Citation Nr: 20031933 Decision Date: 05/06/20 Archive Date: 05/06/20 DOCKET NO. 12-17 928 DATE: May 6, 2020 ORDER Service connection for insomnia is granted. Service connection for a back disorder is denied. Service connection for a bilateral leg disorder is denied. Service connection for a disability manifested by loss of balance is denied. FINDINGS OF FACT 1. Resolving all doubt in favor of the Veteran, his insomnia is proximately due to his service-connected psychosis not otherwise specified (NOS) with depression. 2. A back disorder is not shown to be causally or etiologically related to any disease, injury, or incident during service, and arthritis did not manifest to a compensable degree within one year of discharge from active duty. 3. A bilateral leg disorder is not shown to be causally or etiologically related to any disease, injury, or incident during service, is not caused or aggravated by a service-connected disability, and an organic disease of the nervous system did not manifest to a compensable degree within one year from discharge from active duty. 4. A disability manifested by loss of balance is not shown to be causally or etiologically related to any disease, injury, or incident during service, is not caused or aggravated by a service-connected disability, and an organic disease of the nervous system did not manifest to a compensable degree within one year from discharge from active duty. CONCLUSIONS OF LAW 1. The criteria for service connection for insomnia have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 2. The criteria for service connection for a back disorder have not been met. 38 U.S.C. §§ 1101, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 3. The criteria for service connection for a bilateral leg disorder have not been met. 38 U.S.C. §§ 1101, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. 4. The criteria for service connection for a disability manifested by loss of balance have not been met. 38 U.S.C. §§ 1101, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1977 to June 1979. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in October 2011 by a Department of Veterans Affairs (VA) Regional Office (RO). In November 2014, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of that hearing has been associated with the record. In March 2015 and September 2017, the Board remanded the case for additional development and it now returns for further appellate review. The Board notes that, since the issuance of the August 2019 supplemental statement of the case, additional VA-generated evidence, including updated VA treatment records and a January 2020 VA psychiatric examination, was associated with the file. While the Veteran has not waived Agency of Original Jurisdiction (AOJ) consideration of such evidence, the Board finds that such records contain findings duplicative to those previously considered or are irrelevant to the issues decided herein. Thus, there is no prejudice to him in the Board proceeding with a decision at the present time. 38 C.F.R. § 20.1304(c). Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury. Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff’d, 78 F.3d 604 (Fed. Cir. 1996) [(table)]. Additionally, where a veteran served for at least 90 days during a period of war or after December 31, 1946, and manifests certain chronic diseases, such as arthritis and organic diseases of the nervous systems, to a degree of 10 percent within one year, from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309. Alternatively, when a disease 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). 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 v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). Further, service connection may not be awarded on the basis of aggravation without establishing a pre-aggravation baseline level of disability and comparing it to the current level of disability. 38 C.F.R. § 3.310(b). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 1. Entitlement to service connection for a sleep disorder, to include as secondary to service-connected Bell’s palsy and/or tinnitus. As an initial matter, the Board notes that the Veteran does not allege, nor does the record reflect, that he has a sleep disorder that is related to his military service on a direct basis. Rather, he contends that his sleep disorder, which has been diagnosed as insomnia (see January 2019 VA examination), is secondary to his service-connected Bell’s palsy and/or tinnitus. However, based upon a review of the evidence, the Board finds that, after resolving all doubt in favor of the Veteran, service connection for insomnia as secondary to his service-connected psychosis NOS with depression is warranted. In this regard, the Veteran was afforded a VA examination in December 2016 to determine if he had a sleep disorder. At such time, the examiner found that he did not have, and never had, a diagnosis of sleep apnea. However, the examiner was requested to identify all sleep disorders found to be present, not just sleep apnea. Therefore, an addendum opinion was requested to determine if the Veteran had a current sleep disorder other than sleep apnea, and if so, whether such disorder was secondary to his service-connected Bell’s palsy and/or tinnitus. Thereafter, in a January 2019 addendum opinion, the examiner found that the Veteran had sleep disturbance, diagnosed as insomnia. While he opined that such disorder was less likely than not proximately due to or the result of the Veteran’s service-connected Bell’s palsy and/or tinnitus, he found that such was secondary to the Veteran’s major depressive disorder (MDD) with psychosis and poor sleep hygiene as evidenced by statements from his family, comorbid 37 year history of alcoholism with polyneuropathy, multiple suicidal gestures, and long standing engagement with mental health services necessitating multiple psychoactive drugs and cognitive therapy. Therefore, based on the foregoing, the Board resolves all doubt in the Veteran’s favor and finds that his sleep disorder, diagnosed as insomnia, is proximately due to his service-connected psychosis NOS with depression. Consequently, service connection for such disorder. In this regard, the Board notes that, while the Veteran’s insomnia will be rated with his service-connected psychiatric disability, service connection for insomnia is still warranted as it is a separate diagnosis from his currently service-connected psychosis NOS with depression. 