Citation Nr: 18151411 Decision Date: 11/19/18 Archive Date: 11/16/18 DOCKET NO. 16-48 617 DATE: November 19, 2018 ORDER Service connection for a disability manifested by high cholesterol is denied. REMANDED Service connection for hypertension. FINDINGS OF FACT 1. The Veteran had active service from July 196 to February 1970. 2. High cholesterol, without manifestations of an underlying disorder, is not a disability for which compensation is payable. CONCLUSION OF LAW A disability manifested by high cholesterol was not incurred in service. 38 U.S.C. §§ 1101, 1110, 1112, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a) (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSION Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). As an initial matter, post-service medical records reflect the Veteran’s continued treatment for high cholesterol. In this regard, multiple medical treatment notes between September 2013 and February 2015 diagnosed hypercholesterolemia. Therefore, high cholesterol is currently shown. A disability for VA compensation purposes refers to an impairment of earning capacity due to a disease or injury, rather than to a disease or injury itself. See Allen v. Brown, 7 Vet. App. 439 (1995). Hyperlipidemia is a general term for elevated concentrations of any or all of the lipids in the plasma, including hypercholesterolemia. Hypercholesterolemia is excessive cholesterol in the blood. Dorland’s Illustrated Medical Dictionary (32nd ed. 2012). Such findings are laboratory tests and not, in and of themselves, considered a disability for the purpose of VA compensation. See 61 Fed. Reg. 20, 440, 20,445 (1996). Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in a disability. 38 U.S.C. §1110. High cholesterol is not a disability. Hence, in the absence of competent evidence of disability manifested by or associated with the finding of hyperlipidemia (i.e. elevated cholesterol levels), the medical evidence presents no basis for a grant of service connection. The Board has considered lay statements offered by the Veteran regarding the severity and etiology of his high cholesterol. He is competent to report symptoms and describe his observations because this requires only personal knowledge as it comes to him through his senses. Layno v. Brown, 6 Vet. App. 465, 469 (1994). However, he is not competent to offer an opinion that a laboratory finding of high cholesterol results in an underlying disability. Here, the Board attaches greater probative weight to the clinical findings than to his lay statements. As noted above service connection may only be granted for a current disability. Brammer v. Derwinski, 3 Vet. App. 223 (1992). As high cholesterol constitutes a laboratory test rather than a disability, the appeal is denied. Finally, the Veteran has not raised any other outstanding issues, nor have any other issues been reasonably raised by the record for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). REASONS FOR REMAND In multiple lay statements between March 2015 and September 2016, the Veteran asserted that, as a result of the treatment required for his service-connected type II diabetes mellitus, his blood pressure levels rose to the point where his doctor told him that it was too high. The Veteran explained that as a result, he was prescribed blood pressure medication to control his hypertension. A review of the record shows that the Veteran was last afforded an examination for his hypertension and diabetes mellitus in January 2015 but no opinion was rendered as to a potential causal relationship between the two. In light of his multiple lay statements indicating that his hypertension was caused or aggravated by his service-connected type II diabetes mellitus, a remand is necessary to afford him a new examination to determine the nature and etiology of his hypertension. Additionally, current treatment records should be identified and obtained before a decision is made with regard to the current issue on appeal. The matter is REMANDED for the following actions: 1. Identify and obtain any pertinent, outstanding VA and private treatment records not already of record in the claims file. 2. Schedule the Veteran for an examination to determine the nature and etiology of any currently present hypertension. The claims file must be made available to, and reviewed by, the examiner. Any indicated studies should be performed. Based on the examination results and review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s hypertension is caused or aggravated by service-connected type II diabetes mellitus. In forming the opinions, the examiner should address lay statements submitted by the Veteran in March 2015, June 2015, and September 2016. The rationale for all opinions must be provided. 3. Then, readjudicate the claim on appeal. If a decision is adverse to the Veteran, issue a supplemental statement of   the case and allow appropriate time for response. Then, return the case to the Board. L. HOWELL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Spigelman, Associate Counsel