Citation Nr: 20021216 Decision Date: 03/25/20 Archive Date: 03/25/20 DOCKET NO. 14-34 514A DATE: March 25, 2020 ORDER The petition to reopen the previously denied claim for entitlement to service connection for a low back condition is denied. The petition to reopen the previously denied claim for entitlement to service connection for arthritis of the legs is denied. The petition to reopen the previously denied claim for entitlement to service connection for degenerative arthritis of the knees is denied. The petition to reopen the previously denied claim for entitlement to service connection for glaucoma of the right eye is denied. The petition to reopen the previously denied claim for entitlement to service connection for a rash on the scrotum, penis, buttocks, shoulders, and arms is denied. The petition to reopen the previously denied claim for entitlement to service connection for residuals of a head injury, to include headaches, is denied. Entitlement to service connection for a cervical spine disability is denied. Entitlement to service connection for enlarged prostate with urinary frequency is denied. Entitlement to special adapted housing is denied. Entitlement to an effective date prior to August 25, 2010, for the award of service connection for hypertensive cardiomyopathy is denied. FINDINGS OF FACT 1. The Veteran did not timely appeal a June 1986 Board decision that denied his original claims for entitlement to service connection for residuals of an injury to the head and for a skin disorder as a residual of exposure to Agent Orange, and reconsideration of that decision has not been requested or ordered. 2. The Veteran did not timely appeal a November 1996 administrative decision that denied his petition to reopen the previously denied claim for entitlement to service connection for a skin disorder as a residual of exposure to Agent Orange. 3. The Veteran did not timely appeal a December 1997 rating decision that denied his original claim for entitlement to service connection for arthritis in multiple joints, including the back, legs, and knees. 4. The Veteran did not timely appeal a May 2002 rating decision that denied his original claim for entitlement to service connection for glaucoma of the right eye. 5. The Veteran did not timely appeal a July 2006 rating decision that denied his petition to reopen the previously denied claim for entitlement to service connection for a skin disorder as a residual of exposure to Agent Orange. 6. The Veteran did not timely appeal a December 2009 rating decision that denied his petitions to reopen the previously denied claims for entitlement to service connection for a skin disorder as a residual of exposure to Agent Orange, for residuals of a head injury, and for glaucoma of the right eye. 7. Evidence received since the December 1997 rating decision is not new and material as to the issue of entitlement to service connection for a low back condition. 8. Evidence received since the December 1997 rating decision is not new and material as to the issue of entitlement to service connection for arthritis of the legs. 9. Evidence received since the December 1997 rating decision is not new and material as to the issue of entitlement to service connection for degenerative arthritis of the knees. 10. Evidence received since the December 2009 rating decision is not new and material as to the issue of entitlement to service connection for glaucoma of the right eye. 11. Evidence received since the December 2009 rating decision is not new and material as to the issue of entitlement to service connection for a rash on the scrotum, penis, buttocks, shoulders, and arms. 12. Evidence received since the December 2009 rating decision is not new and material as to the issue of entitlement to service connection for residuals of a head injury, to include headaches. 13. The preponderance of the evidence is against finding that the Veteran’s cervical spine disability began during his active service, or is otherwise related to an in-service injury or disease. 14. The preponderance of the evidence is against finding that the Veteran’s enlarged prostate with urinary frequency began during his active service, or is otherwise related to an in-service injury or disease. 15. The Veteran’s service-connected disabilities do not result in a loss or loss of use of a lower extremity, and he is not service connected for an upper extremity disability, severe burn injury, amyotrophic lateral sclerosis, blindness, or an inhalation injury. 16. No communication was received prior to August 25, 2010, that may reasonably be construed as a claim for entitlement to service connection for hypertensive cardiomyopathy. CONCLUSIONS OF LAW 1. The June 1986 Board decision and the November 1996, December 1997, May 2002. July 2006, and December 2009 rating decisions are final. 38 U.S.C. §§ 7104, 7105; 38 C.F.R. §§ 3.104, 3.156, 20.201, 20.202, 20.1100, 20.1103. 2. The criteria for reopening the previously denied claim for entitlement to service connection for a low back condition have not been met. 38 U.S.C. §§ 1110, 5108; 38 C.F.R. §§ 3.303, 3.307, 3.309. 3. The criteria for reopening the previously denied claim for entitlement to service connection for arthritis of the legs have not been met. 38 U.S.C. §§ 1110, 5108; 38 C.F.R. §§ 3.303, 3.307, 3.309. 4. The criteria for reopening the previously denied claim for entitlement to service connection for degenerative arthritis of the knees have not been met. 38 U.S.C. §§ 1110, 5108; 38 C.F.R. §§ 3.303, 3.307, 3.309. 5. The criteria for reopening the previously denied claim for entitlement to service connection for glaucoma of the right eye have not been met. 38 U.S.C. §§ 1110, 5108; 38 C.F.R. §§ 3.303, 3.307, 3.309. 6. The criteria for reopening the previously denied claim for entitlement to service connection for a rash on the scrotum, penis, buttocks, shoulders, and arms have not been met. 38 U.S.C. §§ 1110, 5108; 38 C.F.R. §§ 3.303, 3.307, 3.309. 