Citation Nr: 20026062 Decision Date: 04/15/20 Archive Date: 04/15/20 DOCKET NO. 15-27 455 DATE: April 15, 2020 ORDER Entitlement to service connection for bilateral hearing loss is denied. Entitlement to service connection for type 2 diabetes mellitus is denied. Entitlement to service connection for right lower extremity peripheral neuropathy is denied. Entitlement to service connection for left lower extremity peripheral neuropathy is denied. Entitlement to service connection for a sleep disorder to include obstructive sleep apnea is denied. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), anxiety disorder and depressive disorder, is denied. Entitlement to service connection for right knee degenerative joint disease is denied. Entitlement to service connection for left knee degenerative joint disease is denied. Entitlement to service connection for right hip degenerative joint disease is denied. Entitlement to service connection for left hip degenerative joint disease is denied. Entitlement to service connection for right foot degenerative joint disease is denied. Entitlement to service connection for left foot degenerative joint disease is denied. Entitlement to service connection for hypertension is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran has a bilateral hearing loss disability that began during active service or is otherwise related to service or events therein, to include claimed noise exposure; and there is no evidence of bilateral hearing loss manifested to a compensable degree within one year following discharge from active service. 2. The Veteran did not serve in the Republic of Vietnam and was not otherwise exposed to herbicide agents. 3. The preponderance of the evidence is against finding that diabetes began during active service or is otherwise related to active service or events therein; and there is no evidence of diabetes manifested to a compensable degree within one year following discharge from active service. 4. The preponderance of the evidence is against finding that right lower extremity peripheral neuropathy began during active service or is otherwise related to service or events therein; and there is no evidence of right knee arthritis manifested to a compensable degree within one year following discharge from active service. 5. The preponderance of the evidence is against finding that left lower extremity peripheral neuropathy began during active service or is otherwise related to service or events therein; and there is no evidence of right knee arthritis manifested to a compensable degree within one year following discharge from active service. 6. The preponderance of the evidence is against finding that a sleep disorder to include obstructive sleep apnea began during active service or is otherwise related to service or events therein. 7. The Veteran does not have a confirmed diagnosis of PTSD and the preponderance of the evidence is against finding that anxiety and depressive disorders are related to active service or events therein. 8. The preponderance of the evidence is against finding that right knee degenerative joint disease began during active service or is otherwise related to service or events therein; and there is no evidence of right knee arthritis manifested to a compensable degree within one year following discharge from active service. 9. The preponderance of the evidence is against finding that left knee degenerative joint disease began during active service or is otherwise related to service or events therein; and there is no evidence of left knee arthritis manifested to a compensable degree within one year following discharge from active service. 10. The preponderance of the evidence is against finding that right hip degenerative joint disease began during active service or is otherwise related to service or events therein; and there is no evidence of right hip arthritis manifested to a compensable degree within one year following discharge from active service. 11. The preponderance of the evidence is against finding that left hip degenerative joint disease began during active service or is otherwise related to service or events therein; and there is no evidence of left hip arthritis manifested to a compensable degree within one year following discharge from active service. 12. The preponderance of the evidence is against finding that right foot degenerative joint disease began during active service or is otherwise related to service or events therein; and there is no evidence of right foot arthritis manifested to a compensable degree within one year following discharge from active service. 13. The preponderance of the evidence is against finding that left foot degenerative joint disease began during active service or is otherwise related to service or events therein; and there is no evidence of left foot arthritis manifested to a compensable degree within one year following discharge from active service. 14. The preponderance of the evidence is against finding that hypertension began during active service or is otherwise related to active service or events therein; and there is no evidence of hypertension manifested to a compensable degree within one year following discharge from active service. CONCLUSIONS OF LAW 1. A bilateral hearing loss disability was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. § 1110, 38 C.F.R. §§ 3.303, 3.307, 3.309. 2. Type 2 diabetes mellitus was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. §§ 1110, 1116; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.313. 