Citation Nr: 18154079 Decision Date: 11/29/18 Archive Date: 11/28/18 DOCKET NO. 16-42 825 DATE: November 29, 2018 ORDER Entitlement to service connection for a right knee cap disability is denied. Entitlement to service connection for left big toe fracture is denied. Entitlement to service connection for bullet fragments in buttocks is denied. Entitlement to service connection for a left eye disability is denied. Entitlement to service connection for bilateral hearing loss disability is denied. Entitlement to service connection for allergies is denied. Entitlement to service connection for a heart disability is denied. Entitlement to service connection for partial removal of the sphincter muscle is denied. Entitlement to service connection for sterility is denied. Entitlement to service connection for posttraumatic stress disorder (PTSD) is denied. Entitlement to service connection for residuals of a right craniotomy (claimed as “right side of head”) is denied. FINDINGS OF FACT 1. The evidence does not show diagnoses of a right knee cap disability, a left big toe fracture, bullet fragments in the buttocks, a left eye disability, bilateral hearing loss for VA purposes, allergies, a heart disability, partial removal of sphincter muscle, sterility, or PTSD. 2. Residuals of a right craniotomy are not etiologically related to the Appellant’s service. CONCLUSIONS OF LAW 1. The criteria for service connection for a right knee cap disability have not been met. 38 U.S.C. § 1112, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2018). 2. The criteria for entitlement to service connection for a left big toe fracture have not been met. 38 U.S.C. §§ 1112, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2018). 3. The criteria for service connection for bullet fragments of the buttocks have not been met. 38 U.S.C. §§ 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). 4. The criteria for service connection for a left eye disability have not been met. 38 U.S.C. §§ 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). 5. The criteria for service connection for hearing loss disability have not been met. 38 U.S.C. §§ 1112, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385 (2018). 6. The criteria for service connection for allergies have not been met. 38 U.S.C. §§ 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). 7. The criteria for service connection for a heart disability have not been met. 38 U.S.C. §§ 1112, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2018). 8. The criteria for service connection for partial removal of the sphincter muscle have not been met. 38 U.S.C. § 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). 9. The criteria for entitlement to service connection for sterility have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303 (2018). 10. The criteria for service connection for PTSD have not been met. 38 U.S.C. §§ 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). 11. The criteria for service connection for residuals of a right craniotomy have not been met. 38 U.S.C. §§ 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Appellant had service in the Army National Guard, with a period of active duty for training (ACDUTRA) from October 1963 to April 1964. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma. Service Connection 1. Right Knee Cap Disability, Left Big Toe Fracture, Bullet Fragments in Buttocks, Left Eye Disability, Bilateral Hearing Loss Disability, Allergies, a Heart Disability, Partial Removal of Sphincter Muscle, Sterility, and PTSD The Appellant’s service treatment records (STRs) do not document any complaints, diagnosis, or treatment for a right knee cap disability, left big toe fracture, bullet fragments in the buttocks, a left eye disability, hearing loss disability, allergies, a heart disability, removal of the sphincter muscle, sterility, or PTSD. The Appellant’s post-service treatment records are silent with respect to any right knee cap disability, left big toe fracture, bullet fragments in the buttocks, a left eye disability, hearing loss disability, allergies, a heart disability, removal of the sphincter muscle, sterility, or PTSD. The Board acknowledges that a VA medical examination or medical opinion has not been obtained in response to the claim. VA is obliged to provide a VA examination or obtain a medical opinion when: (1) there is competent evidence that the Appellant has a current disability (or persistent or recurrent symptoms of a disability), (2) there is evidence establishing that the Appellant suffered an event, injury or disease in service or has a disease or symptoms of a disease within a specified presumptive period, (3) the evidence indicates that the current disability or symptoms may be associated with service or with another service-connected disability, and (4) there is not sufficient medical evidence to make a decision. 