Citation Nr: 18153528 Decision Date: 11/28/18 Archive Date: 11/27/18 DOCKET NO. 16-28 037 DATE: November 28, 2018 ORDER 1. Entitlement to service connection for a right foot disability is denied. 2. Entitlement to service connection for a left foot disability is denied. 3. Entitlement to service connection for a lumbar spine disability is denied. 4. Entitlement to service connection for a liver disability, to include hepatitis B and nonalcoholic steatohepatitis, is denied. 5. Entitlement to service connection for memory loss is denied. 6. Entitlement to service connection for headaches is denied. 7. Entitlement to service connection for a left eye disability, to include cataracts and glaucoma, is denied. 8. Entitlement to service connection for high cholesterol is denied. 9. Entitlement to service connection for a right knee disability is denied. 10. Entitlement to service connection for a left knee disability, to include arthritis, is denied. 11. Entitlement to service connection for diabetes mellitus, type II, to include as due to Agent Orange/herbicide exposure during service, is denied. 12. Entitlement to service connection for prostate cancer, to include as due to Agent Orange/herbicide exposure during service, is denied. 13. Entitlement to service connection for a kidney disability, to include acute kidney failure, is denied. 14. Entitlement to service connection for a heart disability is denied. 15. Entitlement to service connection for bilateral hearing loss disability is denied. 16. Entitlement to service connection for tinnitus is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against a finding that the Veteran has been diagnosed with a right foot disability at any time during the pendency of the appeal. 2. The preponderance of the evidence is against a finding that the Veteran has been diagnosed with a left foot disability at any time during the pendency of the appeal. 3. The preponderance of the evidence is against a finding that the Veteran has been diagnosed with a lumbar spine disability at any time during the pendency of the appeal. 4. The preponderance of the evidence is against a finding that a liver disability, to include hepatitis B and nonalcoholic steatohepatitis had its onset in service, or that hepatitis B and nonalcoholic steatohepatitis are otherwise related to service. 5. The preponderance of the evidence is against a finding that memory loss had its onset in service or is otherwise related to service. 6. The preponderance of the evidence is against a finding that headaches had their onset in service or are otherwise related to service. 7. The Veteran did not enter service with a left eye injury and he is entitled to the presumption of soundness. 8. The preponderance of the evidence is against a finding that a left eye disability, to include cataracts and glaucoma, had its onset in service or is otherwise related to service. 9. High cholesterol is not a disability for VA purposes. 10. The preponderance of the evidence is against a finding that the Veteran has been diagnosed with a right knee disability at any time during the pendency of the appeal. 11. The preponderance of the evidence is against a finding that a left knee disability, to include arthritis, had its onset in service, was manifested to a compensable degree within one year of service discharge or is otherwise related to service. 12. The Veteran was not exposed to herbicide agents during service, to include Agent Orange, and herbicide exposure during service is not presumed. 13. The preponderance of the evidence is against a finding that the Veteran has been diagnosed with diabetes mellitus, type II at any time during the pendency of the appeal. 14. The preponderance of the evidence is against a finding that prostate cancer, to include as due to Agent Orange/herbicide exposure during service had its onset in service, manifested to a compensable degree within one year of service discharge or is otherwise related to service. 15. The preponderance of the evidence is against a finding that a kidney disability, to include acute kidney failure, had its onset in service, was manifested to a compensable degree within one year of service discharge or is otherwise related to service. 16. The preponderance of the evidence is against a finding that the Veteran has been diagnosed with a heart disability at any time during the pendency of the appeal. 17. A heart disability cannot be secondary to a kidney disability because the Veteran is not service connected for a kidney disability. 18. The Veteran was exposed to acoustic trauma during service. 19. The preponderance of the evidence is against a finding that bilateral hearing loss disability had its onset in service, that sensorineural hearing loss was manifested to a compensable degree within one year of service discharge, or that bilateral hearing loss disability is otherwise related to service. 