Citation Nr: 20021926 Decision Date: 03/27/20 Archive Date: 03/27/20 DOCKET NO. 19-33 414 DATE: March 27, 2020 ORDER New and material evidence having been received, the previously denied claim of entitlement to service connection for bilateral hearing loss is reopened. New and material evidence having been received, the previously denied claim of entitlement to service connection for tinnitus is reopened. Entitlement to service connection for erectile dysfunction is denied. Entitlement to service connection for bilateral hearing loss is denied. Entitlement to service connection for tinnitus is granted. Entitlement to service connection for tension headaches is denied. Entitlement to service connection for a bilateral eye condition is denied. Entitlement to service connection for a lung condition is denied. Entitlement to service connection for hypertension is denied. Entitlement to service connection for a lower back condition is denied. Entitlement to service connection for a left hip condition is denied. Entitlement to service connection for a right hip condition is denied. Entitlement to service connection for a right ankle condition is denied. Entitlement to service connection for a left ankle condition is denied. FINDINGS OF FACT 1. A March 1995 Rating Decision denied the claim for bilateral hearing loss and tinnitus on the basis that the Veteran lacked a diagnosis of either condition. Subsequently, new evidence was associated with the file that is material to these claims on appeal. 2. The Veteran does not have a diagnosed erectile dysfunction condition that had an onset during active service or is otherwise related to any incurrence of active duty. 3. Since the filing of the claim, the Veteran’s hearing loss has not met the criteria for a disability for VA purposes. 4. The Veteran did not have a diagnosis of tinnitus upon entry into service, and has experienced tinnitus since December 1994, within one year of his separation from active duty. 5. The Veteran’s current diagnosis of tension headaches is not related to any incurrence of active duty. 6. The Veteran’s bilateral eye condition claimed as sensitivity to light is not related to any service-connected condition. 7. The Veteran does not have a current diagnosis of a lung condition. 8. The Veteran’s hypertension did not manifest during active service and is not otherwise related to any incurrence of active service. 9. The Veteran does not have a diagnosed lower back condition. 10. The Veteran does not have a diagnosed left hip condition. 11. The Veteran does not have a diagnosed right hip condition. 12. The Veteran does not have a diagnosed right ankle condition. 13. The Veteran does not have a diagnosed left ankle condition. CONCLUSIONS OF LAW 1. The criteria to reopen the previously denied claim of entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. §§ 3.156, 20.200, 20.201, 20.302, 20.1103. 2. The criteria to reopen the previously denied claim of entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. §§ 3.156, 20.200, 20.201, 20.302, 20.1103. 3. The criteria for entitlement to service connection for erectile dysfunction have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for entitlement to service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309. 3.385. 5. The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 6. The criteria for entitlement to service connection for tension headaches have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 7. The criteria for entitlement to service connection for a bilateral eye condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 8. The criteria for entitlement to service connection for a lung condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 9. The criteria for entitlement to service connection for hypertension have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 10. The criteria for entitlement to service connection for a lower back condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 11. The criteria for entitlement to service connection for a left hip condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 12. The criteria for entitlement to service connection for a right hip condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 13. The criteria for entitlement to service connection for a right ankle condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 14. The criteria for entitlement to service connection for a left ankle condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had honorable active duty service in the United States Air Force from July 1991 through October 1994. The appeal comes to the Board of Veterans’ Appeals (“Board”) from an August 2015 Rating Decision. As the claims of entitlement to service connection for bilateral hearing loss and tinnitus were denied in a prior decision that became final, it must be initially determined if there is a basis to revisit the merits of the claim. Claims to Reopen A final decision cannot be reopened unless new and material evidence is presented. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a). Evidence is considered “new” if it was not previously submitted to agency decision makers; “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 to be presumed.” Justus v. Principi, 3 Vet. App. 510, 513 (1992). New and material evidence is not required as to each previously unproven element of a claim in order to reopen. Shade v. Shinseki, 24 Vet. App. 110, 120 (2010). There is a low threshold for determining whether evidence raises a reasonable possibility of substantiating a claim. Id. at 117-18. 1. New and material evidence was submitted to reopen the previously denied claim of entitlement to service connection for bilateral hearing loss; and 2. Whether new and material evidence was submitted to reopen the previously denied claim of entitlement to service connection for tinnitus. In this case, the Veteran was denied service connection for bilateral hearing loss and tinnitus in a March 1995 rating decision. This claim was denied on the basis that there was no current diagnosis of either condition. The RO notified the Veteran of this decision and of his right to appeal, but he did not initiate an appeal of the RO’s decision within one year. Nor was any new and material evidence received within a year. 38 C.F.R. § 3.156(b). As a result, the RO’s decision became final. 38 U.S.C. § 7105; 38 C.F.R. §§ 3.156, 20.200, 20.201, 20.302, 20.1103. Accordingly, the claim may now be considered on the merits only if new and material evidence has been received since the time of the prior adjudication. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a); Jackson v. Principi, 265 F.3d 1366 (Fed. Cir. 2001). New evidence associated with the file includes the Veteran’s lay statements of hearing loss and tinnitus, as well as a VA examination that was conducted in April 2015. This new evidence is material and is considered to have a reasonable possibility of substantiating the claims, and as such, reopening of the claims is warranted. 38 C.F.R. § 3.156(a). Service Connection To establish direct service connection, there must be competent evidence showing: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the in-service injury incurred or aggravated during service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303; Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Certain chronic diseases may be presumed to have been incurred in or aggravated by service if manifested to a compensable degree within one year of discharge from service. See 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. In such cases, the disease is presumed under the law to have had its onset in service even though there is no evidence of that disease during the period of service. 38 C.F.R. § 3.307(a). This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. § 1113; 38 C.F.R. §§ 3.307(d), 3.309(a). A showing of chronicity requires a combination of manifestations sufficient to identify a disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word “chronic.” 38 C.F.R. § 3.303(b). When a disease listed at 38 C.F.R. § 3.309(a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service. See 38 C.F.R. § 3.303(b). Continuity of symptomatology may be established if a claimant can demonstrate (1) that a condition was shown in service; (2) evidence of post-service continuity of the same symptomatology; and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. Id.; Savage v. Gober, 10 Vet. App. 488, 495-96 (1997); Walker v. Shinseki, 708 F.3d 1331, 1336, 1339 (Fed. Cir. 2013) (explaining that “shown as such in service” means “clearly diagnosed beyond legitimate question”). However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309(a) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker, 708 F.3d at 1338-39. Generally, a claimant has the responsibility to present and support a claim for benefits. All information, lay evidence and medical evidence in a case is to be considered by the Board in deciding the claim. When there is an approximate balance of positive and negative evidence regarding any material issue, the claimant is to be given the benefit of the doubt. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. Lay evidence, if competent and credible, may serve to establish a nexus in certain circumstances. See Davidson v. Shinseki, 581 F.3d 1313 (2009) (noting that lay evidence is not incompetent merely for lack of contemporaneous medical evidence). When considering whether lay evidence may be competent, the Board must determine, on a case by case basis, whether the Veteran’s particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) (holding that “[w]hether lay evidence is competent and sufficient in a particular case is a factual issue.”). The Board has an obligation to provide reasons and bases supporting its decision, but there is no need to discuss, in detail, every piece of evidence of record. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). The Board’s analysis is to focus specifically on what the evidence shows, or fails to show, on the claim. See Timberlake v. Gober, 14 Vet. App. 122, 129 (2000) (noting that the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant). 