Citation Nr: 18152258 Decision Date: 11/21/18 Archive Date: 11/21/18 DOCKET NO. 18-14 320 DATE: November 21, 2018 ORDER Service connection for dyslipidemia is denied. REMANDED Entitlement to service connection for a right shoulder disability is remanded. Entitlement to service connection for a neck disability is remanded. Entitlement to service connection for erectile dysfunction is remanded. Entitlement to service connection for an acquired psychiatric disability is remanded. Entitlement to service connection for nerve disability of the right lower extremity, including radiculopathy and sciatica, is remanded. Entitlement to service connection for hypertension is remanded. FINDING OF FACT The Veteran’s dyslipidemia is a laboratory finding without underlying or resulting disability and is not a disability for VA compensation purposes. CONCLUSION OF LAW The criteria for service connection for dyslipidemia are not met. 38 U.S.C. §§ 1110, 1131, 5103A; 5107(b); 38 C.F.R. §§ 3.159, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1989 to June 1989. Compensation may be awarded for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131. Service connection basically means that the facts, shown by evidence, establish that an injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein. 38 C.F.R. § 3.303. The claim of entitlement to service connection for dyslipidemia is denied. The Veteran contends that, because his dyslipidemia started while in service, he is entitled to compensation for that condition. The Board concludes that the preponderance of the evidence is against the claim as the presence of disability associated with dyslipidemia is not shown during the pendency of this appeal, or prior thereto. 38 U.S.C. §§ 1110, 1131, 5103A; 5107(b); 38 C.F.R. §§ 3.159, 3.303(a). The Veteran’s medical records show he has been assessed with dyslipidemia, with elevated LDL cholesterol. Dyslipidemia is an “abnormality in, or abnormal amounts of, lipids and lipoproteins in the blood” also referred to as hyperlipidemia. DORLAND’S ILLUSTRATED MEDICAL DICTIONARY 586 (31st ed. 2012). Hyperlipidemia is a “general term for elevated concentrations of any or all of the lipids in the plasm.” Id. at 903. VA has determined that dyslipidemia is a laboratory finding and not a disability in and of itself for which VA compensation benefits are payable. See the Schedule for Rating Disabilities; Endocrine System Disabilities, 61 Fed. Reg. 20,440, 20,445 (May 7, 1996) (noting that diagnoses of dyslipidemia, elevated triglycerides, and elevated cholesterol are actually laboratory results and are not, in and of themselves, disabilities). The record does not identify or suggest, and the Veteran has not alleged, that there is an underlying disease to which the dyslipidemia may be a symptom. A symptom (to include an abnormal laboratory study), without a diagnosed or identifiable underlying malady or condition, does not, in and of itself, constitute a “disability” for which service connection may be granted. See Sanchez-Benitez v. West, 13 Vet. App. 282, 285 (1999), appeal dismissed in part, and vacated and remanded in part sub nom. Sanchez-Benitez v. Principi, 259 F.3d 1356 (Fed. Cir. 2001). The Board accepts that the Veteran has dyslipidemia. However, as discussed above, neither the lay nor the medical evidence demonstrates the presence of “disability.” In the absence of proof of a present disability due to disease or injury, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). See McClain v. Nicholson, 21 Vet. App. 318, 321 (2007) (The current disability requirement for a service connection claim is satisfied if the claimant has a disability at the time the claim is filed or during the pendency of that claim). The Board notes that the Veteran has not identified any functional impairment associated with the laboratory finding. See Saunders v. Wilkie, 886 F.3d 1356, 1363 (Fed. Cir. 2018) (“disability” exists under 38 U.S.C. § 1110 where there is functional impairment). Accordingly, this claim is denied. There is no doubt to resolve. 38 U.S.C. § 5107(b). REASONS FOR REMAND 1. Entitlement to service connection for a right shoulder disability is remanded. 2. Entitlement to service connection for a neck disability is remanded. 3. Entitlement to service connection for erectile dysfunction is remanded. 4. Entitlement to service connection for an acquired psychiatric disability is remanded. 5. Entitlement to service connection for nerve disability of the right lower extremities, including radiculopathy and sciatica, is remanded. 6. Entitlement to service connection for hypertension is remanded. Issues 1-6. To ensure VA has met its duty to assist, remand is necessary. 