20. The preponderance of the evidence is against a finding that tinnitus had its onset in service, that it manifested to a compensable degree within one year of service discharge or that it is otherwise related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for a right foot disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a left foot disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303 3. The criteria for service connection for a lumbar spine disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for a liver disability, to include hepatitis B and nonalcoholic steatohepatitis, have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 5. The criteria for service connection for memory loss have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 6. The criteria for service connection for headaches have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 7. The criteria for service connection for a left eye disability, to include cataracts and glaucoma, have not been met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 8. The criteria for service connection for high cholesterol have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 9. The criteria for service connection for a right knee disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 10. The criteria for service connection for a left knee disability, to include arthritis, have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 11. The criteria for service connection for diabetes mellitus, type II, to include as due to Agent Orange/herbicide exposure during service, have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 12. The criteria for service connection for prostate cancer, to include as due to Agent Orange/herbicide exposure during service, have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 13. The criteria for service connection for a kidney disability, to include acute kidney failure, have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 14. The criteria for service connection for a heart disability have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. 15. The criteria for service connection for bilateral hearing loss disability have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 16. The criteria for service connection for tinnitus have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty service from May 1965 to May 1968. In April 2017, the Veteran had a hearing at the VA Regional Office in Jackson, Mississippi before a Division Review Officer (DRO). A transcript of that hearing is associated with this claim’s file. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a veteran must show: (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 or aggravated during service. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009). Service connection may also be established under 38 C.F.R. § 3.303(b), if a chronic disease, such as hepatitis, arthritis, diabetes mellitus, prostate cancer, kidney disease, cardiovascular disease, sensorineural hearing loss or tinnitus is shown in service, and subsequent manifestations of the same chronic disease, however remote, is shown, unless clearly attributable to intercurrent causes. Service connection may also be established under 38 C.F.R. § 3.303(b), where a disability in service is noted but is not, in fact, chronic, or where a diagnosis of chronicity may be legitimately questioned. The continuity of symptomatology provision of 38 C.F.R. § 3.303(b) has been interpreted as an alternative to service connection only for specific chronic diseases listed in 38 C.F.R. § 3.309(a). Additionally, where a veteran served 90 days or more of active service, and certain chronic diseases, such as cancers, arthritis, and renal disease, become manifest to a degree of 10 percent or more within one year after the date of separation from service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). Secondary service connection may be granted for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). The United States Court of Appeals for Veterans Claims (Court) has held that Congress specifically limited entitlement to service connected benefits to cases where there is a current disability. In the absence of proof of a present disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The requirement of a current disability is satisfied when a veteran has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Every veteran shall be taken to have been in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance, and enrollment, or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service. 38 U.S.C. § 1111; 38 C.F.R. § 3.304 (b); see Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004). Only such conditions as are recorded in examination reports are to be considered as noted. 38 U.S.C. § 1111. To rebut this presumption of soundness, VA must show, by clear and unmistakable evidence, that the disease or injury existed prior to service, and that the disease or injury was not aggravated by service. VAOPGCPREC 3-2003 (July 16, 2003). 1. Entitlement to service connection for a right foot disability. 2. Entitlement to service connection for a left foot disability. The Veteran claims entitlement to service connection for a right foot disability and a left foot disability. The Veteran testified in April 2017 before a DRO, that he was involved in motor vehicle accident during service in which he injured his right foot and left foot. The Board finds that the evidence of record is negative for any evidence that the Veteran has a current right foot or left foot disability. As such, service connection for a right foot disability and a left foot disability is not warranted. See Brammer, 3 Vet. App. at 225. Moreover, the Veteran’s service treatment records (STRs) are negative for a motor vehicle accident in service. For example, in the April 1968 Report of Medical History, when asked if he had had an illness or injury other than those already documented in the form (which did not include a motor vehicle accident), the Veteran checked no. He also denied any history of foot trouble. Such statements by the Veteran close to separation from service tend to show that there was no motor vehicle accident in service, wherein he sustained injuries to his feet. In conclusion, the Board finds that the preponderance of the evidence weighs against the Veteran’s claim of entitlement to service connection for a right foot disability and a left foot disability. Thus, there is no reasonable doubt to be resolved, and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.   