3. Right lower extremity peripheral neuropathy was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. § 1110; 38 C.F.R. § 3.303, 3.307, 3.309. 4. Left lower extremity peripheral neuropathy was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. § 1110; 38 C.F.R. § 3.303, 3.307, 3.309. 5. A sleep disorder to include obstructive sleep apnea was not incurred during active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 6. An acquired psychiatric disorder, to include PTSD, anxiety disorder and depressive disorder, was not incurred during active service. 38 C.F.R. § 1110; 38 C.F.R. §§ 3.303, 3.304(f). 7. Right knee degenerative joint disease was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.307, 3.309. 8. Left knee degenerative joint disease was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.307, 3.309. 9. Right hip degenerative joint disease was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.307, 3.309. 10. Left hip degenerative joint disease was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.307, 3.309. 11. Right foot degenerative joint disease was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.307, 3.309. 12. Left foot degenerative joint disease was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.307, 3.309. 13. Hypertension was not incurred during active service nor may it be presumed to have been incurred therein. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1968 to January 1970. The Veteran requested that VA examinations be scheduled as to all issues and the Board acknowledges that this has not been accomplished. On review and as explained below, the record does not contain probative evidence establishing an injury or disease in service or indicating a link between the claimed disorders and active service. Accordingly, VA examinations are not warranted. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006). Service Connection 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). Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic 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 (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). Service connection may also be granted on a secondary basis for a disability that is proximately due to a service-connected condition. 38 C.F.R. § 3.310(a). Service connection is also possible when a service-connected condition has aggravated a claimed condition, but compensation is only payable for the degree of additional disability attributable to the aggravation. Allen v. Brown, 7 Vet. App. 439 (1995). In October 2006, VA amended 38 C.F.R. § 3.310 to incorporate the decision in Allen except that VA will not concede aggravation unless there is medical evidence showing the baseline level of the disability before its aggravation by the service-connected disability. 38 C.F.R. § 3.310(b). Entitlement to service connection for bilateral hearing loss In October 2014, VA denied entitlement to service connection for bilateral hearing loss. In March 2015, within the one-year appeal period, VA readjudicated the claim and confirmed and continued the prior denial. The Veteran disagreed with the decision and perfected this appeal. He generally asserts that he has hearing loss related to military service. In February 2009, the Veteran underwent a VA audiology consult. He reported military noise exposure for 2 years. Audiometric testing showed a bilateral hearing loss disability for VA purposes. 38 C.F.R. § 3.385. Subsequent VA records show continued treatment for hearing loss, to include hearing aids. In an undated statement initially received in December 2013, Dr. C.M.Q. noted that the Veteran complains of bilateral deafness since his military service. Diagnosis was bilateral deafness. Having found evidence of a current hearing loss disability, the question is whether there is any nexus to active service. Service treatment records do not note complaints or findings related to hearing loss. On report of medical history completed at separation in December 1969, the Veteran denied any ear trouble. The Veteran’s ears were reported a normal on corresponding physical examination. Audiometric findings were not provided. VA outpatient records document the Veteran’s report of noise exposure during service, but he does not elaborate or provide specifics as to the nature of any acoustic trauma. Service personnel records show he underwent basic combat training and then was assigned a military occupational specialty of “cook”. There is no indication of service in a combat zone and the Veteran’s reports of military noise exposure do not appear consistent with the circumstances of his service. Thus, the Board does not find his report of in-service acoustic trauma credible. On review, a bilateral hearing loss disability did not begin during active service and there is no indication that such manifested to a compensable degree within one year following discharge. Further, the record does not contain competent evidence relating current hearing loss to active service or events therein, to include claimed noise exposure. In making this determination, the Veteran’s lay statements were considered. He is competent to report perceived hearing impairment since service. Layno v. Brown, 6 Vet. App. 465, 470 (1994). The Veteran has not shown that he has the medical training, experience, or expertise to be competent to diagnose hearing loss for VA purposes or to provide a medical etiology opinion. