Citation Nr: 20021896 Decision Date: 03/27/20 Archive Date: 03/27/20 DOCKET NO. 16-29 868 DATE: March 27, 2020 ORDER Entitlement to service connection for a heart disorder is denied. Entitlement to service connection for a left arm and shoulder disorder is denied. Entitlement to service connection for a right arm and shoulder disorder is denied. Entitlement to service connection for a cervical spine disorder is denied. REMANDED Entitlement to service connection for metatarsalgia is remanded. Entitlement to service connection for calluses of the bilateral great toes is remanded. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has had a heart disorder at any time during or approximate to the pendency of the claim. 2. The Veteran has not been shown to have a left arm and shoulder disorder that manifested in service or within one year thereafter or that is otherwise causally or etiologically related to his military service. 3. The Veteran has not been shown to have a right arm and shoulder disorder that manifested in service or within one year thereafter or that is otherwise causally or etiologically related to his military service. 4. The Veteran has not been shown to have a cervical spine disorder that manifested in service or within one year thereafter or that is otherwise causally or etiologically related to his military service. CONCLUSIONS OF LAW 1. The criteria for service connection for a heart disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. A left arm and shoulder disorder was not incurred in active service, and arthritis may not be presumed to have been so incurred. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309 (2018). 3. A right arm and shoulder disorder was not incurred in active service, and arthritis may not be presumed to have been so incurred. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309 (2018). 4. A cervical spine disorder was not incurred in active service, and arthritis may not be presumed to have been so incurred. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1974 to April 1976, from April 1976 to May 1978, and from May 1978 to January 1987. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a January 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. The Board remanded the case for further development in July 2018. That development has been completed, and the case has been returned to the Board for appellate review. Regarding the issues decided herein, the Board finds that the RO substantially complied with prior remand directives, to the extent possible, and no further action in this regard is warranted. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999) (concluding that a remand is not required under Stegall v. West, 11 Vet. App. 268 (1998) where there was substantial compliance with the Board's remand instructions). The Board notes that there are VA records that were added to the claims file after the May 2019 supplemental statement of the case (SSOC) for which there is not an automatic waiver of initial AOJ consideration. 38 U.S.C. § 7105(e) (automatic waiver of new evidence does not apply to evidence developed by VA). However, the Board finds that the additional VA treatment records and examinations are not relevant to the issues on appeal. Thus, the additional evidence does not materially alter the outcome of the case. Accordingly, the Board finds that a remand for initial AOJ review of this evidence is not necessary, and there is no prejudice to the Veteran in proceeding with adjudication of the claim. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (noting that remands which would only result in unnecessarily imposing additional burdens on VA with no benefit flowing to the veteran are to be avoided). Additionally, the Veteran was granted a 90-day extension of time in December 2019 but has not submitted any additional evidence and/or argument in support of the appeal. Law and Analysis The Veteran has not raised any issues with the duty to notify or duty to assist. 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). Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty in the active military, naval, or air service. 38 U.S.C. §§ 1110, 1131. That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease. If there is no showing of a resulting chronic condition during service, then a showing of continuity of symptomatology after service is required to support a finding of chronicity. 38 C.F.R. § 3.303(b). Service connection may also 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). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. As arthritis is a chronic disease for VA compensation purposes, if chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). In addition, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including arthritis, are presumed to have been incurred in service if they manifested to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. §§ 1110, 1131; Degmetich v. Brown, 104 F.3d. 1328, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). Evidence must show that the Veteran currently has the disability for which benefits are being claimed. In the absence of proof of a present disability due to disease or injury that occurred in service, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Sanchez-Benitez v. Principi, 259 F.3d. 1356 (2001). The requirement for a current disability is satisfied when a claimant has a disability either at the time a claim for VA compensation is filed, or at any time during the pendency of that claim. A claimant may be granted service connection even though the disability resolves prior to the Secretary’s adjudication of the claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information and lay and medical evidence of record in a case. 