7. The criteria for reopening the previously denied claim for entitlement to service connection for residuals of a head injury, to include headaches, have not been met. 38 U.S.C. §§ 1110, 5108; 38 C.F.R. §§ 3.303, 3.307, 3.309. 8. The criteria for entitlement to service connection for a cervical spine disability have not been met. 38 U.S.C. §§ 1110, 5103, 5107A; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. 9. The criteria for entitlement to service connection for enlarged prostate with urinary frequency have not been met. 38 U.S.C. §§ 1110, 5103, 5107A; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. 10. The criteria for establishing eligibility for financial assistance for specially adapted housing or special home adaptation are not met. 38 U.S.C. §§ 2101, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.809, 3.809a. 11. The criteria for entitlement to an effective date prior to August 25, 2010, for the award of service connection for hypertensive cardiomyopathy have not been met. 38 U.S.C. §§ 5107, 5110; 38 C.F.R. §§ 3.102, 3.400, 3.816. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from February 1969 to December 1971. The Board remanded this case in in June 2018 and December 2019. The June 2018 remand directed the Agency of Original Jurisdiction (AOJ) to obtain the Veteran’s VA treatment records from September 2017 to the present; make appropriate efforts to obtain the Veteran’s Social Security Administration records; and issue a statement of the case as to five issues. The December 2019 instructed the AOJ to issue a supplemental statement of the case. Pursuant to the June 2018 and December 2019 remands, the AOJ obtained the Veteran’s updated VA treatment records; made appropriate efforts to obtain the Veteran’s Social Security Administration records; issued statements of the case in March 2019 and July 2019as to the five issues listed in the June 2018 remand; and issued a supplemental statement of the case in January 2020. Accordingly, the Board finds that VA at least substantially complied with the June 2018 and December 2019 remands. See 38 U.S.C. § 5103A(b); Stegall v. West, 11 Vet. App. 268, 271 (1998); D’Aries v. Peake, 22 Vet. App. 97, 105 (2008). In regard to the Veteran’s Social Security Administration records, the Social Security Administration informed the AOJ in March 2019 that it had no medical records pertaining to the Veteran. In July 2019, the AOJ informed the Veteran that the Social Security Administration records could not be obtained and that he could submit any such records that he may have in his possession. In August 2019, the Veteran notified VA that he did not have any copies of his Social Security Administration records to submit. In view of those actions, the Board finds that VA has satisfied its duty to assist the Veteran in obtaining his Social Security Administration records. See 38 C.F.R. § 3.159(c)(2) and (e). As noted in the June 2018 remand, the Veteran indicated on his substantive appeal that he did not want a Board hearing. However, in May 2016, more than 90 days following notice of certification of this case to the Board, the Veteran requested a personal hearing with a member of the Board. The Board found in the June 2018 remand the that the hearing request was untimely, had been mailed to an incorrect location, and included no explanation showing good cause for the delay in requesting a Board hearing. Therefore, the Board denied the request for a hearing under the provisions now found at 38 C.F.R. § 20.1305. The Veteran has not since made another request for a Board hearing or provided good cause to support the May 2016 hearing request. Therefore, his request remains denied. Additional evidence, to include VA treatment records, was associated with the record following the most recent adjudication of the issues on appeal by the AOJ. However, the additional evidence is not relevant to the issues denied in this decision. Accordingly, a remand for issuance of a supplemental statement of the case is not necessary, and the Board may proceed with appellate consideration. See 38 C.F.R. § 19.37. Neither the Veteran nor his representative has raised any issues with regard to the duty to notify or duty to assist as they pertain to the issues denied in this decision. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board . . . to search the record and address procedural arguments when the veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). The analysis in this decision focuses on the most relevant evidence and on what the evidence shows or does not show with respect to the issues denied in this decision. The Veteran should not assume that evidence that is not explicitly discussed in this decision has been overlooked. See Timberlake v. Gober, 14 Vet. App. 122 (2000) (noting that the law requires only that reasons for rejecting evidence favorable to the claimant be addressed). Reopening issues The Veteran seeks to reopen his previously denied claims for entitlement to service connection for a low back condition; arthritis of the legs; degenerative arthritis of the knees; glaucoma of the right eye; rash on the scrotum, penis, buttocks, shoulders, and arms; and residuals of a head injury, to include headaches. In general, rating decisions that are not timely appealed are final. See 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. In addition, a Board decision is final unless the Chairman of the Board orders reconsideration. See 38 U.S.C. §§ 7103(a), 7104; 38 C.F.R. § 20.1100. However, under 38 U.S.C. § 5108, if new and material evidence is presented or secured with respect to a claim that has been disallowed, the Secretary shall reopen the claim and review the former disposition of the claim. The question of whether new and material evidence has been received to reopen a previously denied claim must be addressed by the Board in the first