Citation Nr: 20005509 Decision Date: 01/24/20 Archive Date: 01/22/20 DOCKET NO. 16-22 474 DATE: January 24, 2020 ORDER Entitlement to service connection for residuals of an inguinal hernia is denied. FINDING OF FACT The Veteran’s residuals of an inguinal hernia were not caused by active service. CONCLUSION OF LAW The criteria for service connection for residuals of an inguinal hernia have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1968 to February 1988. This case comes before the Board of Veterans’ Appeals (Board) on appeal of an October 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This case was previously before the Board in October 2018, when it was remanded to the RO to afford the Veteran a VA examination to determine the nature and etiology of his residuals of an inguinal hernia. Service connection may be granted for a disability resulting from disease or injury incurred or aggravated during active service. 38 U.S.C. §§ 1110, 1131. Generally, service connection requires (1) the existence of a present disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a causal relationship (nexus) between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). VA shall consider all information and 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; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Veteran’s service treatment records are silent for complaints of inguinal hernia or residuals in service. In a September 1979 in-service medical overseas examination, the Veteran’s abdomen was noted as normal, and there are no references to any hernia. On an October 1987 Report of Medical History completed by the Veteran for his retirement physical, he indicated that he was in good health and did not mention a hernia. A September 2013 VA medical treatment note listed no hernia discovered when a review of the abdomen was completed. In his Notice of Disagreement received in November 2014, the Veteran explained that he served on many work parties in service loading stores onto the ship during the early part of his service. He further stated that he believes that such heavy lifting led to his inguinal hernia. A January 2016 Report of General Information noted that the Veteran explained that he was diagnosed with an inguinal hernia two months prior to discharge. The Veteran’s VA medical records first indicate the presence of an inguinal hernia in May 2016. In his May 2016 VA Form 9 Substantive Appeal, the Veteran stated that his hernia was diagnosed within two months of his retirement and that his doctor advised him not to lift anything over 25 pounds. In November 2019, the Veteran underwent a VA hernia examination. The Veteran was diagnosed with inguinal hernia with a date of diagnosis listed as 2016. In the report, the examiner noted that the Veteran’s October 1987 retirement examination shows no hernia, and a VA record from September 2013 noted no hernia discovered. The examiner further noted the Veteran’s May 2016 complaint of left inguinal pain and his statement that years ago a doctor told him that he had a hernia. The examiner reviewed the Veteran’s claims file and provided a negative nexus opinion. The examiner reasoned that the Veteran’s files were reviewed in detail and there is no evidence found to support the existence of a left inguinal hernia in service or caused by service. Further, the examiner stated that the records indicate as recently as 2013 that no hernia was found. The absence of documented treatment in service or thereafter is not fatal to a service connection claim, and the absence of evidence in the service treatment records is an insufficient basis, by itself, for a negative opinion. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). However, the Veteran has presented no competent and persuasive evidence showing that the residuals of an inguinal hernia, first documented years after service, are related to his active service. See Ledford, 3 Vet. App. at 89. The Veteran is competent to observe pain symptoms but is not competent to ascertain whether current symptoms represent a continuation or sequelae of residuals of an inguinal hernia. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). A medical opinion that is factually accurate, fully articulated, and based on sound reasoning carries significant weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); see also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Accordingly, the Board finds the November 2019 VA negative nexus opinion to be well-reasoned and affords this opinion significant probative value. The Board finds that the preponderance of the evidence is against the claim of entitlement to service connection for residuals of an inguinal hernia. In reaching this conclusion, 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. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The claim is denied. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Alexis B. Markeson, 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.