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; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the weight of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). 1. Entitlement to service connection for a heart disorder In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran is not entitled to service connection for a heart disorder. The Veteran was afforded a VA examination in January 2014. The VA examiner determined that he did not have a current diagnosis of a heart condition. See January 2014 VA examination report. In the examination report, the examiner noted that the Veteran met the voltage criteria for left ventricular hypertrophy based on an EKG associated with the examination. However, the examiner stated that the Veteran had not been diagnosed with a heart disorder. The examiner also noted that in response to an interview-based METs test, the Veteran denied experiencing symptoms with any level of physical activity. Following remand, the Veteran had another VA examination in February 2019. A physical examination was normal, and the Veteran denied any symptoms attributable to a cardiac disorder with any activity such as dyspnea or fatigue in response to the interview-based METs test. There were no physical findings on examination to suggest an enlarged heart. Although an April 2007 EKG showed cardiac hypertrophy, the examiner noted that it was the minimal voltage criteria for left ventricular hypertrophy and was more of a reflection of uncontrolled hypertension. The Veteran has never been diagnosed with a heart disorder and has no history of heart disease. See February 2019 VA examination report. A December 2018 echocardiogram was within normal limits. As noted above, service connection requires a showing of a current disability. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. §§ 1110, 1131; Degmetich v. Brown, 104 F.3d 1328, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). Evidence must show that the veteran currently has the disability for which benefits are being claimed. The evidence shows that the Veteran has not had a current heart disorder or symptoms thereof that caused a functional impairment during the pendency of the appeal. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consequently, the Board concludes that service connection is not warranted, and no discussion of the remaining elements is necessary. See Coburn v. Nicholson, 19 Vet. App. 427, 431 (2006) (the absence of any one element will result in denial of service connection). For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for a heart disorder, and the claim must be denied. As the preponderance of the evidence is against the claim for service connection for a heart disorder, the benefit of the doubt doctrine is not for application. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 2. Entitlement to service connection for a left arm and shoulder disorder In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran is not entitled to service connection for a left arm and shoulder disorder. The Veteran’s service treatment records document a one-centimeter laceration of the left lateral upper arm in January 1976 but are otherwise negative for any complaints, treatment or diagnosis of a left arm and shoulder injury or disorder. In fact, the November 1986 separation examination found his upper extremities to be normal and on the separation report of medical history, the Veteran checked the box “Yes” for past or present venereal disease but denied having a medical history of swollen or painful joints, arthritis, rheumatism or bursitis. See AZ v. Shinseki, 731 F.3d 1303, 1318 (Fed. Cir. 2013) (recognizing the widely-held view that the absence of an entry in a record may be considered evidence that the fact did not occur if it appears that the fact would have been recorded if present). The Board notes that neither arthritis nor manifestations sufficient to identify the disease entity are shown during service. The pertinent regulations require that manifestations are “noted” in the service records and that is not the case in this instance. Therefore, while arthritis is a chronic disease under 38 C.F.R. § 3.309(a), no notations of the disease or any characteristic manifestations were shown in the service records. As such, service connection under 38 C.F.R. § 3.303(b) is not warranted, and degenerative arthritis may not be presumed to have been incurred in service. 38 U.S.C. § 1101; 38 C.F.R. §§ 3.307, 3.309. Moreover, there is no objective x-ray evidence of arthritis within one year of the Veteran’s military service. In fact, there is no medical evidence pertaining to a left arm and shoulder disorder for many years thereafter. The Board does acknowledge the Veteran’s statements that he injured his shoulders and arms in service and has had continuing pain since that time, particularly in cold weather. See January 2013 correspondence. Lay persons are competent to report observable symptoms, such as problems since the Veteran’s military service. Layno v. Brown, 6 Vet. App. 465, 469 (1994); Barr v. Nicholson, 21 Vet. App. 303 (2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). A veteran can attest to factual matters of which he had first-hand knowledge, e.g., experiencing pain in service, reporting to sick call, being placed on limited duty, and undergoing physical therapy. