Citation Nr: 18155999 Decision Date: 12/06/18 Archive Date: 12/06/18 DOCKET NO. 14-36 557 DATE: December 6, 2018 ORDER 1. Entitlement to service connection for hypertension, to include as secondary to tuberculosis or chronic obstructive pulmonary disease (COPD), is denied. 2. The application to reopen the claim of entitlement to service connection for tuberculosis due to the receipt of new and material evidence is granted. 3. The reopened claim of entitlement to service connection for tuberculosis is denied. 4. New and material evidence sufficient to reopen the claim of entitlement to service connection for a bilateral hearing loss disability has not been received, and the application for reopening the claim is denied. 5. Entitlement to a compensable rating for fracture of the nasal bone is denied. FINDINGS OF FACT 1. The Veteran’s hypertension did not have its onset during service or within one year of service discharge, is not otherwise related to service, and is not caused or aggravated by a service-connected disability, to include tuberculosis or COPD. 2. In a December 2003 rating decision, the regional office (RO) denied service connection for tuberculosis based on a finding that the Veteran’s tuberculosis was not related to service. The Veteran was informed of the decision in a December 2003 notification letter that included his appeal rights. He did not appeal the decision and did not submit new and material evidence within one year of the decision. The December 2003 rating decision is final. 3. Evidence associated with the claims file since the December 2003 rating decision relates to an unestablished fact necessary to substantiate the claim of entitlement to service connection for tuberculosis, and raises a reasonable possibility of substantiating the claim. 4. In a March 2004 rating decision, the RO denied service connection for a bilateral hearing loss disability based on a finding that the current bilateral hearing loss disability was not related to service. The Veteran was informed of the decision in an April 2004 notification letter that included his appeal rights. He did not appeal the decision and did not submit new and material evidence within one year of the decision. The March 2004 rating decision is final. 5. Evidence received since the March 2004 rating decision shows that the Veteran has a current bilateral hearing loss disability, which is cumulative and redundant of evidence already of record and does not relate to a previously unestablished fact necessary to substantiate the claim of entitlement to service connection for a bilateral hearing loss disability. 6. Fracture of the nasal bone has not been manifested by a 50 percent obstruction of the nasal passage on both sides or complete obstruction on one side. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for hypertension, to include as secondary to tuberculosis, have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309, 3.310. 2. As evidence received since the December 2003 rating decision regarding the Veteran’s claim for service connection for tuberculosis is new and material, the criteria for reopening the claim of entitlement to service connection for tuberculosis have been met. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. § 3.156. 3. The criteria for entitlement to service connection for tuberculosis have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 4. New and material evidence sufficient to reopen the previously denied claim of entitlement to service connection for a bilateral hearing loss disability has not been added to the record. 38 U.S.C. § 5108, 38 C.F.R. § 3.156(a). 5. The criteria for entitlement to a compensable rating for fracture of the nasal bone have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.97, Diagnostic Code (DC) 6502. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served in the Air Force from December 1955 to May 1959. The Board notes that the Veteran is deceased, and that the Veteran’s surviving spouse has been substituted in this case, as documented in an August 2018 rating decision. The Veteran requested a Board video conference hearing on his October 2014 VA Form 9 and his substituted spouse was scheduled for a hearing in October 2018. However, the Veteran’s spouse did not appear at this hearing and has not requested a new hearing. Accordingly, the hearing request is deemed withdrawn. The Board also notes that an October 2003 response to a request for information from the VA shows that the Veteran’s service medical records are fire related. Service Connection—Generally Service connection 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. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010). Service connection may also be granted on a secondary basis for a disability which is “proximately due to or the result of a service-connected disease or injury.” 