Citation Nr: 18154709 Decision Date: 11/30/18 Archive Date: 11/30/18 DOCKET NO. 16-15 149 DATE: November 30, 2018 ORDER The appeal of the denial of service connection for a thoracolumbar disorder is DISMISSED. The appeal of the denial of service connection for a cervical strain disorder is DISMISSED. The appeal of the denial of service connection for left knee strain and degenerative joint disease is DISMISSED. The appeal of the denial of service connection for right knee strain and degenerative joint disease is DISMISSED. The appeal of the denial of service connection for an acquired psychiatric disability, to include depression, is DISMISSED. Entitlement to service connection for bilateral hearing loss is GRANTED. New and material evidence has not been submitted sufficient to reopen a claim for entitlement to service connection for ulcers, and the application to reopen the claim is DENIED. New and material evidence has not been submitted sufficient to reopen a claim for entitlement to service connection for a gastrointestinal disorder, and the application to reopen the claim is DENIED. FINDINGS OF FACT 1. During the April 2018 travel Board hearing in Waco, Texas, the Veteran, through his representative explicitly, unambiguously, and with a full understanding of the consequences, withdrew his claim for entitlement to service connection for a thoracolumbar disorder. 2. During the April 2018 travel Board hearing in Waco, Texas, the Veteran, through his representative explicitly, unambiguously, and with a full understanding of the consequences, withdrew his claim for entitlement to service connection for a cervical strain disorder. 3. During the April 2018 travel Board hearing in Waco, Texas, the Veteran, through his representative explicitly, unambiguously, and with a full understanding of the consequences, withdrew his claim for entitlement to service connection for a left knee strain and degenerative joint disease. 4. During the April 2018 travel Board hearing in Waco, Texas, the Veteran, through his representative explicitly, unambiguously, and with a full understanding of the consequences, withdrew his claim for entitlement to service connection for a right knee strain and degenerative joint disease. 5. During the April 2018 travel Board hearing in Waco, Texas, the Veteran, through his representative explicitly, unambiguously, and with a full understanding of the consequences, withdrew his claim for entitlement to service connection for an acquired psychiatric disability, to include depression. 6. The Veteran has a current bilateral hearing loss disability for VA compensation purposes that is the result of hazardous noise exposure as part of his duties as a rifleman and fire team leader during engagements in the Republic of Vietnam. 7. An October 1981 rating decision denied the Veteran’s claim for service connection for ulcers; the Veteran was notified of the decision and apprised of his right to appeal, but he did not appeal in a timely fashion or submit new and material evidence within one year of the notice of decision. 8. The evidence received since the October 1981 rating decision, for the Veteran’s ulcers, is cumulative and/or repetitive of facts that were previously considered. 9. An October 1981 rating decision denied the Veteran’s claim for service connection for a gastrointestinal disorder; the Veteran was notified of the decision and apprised of his right to appeal, but he did not appeal in a timely fashion or submit new and material evidence within one year of the notice of decision. 10. The evidence received since the October 1981 rating decision, for the Veteran’s gastrointestinal disorder, is cumulative and/or repetitive of facts that were previously considered. CONCLUSIONS OF LAW 1. The criteria for withdrawal of an appeal for entitlement to service connection for a thoracolumbar disorder have been met. 38 U.S.C. § 7105 (b)(2), (d)(5) (West 2014); 38 C.F.R. § 20.204 (2018). 2. The criteria for withdrawal of an appeal for entitlement to service connection for a cervical strain disorder have been met. 38 U.S.C. § 7105 (b)(2), (d)(5) (West 2014); 38 C.F.R. § 20.204 (2018). 3. The criteria for withdrawal of an appeal for entitlement to service connection for a left knee strain and degenerative joint disease have been met. 38 U.S.C. § 7105 (b)(2), (d)(5) (West 2014); 38 C.F.R. § 20.204 (2018). 4. The criteria for withdrawal of an appeal for entitlement to service connection for a right knee strain and degenerative joint disease have been met. 38 U.S.C. § 7105 (b)(2), (d)(5) (West 2014); 38 C.F.R. § 20.204 (2018). 5. The criteria for withdrawal of an appeal for entitlement to service connection for an acquired psychiatric disability, to include depression, have been met. 38 U.S.C. § 7105 (b)(2), (d)(5) (West 2014); 38 C.F.R. § 20.204 (2018). 