3. Entitlement to service connection for erectile dysfunction is denied. The Veteran seeks service connection for erectile dysfunction. It is not found that the evidence in support of the Veteran’s claim for service connection for erectile dysfunction is sufficient to satisfy the current disability element for service connection. However, assuming arguendo that this element was shown, it is concluded that the preponderance of the evidence is still against service connection, as there is no evidence that the claimed condition began during active service, or is otherwise related to an in-service injury, event, or disease. The Veteran does not specify a date of onset of erectile dysfunction and does not present credible evidence of continuous symptoms since service. As such, continuity of symptomatology was not alleged and service connection for a chronic disease or based on chronicity cannot be established. Regarding direct service connection, there is neither evidence of an identified in-service injury or disease to have caused the claimed condition, nor is there any indication in competent medical evidence that erectile dysfunction condition may otherwise be related to service. The Veteran is not considered competent to establish a medical nexus. Under the circumstances where there is no disability, in-service incurrence established, and no competent evidence suggesting a relationship between the current condition and active service, the VA had no obligation to provide a VA examination for this claimed condition. See 38 U.S.C. § 5103A (d). For the foregoing reasons, service connection for erectile dysfunction is denied, and there is no doubt to resolve. 38 C.F.R. §§ 3.102, 3.303, 3.309. 4. Entitlement to service connection for bilateral hearing loss is denied. The Veteran seeks service connection for bilateral hearing loss. For any claim for service connection to prevail, there must be a current disability. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.309. When considering whether lay evidence may be competent to establish the presence of a current disability, the Board must determine, on a case by case basis, whether the claimed disability is the type for which lay evidence may be competent. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) (holding that “[w]heter lay evidence is competent and sufficient in a particular case is a factual issue.”). A disability due to impaired hearing, for the purposes of applying the laws administered by VA, exists only when auditory thresholds in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 40 decibels or greater; or the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or the Maryland CNC Test speech recognition scores are less than 94 percent. 38 C.F.R. § 3.385. There is no diagnosis of hearing loss meeting these standards. Most probative is the April 2015 VA examination, in which the VA examiner conducted air, bone, speech, and tympanometry tests. The VA examination measured pure tone thresholds bilaterally in the frequencies of 500, 1000, 2000, 3000, and 4000 Hertz; the examination report lists measurements at each relevant frequency, but no measurement in either ear at any frequency exceeded 25 decibels. The Veteran’s Maryland CNC speech recognition scores were recorded as 94 percent, right ear; 96 percent, left ear. The VA examiner noted that the Veteran clinically normal hearing, bilaterally, with no hearing loss present. There is no conflict with the April 2015 VA examination in the medical evidence of record. The VA examination is considered the most probative and competent evidence of record, and it does not show that the Veteran has that the Veteran has a hearing loss disability, as defined under 38 C.F.R. § 3.385, as there is no evidence that the Veteran’s auditory thresholds in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are not 40 decibels or greater; nor are his auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz 26 decibels or greater; nor are his Maryland CNC Test speech recognition scores less than 94 percent. Lay statements of record regarding hearing loss are not considered competent evidence to substantiate a diagnosis of hearing loss and are given no weight. Reexamination was considered as an alternative to ruling on the appeal given the age of the VA examination. However, there is no evidence showing the Veteran’s condition has worsened to warrant reexamination. Moreover, the Veteran does not otherwise contend his hearing has worsened and has not submitted any argument on this appeal. Remand for reexamination is not warranted under the circumstances. The Veteran’s claim of entitlement to service connection for bilateral hearing loss fails for lack of a current disability as defined by 38 C.F.R. § 3.385. The preponderance of the evidence is against the claim, and the benefit-of-doubt rule is inapplicable. 38 C.F.R. §§ 3.102, 3.303. 5. Entitlement to service connection for tinnitus is granted. The Veteran seeks service connection for tinnitus. Organic diseases of the nervous system, including tinnitus, will be presumed related to service if they were shown as chronic (reliably diagnosed) in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service, with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303, 3.307, 3.309. The Veteran’s entrance examination is silent for any diagnosis of tinnitus, and the Veteran is presumed to have been sound upon entry. He initially sought service connection for tinnitus in December 1994, within two months of his separation. As the claimed condition was documented as having had an onset during service, or within one year thereafter, and has now been confirmed with the April 2015 VA examination, service connection for such is granted on a presumptive basis. 