instance because the issue goes to the Board’s jurisdiction to reach and adjudicate the underlying claim on a de novo basis. See Jackson v. Principi, 265 F.3d 1366 (Fed. Cir. 2001); Barnett v. Brown, 83 F.3d 1380 (Fed. Cir. 1996). If the Board finds that no such evidence has been offered, that is where the analysis must end, and further analysis beyond consideration of whether the evidence received is new and material is neither required nor permitted. Barnett, 83 F.3d at 1384. New evidence is existing evidence not previously considered by VA. Material evidence is existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). In determining whether evidence is new and material, the credibility of the evidence is generally presumed. Justus v. Principi, 3 Vet. App. 510, 512-13 (1992). In Elkins v. West, 12 Vet. App. 209 (1999), the United States Court of Appeals for Veterans Claims (Court) held that the Board must first determine whether the appellant has presented new and material evidence under 38 C.F.R. § 3.156(a) to have a finally denied claim reopened under 38 U.S.C. § 5108. The Court has also held that the law should be interpreted as enabling reopening of a claim, rather than to precluding it. See Shade v. Shinseki, 24 Vet. App. 110 (2010). The focus is not exclusively on whether evidence remedies the principal reason for denial in the last prior final decision, but on whether the evidence, taken together, could at least trigger the duty to assist or consideration of a new theory of entitlement. Id. at 118. In general, service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 1. Previous decisions VA received the Veteran’s original claims for entitlement to service connection for residuals of a head injury and for a skin disorder as a residual of exposure to Agent Orange in June 1984. The Veteran attended a VA examination in August 1984 where he reported that he had headaches as a result of the in-service head injury. The Veteran perfected an appeal to the Board of a November 1984 rating decision that denied the claims. In June 1986, the Board issued a decision denying the Veteran’s claims. In the decision, the Board explained that although the Veteran may have been involved in a motor vehicle accident in Vietnam and suffered resultant injuries to his head, shoulders, and arms, his post-service records did not show any residuals from such an in-service injury. The Board further explained that chloracne is the only skin condition that has been determined to be an adverse health effect caused by Agent Orange. Therefore, any other skin problems that the Veteran may have currently had were not the residuals of his exposure to Agent Orange while in Vietnam. The Veteran has not filed a motion for reconsideration of the June 1986 Board decision, nor has such reconsideration been ordered by the Chairman of the Board. The Veteran also did not appeal the decision to the Court of Appeals for Veterans Claims within the prescribed period of time. Accordingly, the June 1986 Board decision is final. See 38 U.S.C. § 7104; 38 C.F.R. § 20.1100. VA received the Veteran’s petition to reopen the previously denied claim for service connection for a skin disorder as a residual of exposure to Agent Orange in August 1996. The Regional Office denied the Veteran’s petition in the November 1996 administrative decision, explaining that the claimed condition was not among the conditions newly added to the list Agent Orange-related presumptive conditions. The Veteran did not timely appeal the November 1996 decision, and new and material evidence was not received as to the issue within the one-year appeal period following notice of the decision. See 38 C.F.R. §§ 3.156(b), 20.201, 20.202. The November 1996 decision is therefore final. 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. VA received the Veteran’s original claim for entitlement to service connection for arthritis in multiple joints, including the back, legs, and knees, in October 1997. The Regional Office denied the Veteran’s claim in the December 1997 rating decision, explaining that the service treatment records are negative for record of treatment in service for arthritis of the back, legs, and knees. Although the Veteran was diagnosed with arthritis of multiple joints at the time of the rating decision, there was no evidence of a link between that diagnosis, more than 25 years after the Veteran’s discharge from active service, and his military service. The Veteran did not timely appeal the December 1997 rating decision, and new and material evidence was not received as to the issue within the one-year appeal period following notice of the decision. See 38 C.F.R. §§ 3.156(b), 20.201, 20.202. The December 1997 rating decision is therefore final. 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. VA received the Veteran’s original claim for entitlement to service connection for an eye condition, claimed as due to an in-service head injury, in December 1998. In February 2002, the Veteran specified that the eye condition at issue was glaucoma. The Regional Office denied the Veteran’s claim in the May 2002 rating decision, explaining that the Veteran’s service treatment records are negative for treatment or diagnosis of glaucoma of the right eye and that the Veteran’s currently diagnosed glaucoma of the right eye neither occurred in nor was caused by his active service. The Veteran did not timely appeal the May 2002 rating decision, and new and material evidence was not received as to the issue within the one-year appeal period following notice of the decision. See 38 C.F.R. §§ 3.156(b), 20.201, 20.202. The May 2002 rating decision is therefore final. 