Citation Nr: 18153101 Decision Date: 11/27/18 Archive Date: 11/27/18 DOCKET NO. 16-49 907 DATE: November 27, 2018 ORDER Entitlement to service connection for pseudofolliculitis barbae (PFB) is denied. Entitlement to service connection for alcohol abuse/dependency is denied. Entitlement to an initial compensable disability evaluation for postoperative nasal fracture residuals is denied. REMANDED Entitlement to service connection for a right hand disorder is remanded. FINDINGS OF FACT 1. The evidence of record does not objectively demonstrate that the Veteran has a current diagnosis of PFB. 2. The evidence of record does not objectively demonstrate that the Veteran has a current diagnosis of alcohol abuse/dependency. 3. At all times during the pendency of the appeal, the preponderance of the evidence shows that the Veteran's service-connected postoperative nasal fracture residuals did not obstruct 50 percent of the nasal passage on both sides and it did not completely obstruct one side. CONCLUSIONS OF LAW 1. The criteria for service connection for PFB have not been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). 2. The criteria for service connection for alcohol abuse/dependency have not been met. 38 U.S.C. §§ 105, 1110, 5107 (2012); 38 C.F.R. §§ 3.1(n), 3.102, 3.301(c), 3.303 (2017). 3. At all times during the pendency of the appeal the criteria for a compensable rating for postoperative nasal fracture residuals have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.97, Diagnostic Code 6502 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran, who is the appellant, had active service from February 2000 to November 2001. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may 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). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004); see also Hickson v. West, 12 Vet. App. 247, 253 (1999), citing Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996). It is the defined and consistently applied policy of VA to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. 38 C.F.R. § 3.102. It is the Board's responsibility to evaluate the entire record on appeal. See 38 U.S.C. § 7104(a) (2012). In this case, the Board has thoroughly reviewed all the evidence in the Veteran's file. Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, all of the evidence submitted by the Veteran or on his behalf. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (the Board must review the entire record, but does not have to discuss each piece of evidence). In evaluating the evidence in any given appeal, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d. 372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F. 3d 1331 (Fed. Cir. 2006); Klekar v. West, 12 Vet. App. 503, 507 (1999); Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). PFB The Veteran maintains that he currently has PFB, which started in service and has continued to the present time. A review of the Veteran's service treatment records reveals that there were no complaints or findings of PFB. Post-service treatment records contain no complaints or findings of PFB. After reviewing all the evidence both lay and medical, service connection for PFB is not warranted. To date, there has been no medical evidence submitted or received demonstrating that the Veteran has PFB or had PFB at any time throughout the appeal period. The Veteran was afforded the opportunity to submit evidence demonstrating a relationship between any current PFB and his period of service and has not done so. Congress, as a general rule, limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability. See 38 U.S.C. § 1110; and see Brammer v. Derwinski, 3 Vet. App. 223 (1992). In Degmetich v. Brown, 104 F.3d 1328 (Fed. Cir. 1997), it was observed that 38 U.S.C.§ 1110, as well as other relevant statutes, only permitted payment for disabilities existing on and after the date of application for such disorders. The Federal Circuit observed that the structure of these statutes "provided strong evidence of congressional intent to restrict compensation to only presently existing conditions," and VA's interpretation of the law requiring a present disability for a grant of service connection was consistent with the statutory scheme. Degmetich, 104 F.3d at 1332; and see Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998) (holding VA's interpretation of the provisions of 38 U.S.C.