Citation Nr: 19151295 Decision Date: 07/02/19 Archive Date: 07/01/19 DOCKET NO. 16-55 764 DATE: July 2, 2019 ORDER Entitlement to service connection for high blood pressure is denied. Entitlement to service connection for Barrett's Disease is denied. Entitlement to service connection for esophageal varices with bands, to include as secondary to cirrhosis of the liver is denied. Entitlement to service connection for bleeding ulcers is denied. Entitlement to service connection for cirrhosis of the liver is denied. Entitlement to service connection for hiatal hernia is denied. Entitlement to service connection for Hepatitis C is denied. FINDINGS OF FACT 1. High blood pressure was not shown in service or for many years thereafter, and there is no probative evidence linking high blood pressure to service. 2. Barrett’s Disease was not shown in service or for many years thereafter, and there is no probative evidence linking Barrett’s Disease to service. 3. Esophageal varices with bands, was not shown in service or for many years thereafter, and there is no probative evidence linking esophageal varices with bands to service on a direct or secondary basis. 4. Bleeding ulcers were not shown in service or for many years thereafter, and there is no probative evidence linking bleeding ulcers to service. 5. Cirrhosis of the liver was not shown in service or for many years thereafter, and there is no probative evidence linking cirrhosis of the liver to service. 6. A hiatal hernia was not shown in service or for many years thereafter, and there is no probative evidence linking a hiatal hernia to service. 7. Hepatitis C was not shown in service or for many years thereafter, and there is no probative evidence linking Hepatitis C to service. CONCLUSIONS OF LAW 1. The criteria for establishing entitlement to service connection for high blood pressure have not been met. 38 U.S.C.A. § 1110, 1112, 1137, 5107 (West 2014); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2018). 2. The criteria for establishing entitlement to service connection for Barrett’s Disease have not been met. 38 U.S.C.A. § 1110, 1112, 1137, 5107 (West 2014); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2018). 3. The criteria for establishing entitlement to service connection for esophageal varices with bands, to include as secondary to cirrhosis of the liver, have not been met. 38 U.S.C.A. § 1110, 1112, 1137, 5107 (West 2014); 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310 (2018). 4. The criteria for establishing entitlement to service connection for bleeding ulcers have not been met. 38 U.S.C.A. § 1110, 1112, 1137, 5107 (West 2014); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2018). 5. The criteria for establishing entitlement to service connection for cirrhosis of the liver have not been met. 38 U.S.C.A. § 1110, 1112, 1137, 5107 (West 2014); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2018). 6. The criteria for establishing entitlement to service connection for hiatal hernia have not been met. 38 U.S.C.A. § 1110, 1112, 1137, 5107 (West 2014); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2018). 7. The criteria for establishing entitlement to service connection for Hepatitis C have not been met. 38 U.S.C.A. § 1110, 1112, 1137, 5107 (West 2014); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1979 to February 1982. Service Connection The Board notes that, for all of the issues contained herein, VA’s duty to provide an examination has not been triggered. As part of its duty to assist, VA is to provide the Veteran with an examination when: (1) there is competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) there is evidence establishing that an event, injury, or disease occurred in service, or evidence establishing certain diseases manifesting during an applicable presumption period; (3) there is an indication that the disability or symptoms may be associated with the veteran’s service or with another service-connected disability; and (4) there otherwise is sufficient competent medical evidence of record to make a decision on the claim. 38 U.S.C. § 5103A (d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006); 38 C.F.R. § 3.159 (c)(4). The Board notes that the Veteran has asserted that VA failed in its duty to assist him in the development of his claim by not providing him with a compensation and pension examination. For all of the issues herein for which no examination was provided, the Veteran has failed to allege any in-service event, injury, or disease which does not constitute willful misconduct. The Veteran also has failed to indicate how any hypothetical in-service event, injury, or disease may be associated to a particular condition. Notably, he has not attributed any of his claimed disabilities to an incident during service other than his intravenous drug use. Without even bare allegations as such, VA’s duty to provide the Veteran with an examination has not been triggered. See 38 U.S.C. § 5103A (d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006); 38 C.F.R. § 3.159 (c)(4). To establish service connection, there must exist medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013); 38 C.F.R. § 3.303 (a). To establish secondary service connection, a veteran must provide evidence of (1) a current, non-service-connected disability, (2) a current service-connected disability, and (3) evidence that the non-service-connected disability is either (i) proximately due to or the result of a service-connected disability or (ii) aggravated (increased in severity) beyond is natural progression by a service-connected disability. 