service, the Board finds that the preponderance of the evidence is against such a nexus. An October 1992 private record shows that examination of the Veteran’s musculoskeletal system was normal. Thus, approximately one year following service discharge, the Veteran’s musculoskeletal system was normal. In January 2003, the Veteran was seen at VA for primary care. In reviewing the Veteran’s systems, the document states to put an x if the review is positive. There was no x under the review of the musculoskeletal system, which included joint pain or swelling, arthritis, and myalgias. The examiner noted that the Veteran’s range of motion was intact with adequate muscle tone, and no deformities. This tends to show that more than 10 years following service discharge, the Veteran was not complaining of back problems. An October 2014 DBQ shows diagnoses for faucet joint atrophy diagnosed December 2013 and radiculopathy diagnosed January 1984. It is noted in the DBQ that the Veteran’s back condition “onset circa 1984 or so on active duty in Honduras after living heavy equipment. Low back with bilateral radicular pain.” However, as noted above, service treatment records are silent for any low back complaints. The diagnosis of faucet joint atrophy or DJD was noted to be from December 2013, which is over 20 years after service separation. The preponderance of the evidence is against a finding that arthritis manifested itself to a degree of 10 percent disabling or more within one year from the date of separation from service and a presumption of service connection based on chronicity of arthritis is not appropriate. 38 U.S.C. § 1101; 38 C.F.R. §§ 3.307, 3.309(a). The Board finds that the Veteran has not offered probative and competent evidence establishing a nexus between his lumbar spine disability and service. Lay evidence may be competent to establish medical etiology or nexus. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). However, “VA must consider lay evidence but may give it whatever weight it concludes the evidence is entitled to.” See Waters v. Shinseki, 601 F.3d 1274, 1278 (2010). A diagnosis of a lumbar spine disability requires specialized training for determinations as to diagnosis and causation, and is therefore, not susceptible to lay opinions on etiology. Therefore, the Board finds that the lay assertions proffered by the Veteran lack probative value. There are numerous post-service medical records reflecting complaints and treatment for a lumbar spine disability. However, these records do not provide a positive nexus regarding the onset, etiology, or relationship of a lumbar spine disability to military service. Absent competent, credible, and probative evidence of a nexus between the Veteran’s service and his lumbar spine disability, the Board finds that the current lumbar spine disability was not incurred in service and it is not otherwise related to service. See 38 U.S.C. § 5107(a). Accordingly, service connection for a lumbar spine disability is not warranted. 3. Entitlement to service connection for emphysema The Veteran asserts that service connection for emphysema is warranted because it was incurred in service or otherwise a result of service. The Board finds that service connection for emphysema is not warranted because the preponderance of the evidence is against a finding that the Veteran has emphysema that is related to service, as discussed below. The Veteran has a current diagnosis of emphysema, which is documented in VA medical records including March 2016 that shows a past medical history of other emphysema. In a February 2013 VA medical record, the medical professional specifically noted that the Veteran had emphysema. VA treatment records show the diagnosis as of July 2001. Thus, the Veteran meets the first element for service connection. As to an in-service disease or injury, the service treatment records and personnel records do not document complaints related to emphysema. For example, a November 1990 Report of Medical Examination reveal a normal clinical evaluation of all bodily systems including “lungs and chest.” In April 2010 statements, the Veteran asserted that his respiratory problems, including emphysema, were caused by exposure to fumes from oil wells/fields that were burned by the enemy and smoke inhalation during his tour of duty in the Gulf. The Veteran’s Certificate of Release or Discharge from Active Duty (DD Form 214) shows that he served in the Southwest Asia theater of military operations from December 1998 to May 1991. The Board finds the Veteran credible to report exposure to smoke from oil fields and concedes that the Veteran was exposed to such in service. As to a nexus to service, the Board finds that the preponderance of the evidence is against such a nexus. The Board has reviewed service treatment records and personnel records for evidence that emphysema was incurred in service or otherwise caused by service and finds the preponderance of the evidence is against such relationship. Service treatment records are silent for any complaints, treatment or diagnosis related to emphysema. There are numerous post-service medical records reflecting complaints and treatment for emphysema. However, these records do not provide a positive nexus regarding the onset, etiology, or relationship of emphysema to military service. The Veteran has asserted that his emphysema is related to service; however, the Veteran has not offered probative and competent evidence establishing a nexus between emphysema and service, to include inhalation of smoke from oil fields. Lay evidence may be competent to establish medical etiology or nexus. However, “VA must consider lay evidence but may give it whatever weight it concludes the evidence is entitled to.” A diagnosis of emphysema requires specialized training for determinations as to diagnosis and causation, and is