6. Resolving all reasonable doubt in his favor, the Veteran has a bilateral hearing loss disability that was incurred in active service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137, 1154(a), 5103, 5103A, 5107 (West 2016); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309, 3.385 (2017). 7. The October 1981 rating decision that denied service connection for ulcers is final. 38 U.S.C. § 7105 (West 2014); 38 C.F.R. §§ 3.156, 20.201, 20.302, 20.1103 (2017). 8. The evidence received since the October 1981 rating decision is not new and material for the purpose of reopening the claim for service connection ulcers. 38 U.S.C. § 5108 (West 2014); 38 C.F.R. § 3.156 (a)(2017). 9. The October 1981 rating decision that denied service connection for a gastrointestinal disorder is final. 38 U.S.C. § 7105 (West 2014); 38 C.F.R. §§ 3.156, 20.201, 20.302, 20.1103 (2017). 10. The evidence received since the October 1981 rating decision is not new and material for the purpose of reopening the claim for service connection a gastrointestinal disorder. 38 U.S.C. § 5108 (West 2014); 38 C.F.R. § 3.156 (a)(2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served honorably on active duty in the United States Marine Corps from February 1966 to February 1968. The Veteran’s certificate of release from active duty (DD214) reflects that he was a rifleman who received the Vietnam Service Medal. The Board has thoroughly reviewed all the evidence in the Veteran’s claims file. Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, all of the evidence submitted by the Veteran or on his behalf. See Gonzalez v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (the Board must review the entire record, but does not have to discuss each piece of evidence). The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claims. The Veteran must not assume that the Board has overlooked pieces of evidence that are not explicitly discussed herein. See Timberlake v. Gober, 14 Vet. App. 122, 128-30 (2000) (the law requires only that the Board address its reasons for rejecting evidence favorable to the Veteran). Withdrawal The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105 (West 2014). An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204 (2015). Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. § 20.204. To effectively withdraw an entitlement claim at a Board hearing, it must be done explicitly, unambiguously, and with a full understanding of the consequences. See Acree v. O’Rourke, 891 F.3d 1009 (Fed. Cir. 2018). 1. Entitlement to service connection for the thoracolumbar spine, cervical spine, bilateral knees, and an acquired psychiatric disorder have been effectively withdrawn. In his June 2012 VA Form 21-4138, the Veteran initiated claims for entitlement to service connection for the thoracolumbar spine, cervical spine, and left and right knees. Therein, the Veteran also requested to reopen a previously denied entitlement claim for an acquired psychiatric disorder. In April 2018, the Veteran supplied sworn testimony at a Board hearing chaired by the undersigned Veterans Law Judge (VLJ). At that time, the undersigned VLJ observed that, “it’s my understanding that you wish to withdrawal all the appeals pertaining to his right knee, left knee, cervical spine, thoracolumbar spine compression agitation, and the acquired psychiatric disorder.” In reply, the Veteran’s representative stated, “Yes, Sir.” The undersigned VLJ then noted that following the withdraw three claims would be remaining on appeal: entitlement to service connection for hearing loss and claims to reopen previously denied claims for service connection for gastrointestinal and ulcer disabilities. The Veteran’s representative concurred that those three issues would be remaining on appeal and the Veteran only presented testimony on the hearing loss, gastrointestinal, and ulcer claims. Neither the Veteran, nor his representative have suggested that the Veteran did not intend to withdraw from appellate consideration the issues of entitlement to service connection for the thoracolumbar spine, cervical spine, and left and right knees or the application to reopen the previously denied entitlement claim for an acquired psychiatric disorder. In the present case, the Veteran, through his authorized representative, requesting to withdraw this appeals of his right knee, left knee, cervical spine, thoracolumbar spine, and the acquired psychiatric disorder prior to the promulgation of a decision. Hence, there remain no allegations of errors of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review the appeals and they are dismissed. Service Connection In general, a service connection claim may be granted for a disability resulting from a disease or injury incurred in, or aggravated by, active 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-the so-called ‘nexus’ requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010)(quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). In each case where service connection for any disability is sought, due consideration shall be given to the places, types, and circumstances of such Veteran’s service as shown by such Veteran’s service record, the official history of each organization in which such Veteran served, such Veteran’s medical records, and all pertinent medical and lay evidence. 