38 C.F.R. §§ 3.307, 3.309. 6. Entitlement to service connection for tension headaches is denied. The Veteran seeks service connection for a headache condition. Before service, during prescreening in October 1990, the Veteran reported taking minor medication for headaches. During active service, in August 1992, the Veteran reported having headaches. Thereafter, the Veteran’s medical records do not show any report of headaches until 2014. He reported “migraines” after taking Gabapentin. Thereafter, VA records show he was prescribed zolmitriptan for headaches. The Veteran was afforded a VA examination in May 2015. The examiner diagnosed the Veteran with tension headaches and noted that the Veteran reported that the headaches developed while in the military, and continued, worse with stress and tension. They were noted to be non-migraine, and to occur more frequently than once per month. The examiner opined that the claimed condition was less likely than not incurred in or caused by service. The examiner also noted that there was insufficient documentation to show a chronic history of diagnosed headaches from his military days to the present. As an initial matter in this analysis, it is noted that headache conditions are not chronic conditions under 38 C.F.R. § 3.309, and a medical nexus is required to link any current condition confirmed on examination to service. Careful review of the evidence of record does not support a finding of a headache condition that is related to service. The sole competent opinion on the matter is in the May 2015 VA examination. Therein, the examiner opined that the condition was less likely than not related to service. Independent review of the treatment records supports the opinion and the finding that there is inadequate evidence to show a chronic condition. There is no contrary medical opinion of record, and the opinion of the VA examiner is afforded dispositive weight. The Veteran’s report of symptoms is afforded some weight. However, this is not afforded any weight as to etiology, as it is the role of the VA examiner to determine if such is enough to relate the condition to any condition that was shown in service. Finally, the Board must take into consideration the absence of treatment for a shoulder condition or associated symptomatology for more than 20 years following separation from active duty. See Maxson v. West, 12 Vet. App. 453, 459 (1999), aff’d sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000); see also Forshey v. West, 12 Vet. App. 71, 74 (1998), aff’d sub nom. Forshey v. Principi, 284 F.3d 1335, 1358 (Fed. Cir. 2002) (the definition of evidence encompasses “negative evidence” which tends to disprove the existence of an alleged fact, i.e., the lack of evidence is itself evidence). In the present case, the absence of treatment for headaches for more than two decades following separation from active duty tends to indicate that this condition had not been chronic since separation from the military. The claim is denied as the evidence does not show a nexus between the currently diagnosed condition and his active service. 38 C.F.R. § 3.303. The evidence preponderates against the claim, and there is no doubt to resolve. 38 C.F.R. § 3.102. 7. Entitlement to service connection for a bilateral eye condition is denied. The Veteran seeks service connection for a bilateral eye condition, namely, light sensitivity secondary to headaches. Service connection may be granted for any disability that is proximately due to or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310. Sensitivity to light was noted on the May 2015 VA examination. However, there is no specific diagnosis of an eye condition of record other than myopia. The Veteran’s claim is not considered to be for myopia, as he specified photophobia related to headaches. Notwithstanding the lack of a current diagnosis of a specific eye condition causing photophobia, as the Veteran’s headache condition is not entitled to service connection, any related photophobia is also not entitled to service connection. Accordingly, the claim is denied. 38 C.F.R. § 3.310. The evidence preponderates against the claim, and there is no doubt to resolve. 38 C.F.R. § 3.102. There is no other theory of service connection raised in the pleadings or otherwise in the evidence of record. See Robinson v. Shinseki, 557 F.3d 1355, 1361 (2008) (where a fully developed record is presented to the Board with no evidentiary support for a particular theory of recovery, there is no reason for the Board to address or consider such a theory). 8. Entitlement to service connection for a lung condition is denied. The Veteran seeks service connection for a lung condition. He has submitted no evidence or argument on appeal. There is no evidence of a diagnosed lung condition during or after service. During the May 2015 VA examination, the clinician noted review of the Veteran’s records and having performed an in-person examination and noted that there were no findings consistent with a diagnosed lung condition. There is no contrary medical evidence of record. The record does not reflect that the Veteran possesses the requisite expertise to provide any medical diagnosis, and his lay assertions, insofar as they are intended as such, are given no weight. See Jandreau v. Nicholson, 492 F.3d at 1374 (affirming that lay evidence is generally not competent to establish medical diagnosis or etiology). The claim is denied as the evidence does not show a currently diagnosed lung condition. 