Citation Nr: 18136830 Decision Date: 09/19/18 Archive Date: 09/19/18 DOCKET NO. 16-14 880 DATE: September 19, 2018 ORDER Entitlement to service connection for cardiac disability other than hypertensive heart disease/left ventricular hypertrophy, to include ischemic heart disease, is denied. REFERRED The issue of entitlement to special monthly compensation based on the regular need for the aid and attendance of another person or on account of being housebound was raised in an August 2018 “Statement in Support of Claim” form (VA Form 21-4138). This issue is referred to the agency of original jurisdiction for appropriate action, to include informing the Veteran and his representative that a claim for benefits must be submitted on the application form prescribed by the Secretary of VA and providing such forms. See 38 C.F.R. § 3.150(a) (2017) (providing for furnishing of appropriate application form upon request for VA benefits); 38 C.F.R. § 19.9(b) (2017) (continuing to provide for Board referral of unadjudicated claims). FINDING OF FACT The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time, a current diagnosis of cardiac disability other than hypertensive heart disease/left ventricular hypertrophy. CONCLUSION OF LAW The criteria for service connection for cardiac disability other than hypertensive heart disease/left ventricular hypertophy, to include ischemic heart disease, are not met. 38 U.S.C. §§ 1110, 1131, 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 November 1961 to March 1966, which includes service in the Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) from a September 2014 rating decision. As service connection has already been awarded for hypertensive heart disease/left ventricular hypertrophy and in light of the Veteran’s reported symptoms and contentions and to encompass all disorders that are reasonably raised by the record, the Board has re-characterized the claim of service connection for ischemic heart disease as a claim of service connection for cardiac disability other than hypertensive heart disease/left ventricular hypertrophy, to include ischemic heart disease. See Clemons v. Shinseki, 23 Vet. App. 1 (2009) (holding that, in determining the scope of a claim, the Board must consider the claimant’s description of the claim, the symptoms described, and the information submitted or developed in support of the claim). Entitlement to service connection for cardiac disability other than hypertensive heart disease/left ventricular hypertrophy, to include ischemic heart disease Service connection will be granted if the evidence demonstrates that current disability resulted from a disease or injury incurred in active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service incurrence of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). In the absence of proof of present disability there can be no successful claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). See also Degmetich v. Brown, 104 F.3d 1328 (1997) (also interpreting 38 U.S.C. § 1131 as requiring the existence of a present disability for VA compensation purposes). To be present as a current disability, there must be evidence of the condition at some time during the claim period. Gilpin v. West, 155 F. 3d 1353, 1356 (Fed. Cir. 1998); see also McClain v. Nicholson, 21 Vet. App. 319, 321 (2007) (the Gilpin requirement that there be current disability is satisfied when the disability is shown at the time of the claim or during the pendency of the claim, even though the disability subsequently resolves). Moreover, the Board cannot draw a bright line at the date of claim but must consider all of the evidence of record in determining whether the Veteran has met the current disability requirement. Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013) (Board erred in failing to address pre-claim evidence in assessing whether a current disability existed, for purposes of service connection, at the time the claim was filed or during its pendency). The Veteran contends that he has current ischemic heart disease that is related to his presumed exposure to herbicide agents in Vietnam. The question for the Board in this case is whether the Veteran has current cardiac disability other than hypertensive heart disease/left ventricular hypertrophy that began during service or is at least as likely as not related to an in-service injury, event, or disease. For the following reasons, the Board concludes that the Veteran does not have any current cardiac disability other than hypertensive heart disease/left ventricular hypertrophy and has not had one at any time during the pendency of the claim or any time. In April 2014, the Veteran submitted a letter from a private physician who opined that because of the Veteran’s hypertension, he would “more than likely contact 50% or greater, ischemic heart disease. . . .” This letter suggests that it was the physician’s opinion that the Veteran would likely eventually develop ischemic heart disease due to his hypertension, but it does not indicate that the Veteran had already been diagnosed as having ischemic heart disease or any other cardiac disability other than hypertensive heart disease/left ventricular hypertrophy. Parenthetically, the Board notes that service connection has already been awarded for hypertension. The Veteran was afforded a VA cardiac examination in July 2014 and was diagnosed as having left ventricular hypertrophy. He reported that he had been evaluated for indigestion and that there was “some concern about heart problems.” He had never experienced any heart attack or been diagnosed as having any heart disease, condition, or problems. The physician who conducted the July 2014 examination noted that none of the Veteran’s heart conditions qualified as ischemic heart disease, that he had not experienced any myocardial infarction, congestive heart failure, arrhythmia, heart valve condition, infectious heart condition, or pericardial adhesions, that he had not undergone any non-surgical or surgical procedures for the treatment of a heart condition, and that he had not been hospitalized for any heart condition. Examination revealed that the Veteran’s heart rhythm was regular, that his heart sounds were normal, that there was no jugular-venous distension, that peripheral pulses were normal, that there was no peripheral edema, and that there were no other pertinent physical findings, complications, conditions, signs, or symptoms. An echocardiogram revealed left ventricular hypertrophy, but no other abnormalities. Moreover, the Veteran’s treatment records do not document any cardiac disability other than hypertensive heart disease/left ventricular hypertrophy. While the Veteran believes that he has current ischemic heart disease, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education and the ability to interpret complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n. 4 (Fed. Cir. 2007) (“sometimes the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer”); Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007) (unlike varicose veins or a dislocated shoulder, rheumatic fever is not a condition capable of lay diagnosis). Consequently, the Veteran’s statements in this regard are not competent. In sum, the above evidence does not establish the presence of any cardiac disability other than hypertensive heart disease/left ventricular hypertrophy, and neither the Veteran nor his representative has alluded to the existence of any other evidence establishing such disability. 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. §§ 1110, 1131. Thus, where, as here, the evidence establishes that the Veteran does not have the cardiac disability for which service connection is sought, there can be no valid claim for service connection. See Gilpin, 155 F.3d at 1353; Brammer, 3 Vet. App. at 225. As such, service connection for cardiac disability other than hypertensive heart disease/left ventricular hypertrophy must be denied because the first criterion for an award of service connection-evidence of current disability upon which to predicate such an award-has not been met. Accordingly, the Board finds that the claim of service connection for cardiac disability other than hypertensive heart disease/left ventricular hypertrophy (to include ischemic heart disease) must be denied. In reaching the conclusion to deny the claim, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim, that doctrine is not applicable in this instance. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Elwood, Counsel