therefore, not susceptible to lay opinions on etiology. Therefore, the Board finds that the lay assertions proffered by the Veteran lack probative value. Absent competent, credible, and probative evidence of a nexus between emphysema and the Veteran’s service, the Board finds that emphysema was not incurred in service and is not otherwise related to service. See 38 U.S.C. § 5107(a). Accordingly, service connection for emphysema is not warranted. The preponderance of the evidence is against the claim of service connection for emphysema, the benefit-of-the-doubt doctrine is not for application, and the claim is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 4. Entitlement to service connection for obstructive sleep apnea (OSA). The Veteran contends that service connection for obstructive sleep apnea (OSA) is warranted because it was incurred in, caused by or otherwise related to service. See April 2010 statements. As to a current diagnosis, a November 2010 VA examination report confirms a diagnosis of mild OSA. The Board has reviewed the record, including service treatment records and post-service medical records and finds that the preponderance of the evidence is against a finding that OSA had its onset in service or is otherwise due to service. The Veteran’s service treatment records are silent for any diagnosis, symptoms, or treatment of a sleep disorder. Further, the November 1990 Report of Medical Examination reveals a normal clinical evaluation of all bodily systems including “lungs and chest” and no sleep disorders are noted by the examiner. However, the Veteran reported that he was exposed to smoke and fumes from oil fires while serving in the Gulf. The Veteran was provided a VA Gulf War Examination in November 2010. The examiner noted that the Veteran’s sleep disorder onset in 2007. He indicated that the Veteran’s mild OSA is a disease with a clear and specific etiology and diagnosis and that it is not related to a specific exposure vent experienced by the Veteran during service in Southwest Asia. The Veteran has not offered probative and competent evidence establishing a nexus between his OSA and service. Lay evidence may be competent to establish medical etiology or nexus. However, “VA must consider lay evidence but may give it whatever weight it concludes the evidence is entitled to.” The Board notes that the Veteran was diagnosed with OSA almost 16 years after his October 1991 separation from service, as shown in a March 2007 VA medical record which includes a diagnosis “suggestive of mild obstructive sleep apnea.” The Board may take into consideration the passage of a lengthy period of time in which the Veteran did not complain of the disorder at issue. See Maxon v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). A diagnosis of OSA requires specialized training for determinations as to diagnosis and causation, and is therefore, not susceptible to lay opinions on etiology. Therefore, the Board finds that the lay assertions proffered by the Veteran lack probative value. Absent competent, credible, and probative evidence of a nexus between the Veteran’s service and his OSA, the Board finds that his current OSA was not incurred in service and it is not otherwise related to service. See 38 U.S.C. § 5107(a). Accordingly, service connection for OSA is not warranted. The preponderance of the evidence is against the claim of service connection for obstructive sleep apnea, the benefit-of-the-doubt doctrine is not for application, and the claim is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 5. Entitlement to service connection for diabetes mellitus, type II. The Veteran contends that service connection for diabetes mellitus, type II, is warranted because it was incurred in service or otherwise a result of service. Specifically, during the January 2016 DRO hearing, the Veteran stated that he was advised of elevated blood glucose in service, but not diagnosed until several years after discharge. The Veteran has a diagnosis of diabetes mellitus, type II, which has been shown in private medical records as early as November 1998. Accordingly, the first element of service connection is met. However, the Board finds that service connection for diabetes mellitus, type II, is not warranted because the medical evidence of record does not establish the required nexus between the disability and the Veteran’s military service. The Board has reviewed the evidence to include service treatment records; personnel records; and post-service medical records and finds that the perdurance of the evidence is against a finding that diabetes mellitus type II was incurred in service or otherwise caused by service. The Veteran’s earliest diagnosis of diabetes mellitus, type II, was in November 1998, which is almost seven years after service discharge. The medical evidence does not show that the Veteran’s diabetes mellitus, type II, manifested to a degree of 10 percent disabling or more within one year from his October 1991 separation from service and a presumption of service connection based on the chronicity of diabetes mellitus, type II, is not appropriate. 