Citation Nr: 20020004 Decision Date: 03/18/20 Archive Date: 03/18/20 DOCKET NO. 20-09 232 DATE: March 18, 2020 ORDER Service connection for a nasal polyp is denied. FINDING OF FACT The Veteran’s nasal polyp was not caused by service. CONCLUSION OF LAW The criteria to establish entitlement to service connection for a nasal polyp have not been met. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303(d) (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Army National Guard from June 1984 to October 1984, U.S. Army from March 1987 to March 1990, U.S. Army Reserve from January 2003 to March 2004, U.S. Air National Guard from September 2005 to February 2006, and U.S. Army National Guard from January 2009 to March 2010, to include service in Southwest Asia. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2018 rating decision of the Oakland, California Regional Office (RO). Service Connection Service connection may be granted for a current disability arising from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131 (2012). Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2019). Service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of an in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Nasal polyp The Veteran asserts he was exposed to sand, dust, burning trash and feces, solvents and vehicle exhaust from his three deployments to Southwest Asia, and that such exposure caused his nasal polyp. The Veteran’s report of separation from the armed forces (DD Form 214) reflects that the Veteran served in Southwest Asia from March 2003 to February 2004, September 2005 to January 2006, and April 2009 to December 2009 as a Physician Assistant. Due consideration shall be given to the places, types, and circumstances of such veteran’s service as shown by such veteran’s service record, the official history of each organization in which such veteran served, such veteran’s medical records, and all pertinent medical and lay evidence. 38 U.S.C. § 1154(a) (2012). As a Physician Assistant with three deployments in Southwest Asia, the Veteran would have been exposed to sand, dust, burning trash and feces, solvents and vehicle exhaust. In service medical examination reports dated April 2004 and August 2008, no nose abnormalities were noted. In service medical history reports dated April 2004 and August 2008, the Veteran answered in the negative to the question of whether he then had, or once had nose trouble. In pre-deployment health assessments dated August 2008, January 2009 and March 2009, the Veteran reported that his health was excellent and no referral was indicated for an ear, nose and throat (ENT) specialist. In an August 2017 VA treatment record, the Veteran reported experiencing a nasal polyp and requested a referral for an ENT surgeon. In a November 2017 VA treatment record, the Veteran reported experiencing nasal congestion since 2009. The Veteran was diagnosed with a right antrochoanal polyp. The Veteran underwent right endoscopic sinus surgery and right maxillary antrostomy. In a December 2017 VA treatment record, the VA physician found no evidence of a nasal polyp and indicated that the Veteran was status-post one-month maxillary antrostomy and removal of an antrochoanal polyp. In an April 2018 VA medical opinion, the VA examiner opined that the Veteran’s antrochoanal polyp was not caused by exposure to environmental hazards during his Southwest Asia service; rather, having cited medical literature, the examiner indicated that the Veteran’s nasal polyp was caused by allergies. The VA examiner’s medical opinion is of high probative value because the examiner’s opinion was supported by sufficient rationale. Bloom v. West, 12 Vet. App. 185, 187 (1999) (holding that the value of a physician’s statement is dependent, in part, upon the extent to which it reflects clinical data or other rationale to support the opinion). In the January 2020 substantive appeal, the Veteran indicated having been a Physician Assistant for approximately 27 years and that his nasal polyp was caused by exposure to environmental hazards in Southwest Asia. Due to the Veteran’s medical training and education, the Veteran is competent to provide an opinion as the etiology of his nasal polyp. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The Veteran is also credible in his assertion. However, the Veteran’s opinion as to the etiology of his nasal polyp is of low probative value because it is conclusory and does not provide the Board with sufficient analysis to consider and weigh the opinion. Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007) (holding that a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision as to what weight to assign to a doctor’s opinion); see also Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998) (holding that whether a physician provides a basis for his medical opinion goes to the weight or credibility of the evidence in the adjudication of the merits). A preponderance of the probative evidence is against a finding that the Veteran’s nasal polyp was caused by service. Although the Veteran, as a medical professional, opined that his nasal polyp was caused by his service in Southwest Asia, as noted above, his opinion was of low probative value. The April 2018 VA examiner opined, with sufficient rationale, that the Veteran’s nasal polyp was not caused by the Veteran’s exposure to environmental hazards in Southwest Asia. Therefore, service connection is not warranted and the claim is denied. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Cohen, 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.