38 C.F.R. § 3.303. The evidence preponderates against the claim, and there is no doubt to resolve. 38 C.F.R. § 3.102. 9. Entitlement to service connection for hypertension is denied. The Veteran seeks service connection for hypertension. He has submitted no evidence or argument on appeal. There is no diagnosis of hypertension during active service, or during the decade thereafter. A May 2011 VA treatment note indicated the Veteran drinks above the recommended alcohol limits. Hypertension was discussed as a problem associated with alcohol use. At some point thereafter, the Veteran was diagnosed with hypertension. See October 2014 VA Primary Care Outpatient Note (indicating hypertension as appearing on the computerized problem list). While it appears that the Veteran likely has a current diagnosis of hypertension, the competent evidence does not show or suggest a relationship to any in-service injury, event, disease. While the Veteran may believe his condition is related to service, he is not considered competent to offer such an opinion. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). As there is no competent evidence showing such a relationship, and as there has not been any plausible theory of service connection advanced, the AOJ had no obligation to provide a VA examination for this condition. See 38 U.S.C. § 5103A(d). The preponderance of the evidence indicates there is no nexus between the Veteran’s service and his hypertension which appears to have manifested many years later. As such, service connection is not warranted, and the benefit of the doubt rule is inapplicable. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 3.303; Gilbert v. Derwinski, 1 Vet. App. at 53. 10. Entitlement to service connection for a lower back condition is denied; and 11. Entitlement to service connection for a left hip condition is denied; and 12. Entitlement to service connection for a right hip condition is denied; and 13. Entitlement to service connection for a right ankle condition is denied; and 14. Entitlement to service connection for a left ankle condition is denied. The Veteran seeks service connection for a lower back, bilateral hip, and bilateral hip conditions. He has submitted no evidence or argument on appeal with relation to these claims. Review of the service treatment records does not show a persistent or recurrent disability of the hips, ankles, or back. A December 1992 sprain of the left ankle is documented, but there is no evidence of persistent and recurrent symptoms thereafter. Review of the current medical evidence does not show a currently diagnosed lower back, ankle, or hip condition. Post service, it is noted that the Veteran’s back is noted as normal at various points. See, e. g., April 2008 Private Medical Treatment Record (back range of motion within normal limits); May 2010 VA Outpatient Consult Note (“no back pain”). There are no diagnoses of or complaints of back, ankle or hip conditions in the medical evidence associated with the record, despite other conditions (including knee pain) being reported by the Veteran. The evidence is not adequate to show that the Veteran has a current back, hip, or ankle condition that may be related to service. The record does not reflect that the Veteran possesses the requisite expertise to provide any medical diagnosis for these conditions, and his lay assertions, insofar as they are intended as such, are given no weight. See Jandreau v. Nicholson, 492 F.3d at 1374 (affirming that lay evidence is generally not competent to establish medical diagnosis or etiology). A threshold showing to trigger the duty to examine includes “competent evidence of a current disability, or persistent and recurrent symptoms of disability.” 38 U.S.C. § 5103A(d)(2). Although the Veteran is competent to report symptoms, the Veteran has neither submitted competent (medical) evidence of such a disability, nor has he submitted any specific statements regarding the symptoms of the hips, lower back, or ankles that could permit the Board to find “persistent and recurrent symptoms of disability.” As there is insufficient evidence showing such a current diagnosis, much less any plausible theory of service connection advanced, the AOJ had no obligation to provide an examination for these conditions. See 38 U.S.C. § 5103A(d). The claims of entitlement to service connection for lower back, bilateral hip, and bilateral ankle conditions are denied as the evidence does not support a currently diagnosis of any of the claimed conditions. 38 C.F.R. § 3.303. The evidence preponderates against the claims, and there is no doubt to resolve. 38 C.F.R. § 3.102. (CONTINUED ON NEXT PAGE) Of final note, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. C. King, 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.