3. Entitlement to service connection for a lumbar spine disability. The Veteran claims entitlement to service connection for a lumbar spine disability. The Veteran testified in April 2017 before a DRO, that he was involved in a motor vehicle accident during service in which he injured his lumbar spine. As noted above, the April 1968 Report of Medical History, when asked if he had had an illness or injury other than those already documented in the form (which did not include a motor vehicle accident), the Veteran checked no. He also denied any history of recurrent back pain. Such statements by the Veteran close to separation from service tend to show that there was no motor vehicle accident in service wherein he sustained an injury to his lumbar spine. The Board notes that a July 2014 VA treatment note shows that the Veteran stated that he had “back pain a few weeks ago,” but the pain resolved. More importantly, the evidence of record does not show a current disability related to the Veteran’s lumbar spine. Therefore, the Veteran does not meet the first required element for a direct service connection claim because he does not have a current lumbar spine disability. Moreover, there is no functional impairment related to his resolved lumbar spine pain. Accordingly, the claim must be denied. A veteran is competent to provide assertions regarding observable symptoms. Layno v. Brown, 6 Vet. App. 465, 469 (1994). To the extent that the Veteran asserts that he has a lumbar spine disability related to active service, such statements are less probative, as the Veteran lacks the medical training in order to render such a diagnosis. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Also, the STRs do not support the Veteran’s testimony that he was in a motor vehicle accident during service. Given the above, the Board finds that the preponderance of the evidence is against a claim for entitlement to service connection for a lumbar spine disability. 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 claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 4. Entitlement to service connection for a liver disability, to include hepatitis B and nonalcoholic steatohepatitis. The Veteran testified in April 2017 that he was diagnosed with hepatitis B a few weeks after separation from service and that he was told he has been exposed to hepatitis B. After review of the evidence of record, the Board finds that the preponderance of the evidence is against a finding that the Veteran’s liver disability, to include hepatitis B and nonalcoholic steatohepatitis, is related to service. The Board notes that a July 2016 VA treatment note shows that the Veteran was previously exposed to hepatitis B, but that his hepatitis B resolved without treatment. The Board also notes that a cursory listing of the Veteran’s “problems” in a VA treatment note shows that hepatitis may have been diagnosed in August 2006. However, the cursory diagnosis does not accompany laboratory findings to support a hepatitis diagnosis. Therefore, the Board finds that the Veteran does not have a current diagnosis of hepatitis B. Accordingly, service connection for hepatitis on a direct service connection basis is not warranted. A VA treatment record reflects that the Veteran was diagnosed with nonalcoholic steatohepatitis in June 2016. As to direct service connection, the evidence shows that the Veteran has a current diagnosis of nonalcoholic steatohepatitis and meets the first required element for a direct service connection claim. However, the preponderance of the evidence is against a finding for in-service treatment for nonalcoholic steatohepatitis or a fatty liver. For example, the STRs are negative for a diagnosis for nonalcoholic steatohepatitis. Also, in the Report of Medical History completed by the Veteran at separation from service, he specifically denied a history of liver trouble. Moreover, a November 2016 sonogram at a VA facility first documented a fatty liver, 48 years after service discharge. The Board finds that the passage of many years between service discharge and the medical diagnosis of nonalcoholic steatohepatitis is a factor, which weighs against a finding that the disability is related to service. In conclusion, the Board finds that the preponderance of the evidence is against a claim for entitlement to service connection for a liver disability, to include hepatitis B or nonalcoholic steatohepatitis. 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 claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 5. Entitlement to service connection memory loss. 6. Entitlement to service connection for headaches. In April 2017, the Veteran testified before a DRO that his memory loss and headaches are the result of being hit on the head by a spring-loaded jack during service. The Veteran also testified that he lost consciousness as a result of being hit on the head by a spring-loaded jack. Here, VA treatment records show occasional headaches and mild memory loss. Therefore, the Veteran meets the first required element for a direct service connection claim as the evidence of record shows current headaches and memory loss. The STRs show that in June 1967, during service, the Veteran was hit on the side of his head the prior night. Accordingly, the Board finds that the Veteran had an in-service injury to his head. As to evidence of a nexus between the current disabilities of headaches and memory loss and service, the Board finds that the preponderance of the evidence is against a nexus to service. For example, in the February 1968 Report of Medical History completed by the Veteran at separation from service, he specifically denied a history of loss of memory, periods of