Citation Nr: 18159827 Decision Date: 12/20/18 Archive Date: 12/20/18 DOCKET NO. 15-12 227A DATE: December 20, 2018 ORDER Entitlement to an initial compensable rating for bilateral hearing loss prior to April 7, 2016, and a rating in excess of 30 percent thereafter, is denied. Entitlement to service connection for hypertension is denied. Entitlement to service connection for Parkinson’s disease is denied. Entitlement to service connection for peripheral neuropathy of the bilateral upper extremities is denied. Entitlement to service connection for peripheral neuropathy of the bilateral lower extremities is denied. Entitlement to service connection for rheumatoid arthritis is denied. Entitlement to service connection for cardiovascular disease is denied. Entitlement to service connection for an acquired psychiatric disability, to include depression and posttraumatic stress disorder (PTSD), to include as secondary to service-connected bilateral hearing loss, is denied. Entitlement to service connection for tinnitus is denied. Entitlement to service connection for a disability characterized by poor vision is denied. Entitlement to service connection for asthma is denied. FINDINGS OF FACT 1. Audiometric examinations conducted during the period on appeal show that the appellant had no worse than Level III hearing loss in the right ear and Level II hearing loss in the left prior to April 7, 2016, and no worse than Level VI hearing loss in the right ear and Level VI hearing loss in the left since. 2. The most probative evidence establishes that the Veteran did not have hypertension which was incurred in or was otherwise causally related to his active service, or manifested to a compensable degree within one year thereof. 3. The most probative evidence establishes that the Veteran did not have Parkinson’s disease which was incurred in or was otherwise causally related to his active service, or manifested to a compensable degree within one year thereof. 4. The most probative evidence establishes that the Veteran did not have peripheral neuropathy of the bilateral upper extremities which was incurred in or was otherwise causally related to his active service, or manifested to a compensable degree within one year thereof. 5. The most probative evidence establishes that the Veteran did not have peripheral neuropathy of the bilateral lower extremities which was incurred in or was otherwise causally related to his active service, or manifested to a compensable degree within one year thereof. 6. The most probative evidence establishes that the Veteran did not have rheumatoid arthritis which was incurred in or was otherwise causally related to his active service, or manifested to a compensable degree within one year thereof. 7. The most probative evidence establishes that the Veteran did not have cardiovascular disease which was incurred in or was otherwise causally related to his active service, or manifested to a compensable degree within one year thereof. 8. The most probative evidence establishes that the Veteran did not have an acquired psychiatric disability, to include depression or PTSD, which was incurred in or was otherwise causally related to his active service, or was caused or aggravated by a service-connected disability. 9. The most probative evidence establishes that the Veteran did not have tinnitus which was incurred in or was otherwise causally related to his active service, or manifested to a compensable degree within one year thereof. 10. The most probative evidence establishes that the Veteran did not have a disability characterized by poor vision which was incurred in or was otherwise causally related to his active service. 11. The most probative evidence establishes that the Veteran did not have asthma which was incurred in or was otherwise causally related to his active service. CONCLUSIONS OF LAW 1. The criteria for an initial compensable rating for bilateral hearing loss prior to April 7, 2016, and in excess of 30 percent thereafter, are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.85, 4.86, Diagnostic Code 6100. 2. The criteria for service connection for hypertension are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 3. The criteria for service connection for Parkinson’s disease are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 4. The criteria for service connection for peripheral neuropathy of the bilateral upper extremities are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 5. The criteria for service connection for peripheral neuropathy of the bilateral lower extremities are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 6. The criteria for service connection for rheumatoid arthritis are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 7. The criteria for service connection for cardiovascular disease are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 8. The criteria for service connection for an acquired psychiatric disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.310. 9. The criteria for service connection for tinnitus are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 10. The criteria for service connection for a disability characterized by poor vision are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304. 