38 U.S.C. § 1154 (a). Additionally, for Veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, such as hearing loss, are presumed to have been incurred in service if manifest to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309. Alternatively, when a disease at 38 C.F.R. § 3.309 (a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service. See 38 C.F.R. § 3.303 (b). However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309 (a) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). 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 Veteran. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 2. Entitlement to service connection for bilateral hearing loss is granted. In June 2012, the Veteran submitted his VA Form 21-4138. Therein, the Veteran initiated his entitlement claim for service connection for “bilateral hearing loss from concussive explosion in War.” In addition to the above described VA regulations, entitlement to service connection for impaired hearing is subject to additional VA regulations. Specifically, a hearing impairment constitutes a disability for VA purposes when auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz 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. The Court has held that the “the threshold for normal hearing is from 0 to 20 dB (decibels), and higher threshold levels indicate some degree of hearing loss.” Hensley v. Brown, 5 Vet. App. 155, 157 (1993). In September 2013, the Veteran underwent a VA examination to consider the nature and etiology of any currently endured hearing loss. At that time, VA audiologist KJB recorded the following speech discrimination values: 90 percent right ear and 72 percent left ear. Additionally, KJB recorded the following   audiometric values: HERTZ SEPT ‘13 500 1000 2000 3000 4000 RIGHT 20 20 35 70 80 LEFT 20 20 35 70 80 For etiology, KJB determined that the Veteran’s current hearing loss was less likely as not (less than 50 percent probability) caused by, or the result of an event in, military service. For her supporting rationale, KJB posited that, “(d)ue to the absence of ear- and frequency-specific audiometric testing at veteran’s separation physical, it is not possible to determine if there was a change in hearing during military service.” In November 2013, the Veteran’s service treatment records (STRs) were associated with his claims file. Therein, in November 1965, the Veteran’s enlistment audiogram revealed the following values: HERTZ NOV ‘65 500 1000 2000 3000 4000 RIGHT -10 -10 -10 -10 -10 LEFT 0 0 -10 -10 -10 The Veteran’s February 1969 separation examination was also among the his STRs; however, after the enlistment audiogram, no additional hearing and/or audiometric values were recorded in the Veteran’s STRs. Ultimately, review of the Veteran’s entrance and separation audiological examinations fails to establish the demonstrable presence of a bilateral hearing loss disability, under the requirements of 38 C.F.R. § 3.385, during his period of active duty service. However, to establish service connection, it is not required that a hearing loss disability by the standards of 38 C.F.R. § 3.385 be demonstrated during service, although a hearing loss disability by the standards of 38 C.F.R. § 3.385 must be currently present, and service connection is possible if such current hearing loss disability can be adequately linked to service. Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). That is, a claimant may establish direct service connection for a hearing disability initially manifest several years after separation from service on the basis of evidence showing that the current hearing loss is causally related to injury or disease suffered in service. Hensley, 5 Vet. App. at 164; see also 38 U.S.C. 1113 (b); 38 C.F.R. 3.303(d). Thus, the lack of evidence of hearing loss disability per § 3.385 during active service is not fatal to the Veteran’s claim; it is merely one factor to be considered. In November 2013, VA received the Veteran’s military personnel record. Therein, it was recorded that the Veteran was a Rifleman with F Company/2nd Battalion/9th Marine in 1966. In 1968, the Veteran was a fire team leader in A Company/1st Battalion/28th Marine. The personnel record also revealed that the Veteran defended the Phu Bai