Citation Nr: 19159079 Decision Date: 07/31/19 Archive Date: 07/30/19 DOCKET NO. 16-15 129 DATE: July 31, 2019 ORDER Entitlement to service connection for the residuals of hernia surgery is denied. Entitlement to service connection for a painful scar residual, to include as secondary as secondary to hernia surgery is denied. FINDINGS OF FACTS 1. Although the Veteran has a diagnosis of residuals from hernia surgery, the preponderance of the evidence is against finding that his disability began during service or is otherwise related to an in-service injury or disease. 2. Although the Veteran has a diagnosis of painful scar residuals which are secondary to hernia surgery, the preponderance of the evidence is against finding that his disability began during service or is otherwise related to an in-service injury or disease. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for the residuals of hernia surgery have not been met. 38 U.S.C. §§ 1101, 1131 (2012); 38 C.F.R. §§ 3.303, 3.304 (2018). 2. The criteria for entitlement to service connection for a painful scar residual, to include as secondary as secondary to hernia surgery have not been met. 38 U.S.C. §§ 1101, 1131 (2012); 38 C.F.R. §§ 3.303, 3.304 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty from June 1956 to July 1959. He testified in a hearing before the undersigned in March 2019. A transcript is of record. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (2018). “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) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information lay and medical evidence of record in a case and when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (2012); 38 C.F.R. § 3.102 (2018); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, a preponderance of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). 1. Entitlement to service connection for the residuals of hernia surgery 2. Entitlement to service connection for a painful scar residual, to include as secondary as secondary to hernia surgery The Veteran asserts that in May 1957 he was transported to Edwards Airforce base for and received surgical treatment for a protruding hernia. He contends that the residuals of his hernia surgery including his painful residual scarring is related to his time in-service. He also asserts that his in-service hernia surgery has resulted in him undergoing two correctional hernia operations post-service with additional scarring which is painful to the touch. The Veteran's available service treatment records (STRs) show no history of hernia surgery or other gastrointestinal impairment. In a June 1959 examination prior to separation the Veteran’s STRs contain no complaints, diagnosis, or treatments pertaining to a hernia disorder. There are scars set out, but none are reported in the area of any surgery for a hernia. In sum, there is no indication that the Veteran underwent any treatment or surgical procedures a hernia disorder in-service. STRs do not reveal any evidence of post-operative scaring related to a hernia procedure in-service. October 2015 VA outpatient treatment records reveal that the Veteran underwent psychiatric treatment and reported that he was hospitalized for a hernia in 1960’s while serving in the military. (It is noted that the Veteran was discharged in July 1959.) August 2016 VA outpatient treatment records reveal that the examiner noted healed scars from an umbilical and left inguinal hernia repair. August 2017 VA outpatient treatment records reveal that the Veteran reported a history of abdominal wall and left inguinal hernias in the past. On March 2017 the Veteran reported tender scar tissue in his left groin area after inguinal hernia surgery. In a July 2017 VA urgent care treatment report, the Veteran was transported by ambulance to the emergency room with complaints of a painful right groin mass. On examination he reported surgery for a left inguinal hernia fifteen years ago. In an August 2018 Social Security Administration records center response to a medical records request, it was indicated the Veteran’s medical records had been destroyed and any efforts to obtain them would be futile. In a March 2019 hearing before the undersigned, the Veteran testified that between 1956 and 1957 while working in the crash crew, his stomach burst, and he underwent hernia repair surgery at Edwards Air Force base. The Veteran reported that after discharge from service, he continued to have issues pertaining to his hernia surgery including having to wear a homemade truss for support and painful scar tissue in the surgical area. He also reported that he underwent two additional hernia surgical procedures in 1991 and 1998. The Board also reviewed the Veteran’s lay statements and hearing testimony that the residuals of his hernia surgery including painful residual scarring was caused by his time in-service. Lay people are competent to report on matters observed or within their personal knowledge. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). Therefore, the Veteran is competent to provide statements of symptoms which are observable to his senses. His memory, however, is considered somewhat suspect, however, given the absence of residual scarring at the time of separation from service. However, the Board must emphasize that the Veteran is not competent to interpret accurately clinical findings pertaining to the residuals of his hernia surgery including painful residual scarring as this requires highly specialized knowledge and training. 38 C.F.R. § 3.159 (a)(1) (2018). See also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Service connection may be granted for a disease or injury which resulted from a service connected disability or was aggravated thereby. The evidence does not show that hernia residuals of surgery are related to service. Therefore, service-connection for painful scar residual on a secondary basis to this condition cannot be established. There is also no evidence showing that the Veteran’s painful scar residual from hernia surgery was incurred in or aggravated by military service. In sum, the Board finds that the record does not establish service connection for the residuals of hernia surgery including painful residual scarring. While the Veteran contends that his hernia disorder was caused by an injury in-service, this is not found to be probative considering the other evidence of record. It has been determined by the Board that the onset of the Veteran’s hernia condition with painful scarring is not related to his time in-service. As noted, the Veteran’s STRs do not note any complaints, diagnoses, or treatments for a hernia condition. There is no indication that the Veteran underwent a hernia surgical procedure in-surgery, nor is there any notation of a hernia issue or painful residual scarring at an examination prior to his discharge. Significantly, as noted, there is no evidence of pertinent scarring at the examination for separation from service. Furthermore, the record indicates that there is no indication of treatment for a hernia disorder or residual scarring until many years after service. See Mason v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (the passage of many years between discharge from active service and the medical documentation of a claimed disability is evidence against a claim of service connection). Lastly, as a pathology for the residuals of hernia surgery including residual scarring has not been shown to be related to the Veteran’s time in-service, the Board finds no clinical evidence to support the Veteran’s contentions. Based on this evidence, the Board finds service connection is not warranted. The Board has considered the benefit-of-the-doubt doctrine; however, the Board does   not perceive an approximate balance of positive and negative evidence. The preponderance of the evidence is against the claim, the doctrine is not applicable, and the claim must be denied. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 4.3 (2018). MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Elliot Harris, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.