unconsciousness and frequent or severe headaches. Additionally, in April 2017 a VA examiner opined that it is less likely than not that the Veteran has memory loss or headaches due to his military service. The examiner’s rationale was that there was no confirmation that the Veteran had a traumatic brain injury (TBI) during service. The examiner also asserted that although it is possible that the blow in 1967 may have caused a mild TBI, in order to be the cause of headaches and memory loss the TBI would need to have been present at the time or very soon after the 1967 blow to the Veteran’s head. Moreover, the examiner reported that the development of these conditions can be part of aging or many other factors, but it would not likely be linked to an injury 49 years ago. The Board finds that the April 2017 VA examiner’s opinion is based on an accurate medical history and provides a rationale that contains clear conclusions and supporting data. Thus, the Board accords more probative value to the April 2017 VA examiner’s opinion and rationale than to the Veteran’s testimony in the April 2017 DRO hearing. Accordingly, the Board finds that the preponderance of the evidence is against a claim for entitlement to service connection for memory loss and headaches. 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 claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 7. Entitlement to service connection for left eye disability, to include cataracts and glaucoma. In the April 2017 DRO hearing, the Veteran testified that he has a left eye disability as a result of being hit on his head with a spring-loaded jack during service. At entry to service in May 1965, the Veteran’s Report of Medical History noted a left eye injury. However, the VA physician noted on the Report of Medical History that the left eye injury reported by the Veteran was an old injury with no sequela or consequence. In the corresponding Report of Medical Examination at entry to service, the Veteran received a normal clinical evaluation for his eyes and had 20/20 vision for both his distant and near vision. Therefore, the Board finds that the Veteran is entitled to the presumption of soundness at entry to service regarding his left eye based upon the VA examiner’s findings at entry into service in May 1965. After a careful review of the evidence of record, the Board finds that while the Veteran has a current left eye disability, which has been diagnosed as cataracts and glaucoma, the preponderance of the evidence is against a finding that his left eye disability began in service or is otherwise related to service. As noted above, the Veteran has a left eye disability, diagnosed as cataracts and glaucoma. Therefore, the Veteran meets the first required element for a direct service connection claim. Regarding the second required element for a direct service connection claim, an in-service disease or injury, the Veteran’s STRs show that in June 1967 during service, he reported having trouble seeing out of his left eye and reported having been hit on the side of his head. The June 1967 record noted no redness, tenderness or light sensitivity. The Board finds that the Veteran meets the second requirement for a direct service connection claim based upon the June 1967 STR. However, the Board finds that the preponderance of the evidence is against a nexus between the current left eye disability and service. For example, the February 1968 Report of Medical Examination at separation from service shows a normal clinical evaluation for the Veteran’s eyes. While the Veteran reported a history of eye trouble on the Report of Medical History at separation from service, the Board finds that the one-time left eye symptoms in June 1967 had resolved. The STRs did not show additional complaints relating to the left eye and again the Report of Medical Examination at separation from service shows a normal clinical evaluation for the Veteran’s eyes. Further, an April 2017 VA examiner opined that the Veteran’s vision disability was less likely than not incurred in or caused by the claimed in-service injury, event, or illness from June 1967. The examiner’s rationale was that there was no confirmation of a TBI during service causing vision loss and by discharge the Veteran had a normal vision examination. Accordingly, the Board finds that the evidence does not support a relationship between the Veteran’s current left eye disability and service. In conclusion, the Board finds that the preponderance of the evidence is against the claim for entitlement to service connection for a left eye disability, to include cataracts and glaucoma. 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 claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 8. Entitlement to service connection for high cholesterol. The Veteran seeks service connection for high cholesterol. While the Veteran’s VA treatment records show treatment for high cholesterol, the Board finds that the claim must be denied as a matter of law for the reasons set forth below. Post-service treatment records document high cholesterol diagnosed and treated since 2015. However, VA has determined that the diagnoses of hyperlipidemia, elevated triglycerides, and elevated cholesterol are actually laboratory test results and are not, in and of themselves, disabilities. See 61 Fed. Reg. 20440, 20445 (May 7, 1996). The Board notes that a symptom or a finding, 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 (1999). As high cholesterol does not constitute a disability, service connection for high cholesterol is not warranted. Accordingly, the Board concludes that the preponderance of the evidence is against the Veteran’s claim for service connection for high cholesterol, there is no reasonable doubt to be resolved, and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 9. Entitlement to service connection for right knee disability. 