Air Base and participated in operation “Prairie” in 1966. In December 1967, the Veteran received the Presidential Unit Citation (PUC). In December 2013, the Veteran submitted his VA Form 21-0958. Therein, the Veteran posited that, “this Veteran was exposed to artillery/Mortar attacks while in Vietnam.” In February 2016, the Veteran submitted his VA Form 21-4138. Therein, the Veteran posited that, “the Veteran’s occupation MOS 0311 Rifleman... is listed as having a high probability of hearing loss.” In April 2018, the Veteran supplied sworn testimony to the undersigned Veterans Law Judge (VLJ) during a Board hearing in Waco, Texas. At that time, the Veteran averred that, “I’ve been hard of hearing pretty much ever since I got out of the service.” The Veteran testified that, during active duty Marine Corps service in the Republic of Vietnam, he was exposed to “rifles, the hand grenades, the C4 explosions, to bombs, to whatever you want to call, we was involved with all of it.” When questioned by the undersigned VLJ, the Veteran confirmed that no doctor has told him that his current hearing loss is related to military noise exposure. The Veteran also testified that, from 1969 to 1999, he had worked at the same paper production factory, which had undergone several changes of ownership. During testimony, the Veteran averred that he wore earplugs while working in the paper production factory for three decades. With regard to an in-service injury, the Department of Defense’s Duty MOS Noise Exposure Listing indicates that an MOS as an infantryman a “high” probability of noise exposure during service. In-service hazardous noise exposure is therefore consistent with the circumstances of the Veteran’s duties in United States Marine Corps. See 38 U.S.C. 1154 (a); 38 C.F.R. 3.303 (a); Veterans Benefits Administration (VBA) Fast Letter No. 10-35 (September 2, 2010). In addition, considering the Veteran’s MOS as a Rifleman and fire team leader, his testimony regarding exposure to hazardous noise from gunfire, grenades, and various explosions, during the defense of the Phu Bai Air Base and operation “Prairie,” is credible. Ultimately, resolving doubt in the Veteran’s favor, the evidence supports service connection for his current bilateral hearing loss disability, as there is competent and credible evidence of both in-service noise exposure, and post-service bilateral hearing loss disability for VA compensation purposes with no clear post-service intercurrent cause. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. Based on protracted and deliberate review of the evidence, the Board concludes that entitlement to service connection for bilateral hearing loss is warranted for the Veteran’s current disability. Claims to Reopen Under 38 U.S.C. § 5108, VA may reopen a previously and finally disallowed claim when “new and material” evidence is presented or secured with respect to that claim. The provisions of 38 U.S.C. § 5108 require a review of all evidence submitted by or on behalf of a claimant since the last final denial on any basis to determine whether a claim must be reopened. See Evans v. Brown, 9 Vet. App. 273, 282-3 (1996). “New evidence” means evidence not previously submitted to agency decision makers, and “material evidence” means evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. 38 C.F.R. § 3.156 (a). To warrant reopening, the new evidence must not be cumulative or redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened and must raise a reasonable possibility of substantiating the claim. Id. In Shade v. Shinseki, 24 Vet. App. 110, 117 (2010), the Court held that the phrase “raise a reasonable possibility of substantiating the claim” does not create a third element for new and material evidence; rather, it provides guidance as to whether submitted evidence meets the new and material requirements. Id. The Court emphasized that this standard is a “low threshold” for reopening. By way of example, the Court explained that if the newly submitted evidence would likely trigger entitlement to a VA medical nexus examination were the claim reopened, the new evidence would raise a reasonable possibility of substantiating the claim. Id. For the purpose of establishing whether new and material evidence has been submitted, the credibility of the evidence is presumed unless the evidence is inherently false or untrue or, if the evidence is in the form of a statement or other assertion, it is beyond the competence of the person making the assertion. Duran v. Brown, 7 Vet. App. 216, 220 (1994); Justus v. Principi, 3 Vet. App. 510, 513 (1992). 