2. Entitlement to service connection for a back disorder. The Veteran contends that he has a back disorder due to his military service. Specifically, at the November 2014 Board hearing, he testified that he experienced low back pain during service due to heavy lifting required as a cannoneer. However, the Veteran’s service treatment records (STRs) do not reveal any complaints, treatment, or diagnoses referable to a back disorder. In this regard, the Board notes that, in an April 2019 statement, the Veteran stated that medics did not record everything while in the field artillery. He also stated that time did not allow him to complain about all of his aches and pains, and, if he did, he would have been reprimanded. Thus, he claims that service connection for a back disorder is warranted. In this regard, a January 2015 private opinion was received from Dr. P.F., who stated that the Veteran had degenerative arthritis and spinal stenosis of the lumbar spine. He further indicated that the Veteran’s militaries duties involved heavy lifting and other physical intensive work, and opined that these activities accelerated the onset of his current musculoskeletal problems. However, as noted in the March 2015 remand, Dr. P.F. did not appear to have knowledge of the Veteran’s complete medical history, including the lack of documentation in service of any back complaints and that fact that the first post-service medical evidence of any back symptoms was not until many years after service. As such, Dr. P.F.’s opinion is afforded no probative weight. In December 2016, the Veteran was afforded a VA examination. At such time, the examiner diagnosed back pain since July 2012 and opined that such condition was less likely than not incurred in or was caused by the claimed in-service injury, event, or illness. In support thereof, he noted that he could not find documents that supported the Veteran’s contention that he injured his back after falling off a cannon, or any diagnosed back condition in his STRs. The examiner also explained that, since the first diagnosis of back pain was made some 30 years after the Veteran left active duty, it was less likely than not that his low back disorder was related to his active service, including his duties as a cannoneer. However, the Board previously found such opinion to be inadequate as the examiner did not consider or discuss the aforementioned January 2015 opinion as directed in the March 2015 remand. Thus, pursuant to the September 2017 remand, the Veteran underwent another VA examination in June 2018. At such time, he reported that he had back and leg pain for 6 years. The examiner noted that the Veteran had subjective back pain, mild L3-4 disc collapse, and facet arthritis. He opined that the Veteran’s back disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In support thereof, the examiner explained that the Veteran had mild, probably age appropriate, degenerative changes in his back on current x-rays. He also noted that records were silent until 2012 for any complaints of back pain and he was able to work as longshoreman until 2012. In regard to the January 2015 private opinion, the examiner noted that Dr. P.F. suggested a diagnosis of spinal stenosis, but he was unable to find imaging confirming such diagnosis. Thus, he concluded that the temporal relationship between active duty and the development of back pain did not support a finding that the Veteran’s back disorder developed while on active duty. However, as the examiner did not consider the lay statements of record, an addendum opinion was requested. Accordingly, in February 2019, an addendum opinion was provided. At such time, the examiner noted that the lay statements of record were from 2010, were over 30 years after the Veteran’s military service, and did not give a specific timeframe regarding his back pain. He also observed that there was no evidence of a back injury or complaints in the Veteran’s STRs and no abnormality of the back was noted on his discharge examination. The examiner indicated that a review of systems in 2010 revealed that the Veteran had no pain, joint swelling, or redness regarding his muscular/joints. Also, a May 2011 treatment record reflected that the Veteran had back pain since 1981, which is two years after his separation from service. The examiner further explained that the Veteran worked for a power company and as a longshoreman after service, both of which required heavy lifting. Thus, he concluded that it was less likely than not that the Veteran’s back disorder was incurred in or caused by his military service. The Board affords great probative weight to the February 2019 VA examiner’s opinion as such considered all of the pertinent evidence of record, to include the statements of the Veteran, and provided a complete rationale, relying on and citing to the records reviewed. Moreover, the examiner offered clear conclusions with