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). The Veteran’s unsupported lay statements are not sufficient to establish inservice onset or nexus. The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. Entitlement to service connection for type 2 diabetes mellitus In October 2014, VA denied entitlement to service connection for type 2 diabetes mellitus. In March 2015, within the one-year appeal period, VA readjudicated the claim and confirmed and continued the prior denial. The Veteran disagreed with the decision and perfected this appeal. Medical evidence shows the Veteran has a current diagnosis of diabetes. He contends that his diabetes is related to inservice Agent Orange exposure. Service connection may be granted for certain diseases, including type 2 diabetes, associated with in-service exposure to herbicide agents. 38 C.F.R. §§ 3.307, 3.309(e). A veteran who, during active military, naval or air service, served in the Republic of Vietnam during the period beginning on January 9, 1962 and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307(a)(6)(iii). “Service in the Republic of Vietnam” includes service in the waters offshore and service in other locations if the conditions of service involved duty or visitation in the Republic of Vietnam. Id. In his initial informal claim in November 2013, the Veteran reported that he was exposed to Agent Orange in Okinawa. In March 2014, he reported Agent Orange exposure while dealing with ships and equipment used in Vietnam. In a June 2015 statement, he reported being exposed to Agent Orange while in Vietnam. In his July 2015 Form 9, he reported that he used to travel from Okinawa to Vietnam to bring supplies to the troops. Service personnel records do not document service in Vietnam. The records show he served in Okinawa from July 1968 to January 1970. While there, he was assigned to the 585th Maintenance Company and then to the “Aug 2d Log Comd (Spt Staff)”. His principal duty was as a cook. A November 2018 response from the Joint Services Records Research Center (JSRRC) indicates that review of the operational reports – lessons learned documents that the 585th Maintenance Company was assigned to the 2nd Log Cmd located at Okinawa. The records document that equipment was received from Vietnam, but they do not mention or document that personnel from the Veteran’s unit were tasked with taking supplies to Vietnam. The records also did not report unit personnel being exposed to Agent Orange or tactical herbicides while performing their daily duty assignments. Additionally, the record does not document the use, testing, spraying, or storage of Agent Orange or tactical herbicides in Okinawa during the reporting period. In April 2018, information was received from the Compensation Service indicating that the Department of Defense has not identified any location on Okinawa where Agent Orange was used, tested, stored, or transported. Agent Orange was developed for jungle combat operations in Vietnam and was used there from 1962 to early 1971. There were no combat operations on Okinawa during those years and no need for Agent Orange use there. Okinawa was not on the Agent Orange shipping supply line which went directly from storage at Gulfport, Mississippi to South Vietnam via merchant ships. Further, there is no scientific evidence available to VA showing that being in the vicinity of equipment, or cleaning equipment, previously used in Vietnam can be considered as exposure to active Agent Orange or can result in long-term health effects. As set forth, service personnel records do not document service in Vietnam and JSRRC could find no evidence showing that personnel from the Veteran’s unit were tasked with taking supplies from Okinawa to Vietnam. Additionally, information from the Department of Defense does not show any Agent Orange use, storage, or transport in Okinawa and there is no scientific support for exposure via contaminated equipment. While the Veteran is competent to report his inservice activities and perceived exposures, the overall evidence does not support his contentions and his unsubstantiated lay assertions concerning Agent Orange exposure are not found credible. Given the foregoing, presumptive service connection for diabetes based on exposure to herbicide agents is not warranted. 38 C.F.R. § 3.307, 3.309(e). In further support of his claim, the Veteran submitted an April 2018 statement from his private physician, Dr. C.M.Q., which indicates a diagnosis of diabetes and states that his metabolic diseases are more probable than not secondary to his military service performance. While the physician referenced the Veteran’s service treatment records in general, no specific records were cited, and absolutely no rationale was provided for this opinion. Hence, it is not considered probative. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (the probative value of a medical opinion comes from its reasoning). Review of service treatment records is negative for complaints or findings of diabetes and on separation examination in December 1969, the Veteran’s endocrine system was reported as normal on clinical evaluation and urinalysis was negative for sugar. There is simply no evidence of diabetes noted during service with continuing symptoms and there is also no evidence of diabetes manifested to a compensable degree within one year following discharge from active service. Rather, diabetes was not shown until many years following discharge. Service connection on a direct basis and on a presumptive basis as a chronic disease is not warranted. 