3. New and material evidence has not been submitted sufficient to reopen a claim for entitlement to service connection for ulcers. In July 1981, VA received the Veteran’s medical treatment notations from the Pasadena Bayshore Hospital. Important to this Board analysis, on October 21, 1980, there was a treatment note from Dr. Blumenthal that reported “(p)atient had duodenal ulcer symptoms since 1968 and has had one episode of gastrointestinal hemorrhage. However, he has improved during the last year . . ..” On October 25, 1980, Dr. Blumenthal provided a post-operative diagnosis for multiple superficial gastric ulcerations and erosions. In July 1981, the Veteran submitted his VA Form 21-526. Therein, the Veteran initiated his entitlement claim for service connection for ulcers. He asserted that a possible cause of his stomach disorders was “a herbicide called Agent Orange.” In October 1981, the agency of original jurisdiction (AOJ) denied the Veteran’s original service-connection claim because, “(service records) . . . contain no evidence of ulcer.” The AOJ noted that, “(e)xamination of 2-5-68 for discharge showed no defects, all systems normal.” Important to this Board new and material evidence analysis, the AOJ observed that, “Veteran reported post-service medical treatment from 5-7-68, but has not furnished reports of treatment. He was privately hospitalized 10-21-80, with complaint of pain in left inguinal area. Extensive testing showed multiple superficial gastric ulcerations, which surgery was performed 10-25-80.” Again, to warrant reopening, the new evidence must not be cumulative or redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156 (a). In June 2012, the Veteran submitted his VA Form 21-4138. Therein, the Veteran posited that, “the understanding of the toxicity of Agent Orange has vastly improved and (he) wishes VA consider his claim for . . . ulcers be reopened.” In May 2014, the Veteran submitted his notice of disagreement (NOD) with the AOJ’s latest denial to reopen his entitlement claim for service connection for ulcers. Therein, the Veteran posited that, “(he) believes that all of his denied issues are a result of his herbicide exposure. Veteran served in country Vietnam, Veteran’s original claim was submitted in 1981 and denied before Agent Orange exposure was determined to have happened. Veteran suffered for years with stomach problems from an undiagnosed illness. Veteran finally had a Vagotomy to fix his stomach problems, the (root) cause of the illness have not been diagnosed. Is it not possible that the herbicide exposure caused have damage in the Veteran’s stomach?” To substantiate a claim of service connection, there must be evidence of a current disability; evidence of incurrence or aggravation of a disease or injury in service; and evidence of a nexus between the current disability and the disease or injury in service. See Shedden v. Principi, 381 F.3d 1153, 1166-1167 (Fed. Cir. 2004). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303 (a). VA regulations provide that certain diseases associated with exposure to herbicide agents may be presumed to have been incurred in service even if there is no evidence of the disease in service, provided the requirements of 38 C.F.R. § 3.307 (a)(6) are met. 38 C.F.R. § 3.309 (e). A Veteran who, during active service, served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the Veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307 (a). The last date on which such a Veteran shall be presumed to have been exposed to an herbicide agent shall be the last date on which he or she served in the Republic of Vietnam during the period beginning on January 9, 1962 and ending on May 7, 1975. The term “herbicide agent” means a chemical in an herbicide, including Agent Orange, used in support of the United States and allied military operations in the Republic of Vietnam during the Vietnam era. If a Veteran was exposed to an herbicide agent during active service, the following diseases shall be service-connected if the requirements of 38 C.F.R. § 3.307 (a)(6) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 C.F.R. § 3.307 (d) are also satisfied: AL amyloidosis; chloracne or other acneform disease consistent with chloracne; Type 2 diabetes (also known as Type II diabetes mellitus or adult-onset diabetes); Hodgkin's disease; all chronic B cell leukemias; multiple myeloma; non-Hodgkin's lymphoma; Parkinson's disease; early-onset peripheral neuropathy; porphyria cutanea tarda; prostate cancer; respiratory cancers (cancer of the lung, bronchus, larynx or trachea); soft-tissue sarcoma (other than osteosarcoma, chondrosarcoma, Kaposi's sarcoma, or mesothelioma); and ischemic heart disease, (including, but not limited to, acute, subacute, and old myocardial infarction); atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass surgery; and stable, unstable and Prinzmetal's angina), shall be service-connected if the requirements of 38 C.F.R. § 3.307 (a)(6) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 C.F.R. § 3.307 (d) are also satisfied. 