38 C.F.R. § 3.310(a). Where a service-connected disability aggravates a nonservice-connected disability, a Veteran may be compensated for the degree of disability (but only that degree) over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b). Where a Veteran served 90 days or more of active service, and certain chronic diseases become manifest to a degree of 10 percent or more within the presumptive period, 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, 1137; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. Tuberculosis and hypertension are chronic diseases. Tuberculosis has a presumptive period of three years and hypertension has a presumptive period of one year. 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, each piece of evidence of record. The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, regarding the Veteran’s claim on appeal. 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 (2000). 1. Entitlement to service connection for hypertension The Veteran claimed that his hypertension was related to service. Under VA regulation, hypertension must be confirmed by readings taken two or more times on at least three different days. Regulation also clarifies that the term “hypertension” means that the diastolic blood pressure is predominantly 90 mm or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160 mm or greater with a diastolic blood pressure of less than 90 mm. 38 C.F.R. § 4.104, DC 7101. Additionally, in order for hypertension to be considered disabling to a compensable degree, the evidence must show that diastolic pressure is predominantly 100 or more, or that systolic pressure is predominantly 160 or more, or that the individual has a history of diastolic pressure of predominantly 100 or more and requires continuous medication for control. 38 C.F.R. § 4.104, DC 7101. As to a current disability, the Veteran was first noted to have a diagnosis of hypertension in February 2003. In February 2003, the Veteran’s blood pressure was noted to be 151/91. In June 2003, the Veteran’s blood pressure was noted to be 157/98. While these blood pressure readings were never confirmed by two or more readings on at least three different days, the record shows that even if the Veteran did have a diagnosis of hypertension, this diagnosis was not related to service, as discussed below. As to an in-service disease or injury, service treatment records do not show that the Veteran had hypertension during service. The Board acknowledges that the Veteran’s service treatment records are fire related. However, existing service treatment records show that the Veteran’s blood pressure was noted to be 130/80 in December 1955 and was noted to be 100/60 in May 1959 at service discharge. Existing service treatment records do not show that the Veteran had hypertension during service. As the Veteran did not assert that any in-service event was related to his hypertension, a VA examination was not warranted. Regarding presumptive service connection, there is no competent evidence of record that the Veteran’s hypertension manifested to a compensable degree within one year of the Veteran’s discharge from service. See 38 C.F.R. §§ 3.307(a), 3.309(a). Rather, the evidence shows that the Veteran’s hypertension first manifested in February 2003, many years after service. As such, service connection is not warranted on a presumptive basis. Regarding secondary service connection, there is no competent evidence of record that the Veteran’s hypertension was related to any service-connected disability. The Board acknowledges the Veteran’s April 2011 assertion that his hypertension was associated with his chronic obstructive pulmonary disease (COPD). However, as the Veteran was not service connected for COPD, service connection cannot be established on this basis. The Veteran also submitted an April 2010 statement asserting that his hypertension was related to heart problems and has progressed over years of strain due to other conditions related to military service. However, as the Veteran was not service connected for heart disease, service connection cannot be established on this basis. For all the reasons discussed above, the Board finds that the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for hypertension on a direct basis, a presumptive basis, or a secondary basis. Thus, as the preponderance of the evidence is against the claim, there is no reasonable doubt to be resolved, and the claim is denied. 38 U.S.C. § 5107(b). New and Material Evidence—Generally In November 2009, the Veteran submitted applications to reopen claims of entitlement to service connection for tuberculosis and a bilateral hearing loss disability. Generally, when a claim is disallowed, it may not be reopened and allowed, and a claim based on the same factual basis may not be considered. 38 U.S.C. § 7105(c). However, a claim on which there is a final decision may be reopened if new and material evidence is submitted. 