38 U.S.C. §§ 1101; 38 C.F.R. §§ 3.307, 3.309(a). The November 1990 Report of Medical Examination revealed normal findings of all bodily systems and no mention of any symptoms, complaints, or diagnosis related to diabetes mellitus, type II. While the Veteran asserts that he had elevated blood glucose in service, it is not documented in his service treatment records. Thus, the Board finds that the preponderance of the evidence is against an in-service occurrence or an event relating to diabetes mellitus, type II. There are numerous post-service medical records reflecting complaints and treatment for diabetes mellitus, type II. However, these records do not directly provide a positive nexus regarding the onset, etiology, or relationship of diabetes mellitus, type II, to military service. The Veteran has asserted that his diabetes mellitus, type II, is related to service; however, has not offered probative and competent evidence establishing a nexus between the diabetes mellitus type II and service; to include exposure to herbicides. Lay evidence may be competent to establish medical etiology or nexus. However, “VA must consider lay evidence but may give it whatever weight it concludes the evidence is entitled to.” A diagnosis of diabetes mellitus, type II, requires specialized training for determinations as to diagnosis and causation, and is therefore, not susceptible to lay opinions on etiology. Therefore, the Board finds that the lay assertions proffered by the Veteran lack probative value. Absent competent, credible, and probative evidence of a nexus between the Veteran’s service and his diabetes mellitus, type II, the Board finds that diabetes mellitus, type II, was not incurred in-service and is not otherwise related to service. See 38 U.S.C. § 5107. Accordingly, service connection for diabetes mellitus, type II, is not warranted. The preponderance of the evidence is against the claim of service connection for diabetes mellitus, type II, the benefit-of-the-doubt doctrine is not for application, and the claim is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 6. Entitlement to service connection for traumatic brain injury (TBI). The Veteran contends that he experienced a traumatic brain injury (TBI) while in service. Specifically, in an April 2010 notice of disagreement, the Veteran asserted he experienced a TBI from an explosion during a convoy operation in service; a blast within 10 meters. During a January 2016 DRO hearing, the Veteran reported that he hit his head on a generator door, did not lose consciousness, but did have a brief visual disturbance at the time. However, the preponderance of the evidence is against a finding that the Veteran experienced a TBI in service. The November 2010 VA examination report for TBI shows the onset of head trauma with cephaleas as occurring in 1988, when the Veteran suffered a laceration in the right pinna when he received trauma from a metallic door. The examiner noted that there was no loss of consciousness documented but the Veteran required suturing of the pinna. It is also noted that an incision and drainage was done on the left ear previously due to chronic infection. The Veteran reported cephaleas after the trauma that still persisted at the time of the examination. The Veteran stated that the headaches were present prior to the incident. The examiner found that service treatment records are silent for complaints of headaches except those that were associated with upper respiratory infections. A March 1984 service treatment record reflects that the Veteran hit his head on a door of a fuel truck, which resulted in mild bleeding, and slight laceration to the forehead. The area of the forehead was washed off, sterilized, cleaned, and bandaged. The Veteran was provided with head injury instructions and understood to return upon signs of increased cranial pressure or other signs and was stable upon discharge. A March 1988 service treatment record shows a laceration to the right pinna following a metal door slamming on his head, as noted in the November 2010 VA examination report above. The examiner found the severity of the initial injury to be mild. Service treatment records are silent for any record of medical treatment following an explosion during a convoy operation as claimed by the Veteran in an April 2010 statement. The November 1990 Report of Medical Examination revealed normal findings of all bodily systems including “head, face, neck, and scalp,” and no mention of any symptoms, complaints, or diagnosis related to a TBI. The November 2011 VA examiner opined that the Veteran’s claimed TBI was less likely as not (less than 50 percent probability) caused by or a result of trauma to the head by the metallic door. He provided the rationale that the reported trauma was very mild according to the annotation and the temporal distribution and the onset of the symptoms do not establish a definite nexus of causality between them and the trauma. The examiner also added that the Veteran complained of cephaleas prior to the incident, although he noted that the service treatment records were silent for this symptom. In sum, the Veteran was not diagnosed with a TBI in service. The Veteran did not provide any specific details regarding an alleged convoy explosion during medical treatment, and the VA examiner found that the documented service treatment record reflecting trauma from a head injury by a metallic door was mild and attributed headaches to upper respiratory infections, which weighs against the Veteran’s allegation of having sustained a TBI in service. The preponderance of the evidence is against the claim of service connection for TBI, the benefit-of-the-doubt doctrine is not for application, and the claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 7. Entitlement to service connection for headaches, to include as secondary to traumatic brain injury (TBI). The Veteran asserts that he is entitled to service connection for headaches due to TBI, including in a May 2012 statement. The Veteran does not contend or offer evidence to support that headaches are related to service in any way other than as secondary to TBI, nor does the record raise this theory. The Board will limit its analysis to the theory advanced by the Veteran. Robinson v. Peake, 21 Vet. App. 545, 552-56 (2008). Service connection may be granted for a disability that is proximately due to, or the result of, a service-connected disability. See 38 C.F.R. § 3.310(a) (2017). The controlling regulation has been interpreted to permit a grant of service connection not only for disability caused by a service-connected disability, but for the degree of disability resulting from aggravation of a non-service-connected disability by a service-connected disability. See Allen v. Brown, 7 Vet. App. 439, 448 (1995). In other words, service connection may be granted for a disability found to be proximately due to, or aggravated by, a service-connected disease or injury. The Veteran’s claim of entitlement to service connection for TBI is denied herein; therefore, the claimed headaches cannot be granted on a secondary basis as TBI is not a service-connected disability. The claim must be denied. 