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). The Federal Circuit has held that lay evidence is one type of evidence that must be considered and competent lay evidence can be sufficient in and of itself. The Board, however, retains the discretion to make credibility determinations and otherwise weigh the evidence submitted, including lay evidence. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006). Once evidence is determined to be competent, the Board must determine whether such evidence is also credible. See Layno v. Brown, 6 Vet. App. 465 (1994) (distinguishing between competency (“a legal concept determining whether testimony may be heard and considered”) and credibility (“a factual determination going to the probative value of the evidence to be made after the evidence has been admitted”)); see also Barr v. Nicholson, 21 Vet. App. 303 (2007). In this case, although the Veteran is competent to report an injury in service and symptoms since that time, the Board finds that such statements are not reliable or credible. The allegations are inconsistent with the contemporaneous record. As discussed above, the Veteran’s upper extremities were found to be normal at the time of his November 1986 separation examination. Thus, there was actually affirmative medical evidence showing that he did not have a left arm and shoulder disorder at the time of his separation from service (rather than a mere absence of treatment or documentation). For these reasons, the Board finds the reports of onset and continuity of symptomatology to be not reliable or credible. Therefore, the Board concludes that the weight of the competent, credible, and probative evidence shows that a left arm and shoulder disorder did not manifest in service or for many years thereafter. In addition to the lack of evidence showing that the claimed disorder manifested during active duty service or within close proximity thereto, the evidence of record does not link any current diagnosis to the Veteran’s military service. The Veteran was afforded a VA examination in January 2014 in connection with his claim. However, the examiner did not examine the left arm and shoulder, only the right. The Veteran was provided another VA examination in February 2019, and he was diagnosed with bilateral glenohumeral joint osteoarthritis, confirmed by imaging studies. The examiner opined that his left arm and shoulder arthritis is less likely than not related to military service. The examiner explained that the current findings of arthritis in the arms and shoulders are age-related degenerative changes and occurred subsequent to discharge. The examiner noted that there were no complaints of arm and shoulder problems at time of separation and degenerative arthritis is very common for the Veteran’s age. See February 2019 VA examination report. There is no medical opinion otherwise relating a current left arm and shoulder disorder to the Veteran’s military service. The Board has considered the Veteran’s lay statements that his current left arm and shoulder disorder is related to his military service. Although lay persons are competent to provide opinions on some medical issues, Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), the specific issue in this case, the etiology of the disorder, falls outside the realm of common knowledge of a lay person, particularly in light of the delayed onset of the disorder. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Moreover, even assuming that the Veteran is competent to provide such an opinion, the Board finds that the VA examiner’s opinion is more probative, as it was based on a review of the claims file, including the Veteran’s own reported history and lay statements, and is supported by rationale. The VA physician also relied on his own knowledge, training, and expertise as a medical professional. Based on the foregoing, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for a left arm and shoulder disorder. Because the preponderance of the evidence is against the Veteran’s claim, the benefit of the doubt provision does not apply. Accordingly, the Board concludes that service connection for a left arm and shoulder disorder is not warranted. 3. Entitlement to service connection for a right arm and shoulder disorder In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran is not entitled to service connection for a right arm and shoulder disorder. The Veteran’s service treatment records are negative for any complaints, treatment or diagnosis of a right arm and shoulder injury or disorder. In fact, the November 1986 separation examination found his upper extremities to be normal and on the separation report of medical history, the Veteran checked the box “Yes” for past or present venereal disease but denied having a medical history of swollen or painful joints, arthritis, rheumatism or bursitis. See AZ v. Shinseki, 731 F.3d 1303, 1318 (Fed. Cir. 2013) (recognizing the widely-held view that the absence of an entry in a record may be considered evidence that the fact did not occur if it appears that the fact would have been recorded if present). The Board notes that neither arthritis nor manifestations sufficient to identify the disease entity are shown during service. The pertinent regulations require that manifestations are “noted” in the service records and that is not the case in this instance. Therefore, while arthritis is a chronic disease under 38 C.F.R. § 3.309(a), no notations of the disease or any characteristic manifestations were shown in the service records. As such, service connection under 38 C.F.R. § 3.303(b) is not warranted, and degenerative arthritis may not be presumed to have been incurred in service. 