38 U.S.C. § 5108. New evidence is defined as existing evidence not previously submitted to agency decisionmakers, while material evidence is defined as existing 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). New and material evidence can be neither cumulative nor 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. The threshold for determining whether new and material evidence raises a reasonable possibility of substantiating a claim is low. See Shade v. Shinseki, 24 Vet. App. 110 (2010). Moreover, in determining whether this low threshold is met, consideration need not be limited to whether the newly submitted evidence relates specifically to the reason why the claim was last denied, but also whether the evidence could reasonably substantiate the claim were the claim to be reopened, either by triggering the VA’s duty to assist or through consideration of an alternative theory of entitlement. Id. at 118. Regardless of the RO’s determination as to whether new and material evidence has been received, the Board must address the issue of whether new and material evidence has been received in the first instance because it determines the Board’s jurisdiction to reach the underlying claim and to adjudicate the claim de novo. See Woehlaert v. Nicholson, 21 Vet. App. 456, 460-61 (2007). For purposes of reopening a claim, the credibility of newly submitted evidence is generally presumed. See Justus v. Principi, 3 Vet. App. 510 (1992). 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, each piece of evidence of record. The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, regarding the Veteran’s claim on appeal. The Veteran must not assume that the Board has overlooked pieces of evidence that are not explicitly discussed herein. 2. Whether new and material evidence has been presented sufficient to reopen a claim for entitlement to service connection for tuberculosis In March 2003, the Veteran filed a claim for service connection for tuberculosis. A December 2003 rating decision was issued. This rating decision denied service connection for tuberculosis because there was no evidence of an in-service event or occurrence related to the Veteran’s tuberculosis, as the Veteran was not diagnosed with tuberculosis until 16 years after service. The Veteran was informed of the decision in a December 2003 notification letter that included his appeal rights. He did not appeal the decision and did not submit new and material evidence within one year of the decision. The December 2003 rating decision is final. In November 2009, the Veteran submitted an application to reopen his claim for service connection for tuberculosis. On his October 2014 VA Form 9, the Veteran asserted that his tuberculosis was caused by an air gun injection that he received during service. As this assertion presents a new theory of entitlement to service connection, the Veteran’s claim is reopened, and entitlement to service connection for tuberculosis is discussed below. 3. Entitlement to service connection for tuberculosis The Veteran claimed that his tuberculosis was related to an air gun vaccination he received while in service. As to a current disability, the Veteran was admitted to a VA hospital in October 1975 with a diagnosis of tuberculosis. He received treatment and was discharged in November 1975. Thus, the Veteran meets the first element of a claim for service connection. As to an in-service disease or injury, service treatment records do not show that the Veteran received an air gun vaccination during service, or that he was diagnosed with tuberculosis during service or within one year of service discharge. Service treatment records show that the Veteran had a May 1959 chest x-ray at service discharge that was negative for findings of tuberculosis. Further, the Veteran’s May 1959 discharge examination noted normal lungs, chest, mouth and throat, nose, and sinuses. Moreover, an August 2015 VA examiner reasoned that the jet injector air gun was not invented until 1960, and since the Veteran separated from service in 1959, it is highly unlikely that he received any vaccinations during service using this device. In an August 2015 VA medical opinion, the examiner reviewed the Veteran’s file and opined that it is less likely than not that the Veteran’s pulmonary tuberculosis was incurred in or caused by the use of air gun injectors during service. The examiner explained that based on a review of credible peer-reviewed medical references, the only recognized method of transmission of pulmonary tuberculosis is via inhalation of droplets into the respiratory tract, and that there is no objective evidence that injections into the skin have been shown to cause pulmonary tuberculosis. In July 2014 the Veteran was afforded an in-person VA examination for tuberculosis. The examiner reviewed the Veteran’s file and documented that the Veteran had been diagnosed with COPD, inactive tuberculosis, and bronchiectasis. The examiner opined that it is less likely than not that the Veteran’s tuberculosis is related to military service because the Veteran was diagnosed with tuberculosis 16 years after service discharge, and there is no objective evidence that the Veteran had tuberculosis during service. The examiner explained that