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. VA received the Veteran’s petition to reopen the previously denied claim for service connection for a skin disorder in February 2006. In that petition, the Veteran asserted that his skin condition was a result of in-service exposure to Agent Orange and that he has had the condition ever since he left Vietnam. The Regional Office denied the Veteran’s petition in the July 2006 rating decision, explaining that the additional evidence was not new and material because it did not establish that the Veteran suffered from a current skin condition that was due to exposure to Agent Orange or that occurred in or was caused by his active military service. The Veteran did not timely appeal the July 2006 rating decision, and new and material evidence was not received as to the issues within the one-year appeal period following notice of the decision. See 38 C.F.R. §§ 3.156(b), 20.201, 20.202. The July 2006 rating decision is therefore final. 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. VA received the Veteran’s petition to reopen the previously denied claims for service connection for a skin disorder as a residual of exposure to Agent orange, for residuals of a head injury, and for glaucoma of the right eye in April 2009. In that petition, the Veteran asserted that his skin condition was a result of in-service exposure to Agent Orange and that he has had the condition ever since he left Vietnam. He also asserted that his glaucoma of the right eye is due to an in-service head injury. The evidence of record at the time of the April 2009 petition also included arguments from the Veteran that his glaucoma is secondary to his service-connected diabetes mellitus or due to in-service exposure to Agent Orange. The Regional Office denied the Veteran’s petition in the December 2009 rating decision, explaining that additional evidence was new but not material because it did not link any current disability to the Veteran’s service, to include an in-service head injury or in-service exposure to Agent Orange.. The Veteran did not timely appeal the December 2009 rating decision, and new and material evidence was not received as to the issues within the one-year appeal period following notice of the decision. See 38 C.F.R. §§ 3.156(b), 20.201, 20.202. The December 2009 rating decision is therefore final. 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. 2. The petitions to reopen the previously denied claims for entitlement to service connection for a low back condition, arthritis of the legs, and degenerative arthritis of the knees Evidence associated with the record since issuance of the final December 1997 rating decision that is relevant to the claims for service connection for a low back condition, arthritis of the legs, and degenerative arthritis of the knees includes additional medical treatment records and the Veteran’s contentions as to why he believes service connection is warranted. The Veteran’s assertions to the effect that his low back, leg, and knee conditions had their onset during his active service merely reiterate his previously considered contentions. Those assertions are therefore redundant of evidence previously considered and are not considered to be new evidence. His assertions to the effect that his low back, leg, and knee conditions are etiologically related to in-service exposure to Agent Orange or are secondary to service-connected diabetes mellitus are new because they were not previously considered by VA, but they are not material because they do not relate to an unestablished fact necessary to substantiate the claim. Specifically, even if presumed to be credible, the Veteran’s statements are not considered competent. The claimed conditions are not on the list of diseases associated with exposure to herbicide agents in 38 C.F.R. § 3.309(e), and the Veteran has presented no competent evidence that the conditions may be secondary to his service-connected diabetes mellitus. His assertions do not trigger VA’s duty to assist in providing a VA examination. In that regard, the Board notes that although medically competent evidence is not always required to trigger VA’s duty to assist by providing a VA examination, a conclusory generalized lay statement suggesting a nexus between a current disability and service does not suffice to meet the standard of 38 C.F.R. § 3.159(c)(4)(i)(B), as this would, contrary to the intent of Congress, result in medical examinations being “routinely and virtually automatically” provided to all veterans claiming service connection. See Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010); Colantonio v. Shinseki, 606 F.3d 1378 (Fed. Cir. 2010). In this case, the only evidence that the Veteran’s low back, leg, and knee conditions may be related to in-service exposure to herbicide agents or secondary to a service-connected disability is the Veteran’s own conclusory generalized lay statements. Accordingly, the Board finds that there is no evidence establishing a sufficient indication that the low back, leg, and knee conditions may be related to an in-service event, injury, or disease such that the additional contentions from the Veteran, when considered with evidence previously of records, trigger VA’s duty to assist such that reopening is required. See also McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006) (whether a claimant suffered an “in-service event, injury, or disease” under the second prong involves “a classic factual assessment, involving the weighing of facts”). In addition, the additional medical treatment records do not show any link between a current low back, leg, or knee condition and the Veteran’s active service or a service-connected disability. They merely show continued complaints of and treatment for such conditions. Thus, the medical treatment records are new in the sense that they were not previously considered by VA. However, they are not material because they do not relate to an unestablished fact necessary to substantiate the previously denied claim and/or do not raise a reasonable possibility of substantiating the previously denied claim, as they are cumulative of evidence previously considered. 