Citation Nr: 18153859 Decision Date: 11/28/18 Archive Date: 11/28/18 DOCKET NO. 16-19 425A DATE: November 28, 2018 ORDER Entitlement to service connection for a right wrist disability is denied. Entitlement to service connection for a finger disability is denied. Entitlement to service connection for a neck disability is denied. Entitlement to service connection for a left leg disability is denied. Entitlement to service connection for a right leg disability is denied. Entitlement to service connection for a left knee disability is denied. Entitlement to service connection for a right knee disability is denied. Entitlement to service connection for a right ankle disability is denied. Entitlement to service connection for a left foot disability is denied. Entitlement to service connection for a right foot disability is denied. Entitlement to service connection for a headache disability, to include migraines, is denied. Entitlement to service connection for bipolar disorder is denied. Entitlement to service connection for an eating disorder is denied. Entitlement to an initial compensable rating for right shoulder osteoarthritis is denied. Entitlement to a 10 percent rating, but no higher, for allergic rhinitis is granted, subject to the law and regulations governing the payment of monetary benefits. REMANDED Entitlement to service connection for a low back disability is remanded. Entitlement to service connection for a neck disability is remanded. Entitlement to service connection for acne is remanded. Entitlement to service connection for athlete’s foot is remanded. Entitlement to service connection for a chronic disability manifested by dizziness is remanded. Entitlement to an initial rating in excess of 50 percent for posttraumatic stress disorder (PTSD) is remanded. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a right wrist disability. 2. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a finger disability. 3. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current neck disability. 4. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a left leg disability. 5. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a right leg disability. 6. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a left knee disability. 7. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a right knee disability. 8. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a right ankle disability. 9. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a left foot disability. 10. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a right foot disability. 11. The Veteran is found to have been sound upon entry into service with no pre-service diagnosis of a headache disorder; and his current headache disorder had its onset during service. 12. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of bipolar disorder. 13. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of an eating disorder. 14. At no time during the appeal period has the Veteran’s right shoulder osteoarthritis been manifested by pain or limitation of motion. 15. At no time during the appeal period has the Veteran’s allergic rhinitis been manifested by polyps, greater than 50 percent obstruction of the nasal passage on both sides, or complete obstruction of the nasal passage on one side. CONCLUSIONS OF LAW 1. The criteria for service connection for a right wrist disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for service connection for a finger disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 3. The criteria for service connection for a neck disability have not been 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 left leg disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 5. The criteria for service connection for a right leg disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 6. The criteria for service connection for a left knee disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 7. The criteria for service connection for a right knee disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 8. The criteria for service connection for a right ankle disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 9. The criteria for service connection for a left foot disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 10. The criteria for service connection for a right foot disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 11. The criteria for service connection for a headache disability have been met. 38 U.S.C. §§ 1110, 1111, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 12. The criteria for service connection for bipolar disorder have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 13. The criteria for service connection for an eating disorder have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 14. The criteria for an initial compensable rating for right shoulder osteoarthritis have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.7, 4.71a, Diagnostic Codes 5201-5003. 15. The criteria for an initial compensable rating for allergic rhinitis have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.7, 4.97, Diagnostic Code 6522. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from September 2008 to September 2011. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. To prevail on the issue of service connection there must be evidence of a current disability, in-service incurrence or aggravation of a disease or injury; and a causal relationship between the present disability and the disease or injury incurred or aggravated during service. See Shedden v. Principi, 381 F.3d 1163, 1166–67 (Fed. Cir. 2004). Service connection may also be established on a secondary basis for a disability that is proximately due to or the result of a service-connected disease or injury pursuant to 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show that a current disability exists and that the current disability was either caused by or aggravated by a service-connected disability. 38 C.F.R. § 3.310(a); Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). Where a Veteran is seeking service connection for any disability, due consideration shall be given to the places, types, and circumstances of service as shown by the service record, the official history of each organization in which the Veteran served, the Veteran’s medical records, and all pertinent medical and lay evidence. 