38 C.F.R. § 3.159(c). First, the Board notes the Veteran reported that he receives disability compensation from the Social Security Administration. An attempt must be made to obtain those records. Second, the Veteran argues that his service-connected lumbar spine disability has caused his right shoulder disability, his neck disability, erectile dysfunction, and depression. The medical records show current diagnoses. See Dr. C.E.M.Q., dated in August 2016. VA has not provided VA examinations or obtained medical opinions in these matters. Third, as to the lower extremity nerve disorder claim, to include sciatica and radiculopathy, an updated VA examination should be obtained in view of the many notations diagnosing the Veteran with radiculopathy, including at VA examinations conducted in 1994, 1996, and 1998. More recently, a June 2016 private medical record indicates that an MRI report shows root compression. Given that this report was just prior to the Veteran’s claim for service connection, a medical opinion should be obtained addressing the etiology of any shown lower extremity neurological impairment. Fourth, the Veteran asserts that his hypertension was diagnosed while he was in service. It does not appear that his STRs are complete, as there is no entrance or separation examination of record. On remand, an attempt will be made to locate additional records, and a VA medical opinion should also be obtained. The matters are REMANDED for the following action: 1. Obtain the Veteran’s complete service treatment records through official sources. Document all requests for information as well as all responses in the claims file Notify the Veteran of any unsuccessful efforts to obtain these records and request copies of records in his possession. 2. Obtain the Veteran’s medical records from the Social Security Administration. Document all requests for information as well as all responses in the claims file. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any right shoulder disability. The examiner must opine on whether it is at least as likely as not related to an in-service injury, event, or disease; if arthritis is shown, whether it at least as likely as not (a) began during active service, (b) manifested within one year after discharge from service; and address whether any shoulder disability is at least as likely as not (a) proximately due to service-connected disability, or (b) aggravated beyond its natural progression by service-connected disability. The examiner is asked to elicit from the Veteran a detailed history of his symptoms, including approximate onset of symptoms. The Veteran was injured in service climbing over a fence and falling onto his back. The examiner is asked to opine as to whether any right shoulder disability is a result of this injury. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any cervical spine (neck) disability. The examiner must opine on whether it is at least as likely as not related to an in-service injury, event, or disease; if arthritis is shown, whether it at least as likely as not (a) began during active service, (b) manifested within one year after discharge from service; and address whether any neck disability is at least as likely as not (a) proximately due to service-connected disability, or (b) aggravated beyond its natural progression by service-connected disability. The examiner is asked to elicit from the Veteran a detailed history of his symptoms, including approximate onset of symptoms. The Veteran was injured in service climbing over a fence and falling onto his back. The examiner is asked to opine as to whether any neck disability is a result of this injury. 5. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any erectile dysfunction. The examiner must opine on whether it is at least as likely as not related to an in-service injury, event, or disease; and address whether it is at least as likely as not (a) proximately due to service-connected disability, or (b) aggravated beyond its natural progression by service-connected disability. 6. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any acquired psychiatric disability. The examiner must opine on whether it is at least as likely as not related to an in-service injury, event, or disease; and address whether it is at least as likely as not (a) proximately due to service-connected disability, or (b) aggravated beyond its natural progression by service-connected disability. The examiner is asked to elicit from the Veteran a detailed history of his symptoms, including approximate onset of symptoms. 7. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any right lower extremity nerve disability. The examiner must opine on whether it is at least as likely as not related to an in-service injury, event, or disease; if arthritis is shown, whether it at least as likely as not (a) began during active service, (b) manifested within one year after discharge from service; and address whether any nerve disability is at least as likely as not (a) proximately due to service-connected disability, or (b) aggravated beyond its natural progression by service-connected disability. The examiner is asked to elicit from the Veteran a detailed history of his symptoms, including approximate onset of symptoms. The Veteran was injured in service climbing over a fence and falling onto his back. The examiner is asked to opine as to whether any right lower extremity nerve disability is a result of this injury. 8. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of hypertension. The examiner must opine whether it at least as likely as not (a) began during active service, (b) manifested within one year after discharge from service, or (c) is otherwise related to service; and address whether it is at least as likely as not (a) proximately due to service-connected disability, or (b) aggravated beyond its natural progression by service-connected disability. 9. Ensure that the medical opinions obtained include a complete rationale for the conclusions reached. The medical opinion must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. 10. Readjudicate. C.A. SKOW Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Gibson