Citation Nr: 19173291 Decision Date: 09/19/19 Archive Date: 09/19/19 DOCKET NO. 16-11 301A DATE: September 19, 2019 ORDER An entitlement to service connection for bilateral shin splints is denied. REMANDED The claim for a compensable rating for allergic rhinitis is remanded. FINDING OF FACT The evidence of record does not show that it is at least as likely as not (50 percent or greater) that the Veteran’s current bilateral shin splints were caused by service, manifested to a compensable degree within one year after discharge, were caused or aggravated by his service-connected pes planus, or otherwise etiologically related to his service. CONCLUSION OF LAW The criteria for service connection for bilateral shin splints have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran honorably served on active duty from February 1999 to May 2005. In a March 2016 rating decision, the Regional Office (RO) denied his December 2015 claim for service connection claim for bilateral shin splints. The Veteran disagreed with that rating decision and appealed to the Board. The Veteran is seeking service connection for bilateral shin splints, contending that his shin splints etiologically relate to his service-connected bilateral pes planus. In his Notice of Disagreement (NOD) received in March 2016, the Veteran explained that he was treated for pes planus in service, which he believes placed increased stress on his legs, resulting in shin splints. Service connection shall be granted for the disability resulting from an injury or disease incurred during military service. 38 U.S.C. § 1110. Establishing service connection requires the evidence showing: (1) the existence of a present disability; (2) an in-service injury or disease; and (3) an etiological (causal) relationship between the present disability and the injury or disease incurred in service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran’s service treatment records reflect a one-time complaint of shin splints in May 1999. His service treatment records are devoid of any further complaints or treatment until many years after service. Of note, the Veteran has asserted in his NOD that he was told by a doctor that there is no medical treatment for shin splints and this is why he did not continue going to appointments. However, for example, a February 2002 periodic medical examination reports reflect that the Veteran denied having any medical conditions precluding him from physical exercises, apart from reporting that he had his wisdom teeth pulled in September 2001. Likewise, in January 2005, the Veteran did not report any ongoing shin splints issues, denied any conditions precluding him from military physical exercises, and denied taking any medications, to include pain medication. The next recorded complaint is reflected in a letter received from Piedmont Health in December 2015. In February 2016, VA evaluated the nature and etiology of the Veteran’s bilateral shin splints. The examiner confirmed a diagnosis of bilateral shin splints, but opined that it is less likely than not (meaning a probability of 50 percent or less) that the Veteran’s current shin splints etiologically relate to his shin splints in service. The Veteran did not submit any evidence to the contrary. Rather, as reflected in his substantive appeal, the Veteran then argued that his current bilateral shin splints were proximately caused by his service-connected bilateral pes planus. Service connection may be granted on secondary basis for the disability that is proximately due to or the result of an existing service-connected disability. See 38 C.F.R. § 3.310(a). Establishing service connection on secondary basis requires the evidence to show the existence of the claimed disability and a causal link between the claimed disability and any existing service-connected disability. See Allen v. Brown, 7 Vet. App. 439 (1995). Of note, such a link generally must be established by medical evidence. See Barr v. Nicholson, 21 Vet. App. 303 (2007). Here, the Veteran has not been shown to have the specialized training, knowledge, or experience, to render etiological opinions about highly complex disabilities of musculoskeletal system. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Nevertheless, in order to assess his condition, VA obtained a supplemental expert medical opinion concerning the etiology of the Veteran’s bilateral shin splints. In July 2016, the VA examiner reviewed the Veteran’s claims file, including his service and post-service treatment history, past examinations, his contentions, and consulted medical literature. Then, the examiner at some length explained the etiology of shin splints and based on the comprehensive data ultimately opined that it is less likely than not that the Veteran’s current shin splints etiologically relate to his pes planus. The Veteran has neither challenged this medical opinion nor provided any competent evidence to the contrary. Of note, as reflected in the Veteran’s substantive appeal (VA Form 9 received in November 2017), he still experiences severe pain with his shin splints and the shoe pads provided by VA do not relieve this pain, but he hopes that at some point in the future the pads will work. His VA treatment records reflect that the Veteran was prescribed orthopedic pads for his pes planus which has been determined not to have caused his shin splints. The fact that this treatment for pes planus remains ineffective for shin splints further suggests that there is no causal link between his pes planus and his shin splints. The Board has acknowledged the Veteran’s reports of extreme pain in shins and his contention that his shin splints etiologically relate to his pes planus. However, the Veteran did not submit any competent evidence to support this contention. As explained, he does not possess the requisite expertise to render medical opinions concerning etiology of medically complex disabilities of musculoskeletal system. Further considering the Veteran’s contention against the medical expert opinion to the contrary, the Board accords the medical opinion a greater probative weight. In light of this medical opinion that the Veteran’s current shin splints are not at least as likely as not related to his shin splints in service, or his service-connected pes planus, or otherwise relate to his service, the Board has to rely on this lone piece of the competent medical evidence of record which weighs against his claim. Accordingly, service connection for bilateral shin splints is denied. REASONS FOR REMAND In an October 2015 rating decision, the Veteran was granted service connection for allergic rhinitis, evaluated at 0 percent, and effectuated from the date of his claim. The Veteran disagreed with the assigned rating and appealed to the Board. The Veteran is seeking a compensable rating for his allergic rhinitis, contending that he has septum deviation causing a 70-percent nasal obstruction (as reflected in Dr. D.C.’s letter received in December 2015) thereby warranting a 10 percent rating percent. He has also argued that the incapacitating episodes involving sinusitis and headaches due to his rhinitis flare-ups several times per week (as reflected in his NOD received in November 2015) warrant a rating at 30 percent. As further reflected in his substantive appeal (VA From 9 received in March 2016), the Veteran contends that he has more than six non-incapacitating episodes per year due to sinusitis characterized by headaches, pain, and purulent discharge. Given that this evidence has not been reviewed and addressed by the VA examiner, the Board finds that a supplemental medical examination and opinion is necessary to decide the claim. Accordingly, the matter is REMANDED for the following action: Schedule the Veteran for an examination to evaluate the current severity levels of his allergic rhinitis, to include his claims of nasal obstruction and flare-ups. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Bardin, 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.