Citation Nr: 18155346 Decision Date: 12/04/18 Archive Date: 12/04/18 DOCKET NO. 14-44 297 DATE: December 4, 2018 ORDER Entitlement to service connection for a right hip disorder is denied. Entitlement to service connection for a left ear deformity is denied. Entitlement to service connection for facial scars is denied. Entitlement to service connection for any acquired psychiatric disorder is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that a right hip disorder began during active service, or is otherwise related to an inservice injury, event, or disease. 2. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a diagnosis of a left ear deformity. 3. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of facial scars. 4. A psychiatric disorder was not demonstrated inservice, and a psychosis was not compensably disabling within a year of separation from active duty. CONCLUSIONS OF LAW 1. A right hip disorder was not incurred or aggravated inservice, and right hip arthritis may not be presumed to have been so incurred. 38 U.S.C. §§ 1131; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. A left ear deformity was not incurred or aggravated inservice. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 3. Facial scars were not incurred or aggravated inservice. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 4. An acquired psychiatric disorder was not incurred or aggravated inservice, and a psychosis may not be presumed to have been so incurred. 38 U.S.C. §§ 1110, 5103; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served active duty from March 1976 to November 1979. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a September 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania. Service Connection Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131. Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of inservice incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed inservice disease or injury and the present. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303 (d). Right hip disorder Having carefully reviewed the evidence of record, the Board finds that the preponderance of the evidence is against service connection for a right hip disability. There is no medical or lay evidence of an inservice incurrence or aggravation of any right hip disorder. A review of the service treatment records shows that they do not include any complaints, findings or diagnoses pertaining to a right hip disorder. A private medical examination from May 2004 determined that the Veteran’s hip had no internal rotation, limited external rotation at 10 degrees, a limited 15 degrees of abduction and adduction, narrowing of the superior joint space, as well as osteoarthritic flare. While that assessment constitutes a diagnosis, there is no competent evidence that such a disorder is related to the claimant’s active duty service. While the service treatment records note right knee pain, there is no evidence associating such with the right hip, or anything else that would suggest the inservice presence of a right hip disorder. The earliest evidence of any indication of a hip issue dates from a postservice May 1985 VA medical record, which notes complaints of hip “locking” which was reportedly preventing leg movement. Such a finding is years after service separation. As such, the weight of the competent evidence is against the claims for service connection for disability of the right hip. While the Veteran is competent to report that he has had right hip pain since service, he is not competent to provide a diagnosis linking such a disorder to service. The etiology of the claimant’s right hip disorder is medically complex, and requires knowledge of the interaction between multiple organ systems in the body. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Accordingly, as there is no evidence of a chronic right hip disorder inservice, no evidence of compensably disabling right hip arthritis within a year of the appellant’s separation from active duty, and no competent evidence linking such a disorder to service, the claim must be denied. Left ear deformity Under 38 C.F.R. § 3.655, when a claimant does not report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. In this case, VA scheduled the Veteran for an appropriate examination, and he cancelled that examination without showing good cause. Hence, the claim shall be rated based on the evidence of record. Id. Symptoms without a diagnosed or identifiable underlying malady or disorder do not in and of itself constitute a disability for which service connection may be granted. See Sanchez-Benitez v. West, 13 Vet. App. 282, 285 (1999). The record reflects that the Veteran did not report for an ordered VA examination in September 2012, and did not show good cause for his absence. VA scheduled this examination because service treatment records indicated an ear issue, but the service treatment records do not provide a specific diagnosis. The scheduled examination was intended to clarify whether there is a current diagnosis of a left ear deformity, as well as a medical opinion as to whether it is as likely as not that such disability, if diagnosed, is due to military service. Having only the evidence of record on which to decide, the evidence does not reveal any competent evidence that the claimant has a left ear deformity. Even assuming that such a disorder exists there is no competent evidence linking such a disorder to service. Without a diagnosis there is no disability to potentially compensate. Without competent evidence linking the disorder to service there is no basis to grant service connection. Accordingly, the claim is denied. 38 U.S.C. § 1131.   Facial scars Having carefully reviewed the evidence of record, the Board finds that the preponderance of the evidence is against the claim of entitlement to service connection for facial scars. A current disability is not shown at any time during this appeal. Here, the Veteran has not identified any particular current disorder. Moreover, the medical evidence of record does not demonstrate any current disability due facial scars during the pendency of this claim, and therefore, this claim cannot be granted. The existence of a current disability is the cornerstone of a claim for VA disability, and without medical evidence of such, no compensation may be granted. Brammer. An acquired psychiatric disorder For certain chronic diseases such as a psychosis a presumption of service connection arises if the disease is manifested to a degree of 10 percent within one year following discharge from active duty. 38 C.F.R. §§ 3.307, 3.309. A review of the service treatment records reveals no complaints, findings or diagnoses of any psychiatric disorder. Indeed, the Veteran’s separation examination from September 1979 indicates mental soundness. The only evidence of any indication of any psychiatric illness is from a May 2011 authorized release form for the Cumberland County Guidance Center, which included a comment from the Veteran indicating “I get upset quickly, don’t socialize much, mostly stay to myself.” Additionally, there is a letter on record from the Cumberland County Guidance Center, also from May 2011, indicating that the Veteran’s chart had been destroyed. However, this evidence dates more than 30 years after the Veteran’s separation from service. The Veteran did not reference any psychiatric symptoms inservice, and there is no competent evidence linking any current psychiatric disorder to service. In this case, there is no clinical evidence documenting any inservice psychiatric symptoms. Further, there is no evidence indicating that the claimant suffered from any psychiatric disorder until 2011, i.e., more than 30 years after separation from active duty. The lack of medical evidence of any diagnosis or treatment of a psychiatric disorder for many years after service is probative evidence against the claim. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). Accordingly, the claim is denied. While the appellant may sincerely believe that each of the claimed disorders are related to service, as a lay person untrained in the field of medicine, the claimant is not competent to offer a medical opinion linking any of the claimed disorders to service. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). In arriving at this decision, the Board considered the doctrine of reasonable doubt. That doctrine is only invoked, however, where there is an approximate balance of evidence which neither proves nor disproves the claim. In this case, the preponderance of the evidence is against the Veteran’s claims. Therefore, the doctrine of reasonable doubt is not applicable. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. DEREK R. BROWN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Carrie Ferrando