38 C.F.R. § 3.309 (e). The diseases listed at 38 C.F.R. § 3.309 (e) shall have become manifest to a degree of 10 percent or more at any time after service, except that chloracne or other acneform disease consistent with chloracne, porphyria cutanea tarda, and early-onset peripheral neuropathy shall have become manifest to a degree of 10 percent or more within a year after the last date on which the Veteran was exposed to an herbicide agent during active military, naval, or air service. 38 C.F.R. § 3.307(a)(6)(ii). In April 2018, the Veteran supplied sworn testimony to the undersigned Veterans Law Judge (VLJ). At that time, the Veteran testified that Dr. Blumenthal provided a diagnosis for duodenal ulcers in 1968. The Veteran also confirmed that Dr. Blumenthal was his physician in 1968 and 1980. Regarding herbicide agent exposure, the Veteran testified that, “when I turned this in in 1980 . . . I thought all that was gonna be related to the Agent Orange because there was so much information just coming out on Agent Orange at that time about how toxic it was and the complication it causes.” The Board notes that the Veteran is correct; after the final denial of his initial entitlement claim for ulcers in 1981, VA regulations did evolve to include a list of presumptively service-connected disabilities. However, regardless of how the Veteran’s entitlement claim for ulcers is characterized, his long-standing history of ulcers is not presumptively entitled to service connection under the regulatory umbrella created by 38 C.F.R. §§ 3.307(d) & 3.309 (e). The Board notes that VA received service treatment records (STRs) for the Veteran in November 2013. After careful review of those documents, the Board cannot identify any notation that would support an in-service incurrence of the currently ulcers. To the extent that the Veteran has expressed his belief that his VA presumed exposure to herbicide agents while serving within the Republic of Vietnam contributed to his development of ulcers, such assertions were of record when the AOJ denied his claim in October 1981. After prolonged and careful review of the Veteran’s claims file, the only piece of new and material evidence currently before the Board is the Veteran’s statements during his April 2018 testimony. As noted earlier, the Board presumes the credibility of lay evidence, which includes the Veteran’s testimony. Ultimately, the Board concludes that the record before it contains essentially the same evidence the AOJ considered in October 1981. The Board finds that the evidence added to the claims file, after the October 1981 AOJ decision, relates to and confirms an already established service-connection element, which is a current disability. See Shedden, 381 F.3d at 1166-1167. Consequently, the Board finds that new and material evidence has not been submitted. Although the threshold to reopen a claim is low, such threshold has not been met in this case. Shade, 24 Vet. App. at 118. The Veteran’s desire to reopen the claim for entitlement to service connection for ulcers is denied. 4. New and material evidence has not been submitted sufficient to reopen a claim for entitlement to service connection for a gastrointestinal disorder. In July 1981, the Veteran submitted his VA Form 21-526. Therein, the Veteran initiated his entitlement claim for service connection for “digestive problems.” He asserted that a possible cause of his stomach disorders was “a herbicide called Agent Orange.” In October 1981, the agency of original jurisdiction (AOJ) denied the Veteran’s original service-connection claim because, “(service records) show treatment in 1967 for acute digestive problem with intermittent diarrhea. Condition was resolved and (service records) are negative for chronic digestive system problem . . ..” The AOJ noted that, “(e)xamination of 2-5-68 for discharge showed no defects, all systems normal.” “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-the so-called ‘nexus’ requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010)(quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). The Board observes that the Veteran’s claim for entitlement to service connection for a gastrointestinal disorder was originally denied by the AOJ in 1981 because the requisite nexus element was not substantiated. As the Board noted above, “new evidence” means evidence not previously submitted to agency decision makers, and “material evidence” means evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. 