frequent colds, chronic cough causing soaking sweats, and chest pain were noted to have occurred during the Veteran’s childhood, not during service, and that the Veteran had a May 1959 chest x-ray at service discharge that was negative for findings of tuberculosis. Further, the Veteran’s May 1959 discharge examination noted normal lungs, chest, mouth and throat, nose, and sinuses. In a May 2003 statement submitted by the Veteran, he stated that he was diagnosed with and treated for tuberculosis at a VA hospital in late 1975, and took medications associated with tuberculosis for two years. He asserted that he incurred lung scarring as a result of tuberculosis, and that he was diagnosed with bronchiectasis as a result of that scarring. He further stated that he was told by VA doctors that he had most likely come in contact with tuberculosis about 15 to 20 years earlier while in close quarters with people who had tuberculosis, which he asserted coincided with his military service as a mechanic working on a flight line and in hangers. The Veteran also asserted that he worked around heat shields containing asbestos, and that all these elements combined have caused lung scarring and consequently COPD. A June 2003 statement submitted by a private medical provider shows that the Veteran has “old tuberculosis” and a diagnosis of bilateral pulmonary scarring and fibrosis secondary to a combination of asbestosis that he was exposed to during his military service. In an April 2010 statement, the Veteran stated that he was infected with tuberculosis while in service and discharged with symptoms of tuberculosis including constant coughing, night sweats, weight loss, and chest pain. He asserted that the progression of tuberculosis can take anywhere from 15 to 20 years, and that it took 16 years for his symptoms to be diagnosed. Two medical professionals have determined that the Veteran’s current tuberculosis is not related to the Veteran’s service, to include any possible air gun injection, even if the Veteran received an air gun injection during service. The Board acknowledges the Veteran’s statements that he may have contracted tuberculosis via air gun injection or through living in close quarters with others during service. However, these assertions are refuted by the July 2014 VA examination and August 2015 VA medical opinion, which document that the Veteran’s tuberculosis is less likely than not related to service. The Board finds the VA examination and VA medical opinion most probative of the issue at hand, because they were conducted by medical professionals who possess the necessary training and expertise to render the opinions they provided, involved a thorough review of the Veteran’s file, and were each supported by a well-reasoned rationale. The Veteran was competent to state that he had been diagnosed with tuberculosis. However, to the extent that the Veteran asserted that he contracted tuberculosis while living in close quarters with others during service or through an air gun injection during service, such assertions are afforded no probative value, as the Veteran has not been shown to possess the medical expertise necessary to render an opinion regarding the etiology of his tuberculosis. Regarding presumptive service connection, there is no competent evidence of record that tuberculosis manifested to a compensable degree within three years of the Veteran’s discharge from service. See 38 C.F.R. §§ 3.307(a), 3.309(a). Indeed, the Veteran was diagnosed with tuberculosis 16 years after service discharge. As such, service connection is not warranted on a presumptive basis. For all the reasons discussed above, the Board finds that the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for tuberculosis, to include as a result of an air gun injection during service. Thus, as the preponderance of the evidence is against the claim, there is no reasonable doubt to be resolved, and the claim is denied. 38 U.S.C. § 5107(b). 4. Whether new and material evidence has been presented sufficient to reopen a claim for entitlement to service connection for a bilateral hearing loss disability In March 2003, the Veteran filed a claim for service connection for bilateral hearing loss. In a May 2003 statement, the Veteran asserted that he worked as an aircraft mechanic from 1956 to 1959, which required him to work on the flight line and hear the constant whine of the engines on the ground and the overhead roar of aircraft. He asserted that this caused hearing loss and ringing in his head and ears. He further stated that in November 1956 he was injured in an auto accident in which he was knocked unconscious and later transported to a base hospital, where he was treated for multiple injuries and where he complained about pain and ringing in his head. He reported that he was told that it would eventually go away, and it seemed to fade as he became accustomed to it. He asserted that the combination of exposure to extreme noise and the auto accident caused his current hearing loss. In December 