10. Entitlement to service connection for left knee disability, to include arthritis. The Veteran testified in April 2017 before a DRO that his right knee and left knee disability, to include left knee arthritis, are related to a motor vehicle accident during service. The Board finds that the evidence of record is negative for any diagnosis, complaints or treatment related to the Veteran’s right knee. Therefore, without a current diagnosis related to the Veteran’s right knee that claim must be denied. See Brammer, 3 Vet. App. at 225. After a careful review of the evidence of record, the Board finds that while the Veteran has a diagnosis of arthritis in his left knee, the preponderance of the evidence is against finding that left knee arthritis began in service, manifested to a compensable degree within one year of service separation or is otherwise related to service. Arthritis is a chronic disease and may be service connected on a presumptive basis under 38 C.F.R.§ 3.309(a). In February 2016, a VA treatment record shows x-ray evidence of arthritis in the Veteran’s left knee. Here, the Board finds that presumptive service connection under 38 C.F.R. § 3.309(a) is not warranted because left knee arthritis was not manifested to a compensable degree within one year of service discharge. As to direct service connection for the left knee, the Veteran meets the first required element for a direct service connection claim with documented evidence of left knee arthritis. However, the preponderance of the evidence is against an in-service disease or injury pertaining to the Veteran’s left knee. For example, the Report of Medical Examination in February 1968 at separation from service, shows a normal clinical evaluation for the Veteran’s lower extremities. In the corresponding Report of Medical History completed by the Veteran, he specifically denied a history of a trick or locked knee. Also, the Veteran’s STRs are negative for a report of a motor vehicle accident during service, contrary to the Veteran’s testimony. As noted above, the April 1968 Report of Medical History, when asked if he had had an illness or injury other than those already documented in the form (which did not include a motor vehicle accident), the Veteran checked no. These facts, the denial of knee problems, an injury, and normal clinical evaluation of the lower extremities tend to show that there was no motor vehicle accident in service wherein he sustained an injury to his right and left knees. Therefore, the Veteran does not meet the second required element for a direct service connection claim and the claim must be denied. The Board finds that the passage of many years between service discharge and medical documentation of a claimed disability is a factor, which tends to weigh against a finding that the disability is related to service. The evidence shows that the Veteran was first documented with left knee arthritis in February 2016, which is 48 years after separation from service and further supports that left knee arthritis is not related to service. For all the reasons described above, the Board finds that the preponderance of the evidence is against the claim of entitlement to service connection for a right knee and left knee disability, to include left knee arthritis. 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 claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 11. Entitlement to service connection for diabetes mellitus, type II, to include as due to Agent Orange/herbicide exposure during service. 12. Entitlement to service connection for prostate cancer, to include as due to Agent Orange/herbicide exposure. In this case, the Board finds that the evidence of record does not support that the Veteran served in the Republic of Vietnam or was exposed to Agent Orange/herbicide. The Veteran testified before a DRO in April 2017 that he was exposed to Agent Orange/herbicides during training exercises and while sitting next to a veteran who had recently left Vietnam while both flew from Germany to Kansas. However, VA has not expanded herbicide exposure to training exercises or sitting next to someone who has recently left the Republic of Vietnam. Accordingly, the Veteran is precluded from presumptive service connection service connection under 38 C.F.R. § 3.309(e) for diabetes mellitus, type II and prostate cancer, due to exposure to Agent Orange/herbicides. Regarding diabetes mellitus, type II the evidence of record is negative for a current diagnosis of this disease. Further, in April 2017 the Veteran testified that he was borderline diabetic. Therefore, without a current diabetes mellitus, type II disability the claim must be denied. See Brammer, 3 Vet. App. at 225. Prostate cancer is a chronic disease and may be service connected on a presumptive basis under 38 C.F.R.§ 3.309(a). A VA treatment record shows that in March 2009 the Veteran was treated for prostate cancer. However, the Board finds that without prostate cancer being manifested to a compensable degree within one year of service discharge, presumptive service connection under 38 C.F.R. § 3.309(a) is not warranted. Nonetheless, the usual avenue of direct service connection is still available. As noted above, the evidence of record shows that the Veteran was treated for prostate cancer in March 2009. Accordingly, the Veteran meets the first required element for a direct service connection claim. However, the preponderance of the record is against a finding that the Veteran was treated for, or diagnosed with prostate cancer in service. Specifically, the STRs are negative for any such diagnosis. Further, the Report of Medical Examination completed at separation from service in February 1968, shows a normal clinical evaluation for the Veteran’s genitourinary system. See DORLAND’S ILLUSTRATED MEDICAL ENCYCLOPEDIA, 32nd Edition (the genitourinary system includes the prostate). Therefore, the Veteran does not meet the second required element for a direct service connection claim and the claim must be denied. In conclusion, the Board finds that the preponderance of the evidence is against a claim for entitlement to service connection for diabetes mellitus, type II and prostate cancer, to include as due to Agent Orange/herbicide exposure during service on any basis. 