Citation Nr: 18151668 Decision Date: 11/19/18 Archive Date: 11/19/18 DOCKET NO. 12-09 748 DATE: November 19, 2018 ORDER Entitlement to service connection for diabetes mellitus, type II, to include as due to herbicide exposure, is denied. Entitlement to service connection for heart disease, to include coronary artery disease, and as due to herbicide exposure, is denied. Entitlement to service connection for a urinary disorder is denied. Entitlement to service connection for a back disorder, to include lumbar degenerative disc disease, is denied. FINDINGS OF FACT 1. The evidence weighs against a finding that the Veteran was exposed to herbicides during service. 2. The Veteran’s diabetes mellitus did not manifest in service, did not manifest within 1 year after service, and is not otherwise related to active duty. 3. The Veteran’s heart disease, to include coronary artery disease, did not manifest in service, did not manifest within 1 year after service, and is not otherwise related to active duty. 4. The Veteran’s urinary disorder is not due to a disease or injury in service, to include in-service complaints and treatment for burning while urinating and genital warts. 5. The Veteran’s back disorder, to include lumbar degenerative disc disease, is not due to a disease or injury in service, to include an in-service complaint of back pain. CONCLUSIONS OF LAW 1. The criteria for service connection for diabetes mellitus, type II have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for heart disease, to include coronary artery disease, have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 3. The criteria for service connection for a urinary disorder are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 4. [The criteria for service connection for a back disorder, to include lumbar degenerative disc disease, have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Generally, service connection may be granted for a disability or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. In order to establish service connection for a claimed disability, there must be (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). Service connection may also be established when the evidence shows that a veteran had a chronic condition in service or during the applicable presumptive period. 38 C.F.R. § 3.303(b). Certain chronic diseases will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). If a veteran was exposed to an herbicide agent during active military, naval, or air service, the diseases enumerated under 38 C.F.R. § 3.309(e) shall be service-connected if the requirements of §3.307(a)(6) are met even though there is no record of such disease during service. Pursuant to 38 C.F.R. § 3.307(a)(6)(iv), a veteran who, during active service, served between April 1, 1968, and August 31, 1971, in a unit that, as determined by the Department of Defense, operated in or near the Korean DMZ in an area in which herbicides are known to have been applied during that period, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. Diabetes Mellitus The Veteran contends that his diabetes mellitus is related to service, to include as secondary to herbicide exposure in Korea. The Board concludes that, while the Veteran has a diagnosis of diabetes, the preponderance of the evidence is against finding that it began during active service, or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Additionally, the Board concludes that diabetes mellitus was not chronic in service, did not manifest to a compensable degree in service or within a presumptive period, or was not continuous since service. As an initial matter, the Board finds that the Veteran was not exposed to herbicides in Korea. Personnel records do not indicate that the Veteran served in the Korean DMZ at any time between April 1, 1968, and August 31, 1971. See 38 C.F.R. § 3.307(a)(6)(iv). Rather, personnel records indicate that the Veteran’s service in Korea began in October 1971, which is after the presumptive period. A September 2017 formal finding was issued, and concluded that exposure to herbicides could not be verified. There is no evidence of record demonstrating that the Veteran was exposed to herbicides in service. Consequently, service connection is not warranted on this basis. The first element of service connection has been met as the Veteran has a diagnosis of diabetes mellitus. The second element of service connection has not been met as an in-service injury or event has not been established. The record does not establish that diabetes mellitus manifested in service. Service treatment records do not contain any complaints or treatment for diabetes mellitus. Induction and separation reports of examination and medical history are silent for any findings of diabetes. Likewise, reserve records do not contain any notations referring to diabetes mellitus. Further, the evidence does not show that the Veteran’s diabetes mellitus manifested to a compensable degree within 1 year after service, or was continuous since service. Service treatment records from the Veteran’s reserve service do not document any treatment or complaints of diabetes mellitus. Likewise, August 1976 and July 1980 reports of medical history do not contain any complaints of diabetes mellitus or related symptoms. The earliest available documentation of treatment for diabetes mellitus occurred in September 1992. Of note, a January 1982 discharge summary