38 C.F.R. § 3.156 (a). To warrant reopening, the new evidence must not be cumulative or redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened and must raise a reasonable possibility of substantiating the claim. Id. In June 2012, the Veteran submitted his VA Form 21-4138. Therein, the Veteran posited that, “the understanding of the toxicity of Agent Orange has vastly improved and (he) wishes VA consider his claim for . . . digestive problems . . . be reopened.” In November 2012, the Veteran submitted another VA Form 21-4138. Therein, the Veteran posited that, I feel certain that my illnesses are related to the injuries I sustain while serving my country in Vietnam, along with the exposure to the very toxic chemical called Agent Orange. My health condition started immediately after my discharge from the military in FEB 1968. In June of 1968 I was in major pain and being treated for stomach disorders. These problems have affected me my whole adult life causing much pain and suffering. I have sent for my personal medical records dating back to 1968 to support my claim. I have not received these records as of yet. When I receive these records I will forward them to you.” In July 2013, VA received correspondence from the Veteran. Therein, the Veteran posited that, “I have provided all the information to you that pertains to my case. I have given permission to contact any and all these doctors to support my case. I am not certain of anything pertaining to Dioxin nor can I prove that any of my illnesses were caused from Dioxin. However, I am certain that my chronic health conditions started while I was in the USMC and continued immediately after my release and continues until this day. I have not been diagnosed of any of the ailments you listed in your letter caused by Agent Orange. However, I am certain that my illnesses were caused while I was serving in the military while in Vietnam still continue today.” In May 2014, the Veteran submitted his notice of disagreement (NOD) with the AOJ’s latest denial to reopen his entitlement claim for service connection for ulcers. Therein, the Veteran posited that, “(he) believes that all of his denied issues are a result of his herbicide exposure. Veteran served in country Vietnam, Veteran’s original claim was submitted in 1981 and denied before Agent Orange exposure was determined to have happened. Veteran suffered for years with stomach problems from an undiagnosed illness. Veteran finally had a Vagotomy to fix his stomach problems, the (root) cause of the illness have not been diagnosed. Is it not possible that the herbicide exposure caused have damage in the Veteran’s stomach?” In April 2018, the Veteran supplied sworn testimony to the undersigned Veterans Law Judge (VLJ). At that time, the Veteran testified that his gastric problems have been continuous since 1967. Regarding herbicide agent exposure, the Veteran testified that, “when I turned this in in 1980 . . . I thought all that was gonna be related to the Agent Orange because there was so much information just coming out on Agent Orange at that time about how toxic it was and the complication it causes.” The Board notes that the Veteran is correct; after the final denial of his initial entitlement claim for a gastrointestinal disorder in 1981, VA regulations did evolve to include a list of presumptively service-connected disabilities. However, regardless of how the Veteran’s entitlement claim for a gastrointestinal disorder is characterized, his long-standing history of gastrointestinal issues is not presumptively entitled to service connection under the regulatory umbrella created by 38 C.F.R. §§ 3.307(d) & 3.309 (e). After prolonged and careful review of the Veteran’s claims file, the only pieces of new and material evidence currently before the Board is the Veteran’s various statements, to include his April 2018 sworn testimony. As noted earlier, the Board presumes the credibility of lay evidence, which includes the Veteran’s testimony. However, the Veteran’s belief that his VA presumed exposure to herbicide agents (while serving within the Republic of Vietnam) contributed to his development a gastrointestinal disorder was of record when the AOJ denied his claim in October 1981. Ultimately, the Board concludes that the record before it contains essentially the same evidence the AOJ considered in October 1981. The Board finds that the evidence added to the claims file, after the October 1981 AOJ decision, relates to and confirms previously substantiated service-connection elements, a current disability and an in-service incurrence. See Shedden, 381 F.3d at 1166-1167. Consequently, the Board finds that new and material evidence has not been submitted for the remaining, unsubstantiated service-connection element, a nexus. Although the threshold to reopen a claim is low, such threshold has not been met in this case. Shade, 24 Vet. App. at 118. The Veteran’s desire to reopen the claim for entitlement to service connection for a gastrointestinal disorder is denied. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD RLBJ, Associate Counsel