§ 1110 to require evidence of a present disability to be consistent with congressional intent); Rabideau v. Derwinski, 2 Vet. App. 141 (1992) (the law limits entitlement for service-related diseases and injuries to cases where the underlying in-service incident has resulted in a disability). Simply put, the general rule is that in the absence of proof of present disability there can be no valid claim. Based on the above, to the extent that the medical evidence addresses whether the Veteran has PFB, it indicates that he does not. The Veteran is competent to report his current symptoms, but his reports must be weighed against the medical evidence of record. See Grover v. West, 12 Vet. App. 109, 112 (1999); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). To the extent that the Veteran has indicated that he currently has PFB, the medical evidence showing an absence of such a disability is of greater probative weight than the Veteran's reports made during the course of his claim for VA benefits. The weight of the evidence is against a finding that the Veteran currently has PFB. A necessary element for establishing service connection-evidence of a current disability-has not been shown. For the foregoing reasons, the claim for service connection for PFB must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran's claim, that doctrine is not applicable. Alcohol Abuse/Dependency With regard to Veteran's alcohol abuse/dependency claim, VA compensation shall not be paid if the claimed disability or death was the result of the person's own willful misconduct or abuse of alcohol or drugs. See 38 U.S.C. §§ 105, 1110 (2012); 38 C.F.R. §§ 3.1(n), 3.301(c) (2017). With respect to alcohol and drug abuse, Section 8052 of the Omnibus Budget Reconciliation Act (OBRA) of 1990, Pub. L. No. 101-508, § 8052, 104 Stat. 1388, 1388-351, prohibits, effective for claims filed after October 31, 1990, payment of compensation for a disability that is a result of an appellant's own alcohol or drug abuse. Moreover, § 8052 also amended 38 U.S.C. § 105(a) to provide that, with respect to claims filed after October 31, 1990, an injury or disease incurred during active service will not be deemed to have been incurred in the line of duty if the injury or disease was a result of the person's own willful misconduct, including abuse of alcohol or drugs. See also VAOPGPREC 2-97. A veteran may receive compensation for an alcohol or drug abuse disability acquired as secondary to, or as a symptom of, a veteran's service-connected disability. In other words, 38 U.S.C. § 1110 does not preclude compensation for an alcohol or drug abuse disability secondary to a service-connected disability, or use of an alcohol or drug abuse disability as evidence of the increased severity of a service-connected disability. Rather, the statute precludes compensation only for (a) primary alcohol abuse disabilities, and (b) secondary disabilities (such as cirrhosis of the liver) that result from primary alcohol abuse. The Federal Circuit defined "primary" as meaning an alcohol abuse disability arising during service from voluntary and willful drinking to excess. See Allen, 237 F.3d 1368 at 1375. The Veteran's medical records dated prior to the claim, including his service treatment records, and during the pendency of the claim do not reflect alcohol abuse/dependency. VA treatment records also do not indicate the Veteran has been diagnosed with alcohol abuse. The evidence of record includes subjective complaints of use of alcohol. However, the most probative evidence does not reflect that a diagnosis has been provided with respect to the Veteran's reported use of alcohol. Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), as to the specific issue in this case, the Veteran is not considered competent to provide a diagnosis. The Board highlights that competent statements are limited to that which the Veteran has actually observed and is within the realm of his personal knowledge; such knowledge comes to the Veteran through use of his senses - that which is heard, felt, seen, smelled or tasted. See Layno v. Brown, 6 Vet. App. 465 (1994). It is within the Veteran's realm of personal knowledge as to his consumption of alcohol. It is not shown, however, that the Veteran possesses the medical expertise necessary to provide a probative opinion on a complex medical matter such as a diagnosis of chronic alcohol abuse. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). The Veteran's medical records also do not contain a diagnosis of alcohol abuse. Thus, the most probative evidence fails to demonstrate that it is at least as likely as not that the Veteran currently has a diagnosis related to alcohol abuse. As such, service connection for alcohol abuse is not warranted. Degmetich v. Brown, 104 F.3d 1328, 1333 (1997) (holding that the existence of a current disability is the cornerstone of a claim for VA disability compensation). As noted above, entitlement for service-connected disease or injury is specifically limited to cases where such incidents have resulted in a disability and in absence of proof of a present disability there can be no valid claim. Brammer, 3 Vet. App. at 225. In sum, the Veteran has not satisfied the necessary service connection claim element of a present disability with respect to alcohol abuse/dependency, and thus, further discussion of the in-service incurrence or nexus elements is not necessary. Furthermore, based on the reasons and bases discussed, as the preponderance of the evidence is against the claim for service connection for alcohol abuse/dependency, the benefit of the doubt rule is inapplicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Accordingly, service connection is not warranted for alcohol abuse/dependency. Postoperative Nasal Fracture Residuals The Veteran's disability for postoperative nasal fracture residuals is rated under Diagnostic Code (DC) 6502. Under DC 6502, a 10 percent rating is assigned for traumatic deviation of the nasal septum where there is a 50 percent obstruction of the nasal passage on both sides or a complete obstruction on one side of the nasal passage. 