supporting data as well as reasoned medical explanations connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). In March 2019, Dr. P.F. provided another private opinion. He found that repeated exertion and trauma in the form of marching with heavy backpacks and carrying heavy artillery items was not the only cause of the Veteran’s back problems, but such activities most definitely aggravated pre-existing pathologies in those areas. Thus, he determined that, to a reasonable degree of medical certainty, the Veteran’s duties and activities during the course of his military career had partially aggravated his back disorder. However, as the Veteran did not have a pre-existing back disorder, the question of aggravation is not raised in this case. Therefore, as Dr. P.F. did not address the relevant inquiry, his opinion is afforded no probative weight. The Board acknowledges that the Veteran believes that his current back disorder is related to his military service. However, while lay persons are competent to provide opinions on some medical issues, the cause of a back disorder falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007) (lay persons are not competent to diagnose cancer); Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). Specifically, such matter involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. In this regard, the etiology of degenerative arthritis, which involves the degeneration of a joint, are an internal process, and specialized knowledge is necessary to determine whether a specific event led to such disorder. Moreover, whether the symptoms the Veteran reportedly experienced during or after service are in any way related to his currently diagnosed back disorder is a matter that also requires medical expertise to determine. See Clyburn v. West, 12 Vet. App. 296, 301 (1999) (“although the veteran is competent to testify to the pain he has experienced since his tour in the Persian Gulf, he is not competent to testify to the fact that what he experienced in service and since service is the same condition he is currently diagnosed with.”). Accordingly, the Veteran’s opinion as to the onset and etiology of his back disorder is not competent evidence and, consequently, is afforded no probative weight. Furthermore, the evidence of record fails to demonstrate that arthritis of the lumbar spine manifested to a compensable degree within one year of the Veteran’s separation from service. In this regard, his June 1979 separation examination revealed that his spine was normal upon clinical evaluation, and the June 2018 VA examiner explained that x-rays at the time were consistent with normal aging. Moreover, no medical professional has related such complaints to a diagnosis of arthritis in the first post-service year. Additionally, the Veteran’s reports as to the onset of his back pain and the continuity of such since service have been inconsistent and, thus, not credible. In this regard, as noted by the February 2019 VA examiner, a review of systems in 2010 revealed that the Veteran had no pain, joint swelling, or redness regarding his muscular/joints, and a May 2011 treatment record reflected that the Veteran had back pain since 1981, which was two years after his separation from service. Additionally, at the June 2018 VA examination, the Veteran reported having back pain for 6 years. Consequently, presumptive service connection for arthritis of the lumbar spine, to include on the basis of a continuity of symptomatology, is not warranted. 38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309; Walker, supra. In sum, the Board finds the Veteran’s back disorder is not shown to be causally or etiologically related to any disease, injury, or incident during service, and arthritis did not manifest to a compensable degree within one year from discharge from active duty. Consequently, service connection for such disorder is not warranted. In reaching such decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for a back disorder. As such, that doctrine is not applicable in the instant appeal, and his claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. 3. Entitlement to service connection for a bilateral leg disorder, to include as secondary to an associated neurological abnormality of a back disorder and/or service-connected Bell’s palsy. 4. Entitlement to service connection for a disability manifested by loss of balance, to include as secondary to service-connected Bell’s palsy and/or tinnitus. The Veteran contends that he has a bilateral leg disorder and/or a disability manifested by loss of balance that is directly related to his military service. Specifically, at the November 2014 Board hearing, he testified that the first time he started having problems with balance was in 1979. The Veteran also testified that his leg problems came from being in the field artillery. Alternatively, he alleges that his bilateral leg disorder is secondary to an associated neurological abnormality of a back disorder and/or his service-connected Bell’s palsy, and his disability manifested by loss of balance is secondary to his service-connected Bell’s palsy and/or tinnitus. Therefore, he claims that service connection for such disorders is warranted. As an initial matter, the Board notes that, as the Veteran’s back disorder is not service-connected, secondary service connection for his bilateral leg disorder is prohibited as a matter of law. Therefore, such theory of entitlement will not be further addressed herein. The Veteran’s STRs do not reveal any complaints, treatment, or diagnoses referable to a bilateral leg disorder and/or disability manifested by loss of balance. Nonetheless, in December 2010, several statements