11. The criteria for service connection for asthma are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served with the Recognized Guerrillas and Combination Service from January 1945 to October 1945. He died in September 2016. The appellant is his surviving child, who has been substituted as the appellant. This matter comes before the Board of Veterans’ Appeals (Board) from rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). A January 2014 rating decision granted service connection for bilateral hearing loss and assigned an initial noncompensable rating, effective October 17, 2013. A February 2014 rating decision denied service connection for hypertension, Parkinson’s disease, peripheral neuropathy of the bilateral upper and lower extremities, rheumatoid arthritis, cardiovascular disease, depression, PTSD, tinnitus, poor vision, and severe asthma. A timely Notice of Disagreement (NOD) with respect to both rating decisions was received in August 2014. Following a request for clarification, the Veteran indicated his desire to appeal all of the issues adjudicated in these rating decisions in September 2014. A Statement of the Case (SOC) was issued in March 2015, which addressed service connection for hypertension, Parkinson’s disease, peripheral neuropathy of the bilateral upper and lower extremities, rheumatoid arthritis, cardiovascular disease, tinnitus, poor vision, and asthma. An SOC was issued in November 2015 which addressed entitlement to an initial compensable rating for bilateral hearing loss and service connection for depression and PTSD, also claimed as insomnia. A Supplemental Statement of the Case (SSOC) was issued in November 2015, which addressed entitlement to service connection for hypertension, Parkinson’s disease, bilateral upper and lower extremity peripheral neuropathy, rheumatoid arthritis, cardiovascular disease, tinnitus, a disability manifested by poor vision, and asthma. A substantive appeal was received in December 2015. A December 2015 rating decision found that the effective date for the award of service connection for bilateral hearing loss assigned in the January 2014 rating decision was clearly and unmistakably erroneous. An effective date of October 17, 2012, was assigned for the grant of service connection for bilateral hearing loss. Such rating decision also denied service connection for migraine headaches and vertigo, claimed as dizziness. An April 2016 rating decision increased the evaluation of bilateral hearing loss to 30 percent, effective April 7, 2016. Although a higher rating was granted, the issue remains in appellate status, as the maximum schedular rating was not assigned for the entire period on appeal. See AB v. Brown, 6 Vet. App. 35, 38 (1993). The Board observes that the April 2016 rating decision erroneously stated that such was a full grant of the benefit sought on appeal and regrets any confusion which may have arisen from this inaccurate statement. In any event, an NOD was received in June 2016. A Statement of the Case (SOC) was issued in September 2016, which addressed entitlement to an effective date earlier than April 7, 2016, for the award of a 30 percent rating for bilateral hearing loss and entitlement to a rating in excess of 30 percent for bilateral hearing loss. While no timely substantive appeal was received, such are encompassed by the initial increased rating claim for bilateral hearing loss, as discussed infra. The Board has recharacterized the issues of entitlement to service connection for PTSD and depression as entitlement to service connection for an acquired psychiatric disorder. See Clemons v. Shinseki, 23 Vet. App. 1, 5-6, 8 (2009) (holding that the scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by a claimant’s description of the claim, reported symptoms, and the other information of record). Finally, the Board observes a November 2015 VA Form 21-4138, upon which the Veteran appeared to raise the issues of, inter alia, entitlement to a total disability rating based on individual unemployability due to service-connected disability (TDIU) and special monthly compensation based on the need for the aid and attendance of another. The appellant is advised that, effective March 24, 2015, VA amended its regulations to require that all claims governed by VA’s adjudication regulations be filed on a standard form. See 79 Fed. Reg. 57,660 (Sept. 25, 2014), codified as amended at 38 C.F.R. §§ 3.151, 3.155. Should the appellant wish to file any such claim, such should be filed with the RO on the proper form. Increased Rating for Bilateral Hearing Loss Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Separate diagnostic codes identify the various disabilities. Where there is a question as to which of two evaluations should be applied, the higher evaluation will be assigned if that disability picture more nearly approximates the criteria required for that rating. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability is resolved in favor of the veteran. 38 C.F.R. § 4.3. In considering the severity of a disability, it is essential to trace the medical history of the veteran. 