38 U.S.C. § 1101; 38 C.F.R. §§ 3.307, 3.309. Moreover, there is no objective x-ray evidence of arthritis within one year of the Veteran’s military service. In fact, there is no medical evidence pertaining to a right arm and shoulder disorder for many years thereafter. The Board does acknowledge the Veteran’s statements that he injured his shoulders and arms in service and has had continuing pain since that time, particularly in cold weather. See January 2013 correspondence. Lay persons are competent to report observable symptoms, such as problems since the Veteran’s military service. Layno v. Brown, 6 Vet. App. 465, 469 (1994); Barr v. Nicholson, 21 Vet. App. 303 (2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). A veteran can attest to factual matters of which he had first-hand knowledge, e.g., experiencing pain in service, reporting to sick call, being placed on limited duty, and undergoing physical therapy. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). The Federal Circuit has held that lay evidence is one type of evidence that must be considered and competent lay evidence can be sufficient in and of itself. The Board, however, retains the discretion to make credibility determinations and otherwise weigh the evidence submitted, including lay evidence. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006). Once evidence is determined to be competent, the Board must determine whether such evidence is also credible. See Layno v. Brown, 6 Vet. App. 465 (1994) (distinguishing between competency (“a legal concept determining whether testimony may be heard and considered”) and credibility (“a factual determination going to the probative value of the evidence to be made after the evidence has been admitted”)); see also Barr v. Nicholson, 21 Vet. App. 303 (2007). In this case, although the Veteran is competent to report an injury in service and symptoms since that time, the Board finds that such statements are not reliable or credible. The allegations are inconsistent with the contemporaneous record. As discussed above, the Veteran’s upper extremities were found to be normal at the time of his November 1986 separation examination. Thus, there was actually affirmative medical evidence showing that he did not have a right arm and shoulder disorder at the time of his separation from service (rather than a mere absence of treatment or documentation). For these reasons, the Board finds the reports of onset and continuity of symptomatology to be not reliable or credible. Therefore, the Board concludes that the weight of the competent, credible, and probative evidence shows that a right arm and shoulder disorder did not manifest in service or for many years thereafter. In addition to the lack of evidence showing that the claimed disorder manifested during active duty service or within close proximity thereto, the evidence of record does not link any current diagnosis to the Veteran’s military service. The Veteran was afforded a VA examination in January 2014 in connection with his claim. X-rays confirmed mild degenerative changes of the acromioclavicular joint. However, the examiner failed to provide a nexus opinion. The Veteran was provided another VA examination in February 2019, and he was diagnosed with bilateral glenohumeral joint osteoarthritis, confirmed by imaging studies. The examiner opined that his right arm and shoulder arthritis is less likely than not related to military service. The examiner explained that the current findings of arthritis in the arms and shoulders are age-related degenerative changes and occurred subsequent to discharge. The examiner noted that there were no complaints of arm and shoulder problems at time of separation and degenerative arthritis is very common for the Veteran’s age. See February 2019 VA examination report. There is no medical opinion otherwise relating a current right arm and shoulder disorder to the Veteran’s military service. The Board has considered the Veteran’s lay statements that his current right arm and shoulder disorder is related to his military service. Although lay persons are competent to provide opinions on some medical issues, Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), the specific issue in this case, the etiology of the disorder, falls outside the realm of common knowledge of a lay person, particularly in light of the delayed onset of the disorder. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Moreover, even assuming that the Veteran is competent to provide such an opinion, the Board finds that the VA examiner’s opinion is more probative, as it was based on a review of the claims file, including the Veteran’s own reported history and lay statements, and is supported by rationale. The VA physician also relied on his own knowledge, training, and expertise as a medical professional. Based on the foregoing, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for a right arm and shoulder disorder. Because the preponderance of the evidence is against the Veteran’s claim, the benefit of the doubt provision does not apply. Accordingly, the Board concludes that service connection for a right arm and shoulder disorder is not warranted. 