Citation Nr: 18129835 Decision Date: 08/28/18 Archive Date: 08/28/18 DOCKET NO. 14-41 499 DATE: August 28, 2018 ORDER Entitlement to service connection for multiple joint pain is denied. Entitlement to service connection for hepatitis C is denied. Entitlement to service connection for neck condition is denied. REMANDED Entitlement to service connection for an acquired psychiatric disorder to include posttraumatic stress disorder, and major depression with mental stress, memory loss, and headaches, is remanded. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran has multiple joint pain due to a disease or injury in service. 2. The preponderance of the evidence is against finding that the Veteran has hepatitis C due to a disease or injury in service. 3. The preponderance of the evidence is against finding that the Veteran has a neck condition to a disease or injury in service. CONCLUSIONS OF LAW 1. A disorder manifested by multiple joint pain was not incurred or aggravated inservice. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304. 2. Hepatitis C was not incurred or aggravated inservice. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 3. A neck condition was not incurred or aggravated inservice, and cervical arthritis may not be presumed to have been so incurred. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from February 1979 to November 1982. Service Connection Multiple joint pain The Veteran claims entitlement to service connection for a disorder manifested by multiple joint pain that he asserts was incurred while on active duty. Service connection will be granted if it is shown that a veteran suffers from a disability resulting from personal injury suffered or disease contracted in the line of duty, or for aggravation of a preexisting injury suffered or disease contracted during active military service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Disorders diagnosed after discharge will still be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). The ultimate 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 or disease. In this regard, a review of the service treatment records reveals no complaints, findings or a diagnosis of chronic multiple joint pain. While the Veteran has a current diagnosis of degenerative joint disease there is no competent evidence showing that he currently has a disorder manifested by multiple joint pain that is related to service. While the Veteran believes he has such a disorder, and while pain alone which causes functional impairment can be a disability, Saunders v. Wilkie, 886 F.3d 1356 (Fed.Cir. 2018), there must be at least some competent evidence linking such a disorder to service. Without such competent evidence there is no basis to grant service connection. Hence, this claim is denied. In reaching this decision the Board has considered the appellant’s lay statements. The question, however, whether he has a current disorder manifested by multiple joint pain due to service is a medically complex one and it requires specialized medical knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). As a layperson without the appropriate expertise the claimant cannot offer a competent opinion on the etiology of any current disorder manifested by multiple joint pain. The Board acknowledges that the Veteran has not received a VA examination to address this claim. As noted above, however, there is no evidence of an in-service injury or disease manifested by multiple joint pain, and there is no competent evidence suggesting a possible association between such a disorder and service. Therefore, a VA examination is not required. Waters v. Shinseki, 601 F.3d 1274, 1278 (Fed. Cir. 2010) (noting that a conclusory lay statement that a current condition is related to service is insufficient to warrant a medical examination because it would “eliminate the carefully drafted statutory standards governing the provision of medical examinations and require the Secretary to provide such examinations in virtually every veteran’s disability case”). Finally, in reaching this decision, the Board considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the claim, the doctrine is not for application. Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). Hepatitis C The Veteran claims entitlement to service connection for hepatitis C that he asserts was incurred while on active duty. In this regard, a review of the service treatment records reveals no complaints, findings or a diagnosis of hepatitis C. While a review of the records shows that the Veteran has a current diagnosis of hepatitis C, there is no competent evidence showing that hepatitis C is related to service. VA treatment records show the Veteran was not diagnosed with hepatitis C until August 1998, over 15 years after his separation from service, and while the appellant believes that the disorder is relayed to service, as a lay person he is not competent to offer an opinion on the etiology of this disease. Jandreau. Further, a September 2014 VA examiner opined that the Veteran’s hepatitis C is not at least as likely as not related to an in-service injury, event, or disease. The rationale was that hepatitis C was not shown during service, there is no evidence to support that the Veteran acquired hepatitis C during service, and there is no evidence of hepatitis C disease for over 15 years post service. Maxson v. West, 12 Vet. App. 453 (1999), aff’d sub nom., Maxson v. Gober, 230 F.3d 1330 (Fed. Cir. 2000) (The passage of many years between discharge from active service and the medical documentation of a claim disability is a factor that weighs against a claim for service connection.) The Board assigns high probative value to this September 2014 opinion. Accordingly, as the preponderance of the evidence is against the claim, the benefit sought must be denied. In reaching this decision, the Board considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the claims, the doctrine is not for application. Gilbert. Cervical disorder The Veteran contends that he has a neck disorder that was incurred