notes a slightly abnormal glucose test, and provided a final diagnosis of abnormal carbohydrate metabolism. A diagnosis of diabetes mellitus was not provided at that time. As such, the preponderance of the evidence indicates that diabetes mellitus did not manifest within 1 year after service or was continuous since active service. Though the Veteran asserts that he was diagnosed with diabetes shortly after active service, the Board finds that this statement conflicts with available medical records. As discussed above, the record indicates that the Veteran did not report any diabetic symptoms throughout his reserve service and did not appear to receive any post-service treatment for diabetes mellitus until September 1992. See Curry v. Brown, 7 Vet. App. 59, 68 (1994) (noting contemporaneous records are more probative than history as reported by a veteran). Accordingly, the Veteran’s lay statements are of minimal probative value. In light of the above, the Board finds that the preponderance of the evidence is against the claim. Therefore, the benefit-of-the-doubt standard of proof does not apply. Service connection is not warranted for diabetes mellitus. 38 U.S.C. § 5107(b). Heart Disease The Veteran contends that his diabetes mellitus is related to service, to include as secondary to herbicide exposure in Korea. The Board concludes that, while the Veteran has a diagnosis of a heart disease, the preponderance of the evidence is against finding that it began during active service, or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Additionally, the Board concludes that coronary artery disease was not chronic in service, did not manifest to a compensable degree in service or within a presumptive period, or was not continuous since service. As previously discussed, herbicide exposure has not been established by the record. As such, service connection is not warranted on this basis. The first element of service connection, a current diagnosis, has been met. VA treatment records indicate that the Veteran has coronary artery disease. By way of history, a July 1999 VA examination also noted a diagnosis of coronary artery disease. The second element of service connection has not been met as an in-service injury or event has not been established. The record does not establish that a heart disease manifested in service. Service treatment records do not contain any complaints or treatment for a heart disease. Induction and separation reports of examination and medical history are silent for any findings of a heart disease. Likewise, reserve records do not contain any notations referring to a heart disease. Further, the evidence does not show that the Veteran’s a heart disease manifested to a compensable degree within 1 year after service, or was continuous since service. Service treatment records from the Veteran’s reserve service do not document any treatment or complaints of a heart disease. The earliest available documentation of treatment occurred in September 1992. Of note, a January 1982 echocardiogram was normal. As such, the preponderance of the evidence indicates that a heart disease did not manifest within 1 year after service or was continuous since service. In light of the above, the Board finds that the preponderance of the evidence is against the claim. Therefore, the benefit-of-the-doubt standard of proof does not apply. Service connection is not warranted for a heart disease. 38 U.S.C. § 5107(b). Urinary Disorder The Veteran contends that his urinary disorder is due to service. The Board concludes that, while the Veteran has a current diagnosis of hematuria and evidence shows that there were in-service complaints, the preponderance of the evidence weighs against finding that the Veteran’s diagnosis of hematuria began during service or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). The first element of service connection, a current diagnosis, has been met. A March 2017 VA examination notes a diagnosis of hematuria. The second element of service connection, an in-service disease or event, has been met. Multiple service treatment records from 1972 indicate recurrent warts on his penis with burning upon urination. The third element of service connection has not been met because the evidence does not establish a medical nexus between the Veteran’s current diagnosis and the 1972 complaints of burning upon urination. An October 2009 VA examiner determined that the Veteran’s current urinary incontinence was less likely as not caused by or related to the in-service penile warts. She noted that the Veteran’s penile wart during active service resolved with no residuals. Additionally, a March 2017 examiner opined that the Veteran’s urinary disorder was less likely than not incurred in or caused by service or related to the genital warts and transient urinary tract infections that responded to medical treatment in service. She commented that the Veteran’s urinary tract infection and genital wart resolved in 1972 with no residuals or functional limitations. Of note, the Veteran’s reserve records do not contain any complaints or treatment for a urinary condition. Further, the available medical evidence indicates that the earliest documented treatment for urinary symptoms occurred in January 1982. A cystoscopy revealed that, based on an examination, the Veteran’s appeared to have symptoms secondary to posterior urethral irritation and produced by, at least in