38 C.F.R. §§ 4.1, 4.2, 4.41. Consideration of the whole recorded history is necessary so that a rating may accurately reflect the elements of disability present. 38 C.F.R. § 4.2; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where a claimant appeals the initial rating assigned following an award of service connection, evidence contemporaneous with the claim for service connection and with the rating decision granting service connection would be most probative of the degree of disability existing at the time that the initial rating was assigned and should be the evidence “used to decide whether an [initial] rating on appeal was erroneous. . . .” Fenderson v. West, 12 Vet. App. 119, 126 (1999). If later evidence obtained during the appeal period indicates that the degree of disability increased or decreased following the assignment of the initial rating, “staged” ratings may be assigned for separate periods of time based on facts found. Id. Impairment of auditory acuity (hearing loss) is evaluated pursuant to the provisions set forth at 38 C.F.R. § 4.85. Under that regulation, an examination for hearing impairment must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test (Maryland CNC) and a pure tone audiometry test. Examinations are to be conducted without the use of hearing aids. 38 C.F.R. § 4.85(a). To evaluate the degree of disability from defective hearing, the Rating Schedule establishes 11 auditory acuity levels from Level I, for essentially normal acuity, through Level XI, for profound deafness. These are assigned based on a combination of the percent of speech discrimination and the pure tone threshold average, as contained in a series of tables within the regulations. 38 C.F.R. § 4.85(b). The “puretone threshold average” is the sum of the pure tone thresholds at 1000, 2000, 3000, and 4000 Hertz (Hz), divided by four. This average is used in all cases to determine the Roman numeral designation for hearing impairment from Table VI or VIA. 38 C.F.R. § 4.85(d). Table VII, “Percentage Evaluations for Hearing Impairment,” is used to determine the percentage evaluation by combining the Roman numeral designations for hearing impairment of each ear. The horizontal rows represent the ear having the better hearing and the vertical columns the ear having the poorer hearing. The percentage evaluation is located at the point where the row and column intersect. 38 C.F.R. § 4.85(e). In cases where impaired hearing is service-connected in only one ear, in order to determine the percentage evaluation from Table VII, the non-service-connected ear will be assigned a Roman Numeral designation for hearing impairment of I, subject to the provisions of 38 C.F.R. § 3.383. 38 C.F.R. § 4.85(f). The regulatory provisions also provide two additional circumstances under which alternative tables can be employed. One is where the pure tone thresholds of the frequencies of 1000, 2000, 3000, and 4000 Hz are 55 decibels or greater. The second is where pure tone thresholds are 30 decibels or less at frequencies of 1000 Hz and below, and are 70 decibels or more at 2000 Hz. See 38 C.F.R. § 4.86. After reviewing the evidence of record, the Board finds that an initial compensable rating prior to April 7, 2016, and a rating in excess of 30 percent thereafter, is not warranted. The Veteran was afforded a VA examination in January 2014. Pure tone threshold testing revealed: HERTZ 500 1000 2000 3000 4000 RIGHT 55 60 45 45 50 LEFT 55 55 35 45 55 The 1000-4000 Hertz average was 50 decibels in the right ear and 48 in the left. Speech recognition using the Maryland CNC word list was 0 percent in the right ear and 0 percent in the left. However, the VA examiner stated that the use of word recognition scores was not appropriate for the Veteran because of language difficulties, cognitive problems, inconsistent word recognition scores, that make combined use of pure tone average and word recognition scores inappropriate. With respect to functional impact, the Veteran complained of difficulty during conversations in that he is unable to hear words being spoken. The Veteran was afforded a VA examination on April 7, 2016. Pure tone threshold testing revealed: HERTZ 500 1000 2000 3000 4000 RIGHT 65 65 65 80 85 LEFT 55 50 60 75 100 The 1000-4000 Hertz average was 74 decibels in the right ear and 71 in the left. Speech recognition using the Maryland CNC word list was 0 percent in the right ear and 0 percent in the left. However, the VA examiner stated that the use of word recognition scores was not appropriate for the Veteran because of language difficulties, cognitive problems, inconsistent word recognition scores, that make combined use of pure tone average and word recognition scores inappropriate. With respect to functional impact, the Veteran had difficulty hearing words in almost all situations and could not understand spoken words as well. 38 C.F.R. § 4.85(c) directs that Table VIA, “Numeric Designation of Hearing Impairment Based Only on Puretone Threshold Average,” be used when, inter alia, the examiner certifies that use of the speech discrimination test is not appropriate because of language difficulties, inconsistent speech discrimination scores, etc. The January 2014 findings are thus equivalent to Level III hearing