38 C.F.R. § 3.156. In view of the foregoing, the Board finds that the evidence of record contains no new and material evidence received since the final December 1997 rating decision as to the previously denied claims for entitlement to service connection for a low back condition, arthritis of the legs, and degenerative arthritis of the knees. Therefore, new and material evidence to reopen the finally denied claims has not been received, the benefit-of-the-doubt doctrine is not for application, and the claims for entitlement to service connection for a low back condition, arthritis of the legs, and degenerative arthritis of the knees are not reopened. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 3. The petitions to reopen the previously denied claims for entitlement to service connection for glaucoma of the right eye; rash on the scrotum, penis, buttocks, shoulders, and arms; and residuals of a head injury, to include headaches Evidence associated with the record since issuance of the final December 2009 rating decision that is relevant to the claims for service connection for glaucoma of the right eye; rash on the scrotum, penis, buttocks, shoulders, and arms; and residuals of a head injury includes additional medical treatment records, a December 2011 VA examination regarding the Veteran’s glaucoma, and the Veteran’s contentions as to why he believes service connection is warranted. The Veteran’s assertions to the effect that his glaucoma, rash, and head injury residuals, to include headaches, had their onset during his active service and that his glaucoma and rash are due to in-service exposure to Agent Orange merely reiterate his previously considered contentions. Those assertions are therefore redundant of evidence previously considered and are not considered new evidence. The December 2011 VA examination includes an opinion that it is not at least as likely as not that the Veteran’s glaucoma is related to his diabetes mellitus. That negative opinion is not material because it does not support the Veteran’s claim for service connection. The additional medical treatment records do not show any link between current glaucoma, rash, or a condition attributable to a head injury, such as headaches, and the Veteran’s active service. They merely show continued complaints of and treatment for such conditions. Thus, the medical treatment records are new in the sense that they were not previously considered by VA. However, they are not material because they do not relate to an unestablished fact necessary to substantiate the previously denied claim and/or do not raise a reasonable possibility of substantiating the previously denied claim, as they are cumulative of evidence previously considered. 38 C.F.R. § 3.156. In view of the foregoing, the Board finds that the evidence of record contains no new and material evidence received since the final December 2009 rating decision as to the previously denied claims for entitlement to service connection for glaucoma of the right eye; rash on the scrotum, penis, buttocks, shoulders, and arms; and residuals of a head injury. Therefore, new and material evidence to reopen the finally denied claims has not been received, the benefit-of-the-doubt doctrine is not for application, and the claims for entitlement to service connection for glaucoma of the right eye; rash on the scrotum, penis, buttocks, shoulders, and arms; and residuals of a head injury are not reopened. Gilbert, 1 Vet. App. 49; 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Service Connection Issues 4. Entitlement to service connection for a cervical spine disability and for enlarged prostate with urinary frequency The Veteran contends that his current cervical spine disability and enlarged prostate with urinary frequency are related to in-service exposure to Agent Orange or are secondary to his service-connected diabetes mellitus. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, although the Veteran has a current diagnosis for a cervical spine disability and has received treatment for an enlarged prostate and urinary frequency, the preponderance of the evidence weighs against finding that those conditions began during the Veteran’s active service or are otherwise related to an in-service injury, event, or disease. The Veteran has not contended, and the record does not show, that he suffered an in-service injury or disease that may have caused a current cervical spine disability or enlarged prostate and urinary frequency. The service treatment records that are available for review are absent for evidence of complaint of or treatment for a cervical spine condition, prostate condition, or urinary frequency. A February 1972 report of medical examination, which was conducted shortly after the Veteran’s separation from active service for the purpose of his enlistment into the Army National Guard, shows that the Veteran had normal evaluations of the spine and genitourinary system. On a corresponding February 1972 report of medical history, the Veteran denied current or prior frequent or painful urination or bone, joint, or other deformity. A report of medical examination and a report of medical history dated in July 1978 include identical findings. The earliest evidence of a diagnosed cervical spine, prostate, or urinary condition is dated many years after the Veteran’s separation from active service. Of note, a February 1991 treatment note indicates that the Veteran reported acute cervical strain since a motor vehicle accident two months prior. An October 1991 treatment note states that the Veteran had neck pain ever since a December 1990 motor vehicle accident. Those treatment notes place the onset of cervical spine symptoms at nearly two decades after the Veteran’s separation from active service and clearly show that they are due to a post-service motor vehicle accident. Accordingly, the record does not show a complaint or diagnosis of a cervical spine condition, an enlarged prostate, or urinary frequency during service or within one year of the Veteran’s separation from active service. The Board has considered the Veteran’s assertions that his cervical spine condition and enlarged prostate either are due to in-service exposure to herbicide agents or are secondary to his service-connected diabetes mellitus. However, the Veteran is not considered competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires specialized medical knowledge of the effects of chemical exposures and the interaction between multiple bodily systems. The Veteran has not been shown to possess such knowledge. Therefore, such an opinion is outside the competence of the Veteran. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives no probative value to the Veteran’s statements. In addition, the Veteran’s claimed cervical spine condition, enlarged prostate, and urinary frequency are not on the list of diseases associated with exposure to herbicide agents in 38 C.F.R. § 3.309(e). Therefore, they may not be presumed to be associated with in-service exposure to herbicide agents under the provisions of 38 C.F.R. § 3.307(a)(6). Furthermore, the Veteran has presented no competent evidence that the claimed conditions may be due to in-service herbicide exposure or that they may be secondary to his service-connected diabetes mellitus. As discussed above, although medically competent evidence is not always required to trigger VA’s duty to assist by providing a VA examination, a conclusory generalized lay statement suggesting a nexus between a current disability and service does not suffice to meet the standard of 38 C.F.R. § 3.159(c)(4)(i)(B), as this would, contrary to the intent of Congress, result in medical examinations being “routinely and virtually automatically” provided to all veterans claiming service connection. See Waters, 601 F.3d 1274; Colantonio, 606 F.3d 1378. In this case, the only evidence that the Veteran’s cervical spine condition, enlarged prostate, or urinary frequency may be related to in-service exposure to herbicide agents or secondary to a service-connected disability is the Veteran’s own conclusory generalized lay statements. As such, VA is not required to provide him a VA examination. See also McLendon, 20 Vet. App. at 81. Moreover, the Board concludes that there is no probative evidence of record showing that the Veteran’s cervical spine condition, enlarged prostate, or urinary frequency may be related to in-service exposure to herbicide agents or secondary to the service-connected diabetes mellitus. In summary, the preponderance of the evidence is against finding that the Veteran’s cervical spine disability or enlarged prostate with urinary frequency began during active service or are otherwise related to an in-service injury or disease. In view of the foregoing, the Board concludes that the preponderance of the evidence is against the claims for entitlement to service connection for a cervical spine disability and for an enlarged prostate with urinary frequency. Because the preponderance of the evidence is against the claims, the benefit-of-the-doubt doctrine is not for application, and the claims must be denied. 38 U.S.C. § 5107(b); see also Gilbert, 1 Vet. App. 49. Other Issues 5. Entitlement to special adapted housing The Veteran contends that he is entitled to special home adaptation or specially adapted housing because he has difficulty walking up and down the steps to his home due to knee pain and because he has lost sight in one eye due to glaucoma. Specially adapted housing is available to a veteran who is entitled to compensation for permanent and total disability due to: (1) amyotrophic lateral sclerosis rated as 100 percent disabling under 38 C.F.R. § 4.124a, Diagnostic Code 8017; (2) blindness in both eyes, having only light perception, plus the anatomical loss or loss of use of one lower extremity; (3) full thickness or subdermal burns that have resulted in contractures with limitation of motion of two or more extremities or of at least one extremity and the trunk; or (4) the loss or loss of use of both upper extremities such as to preclude use of the arms at or above the elbows. Specially adapted housing is also available to a veteran with a permanent and total disability that precludes locomotion without the aids of braces, crutches, canes, or a wheelchair due to: (5) the loss, or loss of use, of both lower extremities; (6) the loss or loss of use of one lower extremity, together with residuals of organic disease or injury which affect the functions of balance and propulsion; or, (7) the loss or loss of use of one lower extremity together with the loss or loss of use of one upper extremity which affect the functions of balance or propulsion. 38 U.S.C. § 2101(a); 38 C.F.R. § 3.809(a), (b), (d). Specially adapted housing may also be available to a veteran who served on or after September 11, 2001, who has a permanent disability that was incurred during such service, and which results in loss or loss of use of one or more extremities which so affects the functions of balance or propulsion as to preclude ambulating without the aids of braces, crutches, canes, or a wheelchair. See 38 U.S.C. § 2101(a)(2)(C). If entitlement to specially adapted housing is not established, a veteran can qualify for a grant for necessary special home adaptations if he has a service-connected disability that results in blindness in both eyes with 20/200 visual acuity or less in the better eye with the use of a standard correcting lens or a limitation in fields of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees; such a disability need not be permanent and total in nature. Additionally, a special home adaptation grant is available for a veteran that has a permanent and total disability which: (1) includes the anatomical loss or loss of use of both hands; (2) is due to deep partial thickness burns that have resulted in contracture(s) with limitation of motion of two or more extremities or of at least one extremity and the trunk; (3) is due to full thickness or subdermal burns that have resulted in contracture(s) of one or more extremities or the truck; or, (4) is due to residuals of an inhalation injury (including, but not limited to, pulmonary fibrosis, asthma, and chronic obstructive pulmonary disease). 