8. Entitlement to service connection for an acquired psychiatric disorder, to include major depressive disorder. The Veteran asserts that service connection for an acquired psychiatric disorder is warranted because it is caused by or otherwise related to his military service. As to a current disability, the evidence, including a May 2016 VA mental health note, reflects that the Veteran is diagnosed with [major] depressive disorder, which is also referred to as depression in other records. Therefore, the first element of service connection for an acquired psychiatric disorder has been met. While the Veteran has a diagnosis of depressive disorder, the Board has reviewed service treatment records and personnel records for evidence that an acquired psychiatric disorder was incurred in service or otherwise caused by service and finds the preponderance of the evidence is against such a relationship. Specifically, the November 1990 Report of Medical Examination revealed normal findings of all bodily systems, including psychiatric state, and no mention of any symptoms, complaints, or diagnosis related to an acquired psychiatric disorder. There are numerous post-service VA medical records reflecting complaints and treatment for an acquired psychiatric disorder. However, these records do not provide a positive nexus regarding the onset, etiology, or relationship of an acquired psychiatric disorder to military service. To the contrary, an August 2015 VA record reflects that the Veteran reported his first psychiatric attention in 2003/2004 came after his prostate cancer, which caused him to become depressed. November 2012 and December 2012 VA medical records show that the Veteran had a history of depression following prostate cancer in 2003. The Veteran had developed severe financial strain and could not remain employed at the time. The Veteran was also required to care for his mother who was ill and the stress of his medical and social issues led to a diagnosis of “major depression.” Further, in May 2013, the Veteran reported worsening of his depression due to family stress, specifically the inability to help his nephew with his personal problems. The Veteran has also submitted VA medical records from April 2011 in which he annotated a diagnosis of major depressive disorder and a medical history of diabetes mellitus, emphysema, hypertension, elbow pain, prostate cancer, and knee arthroscopy. The VA psychiatry professional noted that the Veteran mentioned chronic medical conditions as the main stressor for feeling “down,” in the preceding weeks. The assessment included major depressive disorder under Axis I, Axis II was deferred, and diabetes mellitus, emphysema, hypertension, elbow pain, prostate cancer (surgery 2003) listed under Axis III. The Veteran is not in receipt of service connection for the disabilities listed under Axis III. The Board notes that knee arthroscopy, which is related to the Veteran’s service-connected bilateral knee disabilities, was not listed under Axis III. The evidence, as discussed above, shows that the Veteran’s depressive disorder followed his prostate cancer and was aggravated by family stress. The Veteran has not submitted evidence which would otherwise show that a psychiatric disorder was caused or aggravated by a service-connected disability. 38 C.F.R. § 3.310 (2017). The preponderance of the evidence is against the claim of entitlement to service connection for an acquired psychiatric disorder, to include major depressive disorder, the benefit-of-the-doubt doctrine is not for application, and the claim is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. New and Material Evidence Prior unappealed decisions of the regional office (RO) and the Board are final. 38 U.S.C. §§ 7104(b); 7105(c); 38 C.F.R. §§ 3.160(d), 20.302(a), 20.1100, 20.1103. The Board does not have jurisdiction to consider a claim that has become final before it determines that new and material evidence has been presented, irrespective of what the regional office may have determined with respect to new and material evidence. Barnett v. Brown, 83 F.3d 1380, 1383 (Fed. Cir. 1996). If, however, new and material evidence is presented or secured with respect to a claim which has been disallowed, VA shall reopen the claim and review the former disposition of the claim. New evidence means existing evidence not previously submitted to agency decision makers. 38 C.F.R. § 3.156(a). Material evidence means existing evidence that, by itself or considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened and must raise a reasonable possibility of substantiating the claim. Id. New and material evidence need not be received as to each previously unproven element of a claim in order to justify reopening thereof; the threshold for determining whether new and material evidence raises a reasonable possibility of substantiating a claim is “low.” Shade v. Shinseki, 24 Vet. App. 110, 117 (2010). 9. Whether new and material evidence has been received to reopen the previously-denied claim of entitlement to service connection for right first toe contusion. In a February 1998 rating decision, the regional office denied the claim of entitlement to service connection for right first toe contusion. The Veteran perfected an appeal, and in December 2000 and September 2003, the Board remanded the claim for further development. In a May 2005 decision, the Board denied the claim, finding that no right big toe injury was shown in service or otherwise related to service. The Board decision is final and binding since the Veteran did not appeal the decision to the U.S. Court of Appeals for Veterans Claims. 