38 U.S.C. § 1154 (a). Special consideration is given when a veteran’s service involves combat. The Veteran’s DD Form 214 shows he served in Afghanistan from December 2009 to December 2010, his military occupational specialty (MOS) was power generation equipment repairer, that he received a Combat Action Badge (CAB). Therefore, 38 U.S.C. § 1154 (b) must be considered. Under this provision, if a combat veteran presents satisfactory lay or other evidence of service incurrence or aggravation of a disease or injury, which is consistent with the circumstances or hardships of his service, then an evidentiary presumption of service connection arises and the burden shifts to the government to disprove service incurrence or aggravation by clear and convincing evidence. Id.; see Maxson v. Gober, 230 F.3d 1330 (Fed. Cir. 2000). Specific presumptive service connection is available to Veterans who served during the Persian Gulf War and exhibit objective indications of a qualifying chronic disability that manifested during active military, naval, or air service in the Southwest Asia theater of operations during the Persian Gulf War, or to a degree of 10 percent or more not later than December 31, 2021. See 38 U.S.C. § 1154; 38 C.F.R. § 3.317 (a)(1). For the purposes of presumptive service connection based upon the Persian Gulf War, Southwest Asia refers to Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations. 38 U.S.C. §§ 1117, 1118; 38 C.F.R. § 3.317 (e). Veterans who served in Afghanistan on or after September 19, 2001, are not considered Persian Gulf War veterans for purposes of compensation under 38 C.F.R. § 3.317, except for infectious diseases under 38 C.F.R. § 3.317(c). Cox v. McDonald, 28 Vet. App. 318 (2016). Therefore, the Veteran does not qualify for service connection on such bases. 1. Entitlement to service connection for a right wrist disability The Board concludes that the Veteran does not have a diagnosis of a current chronic right wrist disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). In conjunction with his VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, received in May 2014, the Veteran identified a right wrist condition “related to: PTSD - Combat.” Post-service medical records are absent complaints, findings and diagnoses of a right wrist condition. The Board notes that of record is a February 2013 record which notes that the Veteran presented for a new patient evaluation to establish care. At that time, he complained of pain all over; however, he did not specifically note right wrist pain. See Nashville VA Medical Center (VAMC) and Murfreesboro VAMC records, received August 2014 in Compensation and Pension Record Interchange (CAPRI)/Veterans Benefit Management System (VBMS). The Veteran underwent VA examination in October 2014 at which time the VA examiner determined that he did not have a current right wrist diagnosis. The examiner noted a normal right wrist condition and normal examination under diagnosis. See October 2014 Wrist Conditions Disability Benefits Questionnaire (DBQ). Thus, there is no diagnosis of a current chronic right wrist disorder. The Board has considered the evidence in light of the case of Saunders v. Wilkie in which the United States Court of Appeals for the Federal Circuit addressed “the legal issue [of] whether pain without an accompanying pathology can constitute a “disability” under [38 U.S.C.] § 1110.” 886 F.3d 1356, 1363-64 (Fed. Cir. 2018) (overruling the Veterans Court’s holding in Sanchez-Benitez v. West, 13 Vet. App. 282, 285 (1999)). The Federal Circuit held that the Veterans Court erred “as a matter of law in holding that pain alone, without an accompanying diagnosis or identifiable condition, cannot constitute a ‘disability’ under [38 U.S.C.] § 1110, because pain in the absence of a presently-diagnosed condition can cause functional impairment.” Id. The Federal Circuit “conclude[d] that pain is an impairment because it diminishes the body’s ability to function, and that pain need not be diagnosed as connected to a current underlying condition to function as an impairment.” Id. Further, the Federal Circuit held that “[w]e do not hold that a veteran could demonstrate service connection simply by asserting subjective pain to establish a disability, the veteran’s pain must amount to a functional impairment. To establish the presence of a disability, a veteran will need to show that [] pain reaches the level of a functional impairment of earning capacity.” Id. In this case, there is no credible persuasive evidence that the Veteran suffers from a right wrist disability productive of chronic functional impairment. There is no evidence pain specific to the right wrist during the appeal period. In addition, the October 2014 VA examiner specifically found that the Veteran’s right wrist diagnosis did not impact his ability to perform any type of occupational task. See October 2014 Wrist Conditions DBQ. To the extent that the Veteran believes that he has a current right wrist disability, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. “Lay testimony is competent... to establish the presence of observable symptomatology and ‘may provide sufficient support for a claim of service connection.’” Id. However, a diagnosis of a knee disability requires expertise that the Veteran has not established. Consequently, the Board gives more probative weight to the competent medical evidence. The Board has considered the evidence in light of the case of Saunders v. Wilkie, but finds no evidence of functional impairment. In the absence of competent evidence that a current chronic right wrist disability exists which was caused by or aggravated by the Veteran’s military service, the criteria for establishing service connection for a right wrist disability have not been established. 38 C.F.R. § 3.303. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for a right wrist disability, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 2. Entitlement to service connection for a finger disability The Board concludes that the Veteran does not have a diagnosis of a current chronic finger disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). In conjunction with his VA Form 21-526EZ, received in May 2014, the Veteran identified a finger condition “related to: PTSD - Combat.” Post-service medical records are absent complaints, findings and diagnoses of a finger condition. Although at the February 2013 new patient evaluation, the Veteran complained of pain all over, he did not specifically note finger pain. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 in CAPRI/VBMS. At the VA examination in October 2014, the VA examiner determined that he did not have a current hand or finger diagnosis. See October 2014 Hand and Finger Conditions DBQ. Thus, there is no competent diagnosis of a current chronic finger disorder. In addition, there is no credible persuasive evidence that the Veteran suffers from a finger disability productive of chronic functional impairment. There is no evidence pain specific to a finger during the appeal period. To the extent that the Veteran believes that he has a current finger disability, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. “Lay testimony is competent... to establish the presence of observable symptomatology and ‘may provide sufficient support for a claim of service connection.’” Id. However, a diagnosis of a knee disability requires expertise that the Veteran has not established. Consequently, the Board gives more probative weight to the competent medical evidence. The Board has considered the evidence in light of the case of Saunders v. Wilkie, but finds no evidence of functional impairment. In the absence of competent evidence that a current chronic finger disability exists which was caused by or aggravated by the Veteran’s military service, the criteria for establishing service connection for a finger disability have not been established. 38 C.F.R. § 3.303; see Brammer v. Derwinski, 3 Vet. App. 223, 225 (1993) (finding that without proof of a current disability, there can’t be a valid claim for service connection). Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for a finger disability, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 3. Entitlement to service connection for a left leg disability The Board concludes that the Veteran does not have a diagnosis of a current chronic left leg disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). In conjunction with his VA Form 21-526EZ, received in May 2014, the Veteran identified a bilateral leg condition “related to: PTSD - Combat.” Post-service medical records are absent complaints, findings and diagnoses of a left leg condition. Although in February 2013, the Veteran complained of pain all over, he did not specifically note left leg pain. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 in CAPRI/VBMS. The Veteran underwent VA examination in October 2014 at which time the VA examiner did not diagnose a left leg condition. See October 2014 Knee and Lower Leg Conditions DBQ. In addition, there is no credible persuasive evidence that the Veteran suffers from a left leg disability productive of chronic functional impairment. There is no evidence pain specific to the Veteran’s left leg during the appeal period. To the extent that the Veteran believes that he has a current left leg disability, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. “Lay testimony is competent... to establish the presence of observable symptomatology and ‘may provide sufficient support for a claim of service connection.’” Id. However, a diagnosis of a knee disability requires expertise that the Veteran has not established. Consequently, the Board gives more probative weight to the competent medical evidence. The Board has considered the evidence in light of the case of Saunders v. Wilkie, but finds no evidence of functional impairment. In the absence of competent evidence that a current chronic left leg disability exists which was caused by or aggravated by the Veteran’s military service, the criteria for establishing service connection for a left leg disability have not been established. 38 C.F.R. § 3.303. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for a left leg disability, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 4. Entitlement to service connection for a right leg disability The Board concludes that the Veteran does not have a diagnosis of a current chronic right leg disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). As noted above, in conjunction with his VA Form 21-526EZ, received in May 2014, the Veteran identified a bilateral leg condition “related to: PTSD - Combat.” Post-service medical records are absent complaints, findings and diagnoses of a right leg condition. Although in February 2013, the Veteran complained of pain all over, he did not specifically note right leg pain. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 in CAPRI/VBMS. The Veteran underwent VA examination in October 2014 at which time the VA examiner did not diagnose a right leg condition. See October 2014 Knee and Lower Leg Conditions DBQ. In addition, there is no credible persuasive evidence that the Veteran suffers from a right leg disability productive of chronic functional impairment. There is no evidence of pain specifically to the right leg during the appeal period To the extent that the Veteran believes that he has a current right leg disability, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. “Lay testimony is competent... to establish the presence of observable symptomatology and ‘may provide sufficient support for a claim of service connection.’” Id. However, a diagnosis of a knee disability requires expertise that the Veteran has not established. Consequently, the Board gives more probative weight to the competent medical evidence. The Board has considered the evidence in light of the case of Saunders v. Wilkie, but finds no evidence of functional impairment. In the absence of competent evidence that a current chronic right leg disability exists which was caused by or aggravated by the Veteran’s military service, the criteria for establishing service connection for a right leg disability have not been established. 38 C.F.R. § 3.303; See Brammer, supra. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for a right leg disability, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 5. Entitlement to service connection for a left knee disability The Board concludes that the Veteran does not have a current diagnosis of a left knee disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). In conjunction with his VA Form 21-526EZ, received in May 2014, the Veteran identified a bilateral knee condition “related to: PTSD - Combat.” Post-service medical records are absent findings and diagnoses of a left knee disability. At the February 2013 new patient evaluation, the Veteran noted that he had pain in his left knee at times. X-rays of the Veteran’s knees showed no evidence of fracture or dislocation, no arthritic changes, and no lytic or sclerotic lesions. Impression was no acute bony findings. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 in CAPRI/VBMS. At the VA examination in October 2014, the VA examiner did not diagnose a current left knee condition; the examiner only noted a left knee injury in 2009 with normal examination and x-rays. On physical examination, all left knee findings were normal. See October 2014 Knee and Lower Leg Conditions DBQ. Thus, there is no diagnosis of a current chronic left knee disorder. In addition, there is no credible persuasive evidence that the Veteran suffers from a left leg disability productive of chronic functional impairment. To the extent that the Veteran believes that he has a current left knee disability, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. “Lay testimony is competent... to establish the presence of observable symptomatology and ‘may provide sufficient support for a claim of service connection.’” Id. However, a diagnosis of a knee disability requires expertise that the Veteran has not established. Consequently, the Board gives more probative weight to the competent medical evidence. The Board has considered the evidence in light of the case of Saunders v. Wilkie, but finds no evidence of functional impairment. In the absence of competent evidence that a current chronic left knee disability exists which was caused by or aggravated by the Veteran’s military service, the criteria for establishing service connection for a left knee disability have not been established. 38 C.F.R. § 3.303; Brammer, supra. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for a left knee disability, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 6. Entitlement to service connection for a right knee disability The Board concludes that the Veteran does not have a current diagnosis of a right knee disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). As noted above, in conjunction with his VA Form 21-526EZ, received in May 2014, the Veteran identified a bilateral knee condition “related to: PTSD - Combat.” Post-service treatment records indicate that the Veteran was seen in April 2012 for right knee pain. The Veteran was seen in May 2012 with complaints of right knee pain. X-rays in February 2013 showed no evidence of fracture or dislocation, no arthritic changes, and no lytic or sclerotic lesions. Impression was no acute bony findings. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 in CAPRI/VBMS. At the VA examination in October 2014, the VA examiner did not diagnose a right knee condition. On physical examination, all right knee findings were normal. See October 2014 Knee and Lower Leg Conditions DBQ. In addition, there is no credible persuasive evidence that the Veteran suffers from a right knee disability productive of chronic functional impairment. There is no evidence to the contrary. To the extent that the Veteran believes that he has a current right knee disability, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. “Lay testimony is competent... to establish the presence of observable symptomatology and ‘may provide sufficient support for a claim of service connection.’” Id. However, a diagnosis of a knee disability requires expertise that the Veteran has not established. Consequently, the Board gives more probative weight to the competent medical evidence, which reflects that the Veteran does not have a current disability of the right knee. The Board has considered the evidence in light of the case of Saunders v. Wilkie, but finds no evidence of functional impairment. In the absence of competent evidence that a current chronic right knee disability exists which was caused by or aggravated by the Veteran’s military service, the criteria for establishing service connection for a right knee disability have not been established. 38 C.F.R. § 3.303; Brammer, supra. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for a right knee disability, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 7. Entitlement to service connection for a right ankle disability The Board concludes that the Veteran does not have a current diagnosis of a right ankle disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). In conjunction with his VA Form 21-526EZ, received in May 2014, the Veteran did not specifically identify an ankle condition. Post-service treatment records are absent findings and diagnoses of a right ankle disability. At the February 2013 new patient evaluation, the Veteran did not report a right ankle injury, but the provider noted that old records reviewed showed joint pain involving ankle/foot from August 2009 to November 2009. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 in CAPRI/VBMS. Mental health treatment notes in April 2015 noted medical issues of history of pain in right ankle. See Nashville VAMC and Murfreesboro VAMC records, received May 2016 in CAPRI/VBMS. The Veteran underwent VA examination in November 2014 at which time VA examiner did not diagnose a current right ankle condition; the examiner only noted a right ankle sprain in 2009 with normal examination and x-rays. On physical examination, all right ankle findings were normal. See November 2014 Ankle Conditions DBQ. Thus, there is no diagnosis of a current chronic right ankle disorder. In addition, there is no credible persuasive evidence that the Veteran suffers from a right ankle disability productive of chronic functional impairment. The November 2014 VA examiner specifically found that the Veteran’s right ankle diagnosis did not impact his ability to perform any type of occupational task. To the extent that the Veteran believes that he has a current right ankle disability, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. “Lay testimony is competent... to establish the presence of observable symptomatology and ‘may provide sufficient support for a claim of service connection.’” Id. However, a diagnosis of a knee disability requires expertise that the Veteran has not established. Consequently, the Board gives more probative weight to the competent medical evidence. The Board has considered the evidence in light of the case of Saunders v. Wilkie, but finds no evidence of functional impairment. In the absence of competent evidence that a current chronic right ankle disability exists which was caused by or aggravated by the Veteran’s military service, the criteria for establishing service connection for a left knee disability have not been established. 