Citation Nr: 18158615 Decision Date: 12/18/18 Archive Date: 12/17/18 DOCKET NO. 17-03 028 DATE: December 18, 2018 ORDER Service connection for a heart disorder is denied. REMANDED The claim for a rating in excess of 10 percent for a right knee disability is remanded. FINDING OF FACT The weight of the evidence is against a finding that any heart disorder is due to or the result of the Veteran’s active service. CONCLUSION OF LAW The criteria for service connection for a heart disorder have not been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service in the Army from September 1982 to April 1988 and September 1990 to May 1991. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection requires competent evidence showing: (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, 1167 (Fed. Cir. 2004). Service connection may also be established under 38 C.F.R. § 3.303(b), where a condition in service is noted but is not, in fact, chronic, or where a diagnosis of chronicity may be legitimately questioned. The continuity of symptomatology provision of 38 C.F.R. § 3.303(b) has been interpreted as an alternative to service connection only for the specific chronic diseases listed in 38 C.F.R. § 3.309(a). See Walker v. Shinseki, 718 F.3d 1331 (Fed. Cir. 2013). Service connection may also be established with certain chronic diseases based upon a legal presumption by showing that the disorder manifested itself to a degree of 10 percent disabling or more within one year from the date of separation from service. 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. The Veteran filed a service connection claim for a heart disorder in September 2016, which was denied by a December 2016 rating decision. He asserts that his heart disorder is due to his active service. The Veteran’s STRs do not show any complaints, symptoms, treatment, or diagnosis for a heart disorder. At September 1982, March 1990, and April 1991 physicals, he had normal examinations of his heart and he specifically denied having any heart symptoms on medical history surveys. In addition, he had normal chest x-rays in November 1986 and June 1994 The Veteran’s STRs show that during reserve service following his active service, he had a normal chest x-ray in June 1994. He also continued to have normal examinations of his heart and denied having any heart symptoms in May 1995. At a June 1995 VA examination, the Veteran had a normal chest x-ray and normal ECG. After her separation from service, the Veteran’s treatment records show that he reported having a heart attacks in March 2016 and June 2016, although there are no medical records confirming he had heart attacks. In July 2016, he was diagnosed with chronic heart failure and coronary artery disease. In November 2016, the Veteran was afforded a VA examination. After reviewing the Veteran’s claims file, interviewing the Veteran, and conducting an examination, the opined that the Veteran’s heart disorder was less likely than not due to his active service as the Veteran’s STRs were silent for a significant heart condition. As described, the record contains no diagnosis of a heart disorder either in service or within one year after service, which would preclude service connection on the basis of continuity of symptomology or on any presumptive basis. The Veteran has not argued to the contrary. There is also no medical evidence linking the Veteran’s current heart disorder to his active service, and he has not submitted any medical opinion that even suggests a relationship between his heart disorder and his active service. See Shedden, 381 F.3d 1163, 1167. Thus, there is no basis for service connection on a direct or presumptive basis. Consideration has been given to the Veteran’s personal assertion that his heart disorder is due to his active service. Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), as to the specific issues in this case, the etiology of heart disorders, the fall outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Heart disorders are not the type of conditions that are readily amenable to mere lay diagnosis or probative comment regarding their etiology, as the evidence shows that physical examinations that include objective medical tests and medical knowledge/expertise are needed to properly assess and diagnose the disorders. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009. That is, although the Board readily acknowledges that the Veteran is competent to report symptoms he can observe through the use of his senses, he has not been shown to possess the requisite medical training, expertise, or credentials needed to render a diagnosis or a competent opinion as to medical causation. Nothing in the record demonstrates that he has received any special training or acquired any medical expertise. See King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). Accordingly, the Veteran’s assertions do not constitute competent medical evidence. Accordingly, the criteria for service connection for a heart disorder have not been met, and the Veteran’s claim is denied. REASONS FOR REMAND The Veteran filed his increased rating claim for his right knee disability in September 2016, which was denied by a December 2016 rating decision. In December 2016 and January 2017, he asserted that his right knee disability had worsened. As such, a remand is necessary to afford the Veteran a new VA examination for his right knee disability. The matter is REMANDED for the following action: 1. Obtain VA treatment records from October 2016 to the present. 2. Schedule the Veteran for a VA examination to determine the current severity of his service connected right knee disability. In so doing, the examiner should ensure to the extent possible, consistent with 38 C.F.R. § 4.59, that the report include results of active and passive motion, in addition to the results following repetitive motion testing. If it is not possible to complete any of the range of motion testing described above, it should be explained. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Berryman, Counsel