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 claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 13. Entitlement to service connection for kidney disability, to include kidney stones and acute kidney failure. In April 2017, the Veteran testified before a DRO that he had kidney stones that he believes are related to service. The Veteran did not provide testimony as to when he had kidney stones or how he believes they were related to service. After a careful review of the evidence of record, the Board finds that while the Veteran has a diagnosis of acute kidney failure, the preponderance of the evidence is against finding that it began in service, manifested to a compensable degree within one year of service discharge or is otherwise related to service. To the extent that the Veteran testified that he had kidney stones, the evidence of record does not support a history of kidney stones or current kidney stones. Kidney disease is a chronic disease and may be service connected on a presumptive basis under 38 C.F.R.§ 3.309(a). A VA treatment record reflects the earliest medical documentation related to the Veteran’s kidney disease is January 2011. However, without kidney disease being manifested to a compensable degree within one year of service discharge, the Veteran’s claim for service connection for a kidney disability is not warranted under 38 C.F.R. § 3.309(a). As to direct service connection, as noted above, VA treatment records show that the Veteran has a current diagnosis of acute kidney failure, and therefore meets the first required element for a direct service connection claim. However, the preponderance of the evidence is against a finding for an in-service disease or injury pertaining to the Veteran’s kidney disability. For example, the Veteran’s STRs are negative for treatments for, or a diagnosis related to his kidneys. The February 1968 Report of Medical Examination at separation from service, shows that the Veteran’s urinalysis was negative for albumin (which is a type of protein that may be a sign of kidney disease). National Kidney Foundation, https://www.kidney.org/atoz/content/albuminuria. In the corresponding Report of Medical History, the Veteran specifically denied a history of kidney stones or blood in his urine and sugar or albumin in his urine. Therefore, the Veteran does not meet the second required element for a direct service connection claim and the claim must be denied. Moreover, the Board finds that the passage of many years between service discharge and medical documentation of a claimed disability is a factor, which tends to weigh against a finding that the disability is related to service. Therefore, the earliest documentation of a kidney disability from 2011 which is 43 years after separation from service further supports that the Veteran’s current kidney disability did not have its onset in service, did not manifest to a compensable degree within one year of service discharge and is not otherwise related to service. For all these reasons, the Board finds that the preponderance of the evidence is against the claim of entitlement to service connection for a kidney disability, to include kidney stones and acute kidney disease. 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 claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 14. Entitlement to service connection for a heart disability. The Veteran testified before the DRO that he had two heart attacks and that his heart disability is related to his kidney disability. After a careful review of the evidence of record, the Board finds that the evidence of record does not document that the Veteran has a current heart disability. A December 2015 EKG, provided at a VA medical facility, showed no acute abnormalities. Therefore, without documentation of heart disease the claim must be denied on direct and presumptive basis. See Brammer, 3 Vet. App. at 225; 38 C.F.R.§ 3.309(a). To the extent that the Veteran testified that his heart disease is related to his kidney disease, the Veteran is not service-connected for kidney disease. Therefore, the Veteran cannot establish secondary service connection. For all these reasons, the Board finds that the preponderance of the evidence is against the claim of entitlement to service connection for heart disability on any basis. 