38 U.S.C. § 7104(b);38 C.F.R. § 20.1100. VA treatment records have been associated with the file since the May 2005 Board decision. However, the additional evidence is not material, as it does not show that a right big toe injury was shown in service or is otherwise related to service. Accordingly, the Board finds that new and material evidence has not been received to reopen the claim of entitlement to service connection for right first toe contusion. Therefore, the application to reopen the previously-denied claim is denied. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 10. Whether new and material evidence has been received to reopen the previously-denied claim of entitlement to service connection for loss of vision is denied. In a November 1998 rating decision, the regional office denied the claim of entitlement to service connection for loss of vision. The Veteran perfected an appeal, and in December 2000 and September 2003, the Board remanded the claim for further development. In a May 2005 decision, the Board denied the claim, finding that no acquired eye disorder manifested by vision loss and a refractive error of the eyes was incurred in or aggravated by active military service, nor otherwise related to service. This Board decision is final and binding since the Veteran did not appeal the decision to the U.S. Court of Appeals for Veterans Claims. 38 U.S.C. § 7104(b); 38 C.F.R. § 20.1100. VA treatment records have been associated with the file since the May 2005 Board decision. Specifically, VA medical records reflect an assessment of diabetic retinopathy and refractive error, including in June 2011. However, the additional evidence is not material, as it does not show that an acquired eye disorder manifested by vision loss was incurred in or aggravated by active military service, or is otherwise related to service. The Veteran is not in receipt of service connection for diabetes, therefore the assessment of diabetic retinopathy is not material in support of the Veteran’s claim. As stated in the May 2005 Board decision, myopia and refractive error are not disabilities for which service connection can be granted. 38 C.F.R. §§ 3.303(b), 4.9. Accordingly, the Board finds that new and material evidence has not been received to reopen the claim of entitlement to service connection for loss of vision. Therefore, the application to reopen the previously-denied claim is denied. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 11. Whether new and material evidence has been received to reopen the previously-denied claim of entitlement to service connection for neurodermatitis is denied. Entitlement to service connection for neurodermatitis was denied in a February 1998 rating decision. In a letter dated later that month, the Veteran was notified of the denial and his appellate rights. In the one-year appeal period that followed, the Veteran submitted neither a notice of disagreement nor any additional evidence. This rating decision is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 20.302, 20.1103. The February 1998 rating decision denied service connection for neurodermatitis because it was not shown that it was incurred-in nor otherwise related to service. VA treatment records and private medical records have been associated with the file since the February 1998 rating decision. Particularly, a DBQ dated July 2014 which reflects a January 2004 diagnosis of dermatitis/photodermatitis was submitted. However, the additional evidence is not material, as it does not show that neurodermatitis was incurred in or is otherwise related to service. Accordingly, the Board finds that new and material evidence has not been received to reopen the claim of entitlement to service connection for neurodermatitis. Therefore, the application to reopen the previously-denied claim is denied. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. REASONS FOR REMAND 12. Entitlement to service connection for hay fever is remanded. In an April 2010 statement, the Veteran indicated that he had a high fever bout with a 103-degree fahrenheit measurement and hospitalized at Fort Leonard Wood Hospital for seven days. In a May 2012 statement, the Veteran indicated that he was hospitalized at Fort Leonard Wood Hospital in Missouri for six days during active duty in 1982 to 1983. After a review of the claims file, it does not appear that such records are associated with the Veteran’s service treatment records and there is no indication that VA attempted to obtain the records from Fort Leonard Wood Hospital, and such records have not been associated with the claims file. The Board finds that the records from Fort Leonard Wood Hospital may be potentially relevant to the Veteran’s hay fever claim on appeal. Thus, an effort must be made to locate and associate the records with the Veteran’s claims file. The matter is REMANDED for the following action: 1. Obtain any outstanding service treatment records, specifically records from Fort Leonard Wood Hospital, Missouri. If any of the records requested are unavailable, clearly document the claims file to that effect and notify the Veteran of any inability to obtain these records, in accordance with 38 C.F.R. § 3.159(e) (2017). 2. After all available evidence has been associated with the record; the AOJ should review the evidence and determine if further development is warranted. The AOJ should take any additional development as deemed necessary.   A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Cheng, Associate Counsel