by service. In this regard, a review of the service treatment records reveals no complaints, findings or a diagnosis of cervical spine disorder. Moreover, there is no competent evidence showing that the appellant currently has a neck disability that is related to service. While the Veteran believes he has a neck disability due to an in-service injury, to grant service connection there must be at least some competent evidence showing that an inservice injury or disease is responsible for a current neck disability. A review of the record reveals no such evidence. In fact, service treatment records negate the presence of a neck injury. A July 1981 examination specifically referenced the absence of a neck injury, and the Veteran specifically denied a neck injury during his September 1982 examination. The Veteran electronic claims file includes documentation of a postservice February 1994 injury at a civilian job when he incurred a cervical strain. Given that there is no evidence of an inservice cervical spine disorder, no competent evidence linking a current cervical disorder to service, and evidence showing that the appellant injured his neck after being separated from active duty, the Board finds no basis upon which to grant service connection. Hence, this claim is denied. In reaching this decision the Board has considered the appellant’s lay statements. The question whether he has neck disorder due to service is a medically complex one and it requires specialized medical education. Jandreau. As a layperson without the appropriate expertise the claimant cannot offer a competent opinion on the etiology of any neck disability. The Veteran has not received a VA examination to address whether he has a neck condition that was incurred due to active duty service. As noted above, however, there is no evidence of an in-service injury or disease involving a neck disability, and no competent evidence suggesting a possible association between any neck disability and service. Therefore, a VA examination is not required. Waters. Finally, in reaching this decision, the Board considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the claims, the doctrine is not for application. Gilbert. REASONS FOR REMAND Entitlement to service connection for an acquired psychiatric disorder to include posttraumatic stress disorder, major depression with mental stress, memory loss, and headaches is remanded. The Veteran contends that service connection for an acquired psychiatric disorder is warranted. With respect to the claim of entitlement to service connection for posttraumatic stress disorder the claimant alleges that he was the victim of military sexual trauma, that he suffers from knowing that his future wife was assaulted while he was on active duty, and that he was held at gunpoint by soldiers he believed were involved in a rape that he reportedly witnessed. With respect to the purported rape the Veteran asserts that he witnessed four individuals raping a woman, that he reported the rape, and that the purported individuals involved in committing the crime fired gunshots at him and his roommate in Pirmasens, Germany. The Veteran explains that he ran and hid for his life, but was ultimately found and attacked by two of the individuals. The Veteran states that a gun was placed to his head, and that he believes he blacked out. The Veteran explains that when he came to, one of the individuals was inside of him, while another individual had his penis out, while another individual was laughing. The Veteran states that he fought the individuals off, and while running away a shot rang out. He asserts that his roommate reported the incident. In November 2011, the Veteran reported to private examiner, Dr. E.L., that individuals attempted to rape him but he “evaded” it. The Veteran also reports that in November 1979 he was struck with an object while walking down a hallway. Further, the Veteran reports that he was later struck again by the same individual after getting out of the shower. The Veteran reports that he grabbed this individual by the shirt and tried to choke him, but another soldier pulled him off the assailant, and picked something off the floor that looked like a syringe. Lastly, the Veteran reports that he wife was sexually assaulted by someone in his unit while on active duty. At his March 2017 travel board hearing the appellant testified that he was called out from the field to deal with the issue. He admits that neither he nor his wife reported the rape. A review of the appellant’s service treatment records does not reveal any aforementioned assaults or injury while during the Veteran’s active duty service. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for posttraumatic stress disorder, major depression with mental stress, memory loss, and headaches because no VA examiner has opined whether the Veteran’s condition is related to service. The matters are REMANDED for the following action: 1.Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any diagnosed psychiatric disorder to include posttraumatic stress disorder, major depression, and any psychiatric disorder manifested by mental stress, memory loss and headaches. For each diagnosed psychiatric disorder, the examiner must opine whether the disorder is at least as likely as not related to an in-service injury, event, or disease, to include pain caused by service connected disabilities. The examiner must specifically comment on references to headaches in the Veteran’s service treatment records; and to a June 25, 2017 letter from Dr. M.H. regarding the etiology of the Veteran’s major depression. A complete, well-reasoned rationale must be provided for any opinion offered. If the requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge, i.e., no one could respond given medical science and the known facts, or by a deficiency in the record or the   examiner, i.e., additional facts are required, or the examiner does not have the needed knowledge or training . DEREK R. BROWN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Booker, Associate Counsel