38 C.F.R. § 4.97, DC 6502. No other rating is provided under DC 6502. In accordance with his claim, the Veteran was afforded a VA examination in July 2014. At that time, a diagnosis of postoperative nasal fracture was rendered. The examiner indicated that the Veteran did not have chronic sinusitis. There had been no incapacitating episodes of sinusitis. There were also no findings of rhinitis. There were also no findings of 50 percent obstruction of nasal passages on both sides nor was there complete obstruction on one side. There was no scarring. There were no other pertinent physical findings, complications, conditions, signs and/or symptoms related to the condition. X-rays revealed a probable old healed fracture at the tip of the nasal spine. Given the above, the Board finds that the most probative evidence of record shows that the Veteran's symptomatology does not include at least 50 percent obstruction of both nasal passages, and there is no complete obstruction of one nasal passage. Therefore, the Board finds that a compensable rating is not warranted under DC 6502. This is true throughout the period of time during which his claim has been pending and therefore consideration of staged ratings is not warranted. Fenderson, supra. The Board has also considered whether a higher rating is warranted under any of the other diagnostic codes relating to the nose. However, the evidence does not reflect the Veteran lost part of his nose, so a rating under DC 6504 is not warranted. See Butts v. Brown, 5 Vet. App. 532, 539 (1993) (holding that the Board's choice of diagnostic code should be upheld so long as it is supported by explanation and evidence). The evidence also does not suggest the Veteran experienced sinusitis at any point during the period on appeal. Therefore, ratings under DCs 6510-6514 are also not warranted. Id. Likewise, the Board finds that the Veteran is not entitled to a higher rating under DC 6522 because VA regulations provide that the same symptoms cannot be provided multiple ratings under various diagnoses. 38 C.F.R. § 4.14. The Board has also considered whether the Veteran is entitled to a higher rating under DC 6523. However, the evidence does not establish the Veteran experienced rhinoscleroma at any point during the period on appeal. Therefore, a higher rating under DC 6523 is also not warranted. See Butts, supra. Based on the foregoing, the evidence does not establish the Veteran's postoperative nasal fracture residuals warrants a compensable rating under DC 6502, or any separate or higher ratings under any applicable diagnostic codes. Accordingly, the Veteran's appeal is denied. REASONS FOR REMAND As it relates to the claimed right hand disorder, the Board notes that the Veteran was seen with complaints of right hand problems while in service in October 2001. He was noted to have injured the hand when he fell on it closed fist four days earlier. A diagnosis of right hand injury, rule out fracture, was rendered. To date, the Veteran has not been afforded a VA examination to determine the etiology of any current right hand disorder, and its relationship, if any, to his period of service, to include the right hand inservice injury. The matter is REMANDED for the following action: 1. Undertake appropriate development to obtain all outstanding VA and/or private treatment records related to the Veteran's outstanding claim. If any requested records are not available, the record should be annotated to reflect such and the Veteran notified. 2. Schedule the Veteran for a VA examination to determine the nature and etiology of any current right hand disorder. All indicated tests and studies should be performed and all findings must be reported in detail. The entire record must be made available to the examiner and the examiner should note such review in his/her report. The examiner is requested to render the following opinions: (a) Does the Veteran currently have any right hand disorders? (b) Is it as likely as not (50 percent probability or greater) that any right hand disorder, if present, had its onset in service or is otherwise related to service? Detailed rationale is requested for any opinion that is rendered. (Continued on the next page)   3. Review the claims file. If any development is incomplete, including if the examination report does not contain sufficient information to respond to the questions posed, take corrective action before readjudication. See Stegall v. West, 11 Vet. App. 268 (1998). K. PARAKKAL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. S. Kelly, Counsel