38 C.F.R. § 3.809a(b). Generally, an eligible veteran will be provided one-time only assistance with a special home adaptation grant or specially adapted housing. However, issuance of a special home adaptation grant before a veteran becomes eligible for specially adapted housing under 38 C.F.R. § 3.809 does not preclude a later grant for specially adapted housing. 38 C.F.R. § 3.809a(a). The Veteran is service connected for diabetes mellitus with erectile dysfunction, hypertension, and peripheral vascular disease; chronic diabetic nephropathy; bilateral leg peripheral neuropathy with pedal edema; gout of the bilateral feet; hypertensive cardiomyopathy; tinea pedis; and posttraumatic stress disorder. He has a combined disability rating of 100 percent. Accordingly, several of the criteria for entitlement to specially adapted housing or a special home adaptation grant are not applicable in this case. Specifically, the Veteran is not service connected for amyotrophic lateral sclerosis; for a disability that results in blindness in both eyes, full thickness or subdermal burns, or functional impairment of either upper extremity; or for an inhalation injury. The only potentially applicable criterion for entitlement is loss of use of one or both lower extremities. “Loss of use” is not specifically defined under 38 C.F.R. § 3.809 or 3.809a. Regulations pertaining to special monthly compensation for loss of use of a hand or foot state that loss of use is held to exist when no effective function remains other than that which would be equally well served by an amputation with use of a suitable prosthetic appliance. The determination should be made on the basis of the actual remaining function, such as the ability balance or to propel oneself forward. See 38 C.F.R. §§ 3.350(a)(2), 4.63. The Court of Appeals for Veterans Claims has found that a “loss of use” exists when there is “deprivation of the ability to avail oneself” of that extremity, and functional impairment caused by pain, weakness, or incoordination should be taken into account when making that determination. See Jensen v. Shulkin, 29 Vet. App. 66, 78-79 (2017). The preponderance of the probative medical evidence demonstrates that the Veteran does not have loss of use of his lower extremities due to a service-connected disability. A December 2011 VA diabetes examination shows that the Veteran’s peripheral neuropathy of the bilateral lower extremities causes numbness and pain. However, on examination he had normal posture and gait, and he had full muscle strength. He reported that he only occasionally uses a cane in relation to his lumbar spine and knees. A January 2018 VA non-degenerative arthritis examination shows that the Veteran experiences pain from his gout about twice per month and has decreased ability to walk and stand during flare-ups in the condition. The examiner indicated that the Veteran does not require an assistive device or have a loss in function such that he would be equally served by an amputation with prosthesis due to the service-connected gout. A December 2018 VA non-degenerative arthritis examination shows that the Veteran’s gout causes pain with standing and ambulating for durations. The examiner indicated that the Veteran does not require an assistive device or have a loss in function such that he would be equally served by an amputation with prosthesis due to the service-connected gout. A December 2018 VA diabetic sensory-motor peripheral neuropathy examination shows that the Veteran’s service-connected peripheral neuropathy causes decreased sensation in the feet and toes and decreased sensation to vibration and cold in the bilateral lower extremities. However, the Veteran did not have decreased motor strength in the lower extremities. Accordingly, the December 2011. January 2018, and December 2018 VA examinations and the other evidence of record indicate that the Veteran has reduced functioning in the bilateral lower extremities due to his service-connected peripheral neuropathy and gout. However, they show that he maintains functioning above that required for there to be entitlement to specially adapted housing or a special home adaptation grant. Specifically, the record does not show preclusion of use of the lower extremities for balance, propulsion, and other such typical functions due to service-connected disability to an extent that the Veteran would be equally served by a prosthetic appliance. The Board has considered the Veteran’s lay statements regarding his problems with mobility and his need for additional alterations to his home. The Board does not doubt those assertions, as the Veteran is competent to report that he has difficulty walking and performing activities of daily living due to his need for use of an assistive device and due to his nonservice-connected knee pain and glaucoma. See Jandreau, 492 F.3d at 1377. The statements, however, are insufficient to establish entitlement to the benefit sought. The Veteran contends that the benefit sought is warranted due to his knee and vision difficulties. However, as noted above, the Veteran does not have a service-connected knee or eye disability. In summary, the weight of the competent and probative medical evidence preponderates against finding that the Veteran’s service-connected disabilities meet any of the criteria under 38 C.F.R. § 3.809 or 3.809a, and the claim is denied. 