38 C.F.R. § 3.303; Brammer, supra. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for a right ankle disability, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 8. Entitlement to service connection for a left foot disability The Board concludes that the Veteran does not have a diagnosis of a current chronic left foot disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). In conjunction with his VA Form 21-526EZ, received in May 2014, the Veteran identified a left foot condition “related to: PTSD - Combat.” The service treatment records are absent complaints, findings and diagnoses of any left foot condition during service. Post-service medical records are absent complaints, findings and diagnoses of a left foot condition. Although at the February 2013 new patient evaluation, the Veteran complained of pain all over, he did not specifically note left foot pain. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 in CAPRI/VBMS. Thus, there is no competent diagnosis of a current left foot disorder. In addition, there is no credible persuasive evidence that the Veteran suffers from a left foot disability productive of chronic functional impairment. There is no evidence of pain specific to the left foot during the appeal period. To the extent that the Veteran believes that he has a current left foot disability, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. “Lay testimony is competent... to establish the presence of observable symptomatology and ‘may provide sufficient support for a claim of service connection.’” Id. However, a diagnosis of a knee disability requires expertise that the Veteran has not established. Consequently, the Board gives more probative weight to the competent medical evidence. The Board has considered the evidence in light of the case of Saunders v. Wilkie, but finds no evidence of functional impairment. In the absence of competent evidence that a current chronic left foot disability exists which was caused by or aggravated by the Veteran’s military service, the criteria for establishing service connection for a finger disability have not been established. 38 C.F.R. § 3.303; Brammer, supra. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for a left foot disability, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 9. Entitlement to service connection for a right foot disability The Board concludes that the Veteran does not have a diagnosis of a current chronic right foot disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). In conjunction with his VA Form 21-526EZ, received in May 2014, the Veteran identified a right foot condition “related to: PTSD - Combat.” The service treatment records are absent complaints, findings and diagnoses of any left foot condition during service. Post-service medical records are absent complaints, findings and diagnoses of a right foot condition. Although at the February 2013 new patient evaluation, the Veteran complained of pain all over, he did not specifically note right foot pain. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 in CAPRI/VBMS. Thus, there is no competent diagnosis of a current right foot disorder. In addition, there is no credible persuasive evidence that the Veteran suffers from a right foot disability productive of chronic functional impairment. There is no evidence of pain specific to the right foot during the appeal period. To the extent that the Veteran believes that he has a current right foot disability, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. “Lay testimony is competent... to establish the presence of observable symptomatology and ‘may provide sufficient support for a claim of service connection.’” Id. However, a diagnosis of a knee disability requires expertise that the Veteran has not established. Consequently, the Board gives more probative weight to the competent medical evidence. The Board has considered the evidence in light of the case of Saunders v. Wilkie, but finds no evidence of functional impairment. In the absence of competent evidence that a current chronic right foot disability exists which was caused by or aggravated by the Veteran’s military service, the criteria for establishing service connection for a finger disability have not been established. 38 C.F.R. § 3.303. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for a right foot disability, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 10. Entitlement to service connection for a headache disability, to include migraines In conjunction with his VA Form 21-526EZ, received in May 2014, the Veteran identified migraine “related to: PTSD - Combat.” The Veteran’s service treatment records indicate that on his DD Form 2807-1, Report of Medical History, completed by the Veteran in September 2008, prior to entering service, he denied ever having frequent or severe headaches but noted taking Tylenol PM for headaches. The examiner noted in the comments that the Veteran took Tylenol PM for occasional headache less than once a month. A veteran is presumed to be in sound condition, except for defects, infirmities, or disorders noted when examined, accepted, and enrolled for service, or when clear and unmistakable evidence establishes that an injury or disease existed prior to service and was not aggravated by service. 