loss in the right ear and Level II in the left. When applied to Table VII, the January 2014 findings equate to a noncompensable rating. The April 2016 findings are equivalent to Level VI hearing loss in the right ear and Level VI in the left. When applied to Table VII, the April 2016 findings equate to a 30 percent rating. See 38 C.F.R. § 4.85, Tables VIA, VII. The Board notes the October 2015 private hearing test results from Manila Hearing Aid Center, Inc. Pure tone threshold testing revealed: HERTZ 500 1000 2000 3000 4000 RIGHT 100 100 90 NR 90 LEFT 100 100 100 NR 100 However, these are not valid for rating purposes as puretone thresholds at 3000 Hz were not tested. Further, while the January 2014 and April 2016 examiners certified that the use of the speech discrimination test was not appropriate, the October 2015 private audiologist neither tested speech discrimination nor certified that such was not appropriate. The Board further notes that the Veteran was afforded a VA examination in April 2016, after the October 2015 private test took place, and that puretone thresholds were lower during the latter examination. Thus, the October 2015 private results appear to be an outlier and are thus entitled to minimal probative weight, when all of the deficiencies are considered. Thus, the Board finds that the preponderance of the evidence is against an initial compensable rating prior to April 7, 2016, and a rating in excess of 30 percent thereafter. The Board has considered the Veteran’s description of his hearing loss disability, to include difficulty hearing and understanding spoken words. However, disability ratings for hearing impairment are derived by a mechanical application of the rating schedule to the numeric designations assigned after audiometric evaluations are rendered. See Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). In this case, as explained above, the numeric designations correlate to the current disability ratings. Moreover, the rating criteria contemplate the appellant’s reported decreased hearing acuity and difficulty in understanding conversational speech. “[W]hen a claimant’s hearing loss results in an inability to hear or understand speech or to hear other sounds in various contexts, those effects are contemplated by the schedular rating criteria.” Doucette v. Shulkin, 28 Vet. App. 366, 369-70 (2017). The Board further finds that other than difficulty hearing or understanding speech, the record on appeal contains no evidence of other symptoms attributable to the service-connected hearing loss not contemplated by the rating criteria. The claim of entitlement to service connection for tinnitus is discussed infra. The Board further finds that other than difficulty hearing or understanding speech, the record on appeal contains no evidence of other symptoms attributable to the service-connected hearing loss, such as ear pain, not contemplated by the rating criteria. The Board notes that a December 2015 rating decision, inter alia, denied service connection for migraine headaches and vertigo, claimed as dizziness. An appeal was not perfected with respect to these issues. As noted supra, the Veteran and the appellant expressed disagreement with the effective date of April 7, 2016, for the award of a 30 percent rating. The arguments appear to be centered on the fact that the Veteran’s claim of service connection for bilateral hearing loss was received on October 17, 2012. See e.g. November 2015 VA Form 21-4138 and June 2016 VA Form 21-4138. However, the Board observes that the effective date of the award of service connection for bilateral hearing loss is October 17, 2012. See December 2015 rating decision. To the extent that it is argued that a 30 percent rating is warranted prior to April 7, 2016, the Board emphasizes that, while the Veteran was competent to report difficulty hearing, the most probative evidence of record indicates that the Veteran’s hearing acuity did not meet the criteria for an initial compensable rating prior to April 7, 2016. As discussed supra, the Veteran’s hearing acuity tested during the January 2014 VA examination warranted an initial noncompensable rating. It was not until the April 7, 2016, VA examination that the evidence indicated that the Veteran’s hearing acuity was poor enough to warrant a compensable rating, in this case, 30 percent. As discussed supra, the private hearing test results are entitled to minimal probative weight. For these reasons, the Board finds that the preponderance of the evidence is against the award of an initial compensable rating prior to April 7, 2016, and a rating in excess of 30 percent thereafter, for bilateral hearing loss. As the evidence preponderates against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Service Connection Claims Service connection may be established for disability resulting from personal injury suffered or disease contracted in the line of duty from active military, naval, or air service. 