Citation Nr: 18154646 Decision Date: 11/30/18 Archive Date: 11/30/18 DOCKET NO. 16-52 644 DATE: November 30, 2018 ORDER Entitlement to service connection for frostbite residuals of the left foot is denied. Entitlement to service connection for frostbite residuals of the right foot is denied. FINDINGS OF FACT 1. The Veteran does not have any frostbite injury to the right foot or residuals thereof. 2. The Veteran does not have any frostbite injury to the left foot or residuals thereof. CONCLUSIONS OF LAW 1. The criteria for service connection for residuals of frostbite of the left foot have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107, 7104, 7105 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 4.3 (2018). 2. The criteria for service connection for residuals of frostbite of the right foot have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A , 5107, 7104, 7105 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 4.3 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from May 1966 to April 1968. The matter on appeal before the Board is from an October 2014 rating decision of a regional office of the Department of Veterans Affairs (VA). Service Connection Service connection will be granted for a disability resulting from a disease or injury incurred in or aggravated by military service. 38 U.S.C. § 1110 (2012); 38 C.F.R. § 3.303 (2018). Service connection may also be granted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d) (2018). Service connection requires competent evidence showing, (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004), citing Hansen v. Principi, 16 Vet. App. 110, 111 (2002); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Where a veteran served ninety days or more of active service, and certain chronic diseases become manifest to a degree of 10 percent or more within one year after the date of separation from such 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, 1112, 1113 (2012); 38 C.F.R. §§ 3.307, 3.309(a) (2018). Continuity of symptomatology may be established if a claimant can demonstrate (1) that a condition was noted during service, (2) evidence of post-service continuity of the same symptomatology, and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. Medical evidence is required to demonstrate a relationship between a current disability and the continuity of symptomatology demonstrated if the condition is not one where a lay person’s observations would be competent. Clyburn v. West, 12 Vet. App. 296 (1999). Evidence of a chronic condition must be medical, unless it relates to a condition to which lay observation is competent. Savage v. Gober, 10 Vet. App. 488 (1997). Once the evidence has been assembled, it is the Board’s responsibility to evaluate the evidence. 38 U.S.C. § 7104 (a) (2012). The Secretary shall consider all information and evidence of record in a case before the Board with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 7105 (2012); 38 C.F.R. §§ 3.102, 4.3 (2018). The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. Masors v. Derwinski, 2 Vet. App. 181 (1992); Wilson v. Derwinski, 2 Vet. App. 614 (1992); Hatlestad v. Derwinski, 1 Vet. App. 164 (1991); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 1. Service connection for frostbite residuals for the left and right foot The Veteran asserts that he suffered frostbite to both feet during his time in service. He stated that his feet are very dry and constantly need lotion to prevent them from bleeding. The Veteran reported that he thinks he talked about the frostbite with a doctor when he started treatment at a VA medical center. Review of the service treatment records disclose the absence of any complaints or findings suggestive of a frostbite injury to either foot. The December 1987 separation examination describes the feet as normal, noting a burn scar on the Veteran’s right foot and a history of leg cramps secondary to an accident. In the same separation examination, the Veteran claimed that he did not have any foot trouble. In addition to these notations, there is no indication of any frostbite or foot troubles during the Veteran’s time in service. Review of the post-service medical records indicates no diagnosis, treatment, or symptoms of frostbite residuals on either foot. In September 2001, the diabetic foot exam reported that everything was within normal limits. Later diabetic foot exams in March 2002, March 2003, and March 2004 all indicate that the Veteran’s feet were within normal limits. None of the post-service medical records reference a frostbite injury or any residuals thereof. The Board finds that the weight of the competent and credible evidence establishes that the Veteran does not have current frostbite residuals of either foot and there is no injury or event in active service that shows otherwise. The Veteran filed his claim for compensation for frostbite residuals of his left and right foot in December 2013, 45 years after service separation. This lengthy period of time without complaints or treatment, while not dispositive, is a factor that weighs against the finding that the frostbite residuals of both the left and right foot has existed since service. See Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (holding that a lengthy period without medical complaints about a condition can be considered as a factor in resolving a claim). Despite the Veteran’s contentions, frostbite residuals of the left and right foot are not currently shown. The existence of a current disability is the cornerstone of a claim for VA disability compensation. See Degmetich v. Brown, 104 F. 3d 1328 (1997) (holding that section 1110 of the statute requires the existence of a present disability for VA compensation purposes); see also Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998). The Board acknowledges that the Veteran is competent to report his symptoms and observations, to include his reports as to dryness and bleeding of his feet. However, the Board finds that the identification of the specific disabilities and evaluation, including relating nonspecific symptoms to a disorder, based upon his own knowledge and expertise goes beyond the competency of a lay person. Further, the record does not indicate that the Veteran has medical expertise or training. Thus, his determination that he has frostbite residuals on both his feet is not competent evidence. See Jandreau v. Nicholson, 492 F.3d 1372 (2007); Kahana v. Shinseki, 24 Vet. App. 428, 438 (2011). Therefore, the Veteran’s lay opinions have no probative value. The Veteran has generally related the frostbite residuals on his feet to active service. Although lay persons are competent to describe observable symptoms and provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), as to the specific issue in this case, an opinion as to the etiology and onset of frostbite residuals falls outside the realm of common knowledge of a lay person. Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Some medical issues require specialized training for a determination as to diagnosis and causation, and such issues are therefore not susceptible of lay opinions on etiology. There is no evidence that the Veteran has medical expertise or training. The Veteran has not identified or produced competent evidence that related this disorder to active service. There is no competent evidence that indicates an association between the disorder and any documented event or injury of active service. A VA medical opinion was not provided for the issue of service connection for frostbite residuals on either foot. VA does not have a duty to provide an examination in every case. See Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010). Rather, the Secretary’s obligation under 38 U.S.C. § 5103A (d) to provide the Veteran with a medical examination or to obtain a medical opinion is not triggered unless there is an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the Veteran’s service or with another service-connected disability. See McLendon, 20 Vet. App. at 81. The record in this case is negative for any credible diagnosis of frostbite disability or any symptoms of such disability; there is no competent evidence that suggests dry feet is symptomatic of a frostbite injury. Moreoever, there is no established event, injury or disease in service. As such, VA’s duty to provide an examination with an opinion is not triggered. Accordingly, the evidence is found to preponderate against the claim for service connection for frostbite residuals of the left and right foot. Therefore, service connection is denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine cannot be applied. See 38 U.S.C. § 5107 (2012); 38 C.F.R. § 3.102 (2018). Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Imam, Associate Counsel