4. Entitlement to service connection for a cervical spine disorder In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran is not entitled to service connection for a cervical spine disorder. The Veteran’s service treatment records are negative for any complaints, treatment or diagnosis of a neck injury or disorder. An April 1985 treatment record documents swollen lymph nodes and a diagnosis of viral syndrome; however, there is no indication of any problems relating to the cervical spine during service. In fact, the November 1986 separation examination found his spine to be normal and on the separation report of medical history, the Veteran checked the box “Yes” for past or present venereal disease, but he denied having a medical history of swollen or painful joints, recurrent back pain, arthritis, rheumatism or bursitis. See AZ v. Shinseki, 731 F.3d 1303, 1318 (Fed. Cir. 2013) (recognizing the widely-held view that the absence of an entry in a record may be considered evidence that the fact did not occur if it appears that the fact would have been recorded if present). The Board notes that neither arthritis nor manifestations sufficient to identify the disease entity are shown during service. The pertinent regulations require that manifestations are “noted” in the service records and that is not the case in this instance. Therefore, while arthritis is a chronic disease under 38 C.F.R. § 3.309(a), no notations of the disease or any characteristic manifestations were shown in the service records. As such, service connection under 38 C.F.R. § 3.303(b) is not warranted, and degenerative arthritis may not be presumed to have been incurred in service. 38 U.S.C. § 1101; 38 C.F.R. §§ 3.307, 3.309. Moreover, there is no objective x-ray evidence of arthritis within one year of the Veteran’s military service. In fact, there is no medical evidence pertaining to a cervical spine disorder for many years thereafter. The Board does acknowledge the Veteran’s statements that he injured his neck in service and has had continuing pain since that time, particularly in cold weather. See January 2013 correspondence. Lay persons are competent to report observable symptoms, such as problems since the Veteran’s military service. Layno v. Brown, 6 Vet. App. 465, 469 (1994); Barr v. Nicholson, 21 Vet. App. 303 (2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). A veteran can attest to factual matters of which he had first-hand knowledge, e.g., experiencing pain in service, reporting to sick call, being placed on limited duty, and undergoing physical therapy. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). The Federal Circuit has held that lay evidence is one type of evidence that must be considered and competent lay evidence can be sufficient in and of itself. The Board, however, retains the discretion to make credibility determinations and otherwise weigh the evidence submitted, including lay evidence. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006). Once evidence is determined to be competent, the Board must determine whether such evidence is also credible. See Layno v. Brown, 6 Vet. App. 465 (1994) (distinguishing between competency (“a legal concept determining whether testimony may be heard and considered”) and credibility (“a factual determination going to the probative value of the evidence to be made after the evidence has been admitted”)); see also Barr v. Nicholson, 21 Vet. App. 303 (2007). In this case, although the Veteran is competent to report an injury in service and symptoms since that time, the Board finds that such statements are not reliable or credible. The allegations are inconsistent with the contemporaneous record. As discussed above, the Veteran’s spine was found to be normal at the time of his November 1986 separation examination. Thus, there was actually affirmative medical evidence showing that he did not have a cervical spine disorder at the time of his separation from service (rather than a mere absence of treatment or documentation). For these reasons, the Board finds the reports of onset and continuity of symptomatology to be not reliable or credible. Therefore, the Board concludes that the weight of the competent, credible, and probative evidence shows that a cervical spine disorder did not manifest in service or for many years thereafter. In addition to the lack of evidence showing that the claimed disorder manifested during active duty service or within close proximity thereto, the evidence of record does not link any current diagnosis to the Veteran’s military service. The Veteran was afforded a VA examination in January 2014 in connection with his claim. The examiner provided a diagnosis of degenerative arthritis, confirmed on MRI. However, the examiner failed to provide a nexus opinion. The Veteran was provided another VA examination in February 2019, and he was diagnosed with degenerative arthritis of the spine, greater at C3-C5, confirmed by imaging studies. The Veteran reported occasional stiffness and pain since 2008. The examiner opined that his cervical spine arthritis is less likely than not related to military service. The examiner explained that the current findings of cervical spine arthritis are age-related degenerative changes and occurred subsequent to discharge. The examiner noted that there were no complaints of neck problems at time of separation and degenerative arthritis is very common for the Veteran’s age. See February 2019 VA examination report. There is no medical opinion otherwise relating a current cervical spine disorder to the Veteran’s military service. The Board has considered the Veteran’s lay statements that his current cervical spine disorder is related to his military service. Although lay persons are competent to provide opinions on some medical issues, Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), the specific issue in this case, the etiology of the disorder, falls outside the realm of common knowledge of a lay person, particularly in light of the delayed onset of the disorder. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Moreover, even assuming that the Veteran is competent to provide such an opinion, the Board finds that the VA examiner’s opinion is more probative, as it was based on a review of the claims file, including the Veteran’s own reported history and lay statements, and is supported by rationale. The VA physician also relied on his own knowledge, training, and expertise as a medical professional. Based on the foregoing, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for a cervical spine disorder. Because the preponderance of the evidence is against the Veteran’s claim, the benefit of the doubt provision does not apply. Accordingly, the Board concludes that service connection for a cervical spine disorder is not warranted. REASONS FOR REMAND 1. Entitlement to service connection for metatarsalgia is remanded. The February 2019 examiner found there was no evidence of metatarsalgia. The Veteran had no current symptoms or pain complaints and no functional loss. See February 2019 VA examination report. The examiner found no evidence to support a current diagnosis. Id. However, the January 2014 examiner diagnosed the Veteran with bilateral metatarsalgia and noted his reports of bilateral foot pain since service. The Veteran reported pain in the balls of his feet and lateral aspects. Imaging studies showed two small calcifications in the plantar soft tissues of the hindfoot. See January 2014 VA examination report. As stated above, the requirement for a current disability is satisfied when a claimant has a disability either at the time a claim for VA compensation is filed, or at any time during the pendency of that claim. A claimant may be granted service connection even though the disability resolves prior to the Secretary’s adjudication of the claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Therefore, even if the Veteran’s metatarsalgia had resolved by the time of the February 2019 VA examination, he could still have a current disability for VA purposes. For these reasons, it is necessary to remand for another examination and medical opinion to determine the nature and etiology of the Veteran’s metatarsalgia. 2. Entitlement to service connection for calluses of the bilateral great toes is remanded. Similarly, the February 2019 examiner did not offer a causation opinion for the claimed condition of calluses, bilateral big toes because the physical examination was normal, and the Veteran had no reported symptoms at that time. See February 2019 VA examination report. However, the January 2014 examiner found mild callus formation of the bilateral great toes, lateral aspect. The Veteran reported recurring calluses on both feet since service, and that he has to file them down. See January 2014 VA examination report; see also April 2013 correspondence (alleging foot pain and calluses on both feet since service and that he has to cut or scrape them off). Therefore, the Board finds that remand for another examination and medical opinion is appropriate to determine the nature and etiology of the Veteran’s claimed condition of calluses of the bilateral great toes. The matters are REMANDED for the following action: 1. The Agency of Original Jurisdiction (AOJ) should request that the Veteran provide the names and addresses of any and all healthcare providers who have provided treatment for a foot disorder. After acquiring this information and obtaining any necessary authorization, the AOJ should obtain and associate these records with the claims file. The AOJ should also secure any outstanding VA treatment records. 2. After completing the foregoing development, the Veteran should be afforded a VA examination to determine the nature and etiology of any bilateral foot disorder that may be present. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran’s service treatment records, military personnel records, post-service medical records, and assertions. The examiner should note that the Veteran is competent to attest to factual matters of which he has first-hand knowledge. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should state this with a fully reasoned explanation. The examiner should identify all current foot disorders, to include any metatarsalgia and calluses of the bilateral great toes. If any previously diagnosed disorder is not found on examination, the examiner should address whether it was misdiagnosed or has resolved. For each diagnosis, the examiner should state whether it is at least as likely as not that the disorder manifested in or is otherwise causally or etiologically related to the Veteran’s military service, to include any symptomatology therein. The examiner should consider the Veteran’s lay statements regarding bilateral foot pain and calluses since service as a result of wearing Army boots. See April 2013 correspondence. (The term “at least as likely as not” does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of the conclusion as it is to find against it.) A clear rationale for all opinions must be provided and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. Because it is important “that each disability be viewed in relation to its history[,]” 38 C.F.R. § 4.1, copies of all pertinent records in the Veteran’s claims file, or in the alternative, the claims file, must be made available to the examiner for review. 3. After completing these actions, the AOJ should conduct any other development as may be indicated by a response received as a consequence of the actions taken in the preceding paragraphs. K.C. Spragins Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D.S. Chilcote, 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.