38 U.S.C. § 1111. The burden is on the Government to rebut the presumption of sound condition upon service entrance by clear and unmistakable evidence showing that the disorder existed prior to service and was not aggravated by service. See VAOPGCPREC 3-2003. The Veteran’s entrance examination is not of record. Thus, the record is absent clinical evaluation of the Veteran’s neurologic system at service entrance. Thus, the Veteran is entitled to the presumption of soundness pertaining to a headache condition. If a condition is not noted upon entrance into service, then to rebut the presumption of soundness at service entrance VA must show by clear and unmistakable evidence both that there was a pre-existing condition and that it was not aggravated during or by the Veteran’s service. Wagner v. Principi, 370 F.3d 1089 (Fed. Cir. 2004); VAOPGCPREC 3-2003 (July 16, 2003). To satisfy this second-prong requirement for rebutting the presumption of soundness, the government must show by clear and unmistakable evidence either that there was no increase in disability during service or that any increase in disability was “due to the natural progression” of the condition. Joyce v. Nicholson, 443 F.3d 845, 847 (Fed. Cir. 2006). Where the government fails to rebut the presumption of soundness under section 1111, the Veteran’s claim must be considered one for service incurrence or direct service connection. See Wagner, 370 F.3d at 1094-1096 (indicating that, in cases where the presumption of soundness cannot be rebutted, the effect is that claims for service connection based on aggravation are converted into claims for service connection based on service incurrence). The Board finds that a headache condition clearly and unmistakably existed prior to entrance into service. However, the service treatment records reflect that the symptoms and manifestations of the Veteran’s pre-existing headache condition increased in severity during service. The service treatment records indicated that in January 2009, the Veteran stated that he had experienced increased headache; and on his Post-Deployment Health Assessment completed by the Veteran in December 2010, the Veteran noted that he was still bothered by bad headache. The presence of clear and unmistakable evidence sufficient to rebut the presumption of soundness is a legal determination, not a medical one. In this case the evidence of record is not sufficient to rebut the presumption of soundness regarding headaches. Accordingly, the Veteran is presumed to have been in sound condition when he entered active duty service. His service treatment records reflect that he suffered from “bad” headaches during his active duty service. In addition, post-service medical records reflect that the Veteran continued to experience headaches during the period on appeal. At the February 2013 new patient evaluation, the Veteran complained of headaches which had worsened in the prior weeks to months. The Veteran denied that the headaches affected his eyesight and that there was change with sound or light. He did note that it worsened when he ran and that it was more frontal to temple. Assessment included headaches which the provider felt were due to allergies/sinusitis. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 in CAPRI/VBMS. At the October 2014 VA examination, the Veteran stated that he had been having headaches. The examiner noted that in 2008, the Veteran was having headaches less than once a month and that he did not have prostrating headaches. The Veteran’s headaches were noted to be localized mostly to the left side of the head, accompanied by nausea lasting less than one day. As the Veteran reported headaches during active service and there is sufficient evidence of a continuity of symptomatology into the present day, the Board finds that service connection for a headache disability is warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 3.102., 3.303 (b). 11. Entitlement to service connection for bipolar disorder The Board concludes that the Veteran does not have a diagnosis of bipolar disorder and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). In conjunction with his VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, received in May 2014, the Veteran identified bipolar disorder “related to: PTSD - Combat.” Post-service medical records are absent diagnoses of a bipolar disorder. Although VA treatment records include diagnostic impressions of PTSD, adjustment disorder, polysubstance abuse, and substance induced mood disorder, there is no actual diagnosis of bipolar disorder. An April 2015 psychiatric consultation note states that the Veteran did not endorse recent symptoms consistent with bipolar disorder. An April 2016 psychiatry outpatient note indicates that the Veteran was seen to establish care. After mental status examination, the Veteran was diagnosed as having, inter alia, rule out bipolar. Although these diagnoses are certainly competent evidence, a “rule-out” diagnosis is inherently inconclusive as the examiner is expressing uncertainty as to whether the proposed diagnosis is warranted. Thus, there is no diagnosis of bipolar disorder. See Nashville VAMC and Murfreesboro VAMC, received August 2014 and May 2016 in CAPRI/VBMS. To the extent that the Veteran believes that he has bipolar disorder, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. Consequently, the Board gives more probative weight to the competent medical evidence. In the absence of competent evidence that the Veteran has bipolar disorder which was caused by or aggravated by his military service, the criteria for establishing service connection for bipolar disorder have not been established. 38 C.F.R. § 3.303. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for bipolar disorder, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 12. Entitlement to service connection for an eating disorder The Board concludes that the Veteran does not have a diagnosis of an eating disorder and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294; McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). In conjunction with his VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, received in May 2014, the Veteran identified bipolar disorder “related to: PTSD - Combat.” Post-service medical records are absent diagnoses of an eating disorder. Although VA treatment records include diagnostic impressions of PTSD, adjustment disorder, polysubstance abuse, and substance induced mood disorder, there is no diagnosis of an eating disorder. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 and May 2016 in CAPRI/VBMS. To the extent that the Veteran believes that he has an eating disorder, he is not competent to provide a diagnosis in this case. Jandreau, 492 F.3d at 1377. Consequently, the Board gives more probative weight to the competent medical evidence. In the absence of competent evidence that the Veteran has an eating disorder which was caused by or aggravated by his military service, the criteria for establishing service connection for an eating disorder have not been established. 