38 C.F.R. §§ 3.303, 3.309(a). In making the above determinations, the Veteran’s lay contentions were considered. The Veteran has not shown that he has the medical training, experience, or expertise to be competent to diagnose diabetes or provide an etiology opinion on a complex medical question. Jandreau. The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. Entitlement to service connection for right and left lower extremity peripheral neuropathy In October 2014, VA denied entitlement to service connection for peripheral neuropathy of the right and left lower extremities. In March 2015, within the one-year appeal period, VA readjudicated the claim and confirmed and continued the prior denial. The Veteran disagreed with the decision and perfected this appeal. He generally asserts that service connection is warranted. Early-onset peripheral neuropathy is a disease associated with exposure to herbicide agents. 38 C.F.R. § 3.309(e). As discussed above, the Veteran was not exposed to Agent Orange during service and thus, service connection is not warranted based on this theory. Peripheral neuropathy is considered to be an “organic disease of the nervous system” under 38 C.F.R. § 3.307 and 3.309. Service treatment records are negative for neurologic complaints or findings related to the bilateral lower extremities. On separation examination in December 1969, the Veteran’s lower extremities and neurologic system were reported as normal on clinical evaluation. In an undated statement received in December 2013, Dr. C.M.Q. noted a diagnosis of diabetic neuropathy both lower limbs. In an April 2018 statement, Dr. C.M.Q. again noted diabetic neuropathy in the lower limbs and stated that the Veteran’s metabolic diseases were “more probable than not secondary to his military service performance.” He provided no rationale and the opinion is not considered probative. See Nieves-Rodriguez. VA records dated in June 2018 note complaints of longstanding bilateral toe numbness, which “given type 2 diabetes scenario [is] likely due to peripheral neuropathy.” In October 2018, the Veteran underwent electrodiagnostic studies. In pertinent part, findings were compatible with sensory predominantly axonal polyneuropathy. On review, there is no evidence of lower extremity peripheral neuropathy during service or for many years thereafter, and the record does not contain probative evidence otherwise relating it to active service. While the record shows a current diagnosis of lower extremity neuropathy, it appears related to diabetes. The Veteran is not service connected for diabetes and there is no basis for an award of secondary service connection. 38 C.F.R. § 3.310. Except for the assertions as to Agent Orange exposure and secondary service connection, neither of which are applicable, the Veteran has not provided any other theory of how he believes his lower extremity peripheral neuropathy is related to service. A mere conclusory generalized lay statement that military service caused his current condition is insufficient to establish medical etiology or nexus. Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010). Thus, the Veteran’s lay opinion regarding nexus is not competent or probative. The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. Entitlement to service connection for a sleep disorder In October 2014, VA denied entitlement to service connection for a sleep disorder. In March 2015, within the one-year appeal period, VA readjudicated the claim and confirmed and continued the prior denial. The Veteran disagreed with the decision and perfected this appeal. He generally asserts that he has a sleep disorder related to military service. Service treatment records are negative for complaints or findings related to a sleep disorder. On report of medical history completed at separation in December 1969, the Veteran denied frequent trouble sleeping or nightmares and no abnormalities were noted on corresponding physical examination. VA records dated in January 2012 note the Veteran was showing significant signs and symptoms suggestive of sleep apnea. The diagnosis of sleep apnea was subsequently confirmed by sleep study. In an undated statement received in December 2013, Dr. C.M.Q. noted the Veteran suffers from insomnia and nightmares and listed a diagnosis of sleep disorder. In an April 2018 statement, Dr. C.M.Q. noted a medical diagnosis of obstructive sleep apnea. He further stated that the Veteran’s cardiopulmonary diseases were “more probable than not secondary to his military service performance.” The statement is not supported by any rationale and is not considered probative. Nieves-Rodriguez. On review, a sleep disorder to include obstructive sleep apnea, was not shown during service or for many years thereafter. The record simply does not contain any probative evidence relating the claimed disorder to active service or events therein. In this regard, the Veteran has not shown that he has the medical training, experience, or expertise to be competent to establish medical etiology or nexus. He has not offered any other theory of entitlement and his conclusory generalized lay assertions are insufficient to establish medical etiology or nexus. Waters. The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. Entitlement to service connection for an acquired psychiatric disorder to include PTSD, anxiety disorder and depressive disorder In October 2014, VA denied entitlement to service connection for major