6. Entitlement to an effective date prior to August 25, 2010, for the award of service connection for hypertensive cardiomyopathy The Veteran seeks entitlement to an effective date earlier than August 25, 2010, for the award of service connection hypertensive cardiomyopathy. He asserts that he is entitled to an earlier effective date under the Nehmer Court Orders, as set forth in 38 C.F.R. § 3.816. Generally, the effective date for an award of service connection is the day following the date of separation from active service or the date entitlement arose, if the claim is received within one year after separation from service. Otherwise, the effective date is the date of receipt of the claim, or the date entitlement arose, whichever is later. 38 U.S.C. § 5110(a), (b); 38 C.F.R. § 3.400(b). Under 38 C.F.R. § 3.816, if VA denied compensation to a Vietnam veteran, such as the Veteran in this case, for a covered herbicide disease, including ischemic heart disease, in a decision issued between September 25, 1985 and May 3, 1989, the effective date of a later award will be the later of the date VA received the claim on which the prior denial was based or the date the disability arose. If the Vietnam veteran’s claim for disability compensation for the covered herbicide disease was either pending before VA on May 3, 1989, or was received by VA between that date and the effective date of the statute or regulation establishing a presumption of service connection for the covered disease, the effective date of the award will be the later of the date such claim was received by VA or the date the disability arose. Thus, even under the provisions of 38 C.F.R. § 3.816, an effective date cannot be established prior to VA’s receipt of a claim for compensation benefits. Regulations that were in effect prior to March 24, 2015, required that an informal claim “must identify the benefit sought.” See 38 C.F.R. §§ 3.155, 3.160 (2014). The regulations also provided that a claim may be either a formal or informal written communication “requesting a determination of entitlement, or evidencing a belief in entitlement, to a benefit.” 38 C.F.R. § 3.1(p) (2014). The regulations in effect since March 24, 2015, require that claims be submitted on an application form prescribed by the Secretary and do not allow for informal claims not submitted on such a form. See 38 C.F.R. §§ 3.155, 3.160 (2015). The Board will apply the regulations in effect prior to March 24, 2015, to communications received during that period. Under 38 C.F.R. § 3.816, a claim will be considered a claim for compensation for a particular covered herbicide disease if (1) the claimant’s application and other supporting statements and submissions may reasonably be viewed, under the standards ordinarily governing compensation claims, as indicating an intent to apply for compensation for the covered herbicide disability; or (2) VA issued a decision on the claim, between May 3, 1989, and the effective date of the statute or regulation establishing a presumption of service connection for the covered disease, in which VA denied compensation for a disease that reasonably may be construed as the same covered herbicide disease for which compensation has been awarded. Upon careful review of the record, the Board finds that no communication was received from the Veteran prior to August 25, 2010, that could reasonably be construed as a request for a determination of entitlement, or that evidences a belief in entitlement, to service connection for ischemic heart disease or hypertensive cardiomyopathy. In addition, VA did not issue a decision between May 3, 1989, and the effective date for the statute or regulation establishing presumptive service connection for ischemic heart disease that denied compensation for a disease that may reasonably be construed as ischemic heart disease. The Veteran has not identified such an earlier claim, and the record does not show such an earlier claim. The Board notes that in correspondence received in December 1998 the Veteran stated, “The accident in Vietnam about my head was my head received [stitches] on top of head. And doctors are not please with the way my heart function. I also know that PTSD can link to other diseases and are more likely with PTSD will have heart disease and other disorder of digestive respiratory and skeletal system (check my medical records also on my heart).” Although the statement references heart functions and asks VA to “check my medical records also on my heart”, the statement does not identify any particular benefit sought, such as service connection for a heart condition, or request a determination of entitlement, or evidence a belief in entitlement, to a particular benefit. Therefore, the Board finds that the December 1998 statement does not meet the requirements for an informal claim under 38 C.F.R. §§ 3.1, 3.155, and 3.160 as in effect prior to March 24, 2015, and that the statement cannot serve as the basis for an earlier effective date for the award of service connection for hypertensive cardiomyopathy. Accordingly, there is no basis in the record for establishing service connection for that condition earlier than August 25, 2010. See 38 C.F.R. § 3.400. In view of the foregoing, the Board concludes that no communication was received from the Veteran prior to August 25, 2010, that may reasonably be construed as a formal or informal claim for entitlement to service connection for hypertensive cardiomyopathy or any other ischemic heart disease. Therefore, an effective date prior to August 25, 2010, for the award of service connection for hypertensive cardiomyopathy cannot be established. See 38 C.F.R. § 3.400. The preponderance of the evidence is against the assignment of an effective date earlier than August 25, 2010, for that award, and the appeal must be denied. 38 U.S.C. § 5107(b); see also Gilbert, 1 Vet. App. 49. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. J. Anthony, 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.