38 U.S.C. § 1110; Allen v. Brown, 7 Vet. App. 439, 446 (1995); 38 C.F.R. § 3.310. In rendering a decision on appeal, the Board must analyze the competency, credibility, and probative value of the evidence, account for the evidence that it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. Buchanan v. Nicholson, 451 F.3d 1331, 133537 (Fed. Cir. 2006). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall resolve all reasonable doubt in favor of the claimant. 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990); 38 C.F.R. § 3.102. 1. Entitlement to service connection for high blood pressure 2. Entitlement to service connection for Barrett's Disease 3. Entitlement to service connection for esophageal varices with bands, to include as secondary to cirrhosis of the liver 4. Entitlement to service connection for bleeding ulcers 5. Entitlement to service connection for cirrhosis of the liver 6. Entitlement to service connection for hiatal hernia 7. Entitlement to service connection for Hepatitis C Although the Veteran has made separate service connection claims for the issues listed above, because the Board’s decision for each claim relies upon the same rationale and evidence, all of the claims will be addresses simultaneously. The Veteran has asserted that his high blood pressure, Barrett’s Disease, esophageal varices with bands, bleeding ulcers, cirrhosis of the liver, hiatal hernia and Hepatitis C were all caused by, or a result of, his active duty service. However, the only in-service event, injury or disease cited by the Veteran in his claim, is that his current conditions were caused by intravenous drug use. See April 2014 Statement in Support of Claim. Generally, such drug use is considered willful misconduct and is not an event for service connection purposes. See 38 U.S.C. § 105 (2012); 38 C.F.R. §§ 3.1 (m), 3.301(d); see also VAOPGCPREC 7-99, 64 Fed. Reg. 52,375 (June 9, 1999). Additionally, the Veteran’s service treatment records (STR) are silent for any treatment or complaints related to his blood pressure, heart, digestive system, liver, kidneys or a hernia. During the Veteran’s February 1982 separation examination and report of medical history, it was found that he had normal heart, vascular system, abdomen and viscera (include hernia) and genitourinary system, with no history of palpitation or pounding heart, heart trouble, high or low blood pressure, frequent indigestion, stomach, liver or intestinal trouble, jaundice or hepatitis or recent gain or loss of weight. Additionally, the record is silent as to complaints of or treatment for his claimed conditions for over 30 years after the Veteran’s discharge from active duty. See Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (2006) (the lack of contemporaneous medical records, the significant time delay between the affiants’ observations and the date on which the statements were written, and conflicting statements of the veteran are factors that the Board can consider and weigh against a veteran’s lay evidence). The medical evidence of record shows that the Veteran was not treated for hiatal hernia, Barrett’s Disease, antral ulcers, esophageal varices, Hepatis C, cirrhosis of the liver and hypertension until 2013. Although the Veteran believes that his current disabilities are related to service, as a lay person, he has not shown that he has the specialized training sufficient to render such an opinion. 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 or etiology). In this regard, the diagnosis and etiology of hiatal hernia, Barrett’s Disease, antral ulcers, esophageal varices, Hepatis C, cirrhosis of the liver and hypertension are matters not capable of lay observation and require medical expertise to determine. Moreover, the Veteran has specifically related his current conditions to in-service intravenous drug use, which is considered willful misconduct and is not an event for service connection purposes. See 38 U.S.C. § 105 (2012); 38 C.F.R. §§ 3.1 (m), 3.301(d); see also VAOPGCPREC 7-99, 64 Fed. Reg. 52,375 (June 9, 1999). Thus, the opinion of the Veteran regarding the etiology of his current hiatal hernia, Barrett’s Disease, antral ulcers, esophageal varices, Hepatis C, cirrhosis of the liver and hypertension is not competent medical evidence. As there is no competent, credible, and probative evidence linking his current high blood pressure, Barrett’s Disease, esophageal varices with bands, bleeding ulcers, cirrhosis of the liver, hiatal hernia and Hepatitis C to service, service connection is denied. In reaching this decision, the Board considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the Veteran’s service connection claims for high blood pressure, Barrett’s Disease, esophageal varices with bands, bleeding ulcers, cirrhosis of the liver, hiatal hernia and Hepatitis C, the doctrine is not for application. See Gilbert, 1 Vet. App. at 56. Furthermore, as the Veteran is not currently service connected for any conditions, including cirrhosis of the liver, he cannot be granted service connection for esophageal varices with bands on a secondary basis. 38 U.S.C. § 1110; Allen v. Brown, 7 Vet. App. 439, 446 (1995); 38 C.F.R. § 3.310. Therefore, the Veteran’s claim for service connection for esophageal varices with bands, to include as secondary to cirrhosis of the liver, is also denied on a secondary service connection basis. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Nelson, 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.