Citation Nr: 18157820 Decision Date: 12/13/18 Archive Date: 12/13/18 DOCKET NO. 16-39 976 DATE: December 13, 2018 ORDER Entitlement for service connection for epistaxis (claimed as nose bleeds) is granted. FINDING OF FACT 1. The Veteran’s epistaxis (claimed as nose bleeds) began during service. 2. The preponderance of the evidence reflects that the Veteran’s diagnosis for epistaxis was present at the time the claim for benefits was filed. CONCLUSION OF LAW The criteria for entitlement for service connection for epistaxis (claimed as nose bleeds) have been met. 38 U.S.C. §§ 1101, 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United Stated Navy from January 1992 to January 2012. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office in Cleveland, OH. The Veteran timely filed a Notice of Disagreement in September 2013. The RO issued a Statement of the Case (SOC) reaffirming the denial in June 2016. The Veteran filed a timely substantive appeal in August 2016. The Veteran appeared before the undersigned Veterans Law Judge at a Video Conference Board Hearing in December 2016. A transcript of the proceeding is associated with the claims file. 1. Entitlement for service connection for epistaxis (claimed as nose bleeds) The Veteran contends that service connection is warranted for epistaxis that began in service and has persisted since service. See Veteran’s December 2012 statement; September 2013 Notice of Disagreement; and December 2016 hearing testimony. Service connection may be granted for a disability resulting from disease or injury that was incurred in, or aggravated by, service. 38 U.S.C. § 1110 (2012); 38 C.F.R. § 3.303(a); see also 38 C.F.R. § 3.303 (d) (providing that service connection may be granted for any disease diagnosed after discharge when all the evidence establishes that the disease was incurred in service). To establish service connection, the record must contain competent evidence demonstrating: (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. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). As an initial matter, the Board notes that the record does not contain medical evidence of a current epistaxis disability. Nonetheless, a review of the Veteran’s medical treatment records evidences that the Veteran had an in-service occurrence of epistaxis, as reported by the Veteran and evidenced by the Veteran’s service treatment records. See Service Treatment Records, September 2010. Although the record does not contain corroborating evidence of a positive medical nexus between the Veteran’s in-service occurrence of epistaxis and the claimed disability, the Board finds that the Veteran has credibly and competently established the requisite nexus element. The Veteran is competent to report recurring nosebleeds during and after service and the Board finds his reports to be credible. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465 (1994) (finding lay evidence is competent if provided by a person with knowledge of the facts or circumstances and conveys matters that can be observed and described by a person without specialized knowledge or training); 38 C.F.R. § 3.159(a)(2) (2017). At the December 2016 hearing, the Veteran reported that he had never had problems with epistaxis until he was in the military. Specifically, he reported that in September 2010 he complained and was treated for repeated nosebleeds, non-sequelae. Nonetheless, treatment records from the U.S.S. Normandy also demonstrate a history of recurring epistaxis and denote a 2007 cauterization was unsuccessful. The record also shows that in September 2011, the Veteran reported random bloody nose episodes, indicated that he received treatment twice, and reported recurrent nosebleeds. See Medical Readiness Division Norfolk, Report of Medical History, September 2011. Moreover, medical records from the Naval Medical Center Portsmouth evidences complaints and treatment for nosebleeds (epistaxis) in September 2006; February, April, May, September, October, November, and December 2007; November 2008; March and April 2009; March 2010; May, October, November 2011. Post-service treatment records also demonstrate complaints and treatment for epistaxis in February, June, and August 2012. Including the Veteran’s history of various forms of cauterization in attempts to relieve the symptoms. See post-service treatment records dated April 2007, September 2010, January, April and May 2011, June 2012 (where the Veteran complained of epistaxis). The Veteran additionally reported that his symptoms were initially alleviated post-cauterization; however, his symptoms ultimately recurred and reported nosebleeds on a regular basis. See Veteran’s Statement in Support of [his] Claim, December 2012; Hearing Testimony, December 2016; see also VA Form 9, August 2016. Furthermore, the Veteran underwent a nasal endoscopy in attempts to relieve symptoms. See VA CAPRI Records, August 2012. Here, the record demonstrates the claimed epistaxis disability existed when the Veteran filed his claim for benefits. See Pre-Discharge Compensation Claim, VA Form 21-526c, November 2011, January 2012. Thus, the requirement of a current disability at the time the claim was filed or during the pendency of the claim is satisfied, even though the epistaxis disability was resolved during the appeal period (see Hearing Testimony, December 2016). McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); see also Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013) (noting that evidence of a disability preceding the date of claim should be considered when determining whether a disability existed at the date of the claim). (Continued on the next page)   After careful consideration of all evidence in a given case, any reasonable doubt, meaning a point where there is an approximate balance of positive and negative evidence regarding any issue material to the determination (a legal condition called in equipoise), VA will resolve that doubt in the Veteran’s favor. 38 U.S.C. § 5107 (2012); 38 C.F.R. § 3.102 (2017); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). In this case, a current disability existed when the Veteran filed his claim for benefits, the continuous and consistent reports of symptoms by the Veteran, the evidence of in-service occurrence with repeated follow-up visits for the same impairment post-service, the Board finds that the Veteran is competent and credible to establish a nexus. See 38 C.F.R. § 3.307, 3.309; Brammer, 3 Vet. App. 223; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Accordingly, the Board finds that the evidence of record supports the claim, and that service connection for epistaxis is warranted. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Steele, Associate Counsel