Citation Nr: 18154598 Decision Date: 12/03/18 Archive Date: 11/30/18 DOCKET NO. 13-26 215 DATE: December 3, 2018 ORDER Entitlement to service connection for breathing problems is denied. FINDING OF FACT The probative, competent evidence of record does not demonstrate that the Veteran’s breathing problems are connected to service. CONCLUSION OF LAW The criteria for service connection for breathing problems have not been met. 38 U.S.C. § 1131; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1981 to June 1986. In August 2014, the Veteran was afforded a videoconference hearing. During this hearing, the undersigned Veterans Law Judge was located in Washington, D.C., and the Veteran was located at the Regional Office. A transcript of this hearing is of record. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2012 rating decision by the Department of Veteran Affairs (VA) Regional Office. This case has been remanded by the Board on two separate occasions. The Board remanded the case in September 2015 for additional development, and then later remanded a second time in August 2016 to obtain a medical opinion regarding the likelihood of service connection. The Veteran seeks service connection for his breathing problems; specifically, he contends that he incurred his breathing problems during service and that, while they flare up intermittently, they have persisted since leaving service. Aside from occasional instances of the Veteran seeking medicine for sinus problems, military treatment records do not reflect any persistent symptoms or other evidence of a developing disability. Several years after leaving service the Veteran was diagnosed with chronic obstructive pulmonary disease and chronic sinusitis, which negatively impacted his respiratory system. Following the most recent remand, a VA medical examination was conducted. The medical examiner was asked to provide a professional opinion as to whether the Veteran’s sinusitis, rhinitis, or other ear, nose, and throat conditions were at least as likely as not incurred in or caused by service. The Board also ordered that this medical opinion be accompanied by a detailed rationale as to any opinion rendered, and that the Veteran’s entire electronic record should be considered. In compliance with the Board’s order, the VA examiner reviewed the record and, following an examination of the Veteran, stated that the Veteran’s breathing difficulties were less likely than not incurred in or caused by service. The examiner specifically identified the Veteran’s long history of smoking as a likely alternate ideology for the chronic sinusitis. Furthermore, throughout the entirety of the record prior to 2015, the Veteran has repeatedly been identified as being in good health and having clear breathing in his medical examinations and service treatment records. The Board identifies the existence of specific periods of “decreased breathing,” such as the 2007 medical examination; however, the examinations that classify the Veteran’s breathing as “good” are more voluminous and cast doubt about the origination of the current disability. This discrepancy adds weight to the recent VA examiner’s medical opinion. The Board finds that the probative evidence of record is insufficient to find a nexus. The culmination of the medical records and alternative ideology provided by the recent VA examination–the Veteran’s long history of smoking–support the Board’s determination that there is no nexus between the present breathing difficulties and service. While the Board finds that the Veteran is competent attest to the presence of his symptoms, the statements are merely persuasive and are not dispositive of a service-connection nexus. The entirety of the record, including professional opinions, must be weighed to determine if it is at least as likely as not that a nexus exists. Here, the intermittent occurrence of breathing problems and the existence of chronic obstructive pulmonary disease and chronic sinusitis that corroborate the Veteran’s own statements regarding longevity of his disability, are outweighed by contradicting service treatment records and multiple post-service medical examinations, to include the recent unfavorable medical opinion that provided an alternate ideology to the Veteran’s disabilities. The VA examiners’ opinions are more probative than the Veteran’s lay assertions, as he does not have the medical training or expertise that those individuals do. Therefore, the Board finds that service connection is not warranted. (Continued on the next page)   In making this determination the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim that doctrine is not applicable. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Lherault, Associate Counsel