38 U.S.C. §§ 1110, 1131. “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’—the so-called ‘nexus’ requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (citing Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that which is pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection for certain chronic diseases, including a psychosis, arthritis, cardiovascular-renal disease such as hypertension, other organic diseases of the nervous system, such as peripheral neuropathy, Parkinson’s disease, and tinnitus, may also be established on a presumptive basis by showing that such a disease manifested itself to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307(a) (3), 3.309(a). In such cases, the disease is presumed under the law to have had its onset in service even though there is no evidence of such disease during the period of service. 38 C.F.R. § 3.307(a). To establish service connection under this provision, there must be: evidence of a chronic disease shown as such in service (or within an applicable presumptive period under 38 C.F.R. § 3.307), and subsequent manifestations of the same chronic disease; or if the fact of chronicity in service is not adequately supported, by evidence of continuity of symptomatology after service. The provisions of 38 C.F.R. § 3.303(b) relating to continuity of symptomatology, however, can be applied only in cases involving those conditions explicitly enumerated under 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). In addition, service connection may be established on a secondary basis for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. 38 C.F.R. § 3.310(a); Allen v. Brown, 7 Vet. App. 439 (1995). It is well established that congenital or developmental defects and refractive error of the eyes are not considered diseases or injuries within the meaning of applicable legislation governing the awards of VA compensation benefits. See 38 C.F.R. §§ 3.303(c), 4.9; McNeely v. Principi, 3 Vet. App. 357, 364 (1992). The appellant’s service treatment records are unavailable due to the 1973 fire at the National Personnel Records Center (NPRC). The Court of Appeals for Veterans Claims (Court) has held that in cases where records once in the hands of the government are lost, the Board has a heightened obligation to explain its findings and conclusions and to consider carefully the benefit-of-the-doubt rule. See O’Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). The Board’s analysis of the appellant’s claim has been undertaken with this heightened duty in mind. The case law does not, however, lower the legal standard for proving a claim for service connection, but rather increases the Board’s obligation to evaluate and discuss in its decision all of the evidence that may be favorable to the appellant. See Russo v. Brown, 9 Vet. App. 46 (1996). Moreover, there is no presumption, either in favor of the claimant or against VA, arising from missing records. See Cromer v. Nicholson, 19 Vet. App. 215, 217-18 (2005) (the Court declined to apply an “adverse presumption” where records have been lost or destroyed while in Government control which would have required VA to disprove a claimant’s allegation of injury or disease in service in these particular cases). Hypertension, Parkinson’s disease, peripheral neuropathy of the bilateral upper extremities, peripheral neuropathy of the bilateral lower extremities, rheumatoid arthritis, cardiovascular disease, an acquired psychiatric disorder, a disability characterized by poor vision, and asthma After reviewing the evidence of record, the Board finds that service connection is not warranted for hypertension, Parkinson’s disease, peripheral neuropathy of the bilateral upper extremities, peripheral neuropathy of the bilateral lower extremities, rheumatoid arthritis, cardiovascular disease, acquired psychiatric disorder, a disability characterized by poor vision, or asthma. While his service treatment records are unavailable, as discussed supra, even if an in-service injury or disease were conceded, service connection is not warranted in the instant case. There is no competent evidence that the Veteran had a current disability of hypertension, Parkinson’s disease, peripheral neuropathy of the bilateral upper or lower extremities, rheumatoid arthritis, cardiovascular disease, acquired psychiatric disorder, disability characterized by poor vision, or asthma during the period on appeal. There is no evidence, nor is it contended, that any claimed disability manifest to a compensable degree within one year of separation. In any event, as there is no current disability for any of these claims, service connection on a presumptive basis is not warranted. A January 2014 clinical note states that the Veteran was authorized by VA to travel using a hired vehicle due to “severe back pain/arthritic pain.” However, there is no indication in the claims file that the Veteran was actually diagnosed with arthritis. This entry in the Veteran’s VA medical records was made by an Audio/ENT for the purpose of affording the Veteran transportation to a VA Medical Center for a VA examination. The appellant was afforded a VA psychiatric examination in January 2014. The claims file was reviewed. The Veteran was currently confined to the home due to frailty and easy fatigability on exertion. He reported frequent difficulty breathing when exerting effort. Speech had been laconic; and prolonged talking caused difficulty breathing