38 C.F.R. § 3.159 (c)(4) (2017); Charles v. Principi, 16 Vet. App. 370 (2002). In this case the only evidence that the Appellant has a current right knee cap disability, left big toe fracture, bullet fragments in the buttocks, a left eye disability, hearing loss disability, allergies, a heart disability, removal of the sphincter muscle, sterility, or PTSD is in the various lay statements submitted. However, the lay statements submitted lack sufficient detail to warrant obtaining additional medical evidence. Further, there is no competent evidence of record indicating that the Appellant’s has a right knee cap disability, left big toe fracture, bullet fragments in the buttocks, a left eye disability, hearing loss disability, allergies, a heart disability, removal of the sphincter muscle, sterility, or PTSD that is related to his active service. Therefore, the Board finds that the medical evidence currently of record is sufficient to decide the claim and a VA examination or medical opinion is unnecessary. While the Appellant is competent to report observable symptoms of his various reported disabilities, he is not competent to provide a diagnosis of those disabilities or opinions linking diagnosed disabilities of that nature to active service, as that requires medical expertise and is outside the realm of common knowledge of a layperson. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Therefore, the Appellant is not competent to provide a diagnosis or an etiology opinion in this case. For a disability to be service connected, it must be present at the time a claim for a VA disability compensation is filed or during or contemporary to the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). Here, the Board notes that there are no diagnoses of a right knee cap disability, left big toe fracture, bullet fragments in the buttocks, a left eye disability, hearing loss disability, allergies, a heart disability, removal of the sphincter muscle, sterility, or PTSD of record. In the absence of proof of a present disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223 (1992). Therefore, the Board finds that the preponderance of the evidence is against the claims and entitlement to service connection for a right knee cap disability, a left big toe fracture, bullet fragments in the buttocks, a left eye disability, hearing loss disability, allergies, a heart disability, removal of the sphincter muscle, sterility, or PTSD is not warranted. 38 U.S.C. § 5107 (b) (2012); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 2. SP Right Craniotomy The Appellant maintains that he had a stroke and subsequent right-sided craniotomy that is etiologically related to his active service. The Appellant’s STRs are silent for complaints of, or treatment for a disability pertaining to the right side of his head during active service, to include a stroke or craniotomy. Post-service treatment records indicate the Appellant was diagnosed with a stroke and underwent a right craniotomy. However, in the records submitted by the Appellant, the date of the occurrence was purposefully scratched out by the appellant and is unknown. Additional records regarding the event have not been identified and are not able to be obtained. An opinion as to the nature and etiology of the Appellant’s right craniotomy, or preceding stroke, was not provided. The Board acknowledges that a VA medical examination or medical opinion has not been obtained in response to the claim of entitlement to service connection for a right side of head disability. VA is obliged to provide a VA examination or obtain a medical opinion when: (1) there is competent evidence that the Appellant has a current disability (or persistent or recurrent symptoms of a disability), (2) there is evidence establishing that the Appellant suffered an event, injury or disease in service or has a disease or symptoms of a disease within a specified presumptive period, (3) the evidence indicates that the current disability or symptoms may be associated with service or with another service-connected disability, and (4) there is not sufficient medical evidence to make a decision. 38 C.F.R. § 3.159 (c)(4) (2016); Charles v. Principi, 16 Vet. App. 370 (2002). In this case, there is no competent evidence of record indicating that the Appellant’s right craniotomy, or preceding stroke, is related to active service. Therefore, the Board finds that the medical evidence currently of record is sufficient to decide the claim and no VA examination or medical opinion is warranted. While laypersons are competent to report the presence of observable symptoms, the Appellant is not competent to provide an opinion regarding the etiology of a stroke or subsequent craniotomy. A medical opinion of that nature requires medical testing and expertise that is outside the common knowledge of a layperson. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Therefore, the Appellant is not competent to provide an opinion in this case Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to service connection for residuals of a craniotomy is not warranted. 38 U.S.C. § 5107 (b) (2012); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Mariah N. Sim, Associate Counsel