38 C.F.R. § 3.303. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for service connection for an eating disorder, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. Increased Rating Disability ratings are determined by applying the criteria set forth in the VA’s Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Veteran is appealing the original assignments of disability ratings following awards of service connection for right shoulder osteoarthritis and allergic rhinitis. As such, it is not the present level of disability which is of primary importance, but rather the entire period is to be considered to ensure that consideration is given to the possibility of staged ratings; that is, separate ratings for separate periods of time based on the facts found. Fenderson v. West, 12 Vet. App. 119 (1999). 13. Entitlement to an initial compensable rating for right shoulder osteoarthritis Disabilities of the shoulder and arm are rated under Diagnostic Codes 5200 through 5203. The record reflects the appellant is right-hand dominant. Therefore, his right shoulder disability is rated as impairment of the major upper extremity. 38 C.F.R. § 4.69. The Veteran’s service-connected right shoulder osteoarthritis has been evaluated as noncompensably disabling pursuant to Diagnostic Codes 5201-5003. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the specific basis for the evaluation assigned. The additional code is shown after a hyphen. 38 C.F.R. § 4.27. Under Diagnostic Code 5003, degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under Diagnostic Code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Diagnostic Code 5201 provides that limitation of motion of the major arm at the shoulder level warrants a 20 percent rating. Limitation midway between the side and shoulder level also warrants a 30 percent rating. When motion is limited to 25 degrees from the side, a 40 percent rating is warranted for the major arm. Normal ranges of upper extremity motion are defined by VA regulation as follows: forward elevation (flexion) from zero to 180 degrees; abduction from zero to 180 degrees; and internal and external rotation to 90 degrees. Lifting the arm to shoulder level is lifting it to 90 degrees. 38 C.F.R. § 4.71, Plate I. In order to warrant a compensable evaluation, the evidence must show x-ray evidence of right shoulder arthritis and pain on right arm motion, or limitation of motion of the right arm at the shoulder level. The Veteran underwent VA examination in November 2014 at which time the Veteran demonstrated normal flexion, abduction, external rotation, and internal rotation of the right shoulder; and there was no indication of pain on use. The Veteran also demonstrated normal muscle strength and no instability; no impairment of the clavicle, scapula, acromioclavicular joint, sternoclavicular joint; and no impairment of the humerus. X-rays of the right shoulder showed minimal acromioclavicular osteoarthritis. In addition, although VA treatment records show history of right shoulder pain, they do not note any pain at time of treatment. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 and May 2016 in CAPRI/VBMS. Thus, the evidence demonstrated that the Veteran’s right shoulder osteoarthritis has not been manifested by painful motion, limitation of motion of the right arm at shoulder level, or any other shoulder disability for which a compensable rating may be warranted throughout the appeal period. The Board, therefore, finds that the Veteran’s right shoulder osteoarthritis symptoms have not more nearly approximated the criteria for a compensable rating. The Board has also considered DeLuca v. Brown and Mitchell v. Shinseki. 25 Vet. App. 32, 36-37 (2011); 8 Vet. App. 202, 206 (1995). As recognized in Mitchell v. Shinseki and DeLuca v. Brown, sections 4.40 and 4.45 permit consideration of a higher rating based on a greater limitation of motion due to pain on use, including during flare-ups, and based on weakened movement, excess fatigability, incoordination, and pain on movement, in addition to range of movement. However, as there is no limitation of motion and the evidence does not demonstrate pain upon use, these regulations are not applicable. Accordingly, the Board concludes that the preponderance of the evidence is against the claim for a compensable rating for service-connected right shoulder osteoarthritis, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. 14. Entitlement to an initial compensable rating for allergic rhinitis The Veteran’s allergic rhinitis has been rated as noncompensably disabling pursuant to Diagnostic Code 6522 which provides for a 10 percent rating for allergic rhinitis without polyps but with a greater than 50 percent obstruction of nasal passages on both sides or complete obstruction of one side. A 30 percent rating is warranted for allergic rhinitis with polyps. 38 C.F.R. § 4.97. In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. 38 C.F.R. § 4.31. At the October 2014 VA examination, the Veteran reported that he had drainage during seasonal changes and took over-the-counter Claritin. On physical examination, there was no obstruction greater than 50 percent of the nasal passages of both sides, no complete obstruction on either side, no permanent hypertrophy of the nasal turbinates, and no nasal polyps. In addition, VA treatment records dated during the appeal period do not indicate obstruction of the nasal passage on both sides greater than 50 percent, complete obstruction on one side due to rhinitis, or any nasal polyps. The Board notes that at the February 2013 new patient evaluation, physical examination demonstrates that nares were nearly occluded on the left due to swollen turbinates; nares on the right were also swollen but patent. See Chattanooga CBOC records, received August 2014 in CAPRI/VBMS. The February 2013 evaluation, however, is prior to the beginning of the appeal period. There are no VA treatment records which note symptoms similar to those in February 2013. See Nashville VAMC and Murfreesboro VAMC records, received August 2014 and May 2016 in CAPRI/VBMS. The Board, therefore, finds that the Veteran’s allergic rhinitis symptoms have not more nearly approximated the criteria for a compensable rating. The Board has not considered any other diagnostic code as rhinitis is specifically listed in the Schedule and may not be rated by analogy. Copeland v. McDonald, 27 Vet. App. 333, 337 (2015). Accordingly, the Board concludes that the preponderance of the evidence is against the claim for a compensable rating for service-connected allergic rhinitis, and the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b) is not for application. REASONS FOR REMAND 1. Entitlement to service connection for a low back disability The Board cannot make a fully-informed decision on the issue. The Veteran underwent a VA examination in October 2014 to assess the Veteran’s disability and was diagnosed as having lumbosacral strain. However, no etiology opinion was provided, although the precepts of Mclendon v. Nicholson were satisfied. 