Citation Nr: 18158143 Decision Date: 12/14/18 Archive Date: 12/14/18 DOCKET NO. 17-41 911 DATE: December 14, 2018 ORDER Service connection for psoriasis is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has psoriasis due to service. CONCLUSION OF LAW The criteria for service connection for psoriasis are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1965 to November 1969, to include service in the Republic of Korea from September 1967 to December 1968. This matter was before the Board in November 2017, at which time the undersigned remanded the above issue for a VA examination. The Veteran contends in his notice of disagreement (NOD) that he was exposed to herbicides while performing maintenance work in the Korea DMZ. Specifically, the Veteran stated that he was deployed to Korea August 18, 1965 to November 17, 1969 with Company D, 707th Maintenance Battalion, 7th Infantry Division and based at Camp Hovey located 5 to 7 miles outside the DMZ. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current diagnosis of psoriasis, the evidence does not support exposure to herbicides during service, and the preponderance of the evidence weighs against finding that the Veteran’s psoriasis is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Psoriasis is not a recognized disease associated with herbicide exposure under 38 C.F.R. § 3.309(e) and therefore no presumption applies. Notwithstanding this, the prior November 2017 Board decision found that the preponderance of evidence was against finding that the Veteran was exposed to herbicides while stationed in Korea with Company D, 707th Maintenance Battalion, 7th Infantry Division. As explained in more detail in the Board’s November 2017 decision, Company D, 707th Maintenance Battalion, 7th Infantry Division is not recognized by the Department of Defense (DoD) as having served along the Korean DMZ. VA attempted to verify the Veteran’s reported exposure to herbicide agents, but received a negative response from the Joint Services Records Research Center (JSSRC). The Board also previously found that the Veteran’s only assertion that he was exposed to Agent Orange in Korea (within his February 2016 NOD) contained inconsistencies. This was in relation to another claim based on contended herbicide exposure adjudicated in the November 2017 Board decision that remanded this claim for additional development. First, the Veteran’s reported dates of service in Korea did not match the dates in his military personnel records. Second, the Veteran stated that he was located at Camp Hovey, but the JSRRC confirmed that the 707th Maintenance Battalion was located at Camp Casey. While the Veteran’s service personnel records confirm his unit assigned, there is no other evidence submitted to confirm his claimed trips to the DMZ, except for the lay statement from the Veteran. DoD has provided the units of which are known to have served in such a capacity. Although not being on the list is not dispositive, the Board finds that an assertion without more does not meet the evidentiary burden that a claimant must meet to substantiate this element of the claim. See 38 U.S.C. § 5107(a). Moreover, while VA has a duty to assist a claimant to meet this burden, VA attempted to find evidence that the Veteran or his unit did serve in the requisite location during the requisite time period to no avail. The Board finds that VA has fulfilled its duty to assist in the appeal. Considering the above, to include the noted inconsistencies, the Board finds that the preponderance of the evidence weighs against finding that the Veteran had exposure to herbicides in service. See generally 38 C.F.R. § 3.307(a)(6)(iv) (providing dates and locations for presumed herbicide exposure). The negative response from the JSSRC and lack of corroborating evidence to support the Veteran’s contention warrant a finding that he was not exposed to herbicide while stationed in Korea. Thus, there is no evidence to support the contention of direct causation between his psoriasis and herbicide exposure. Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). Furthermore, the record reflects that the Veteran’s psoriasis occurred many years after discharge from service. In the June 1969 separation examination, the Veteran marked “no” for skin diseases and no skin disorders were found by the military examiner. By the Veteran’s own accounts, his psoriasis did not occur until 1987 or 1988. Therefore, psoriasis did not have its onset until almost 18 years after his separation from service. See Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (prolonged period without medical complaint can be considered, along with other factors concerning a claimant’s health and medical treatment during and after military service, as evidence of whether an injury or a disease was incurred in service which resulted in any chronic or persistent disability). The January 2018 VA examiner opined that the Veteran’s psoriasis was not at least as likely as not related to an in-service injury, event, or disease, including the rash documented during service. The rationale was that the service treatment records from August and October 1968 pertained to a heat rash, while the Veteran’s psoriasis was not evident until 1987 which was many years after service. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains a clear conclusion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Board finds that the most probative evidence of record is the January 2018 VA examination, as it is the only medical opinion of record. Consequently, the Board adopts the opinion of the VA examiner, who ultimately found that the Veteran’s psoriasis was not related to military service. Neither the Veteran nor his representative have presented or identified any contrary medical opinion or treatment that supports his claim. VA adjudicators are not free to ignore or disregard the medical conclusions of a VA physician, and are not permitted to substitute their own judgment on a medical matter. Colvin v. Derwinski, 1 Vet. App. 171 (1991); Willis v. Derwinski, 1 Vet. App. 66 (1991). In reaching its decision, the Board acknowledges the Veteran’s sincere belief that he has psoriasis due to his service in Korea. The Veteran is competent to testify to the presence of symptoms (e.g., itching), because such requires only personal knowledge as it comes through the senses. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, the Board finds that linking his current psoriasis to a heat rash that occurred in 1968 is an inherently complex medical question not capable of lay observation and is not the type of medical issue for which a lay opinion may be accepted as competent evidence. See Kahana v. Shinseki, 24 Vet. App. 428, 438 (2011); see also Colantonio v. Shinseki, 606 F.3d 1378, 1382 (Fed. Cir. 2010) (recognizing that in some cases lay testimony “falls short” in proving an issue that requires expert medical knowledge). Accordingly, the Veteran’s lay statements in this regard are not competent or probative evidence supporting his claim. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the opinion of the January 2018 VA examiner over the Veteran’s general lay assertions. Based on the forgoing, the Board finds a preponderance of the evidence is against service connection for psoriasis, the benefit of the doubt doctrine does not apply, and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Dellarco, Associate Counsel