part, neurogenic components secondary to a recent stroke. There is no evidence of record establishing a medical nexus between the current disability and the in-service urinary symptoms and, as such, the third element of service connection has not been established. Finally, though the Veteran has asserted that there is a relationship between his current urinary symptoms and his in-service complaints, the evidence has not established that the Veteran has the requisite medical experience to provide such an opinion. Additionally, though the Veteran reported to the October 2009 examiner that he experienced urinary incontinence and wore adult diapers since 1972, the Board finds that this statement conflicts with the available medical records. The record indicates that the Veteran did not report any urinary symptoms throughout his reserve service and did not appear to receive any post-service treatment for urinary symptoms until January 1982. See Curry v. Brown, 7 Vet. App. 59, 68. Accordingly, the Veteran’s lay statements are of minimal probative value. In light of the above, and in the absence of any medical evidence establishing a medical nexus, the Board finds that the preponderance of the evidence is against the claim. Therefore, the benefit-of-the-doubt standard of proof does not apply. Service connection is not warranted for a urinary disorder. 38 U.S.C. § 5107(b). Back Disorder The Veteran contends that his back disorder is due to service. The Board concludes that, while the Veteran has a current diagnosis and evidence shows that there was an in-service back injury, the preponderance of the evidence weighs against finding that the Veteran’s current diagnosis began during service or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). The first element of service connection, a current diagnosis, has been met. October 2009 and March 2017 VA examinations provide diagnoses of lumbar degenerative disc disease. The second element of service connection, an in-service disease or event, has been met. A May 1971 service treatment record documents a complaint of back pain. The third element of service connection has not been met because the evidence does not establish a medical nexus between the Veteran’s current diagnosis and the in-service injury. The October 2009 examiner opined that the Veteran’s current degenerative disc disease was less likely than not caused by or related to the acute lumbar strain that occurred during service. She noted that the acute lumbar strain resolved with no residuals in service. Additionally, the March 2017 examiner also determined that the current degenerative disc disease was less likely than not related to service as the May 1971 back strain was not severe enough to result in development of the subsequent degenerative disc disease. She additionally noted the temporal gap of 33 years between the initial injury in 1971 and the recurrence of low back pain in 2004. She commented that the Veteran’s current back disorder was degenerative process that is due to age, familial aggregation, and intrinsic disc loading. Finally, a May 2018 examiner opined that it was less likely as not that the Veteran’s degenerative disc disease manifested within service, manifested within a year after service, or was etiologically related to service. The examiner commented that the Veteran denied recurrent back pain in October 1972, August 1976, and July 1980; that the Veteran reported low back pain in a 1999 VA examination; and that morbid obesity is a high-risk factor for development of back pain. There is no evidence of record establishing a medical nexus between the current disability and the in-service complaint and, as such, the third element of service connection has not been established. Further, the medical evidence of record does not indicate that the Veteran’s current back disorder manifested in service, manifested within a year after service, or presented with symptoms continuous since service. There are no subsequent complaints for back pain after the May 1971 service record. Additionally, service treatment records from the Veteran’s period of reserve service do not document any treatment or complaints of back pain. Likewise, August 1976 and July 1980 reports of medical history deny any recurrent back pain. The earliest available report of back pain occurred in an August 1999 VA examination. Finally, though the Veteran has asserted that there is a relationship between his current back disorder and his in-service complaint, the evidence has not established that the Veteran has the requisite medical experience to provide such an opinion. Additionally, though the Veteran reported that he has experienced back pain since service, the Board finds that this statement conflicts with the statements made contemporaneously with his reserve medical records. The record indicates that the Veteran denied recurrent back pain throughout his reserve service. See Curry v. Brown, 7 Vet. App. 59, 68. Accordingly, the Veteran’s lay statements are of minimal probative value. In light of the above, and in the absence of any medical evidence establishing a medical nexus, the Board finds that the preponderance of the evidence is against the claim. Therefore, the benefit-of-the-doubt standard of proof does not apply. Service connection is not warranted for a back disorder. 38 U.S.C. § 5107(b). K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Vang, Associate Counsel