2003, the RO issued a rating decision denying the claim for service connection for a bilateral hearing loss disability due to a lack of diagnosis, as the Veteran failed to report for his scheduled VA examination. The relevant evidence of record at the time of the December 2003 rating decision included the Veteran’s service treatment records, and other documents described below. Subsequently, the Veteran was afforded a VA examination for bilateral hearing loss in March 2004. In the March 2004 examination report, the examiner noted that the Veteran’s hearing was noted to be normal in both ears on enlistment in 1955 and essentially normal in both ears at discharge from service in 1959. The examiner noted that the Veteran’s puretone thresholds in his right ear were 25 at 1000 Hz, 35 at 2000 Hz, 55 at 3000 Hz, and 70 at 4000 Hz, with an average of 46 dB in the right ear, and a Maryland CNC word recognition score of 98 percent. The examiner noted that the Veteran’s puretone thresholds in his left ear were 25 decibels at 1000 Hz, 20 at 2000 Hz, 50 decibels at 3000 Hz, and 55 decibels at 4000 Hz, with an average of 38 decibels in the left ear, and a Maryland CNC word recognition score of 96 percent. The examiner noted that the Veteran had normal hearing in the 250 – 1000 Hz range, with mild to severe sensorineural hearing loss in the 2000 – 8000 Hz range in both the left and the right ears. The examiner opined that in-service noise exposure was not responsible for the Veteran’s bilateral hearing loss, and reasoned that the Veteran was discharged from service with essentially normal hearing in both ears. In a March 2004 rating decision, the RO concluded that upon consideration of the March 2004 VA examination, the evidence did not establish a nexus between a current bilateral hearing loss disability and in-service noise exposure. The Veteran was notified of the decision in an April 2004 letter, which included his appeal rights. The Veteran did not appeal this decision, and no additional evidence pertinent to the issue was associated with the claims folder within one year of the decision. See 38 C.F.R. § 3.156(b). Thus, the March 2004 rating decision became final based on the evidence then of record. 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. Since the March 2004 final rating decision, relevant evidence added to the file includes an application to reopen the claim, a statement asserting hearing loss related to in-service noise exposure, and a private examination, as described in detail below. In November 2009, the Veteran submitted an application to reopen his claim for bilateral hearing loss. In April 2010, the Veteran submitted a statement asserting that his hearing loss is related to military service working on a flight line daily with exposure to jet aircraft noise. In March 2011, the Veteran underwent a private examination which showed that he has bilateral hearing loss. The Board finds that although the March 2011 private examination for hearing loss was added to the record since the March 2004 rating decision became final, this private examination does not show that the Veteran’s current bilateral hearing loss disability is related to service. At the time of the March 2004 rating decision, there was already evidence of a current bilateral hearing loss disability. This March 2011 private examination confirms a fact that was already of record and thus is cumulative and redundant of evidence in the file at the time of the March 2004 rating decision. What was lacking in March 2004 was a nexus between the post-service bilateral hearing loss disability and service. That nexus between the post service hearing loss disability and service has still not been established. Given that the evidence submitted since the prior March 2004 final rating decision is not both new and material, the application to reopen the Veteran’s claim of entitlement to service connection for a bilateral hearing loss disability is denied. 38 U.S.C. § 5108. Increased Ratings—Generally 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, each piece of evidence of record. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, regarding the Veteran’s claim on appeal. The Veteran must not assume that the Board has overlooked pieces of evidence that are not explicitly discussed herein. Disability evaluations are determined by evaluating the extent to which a veteran’s service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities. 38 C.F.R. Part 4. The percentage ratings represent, as far as can practicably be determined, the average impairment in earning capacity resulting from such diseases and injuries and the residual conditions in civilian occupations. Generally, the degree of disabilities specified are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities and the criteria for specific ratings. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. Whether the issue is one of an initial rating or an increased rating, separate ratings can be assigned for separate periods of time based on the facts found, a practice known as “staged” ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007). With respect to the Veteran’s increased rating claim on appeal, the Board has considered the relevant temporal period, including one year prior to his increased rating claim, as well as whether any additional staged rating periods are warranted. A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. See 38 U.S.C. § 5107. When the evidence supports the claim or is in relative equipoise, the claim will be granted. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). If the preponderance of the evidence weighs against the claim, it must be denied. Id. 5. Entitlement to a compensable rating for fracture of the nasal bone The Veteran is currently entitled to a non-compensable rating for fracture of the nasal bone. Under DC 6502, deviation of the nasal septum warrants a 10 percent rating (the maximum schedular rating) when there is 50 percent obstruction of the nasal passage on both sides or complete obstruction on one side. 38 C.F.R. § 4.97, DC 6502. The rating schedule authorizes the assignment of a noncompensable evaluation (zero percent) in every instance in which the rating schedule does not provide such an evaluation and the requirement for a compensable evaluation has not been met. 38 C.F.R. § 4.31. In a June 2003 statement, a private medical professional asserted that the Veteran had a diagnosis of obstructive sleep apnea due to nose obstruction that was caused by an automobile accident in 1956 during service. In an April 2010 statement, the Veteran asserted that he had difficulty breathing through his nose when wearing glasses, and that he believed that the VA tested him for this problem and found a blockage even when he was not wearing glasses. In July 2014, the Veteran was afforded an in-person VA examination for conditions of the nose and throat. The examiner reviewed the Veteran’s claims file and noted that the Veteran had been diagnosed with allergic rhinitis and a traumatic deviated nasal septum. The examiner documented that there was not at least 50 percent obstruction of the nasal passage on both sides due to traumatic septal deviation, and that there was not complete obstruction of either the left or right side of the nose due to traumatic septal deviation. Imaging studies were performed of the Veteran’s nasal bones, and the medical professional interpreting these studies documented that they showed well-aligned bones with no acute fracture present, no radiographic abnormality, and no radiographic evidence of acute fracture or dislocation. The medical professional interpreting the imaging studies of the Veteran’s sinuses documented that the right frontal sinus is not aerated, and there is polypoid soft tissue within the left frontal sinus, with all remaining sinuses being well-aerated and clear. The medical professional explained that there is a probable polyp within the left frontal sinus. The evidence does not show that this probable polyp is related to the Veteran’s traumatic deviated septum. In August 2015, the Veteran was afforded an in-person VA examination. The examiner reviewed the Veteran’s VA treatment records and documented that the Veteran had been diagnosed with a traumatic deviated nasal septum. The examiner documented that there was not at least 50 percent obstruction of the nasal passage on both sides due to traumatic septal deviation, and that there was not complete obstruction of either the left or right side of the nose due to traumatic septal deviation. After thoroughly reviewing the evidence of record, the Board finds that a 10 percent rating for fracture of the nasal bone is not warranted. The July 2014 and August 2015 VA examinations show that the Veteran’s service-connected disability does not result in 50 percent obstruction of the nasal passage on both sides or complete obstruction on either side. Accordingly, his disability picture does not meet the criteria for a 10 percent rating. The Board finds the July 2014 and August 2015 VA examiners’ findings and conclusions to be the most probative evidence as to the severity of the Veteran’s traumatic nasal septum deviation, because these examiners specifically addressed the rating criteria necessary to rate his disability, including answering whether the symptoms amounted to a 50 percent obstruction of both nasal passages or a complete obstruction of one nasal passage. Additionally, these examiners’ opinions are probative due to their expertise, training, education, proper support and rationale, and thorough reviews of the Veteran’s records. For all the reasons laid out above, the Board finds that the preponderance of the evidence is against the Veteran’s claim of entitlement to a compensable rating for fracture of the nasal bone. Thus, as the preponderance of the evidence is against the claim, there is no reasonable doubt to be resolved, and the claim is denied. 38 U.S.C. § 5107(b). A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Caruso, Associate Counsel