20 Vet. App. 79, 81 (2006). Thus, the Board finds that an addendum etiology opinion should be obtained. 2. Entitlement to service connection for a neck disability The Board cannot make a fully-informed decision on the issue. The Veteran underwent a VA examination in October 2014; the examiner determined that the Veteran had never been diagnosed with a cervical spine (neck) condition. The record, however, indicates that the Veteran has been diagnosed as having neck pain and minimal muscle tension by the provider who evaluated him in February 2013. In light of the Court of Appeals’ decision in Saunders v. Wilkie, the Board finds that a new examination should be conducted to determine if the Veteran’s neck complaints rise to the level of a disability. 3. Entitlement to service connection for acne and athlete’s foot The Board cannot make a fully-informed decision on the issue. The Veteran underwent VA examination in October 2014 at which time the examiner diagnosed the Veteran as having acne and fungal rash between the toes. In November 2014, the VA examiner who conducted the October 2014 VA examination opined that that Veteran’s acne and athlete’s foot was less likely than not incurred in or caused by the Veteran’s active duty service. The examiner noted that there was no diagnosis of acne or athlete’s foot during service although the Veteran stated that he had acne in service. The Board notes that a lay person is competent to give evidence about observable symptoms such as manifestations of acne. Layno v. Brown, 6 Vet. App. 465 (1994). The Board also notes that a lay person is competent to address etiology in some limited circumstances in which nexus is obvious merely through lay observation, such as a fall leading to a broken leg. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Thus, the Board finds that an addendum etiology opinion should be obtained which takes into account the Veteran’s competent lay statements of having acne and fungus of the toe during active service. 4. Entitlement to service connection for a chronic disability manifested by dizziness The Board cannot make a fully-informed decision on the issue. At the February 2013 new patient evaluation, the Veteran complained of dizziness with headaches and when he stands up. As service connection has been established for a headache disability, an examination should be conducted to determine the etiology of any currently diagnosed disability manifested by dizziness. 5. Entitlement to an initial rating in excess of 50 percent for posttraumatic stress disorder (PTSD) is remanded The Veteran underwent VA PTSD examination in October 2014 at which time he endorsed symptoms of depressed mood, anxiety, suspiciousness, panic attacks, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships. In a statement from the Veteran’s former employer, G.B., received by VA in May 2015, he noted issues that the Veteran appeared to be having while performing his occupation including the fact that it was difficult to determine if the Veteran was sufficiently aware of his surroundings or what activities he need to accomplish for the day. The former employer noted that the Veteran presented with very tired eyes, slow speech, and an almost shuffling walk and loss of balance. The former employer noted that he met with the Veteran in March 2015 and that he appeared to be under a great deal of stress and gave all indications that he had not slept in a few nights. VA treatment records indicate that the Veteran was hospitalized in April 2015 for psychiatric and substance abuse treatment. As it appears that the Veteran’s PTSD symptoms may have increased in severity since the Veteran was last examined by VA, he should be provided an opportunity to report for a VA examination to ascertain the current severity and manifestations of his PTSD. The matter is REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from May 2016 to the present. 2. Schedule the Veteran for a spine examination by an appropriate clinician to determine the nature and etiology of any lumbar spine and cervical spine disabilities. The examiner must opine on whether it is at least as likely as not related to an in-service injury, event, or disease. 3. Schedule the Veteran for a skin examination by an appropriate clinician to determine the nature and etiology of his acne and fungus between the toes. The examiner must consider the Veteran’s competent lay statements of having acne and athlete’s foot during active service. Given such, the examiner must opine whether his acne and athlete’s foot at least as likely as not began during service or is otherwise related to an in-service injury, event, or disease. (a.) The examiner must review the claims file and comment on the Veteran’s: 1. impetigo on his upper extremities in August 2010 and eczematoid dermatitis on the right middle finger in January 2011. 2. Post Deployment Health Assessment in December 2010, the Veteran reported going on sick call and being confined to quarters or placed on a profile for skin diseases or rashes but that he was no longer bothered by them. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any complaints of dizziness. The examiner must determine if there is a chronic disability manifested by dizziness or whether such dizziness is a symptom of another disorder. If a chronic disability, the examiner must determine if it is at least as likely as not related to an in-service injury, event, or disease. 5. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected PTSD. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to his PTSD alone. YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Olson, Counsel