Citation Nr: 18154994 Decision Date: 12/04/18 Archive Date: 12/03/18 DOCKET NO. 16-51 061 DATE: December 4, 2018 ORDER Service connection for left breast reduction with residual numbness is granted. Service connection for right breast reduction with residual numbness is granted. Service connection for scars on the left and right breasts, status post-surgery, is granted. FINDING OF FACT The Veteran currently experiences bilateral residual numbness and linear anterior trunk scars, from a medically necessary breast reduction surgery during active duty service. CONCLUSIONS OF LAW 1. The criteria for service connection for left breast reduction with residual numbness are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for service connection for right breast reduction with residual numbness are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 3. The criteria for service connection for scars status post-surgery, left and right breasts, are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veteran served on active duty from March 2010 to March 2014. Service Connection Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110 (2012). Generally, the evidence 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. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Under 38 C.F.R. § 3.303(b), an alternative method of establishing the second and third Shedden element is through a demonstration of continuity of symptomatology if the disability claimed qualifies as a chronic disease listed in 38 C.F.R. § 3.309(a). Regulations also provide that service connection may be granted for a disability diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability is due to disease or injury which was incurred in or aggravated by service. 38 C.F.R. § 3.303(d). Finally, 38 U.S.C. § 1154(a) requires that VA give “due consideration” to “all pertinent medical and lay evidence” in evaluating a claim for disability or death benefits. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Specifically, “[l]ay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional.” Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006). The Veteran claims that she has experienced scarring and numbness since undergoing a medically necessary bilateral breast reduction in service. She asserts her breast reduction surgery was not elective. She asserts that she needed the surgery due to chronic upper back pain and shoulder pain. Service treatment records show that at the Veteran’s January 2010 entrance examination the clinical evaluation of her back was normal. At a November 2010 consultation for breast reduction surgery the Veteran reported upper back and shoulder pain, attributed to having large breasts. She requested an evaluation for breast reduction surgery. A January 2011 service treatment record noted that the Veteran had a history of large breasts and that they were contributing to significant upper back and shoulder pain. The Veteran reported pain when running or with other types of exercise. On physical examination it was noted that she had bilateral heavy pendulous breasts with grade III ptosis. The anticipated benefits, risks, and complications of the surgery were discussed with the Veteran. It was decided that surgery would be performed as soon as possible. The Veteran underwent bilateral breast reduction surgery in February 2011. On VA examination in November 2013, the Veteran was diagnosed with bilateral breast reduction with numbness around the areola bilaterally. The Veteran reported a right breast reduction with numbness around the areola and right side of the right breast. She additionally reported left breast reduction with numbness around the areola. A scar examination at that time reflected a scar from the right breast from the nipple vertically downward, a scar around the areola of the right breast, a scar from the left nipple vertically downward, and a scar around the left areola. These linear scars were noted to be between 10 cm and 14 cm each. In this case, there is indication that the Veteran developed problems, including upper back and shoulder pain, due to her overlarge breasts, beginning during her service. The record also shows that her breast reduction was performed during service and was medically necessary to relieve her pain. Finally, the record shows that the Veteran now has scarring and numbness due to the in-service breast surgery. A February 2017 VA examiner opined that it would be mere speculation to state that the Veteran’s bilateral breast reduction surgery was recommended by a physician to alleviate physical discomfort. She further noted that she would be willing to reconsider her opinion if the Veteran was to produce objective evidence that she had chronicity of upper back pain associated with her breast size. Little probative value is accorded to this speculative opinion. In light of the Veteran’s contentions and the service treatment records, the Board finds that service connection is warranted for residuals of her bilateral breast reduction surgery with resulting numbness and scarring. Thus, the appeal is granted. 38 U.S.C. § 5107 (2012); 38 C.F.R. § 3.102 (2018). CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A.M. Clark, Counsel