were received from the Veteran’s friends and family, who noticed that the Veteran has had bilateral leg pain, problems with stumbling, and dizziness. A July 2012 statement was also received from the Veteran’s first spouse, who was married to the Veteran from 1980 to 1994. She stated that, when she left him, the Veteran had problems with his balance and coordination. However, upon review of the evidence, the Board finds that the preponderance of the evidence is against the Veteran’s claims for service connection for a bilateral leg disorder and a disability manifested by loss of balance. In this regard, a September 2014 private opinion was received from Dr. D.I. He opined that it was more likely than not that the Veteran’s Bell’s palsy and associated symptoms such as balance problems, disequilibrium, and ataxia, started while he was on active duty. However, as he noted that balance problems were a symptom associated with Bell’s palsy rather than a separate disorder, the Board sought a VA examination to determine whether the Veteran had a bilateral leg disorder and/or a disability manifested by loss of balance that was part and parcel of, associated with, and/or proximately due to or aggravated by the Veteran’s Bell’s palsy. Accordingly, the Veteran underwent a VA examination in December 2016 to determine if he had a bilateral leg disorder secondary to his service-connected Bell’s palsy, and a disability manifested by loss of balance secondary to his service-connected Bell’s palsy and/or tinnitus. At such time, the examiner diagnosed polyneuropathy since May 2011 and found that such diagnosis was the cause of his bilateral leg disorder and loss of balance. He further opined that the Veteran’s diagnosed polyneuropathy was less likely than not proximately due to or the result of his service-connected condition. In this regard, the examiner noted the complications associated with Bell’s palsy and tinnitus, and that, since the facial and auditory nerves were both cranial nerves that were confined to the head, they could not affect the peripheral nerves in the Veteran’s legs. Thus, he concluded that it was less likely than not that the Veteran’s polyneuropathy was part and parcel of, associated with, and/or proximately due to or caused by, the Veteran’s service-connected Bell’s palsy and/or tinnitus. The examiner also found that the Veteran’s diagnosed polyneuropathy was not aggravated by his service-connected Bell’s palsy and/or tinnitus. Specifically, he noted that the medical evidence seemed to indicate a worsening of the Veteran’s polyneuropathy between 2011 and 2012 from his EMG results, rather than based on any increases in the Veteran’s complaints or worsening of his physical findings. Thus, the examiner noted that the Veteran’s first baseline was approximately 30 years after his service-connected Bell’s palsy was diagnosed. Nonetheless, he explained that it did not matter if the Veteran’s polyneuropathy had worsened since it was not diagnosed until many years after Bell’s palsy and the fact that polyneuropathy could not have been aggravated by the service-connected Bell’s palsy and/or tinnitus. In support thereof, the examiner referenced his discussion above on Bell’s palsy and tinnitus. While such opinions adequately address the secondary aspect of the Veteran’s claims, the Board found that a remand was warranted to obtain an addendum opinion addressing direct service connection as the examiner did not discuss the September 2014 opinion from Dr. D.I. or the aforementioned lay statements regard the alleged onset of the Veteran’s symptoms proximate to service. Pursuant to the September 2017 remand, the Veteran underwent another VA examination in June 2018. At such time, the examiner noted a diagnosis of polyneuropathy. He opined that such disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In support thereof, he reasoned that the lay statements of record stated that the Veteran’s condition was caused by lifting heavy shells; however, the medical records indicated no symptoms related to his legs for 30 plus years from his time on active duty. The examiner also explained that the Veteran was able to perform heavy manual labor as a longshoreman and water boy until 2012. He further indicated that peripheral neuropathy could have myriad etiologies with the most frequent being idiopathic. However, the examiner noted that repetitive lifting was not commonly associated with peripheral neuropathy, and the preponderance of the Veteran’s symptoms could be explained by such disorder as there was no indication of radiculopathy on the NCVs and there was no imaging supportive of nerve root compression in the spine available. Nonetheless, as the examiner did not discuss the aforementioned September 2014 opinion and the other lay statements of record from the Veteran’s family and friends as requested in the September 2017 remand, an addendum opinion was obtained in February 2019. In the February 2019 addendum opinion, the examiner stated that he reviewed the statements of the Veteran’s family and friends that discussed the Veteran’s history of Bell’s palsy and his stumbling. He also considered the September 2014 private opinion. However, the examiner found that none of the letters or physician notes gave a definite start date of the Veteran’s lower extremity peripheral neuropathy. In this regard, he explained that, at different times, the start date ranged from the 1980s until 2005 and that the Veteran’s hearing testimony placed it as 1979. However, a May 2011 VA treatment record placed the start in the 1980s episodically and then constant from 2006. The examiner also reasoned that there was no mention of gait problems in the Veteran’s