depressive disorder (also claimed as generalized anxiety disorder) and for PTSD. In March 2015, within the one-year appeal period, VA readjudicated the claim and confirmed and continued the prior denials. The Veteran disagreed with the decision and perfected this appeal. The Veteran generally asserts that he has a psychiatric disorder related to active service. The issue is rephrased as stated above. Clemons v. Shinseki, 23 Vet. App. 1 (2009). The general requirements for service connection were previously set forth. Establishing service connection for PTSD requires: (1) medical evidence diagnosing the disorder in accordance with 38 C.F.R. § 4.125; (2) credible supporting evidence that the claimed in-service stressor occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. §§ 3.303, 3.304(f). Service treatment records are negative for mental health complaints or findings. On report of medical history completed at separation in December 1969, the Veteran denied depression or excessive worry, or nervous trouble of any sort. On physical examination, the Veteran’s psychiatric system was reported as normal on clinical evaluation. An undated statement from Dr. C.M.Q. received in December 2013 indicates the Veteran suffers from anxiety and depression. Diagnoses included generalized anxiety disorder and major depression disease. An etiology opinion was not provided. In March 2014, the Veteran submitted a statement in support of claim for service connection for PTSD. He reported his stressful incident as being in Okinawa and dealing with weapons and ships that were in Vietnam causing Agent Orange contamination. In March 2014, the Veteran presented to VA’s psychiatry intervention center for an evaluation due to anxiety and depressive symptoms. He reported psychiatric symptoms for the past 2 years and identified his stressor as being robbed at his house and killing one of the robbers. He reported no prior psychiatric history. Diagnostic impression included unspecified depressive disorder and unspecified anxiety disorder. A June 2015 VA addendum indicates that review of the Veteran’s record showed no evidence of longstanding mental health service. There were notes in March and April 2014 listing diagnoses of unspecified depressive and anxiety disorders. A July 2015 psychology note indicates the Veteran admitted to mild sadness for the past 2 years after a robbery. Diagnostic impression included unspecified depressive disorder and unspecified anxiety disorder. A January 2016 VA social work note indicates the Veteran was exhibiting signs of depression and anxiety. He reported a loss a month ago of his sister, he has another sister ill, and he was the survivor of a shooting where he killed a robber. He also had several medical conditions that were further contributing to his mental health. An April 2016 VA social work note indicates the Veteran came in because he was distressed about all his ailments. He indicated that it was related to his brief experience in Vietnam and subsequently to his experience in Okinawa. Impression was depression and anxiety. On review, the Veteran’s PTSD screens in February 2009 and December 2015 were negative, and a confirmed diagnosis of PTSD is not shown in either VA records or the private medical statements. To the extent the Veteran claims his stressor was serving in Vietnam or being contaminated with Agent Orange, this is not substantiated as discussed above. The record, however, does contain diagnoses of both depressive and anxiety disorders. The overall evidence does not show these began during service or for many years thereafter. Rather, the evidence shows the Veteran began experiencing symptoms of depression and anxiety following a post-service event wherein he shot and killed a robber in self-defense. The record simply does not contain any probative evidence relating the Veteran’s currently diagnosed psychiatric disorders to active service or events therein. In this regard, the Veteran has not shown that he has the medical training, experience, or expertise to be competent to provide an etiology opinion and his lay statements are insufficient to establish nexus on a complex medical question. Jandreau. There is no evidence of psychosis and presumptive service connection as a chronic disease is not for consideration. 38 C.F.R. § 3.309(a). The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. Entitlement to service connection for right and left knee degenerative joint disease In October 2014, VA denied entitlement to service connection for degenerative joint disease of the right and left knees. In March 2015, within the one-year appeal period, VA readjudicated the claim and confirmed and continued the prior denials. The Veteran disagreed with the decision and perfected this appeal. He generally asserts that he has arthritis in the right and left knees related to military service. Service treatment records are negative for complaints or findings related to the knees. On report of medical history completed at separation in December 1969, the Veteran denied having swollen or painful joints or a trick or locked knee. On corresponding physical examination, the Veteran’s lower extremities were reported as normal. An undated statement from Dr. C.M.Q. received in December 2013 includes a diagnosis of degenerative joint disease in both knees. An etiology opinion was not provided. On review, a chronic bilateral knee condition was not noted during active service and there is no evidence of right or left knee arthritis