since 2009. It was noted that the Veteran proudly told and retold of his in-service exploits. He was not observed to have any fear or reservation talking about his service to those who expressed interest in listening. No behavioral complaints were noted. The Veteran did not report any sleeping problems, significant irritability, or intrusive symptoms. There were no noted bothersome anxiety episodes. Following examination, the VA psychiatrist noted that the appellant did not have a mental disorder that conforms with DSM-5 criteria. Indeed, while the appellant was frail and in a wheelchair, no abnormal behaviors were observed. The Veteran was dependent on a grandchild for most of his activities of daily living. He had a low education background and his frailty and physical complaints prevented him from managing his finances personally. In an August 2014 statement, the Veteran’s grandchild, F., reported that the Veteran had impaired vision, was losing weight, experienced headaches, dizziness, nausea, vomiting, anxiety, difficulty breathing, and trouble sleeping. In August 2014, the Veteran submitted a statement detailing his claimed in-service stressor. He also contended that he developed depression secondary to his hearing loss. In April 2015, the Veteran indicated that he was experiencing, inter alia, PTSD and poor eyesight. In November 2015, the Veteran indicated that he had memory loss, was forgetting names and directions, was unable to perform activities of daily living, was hallucinating, had inappropriate behavior, and suffered from chronic sleep impairment. He contended that he had PTSD due to stressful events in service. In a November 2015 statement, the Veteran’s grandchild, H., reported that a quick change in the Veteran’s physical state was observed. The Veteran preferred lying down, sitting in a chair, or on the ground. The Veteran could not rise from a kneeling position very quickly. He also experienced urinary and fecal incontinence. He was irritable and violent. In a November 2015 statement, the Veteran’s grandchild, M., reported that the Veteran was generally observed lying down, sulking, stooped down in a chair, or sitting on the floor. M. reported that the Veteran had reverted to being like a child. He experienced urinary and fecal incontinence and was unable to get dressed or count money. He stayed home and had difficulty eating. M. opined that “old age has accelerated the deterioration of his health.” The Board has considered the Veteran’s, and his grandchildren’s, lay histories of symptomatology related to his claimed disorder throughout the appeal period. They are competent to report such symptoms and observations because this requires only personal knowledge as it comes through an individual’s senses. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, in this case, the Veteran was not, and his grandchildren are not, competent to determine the cause of his symptoms because it would involve medical inquiry into biological processes, anatomical relationships, and physiological functioning. Such internal physical processes are not readily observable and are not within the competence of the Veteran or his grandchildren in this case, who have not been shown by the evidence of record to have had medical training or skills. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis); see also Jones v. West, 12 Vet. App. 383, 385 (1999) (where the determinative issue is one of medical causation or a diagnosis, only those with specialized medical knowledge, training, or experience are competent to provide evidence on the issue). The Board thus affords greater probative weight to the findings of the January 2014 VA examiner as to the presence of an acquired psychiatric disorder than the Veteran’s, and his grandchildren’s, lay contentions. The VA medical opinion was based on a clinical examination of the appellant, a review of the claims file, consideration of the relevant medical history, and the opinion was accompanied by a detailed rationale. The Board has reviewed the evidence of record and notes that there is no competent evidence of a current diagnosis of hypertension, Parkinson’s disease, peripheral neuropathy, rheumatoid arthritis, cardiovascular disease, an acquired psychiatric disorder, a disability characterized by poor vision, or asthma. Again, the Board notes that refractive error of the eyes is not considered a disease or injury within the meaning of applicable legislation governing the awards of VA compensation benefits. See 38 C.F.R. §§ 3.303(c), 4.9; McNeely, supra. The Veteran, prior to his death, and the appellant have had ample opportunity to submit competent evidence of current disabilities, but evidently chose not to do so. As the Veteran is now unfortunately deceased, ordering examinations to determine whether current disabilities exist would be futile. Although VA has a duty to assist in the development of a claim, such duty is not “a one-way street.” Wood v. Derwinski, 1 Vet. App. 190, 193 (1991), aff’d on reconsideration, 1 Vet. App. 406 (1991). Rather, the appellant also has an obligation to assist in the adjudication of his claim. “If a veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence.” Wood, 1 Vet. App. at 195. Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability. See 38 U.S.C. § 1131. Thus, where the collective lay and medical evidence indicates that, fundamentally, the Veteran does not have a current disability for which service connection is sought, there can be no valid claim for service connection. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); Gilpin v. West, 155 F.3d 1353, 1356 (Fed. Cir. 1998). While the Veteran claimed that he developed depression secondary to his service-connected bilateral hearing loss, there is no diagnosed psychiatric disability, including depression. Thus, service connection on a secondary basis is not warranted. The Board notes that “disability” as defined in 38 U.S.C. §§ 1110 and 1131 refers to the functional impairment of earning capacity, not the underlying cause of said disability, and that pain alone can reach the level of a functional impairment of earning capacity. Saunders v. Wilkie, No. 2017-1466, Fed. Cir. (April 3, 2018). In this case, however, there is no indication, nor is it contended, that the Veteran experienced any residuals of an in-service injury or disease which caused a functional impairment in earning capacity. While the record contains competent reports of observed symptomatology, there is no diagnosed disability; and there is no indication that these competently-reported symptoms reached the level of a functional impairment of earning capacity, or that such were causally related to an in-service injury or disease. With respect to the aforementioned January 2014 notation of “severe back pain/arthritic pain,” there is no indication, nor is it contended, that such pain was causally related to an in-service injury or disease, or that such reached the level of a functional impairment of earning capacity. Based on the evidence of record at this time, the Board must conclude that there is no current hypertension, Parkinson’s disease, peripheral neuropathy, rheumatoid arthritis, cardiovascular disease, acquired psychiatric disorder, disability characterized by poor vision, or asthma; and the claims of service connection for such must be denied at this time. See 38 C.F.R. §§ 3.102, 3.303; McClain v. Nicholson, 21 Vet. App. 319 (2007) (the requirement that a current disability be present is satisfied “when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim... even though the disability resolves prior to the Secretary’s adjudication of the claim.”); Brammer, supra. As the evidence preponderates against the claims, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Tinnitus The Board finds that service connection is not warranted for tinnitus. While his service treatment records are unavailable, as discussed supra, combat noise exposure was conceded. See January 2014 rating decision. However, service connection is not warranted in the instant case. There is no competent evidence that the Veteran had a current tinnitus disability during the period on appeal. There is no evidence, nor is it contended, that tinnitus manifest to a compensable degree within one year of separation. In any event, as there is no current disability, service connection on a presumptive basis is not warranted. The Board notes that, although the Veteran claimed service connection for tinnitus and reiterated that he desired service connection for such in a November 2015 statement, he denied experiencing tinnitus during his January 2014 and April 2016 VA examinations. While he was competent to report symptomatology, see e.g. Layno v. Brown, 6 Vet. App. 465, 470 (1994), he personally denied experiencing tinnitus. Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability. See 38 U.S.C. § 1131. Thus, where the collective lay and medical evidence indicates that, fundamentally, the Veteran does not have a current disability for which service connection is sought, there can be no valid claim for service connection. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); Gilpin v. West, 155 F.3d 1353, 1356 (Fed. Cir. 1998). The Board notes that “disability” as defined in 38 U.S.C. §§ 1110 and 1131 refers to the functional impairment of earning capacity, not the underlying cause of said disability, and that pain alone can reach the level of a functional impairment of earning capacity. Saunders v. Wilkie, No. 2017-1466, Fed. Cir. (April 3, 2018). In this case, however, there is no indication, nor is it contended, that the Veteran experienced tinnitus at all. Rather, as noted supra, he denied tinnitus during his VA examinations. Based on the evidence of record at this time, the Board must conclude that there was no current tinnitus disability; and the claim of service connection for such must be denied at this time. See 38 C.F.R. §§ 3.102, 3.303; McClain v. Nicholson, 21 Vet. App. 319 (2007) (the requirement that a current disability be present is satisfied “when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim... even though the disability resolves prior to the Secretary’s adjudication of the claim.”); Brammer, supra. As the evidence preponderates against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). MARTIN B. PETERS Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Behlen, Associate Counsel