STRs nor on his separation examination in 1979, and there was no evidence presented in records that his military service in field artillery caused his leg problems. The examiner further noted that the diagnostic information presented in the Veteran’s records was that his balance issues were due to his lower extremity nerve condition and he had peripheral nerve conduction velocity (PNCV)/EMG proven peripheral neuropathy of the lower extremities. He also explained that the Veteran’s condition had been identified as peripheral rather than central. In this regard, the Board notes that, in January 2019, the Veteran was afforded a VA central nervous system examination, but the examiner found that the Veteran did not have a central nervous system diagnosis. Thus, the February 2019 examiner found that the Veteran’s polyneuropathy of the legs was the cause of his imbalance, and concluded that the preponderance of the evidence favored that it was less likely than not that the Veteran’s peripheral neuropathy of the legs began during or was caused by his military service. The Board affords great probative weight to the December 2016 and February 2019 VA examiners’ opinions as such considered all of the pertinent evidence of record, to include the statements of the Veteran, and provided a complete rationale, relying on and citing to the records reviewed. Moreover, the examiners offered clear conclusions with supporting data as well as reasoned medical explanations connecting the two. See Nieves-Rodriguez, supra; Stefl, supra. In a March 2019 private opinion, Dr. P.F. determined that, in regard to the Veteran’s loss of balance and other peripheral vestibular disease, as field artillery crew man, the Veteran was exposed to thousands of rounds of high caliber gunfire. He also noted the details of this pathology were well-described in Dr. D.I’s September 2014 opinion and that the etiologies of the conditions were similar to the relationship of loud music to hearing loss. Thus, he concluded that to a reasonable degree of medical certainty, his duties and activities during the course of the Veteran’s military career had partially aggravated his conditions. However, as the Veteran did not have pre-existing polyneuropathy, the question of aggravation is not raised in this case. Therefore, as Dr. P.F. did not address the relevant inquiry, his opinion is afforded no probative weight. The Board has considered the Veteran’s statements that his bilateral leg disorder and disability manifested by loss of balance are directly related to his service and/or secondary to a service-connected disability; however, as a lay person, he has not shown that he has specialized training sufficient to render such an opinion. See Jandreau, supra. In this regard, the etiology of such disorders is a matter not capable of lay observation and requires medical expertise to determine. Specifically, the question of etiology of such disorders involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship as it requires the administration and interpretation of musculoskeletal and neurological testing, and determining the etiology of such requires knowledge of the musculoskeletal and nervous systems, respectively. See Woehlaert, supra. Moreover, whether the symptoms the Veteran reportedly experienced during or after service are in any way related to his currently diagnosed bilateral leg disorder and disability manifested by loss of balance is a matter that also requires medical expertise to determine. See Clyburn, supra. Accordingly, the Veteran’s opinion as to the onset and etiology of such disorders is not competent evidence and, consequently, is afforded no probative weight. Furthermore, the evidence of record fails to demonstrate that polyneuropathy manifested to a compensable degree within one year of the Veteran’s separation from service. In this regard, his June 1979 separation examination revealed that his lower extremities and equilibrium were normal upon clinical evaluation. Additionally, the Veteran’s, and others’, reports as to the onset of his polyneuropathy symptoms and the continuity of such since service have been inconsistent and, thus, not credible. In this regard, as noted by the February 2019 VA examiner, other than the Veteran’s testimony at the Board, the onset of such symptoms has been placed at varying times from the 1980s until 2005. Further, in May 2011, the Veteran reported that such began in the 1980’s and became constant in 2006, and at the June 2018 VA examination, he reported leg pain for only 6 years. Consequently, presumptive service connection for polyneuropathy, to include on the basis of a continuity of symptomatology, is not warranted. 38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309; Walker, supra. In sum, the Board finds the Veteran’s bilateral leg disorder and disability manifested by loss of balance are not shown to be causally or etiologically related to any disease, injury, or incident during service, and are not shown to be caused or aggravated by a service-connected disability. Additionally, polyneuropathy did not manifest to a compensable degree within one year of the Veteran’s discharge from active duty. Consequently, service connection for such disorders are not warranted. In reaching such decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, the preponderance of the evidence is against the Veteran’s claims of entitlement to service connection for a bilateral leg disorder and a disability manifested by loss of balance. As such, that doctrine is not applicable in the instant appeal, and his claims must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Clark, 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.