manifested to a compensable degree within one year following discharge from service. While the record shows a current diagnosis, the Veteran has not identified any inservice event or injury or offered a specific theory of entitlement. His conclusory generalized lay assertions are insufficient to establish nexus. Waters. The record simply does not contain any probative evidence relating degenerative joint disease of the right and left knees to active service. The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. Entitlement to service connection for right and left hip degenerative joint disease In October 2014, VA denied entitlement to service connection for degenerative joint disease of the right and left hips. In March 2015, within the one-year appeal period, VA readjudicated the claim and confirmed and continued the prior denials. The Veteran disagreed with the decision and perfected this appeal. He generally asserts that he has right and left hip arthritis related to military service. Service treatment records are negative for complaints or findings related to the hips. On report of medical history completed at separation in December 1969, the Veteran denied having swollen or painful joints. On corresponding physical examination, the Veteran’s lower extremities were reported as normal. An undated statement from Dr. C.M.Q. received in December 2013 includes a diagnosis of degenerative joint disease in both hips. An etiology opinion was not provided. On review, a chronic bilateral hip condition was not noted during active service and there is no evidence of right or left hip arthritis manifested to a compensable degree within one year following discharge from service. While the record shows a current diagnosis, the Veteran has not identified any in-service event or injury or offered a specific theory of entitlement. His conclusory generalized lay assertions are insufficient to establish nexus. Waters. The record simply does not contain any probative evidence relating degenerative joint disease of the right and left hips to active service. The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. Entitlement to service connection for right and left foot degenerative joint disease In October 2014, VA denied entitlement to service connection for right and left foot degenerative joint disease. In March 2015, within the one-year appeal period, VA readjudicated the claim and confirmed and continued the prior denials. The Veteran disagreed with the decision and perfected this appeal. He generally asserts that he has arthritis of the feet related to military service. Service treatment records are negative for complaints or findings related to the feet. On report of medical history completed at separation in December 1969, the Veteran denied having any foot trouble. On corresponding physical examination, the Veteran’s feet were reported as normal. An undated statement from Dr. C.M.Q. received in December 2013 includes a diagnosis of degenerative joint disease of both feet. An etiology opinion was not provided. On review, a chronic bilateral foot condition was not noted during active service and there is no evidence of right or left foot arthritis manifested to a compensable degree within one year following discharge from service. While the record shows a current diagnosis, the Veteran has not identified any in-service event or injury or offered a specific theory of entitlement. His conclusory generalized lay assertions are insufficient to establish nexus. Waters. The record simply does not contain any probative evidence relating right and left foot degenerative joint disease to active service. The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. Entitlement to service connection for hypertension In October 2014, VA denied entitlement to service connection for hypertension. In March 2015, within the one-year appeal period, VA readjudicated the claim and confirmed and continued the prior denial. The Veteran disagreed with the decision and perfected this appeal. He generally asserts that he has hypertension related to military service. Service treatment records do not show complaints or treatment related to hypertension. On report of medical history completed at separation in December 1969, the Veteran denied having high blood pressure. On corresponding physical examination, his blood pressure appears to be recorded as 134/80. An undated statement from Dr. C.M.Q. received in December 2013 includes a diagnosis of hypertension. An etiology opinion was not provided. An April 2018 statement from Dr. C.M.Q. also indicates the Veteran is hypertensive and states that his cardiopulmonary diseases are “more probable than not secondary to his military service performance.” The statement is not supported by any rationale and is not considered probative. Nieves-Rodriguez. On review, hypertension was not noted during active service and there is no evidence of hypertension manifested to a compensable degree within one year following discharge from service. The record simply does not contain any probative evidence relating the claimed disorder to active service or events therein. In this regard, the Veteran has not offered a specific theory of entitlement and his conclusory generalized lay assertions are insufficient to establish medical etiology or nexus. Waters. The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. LAURA E. COLLINS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Carsten, 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.