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 claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 15. Entitlement to service connection for bilateral hearing loss disability. Hearing loss (also referred to as hearing "impairment") will be considered a disability for VA disability compensation purposes when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 hertz (Hz) is 40 decibels or greater; or when the auditory thresholds for at least 3 of the frequencies 500, 1000, 2000, 3000 or 4000 Hz are 26 decibels 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, the threshold for normal hearing is from 0 to 20 decibels, with higher threshold levels indicating some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). In this case, the Veteran testified that his current bilateral hearing loss disability is a result of in-service acoustic trauma. The Veteran also testified that his hearing loss results from a blow to his head by a spring-loaded jack during service in June 1967. After a review of the evidence of record, the Board finds that the preponderance of the evidence is against a finding that the Veteran’s current bilateral sensorineural hearing loss disability is related to service. Regarding presumptive service connection, the preponderance of the evidence is against a finding that the Veteran’s bilateral sensorineural hearing loss disability manifested to a compensable degree within one year of service discharge. Accordingly, presumptive service connection under 38 C.F.R. § 3.309(a) is not warranted. As to direct service connection, the Board finds that the Veteran meets the first required element for direct service connection because he has current bilateral sensorineural hearing loss disability that meets the criteria for a VA hearing loss disability under 38 C.F.R. § 3.385. Next, the Board concedes that the Veteran was exposed to acoustic trauma during service, specifically due to loud firearms (canons and howitzers). As reflected in the DD Form 214, the Veteran’s military occupational specialty (MOS) was a field radio mechanic attached to an infantry division. Therefore, the Veteran meets the second requirement for a direct service connection claim. However, the preponderance of the evidence is against a finding that the Veteran’s current bilateral sensorineural hearing loss disability relates to service. Service treatment records are absent for complaints of, treatment for, and diagnosis of, sensorineural hearing loss, or symptoms of sensorineural hearing loss. Specifically, the February 1968 Report of Medical Examination at service separation reveals normal hearing bilaterally, and the Veteran specifically denied having a history of hearing loss or ear trouble in an associated Report of Medical History. Indeed, despite the Veteran’s testimony that his bilateral hearing loss was related to service, the overall evidence of record does not support the Veteran’s assertions. In addition, the April 2015 VA examiner opined that it is less likely than not that the Veteran’s bilateral sensorineural hearing loss disability was caused by, or a result of, military noise exposure. The examiner’s rationale was that there was normal hearing in both ears at separation in February 1968 with no decrease in hearing compared to enlistment hearing test results in May 1965. The April 2015 VA examiner is an audiologist who has specialized medical expertise and training in auditory matters, had adequate facts and data on which to base the medical opinion, and provided a sound rationale for the medical opinion. Further, an April 2017 VA examiner opined that the blow to the Veteran’s head in 1967 was less likely than not the cause of the Veteran’s left ear hearing loss as there was no concurrent evidence of a TBI that caused hearing loss. For these reasons, the April 2015 and April 2017 VA examiners medical opinions and rationale are of great probative value and the Board accords more weight to these findings than to the Veteran’s testimony. Based on the above, the Board finds that the preponderance of the evidence is against the claim of entitlement to service connection for bilateral hearing loss disability on any basis. 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 claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 16. Entitlement to service connection for tinnitus. The Veteran testified that his current tinnitus is the result of exposure to in-service acoustic trauma. After review of the evidence of record the Board finds that the preponderance of weighs against finding that the Veteran’s current tinnitus began during service, manifested to a compensable degree within one year of service separation or is otherwise related to an in-service injury or disease. Tinnitus is a chronic disease for which presumptive service connection may be granted under 38 C.F.R. § 3.309(a). However, the evidence of record shows that the Veteran reported to the April 2015 VA examiner that he “had no idea as to onset” of his tinnitus. Accordingly, the Board finds that presumptive service connection is not warranted. 38 C.F.R. § 3.309(a). The Board finds that the Veteran meets the first and second requirement elements for a direct service connection claim. The Veteran currently has tinnitus and was exposed to acoustic trauma during service. However, the Board concludes that the preponderance of the evidence weighs against finding that the Veteran’s current tinnitus began during service. Specifically, the April 2015 VA examiner opined that it is less likely than not that the Veteran’s tinnitus was caused by, or a result of, military noise exposure. The April 2015 VA examiner noted that the Veteran “had no idea as to onset” of his tinnitus. Also, the examiner noted that the Veteran asserted that his tinnitus only occurs about once a week. For these reasons, the April 2015 VA examiner’s medical opinion and supportive rationale are of great probative value and the Board gives more weight to the April 2015 VA examiner’s findings than to the Veteran’s testimony. Based on the above reasons, the Board finds that the preponderance of the evidence is against the claim of entitlement to service connection for tinnitus on any basis. 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 claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.   A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Morgan, Associate Counsel