Citation Nr: 20032828 Decision Date: 05/11/20 Archive Date: 05/11/20 DOCKET NO. 19-31 908 DATE: May 11, 2020 ORDER Entitlement to service connection for stroke/transient ischemic attack (TIA) on a secondary basis is granted. Entitlement to service connection for vision loss (claimed as residuals from stroke) is denied. Entitlement to service connection for speech disability (claimed as residuals from stroke) is denied. Entitlement to service connection for loss of motor function (claimed as residuals from stroke) is denied. Entitlement to service connection for a cognitive disorder (claimed as residuals from stroke) is denied. FINDINGS OF FACT 1. The Veteran’s TIA is shown to be due to or the result of his service-connected coronary artery disease. 2. The preponderance of the evidence of record is against a finding that the Veteran has a current disability of vision loss, speech disability, loss of motor function, or cognitive disorder (claimed as residuals from stroke). CONCLUSIONS OF LAW 1. The criteria for service connection for stroke/TIA have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.310. 2. The criteria for service connection for vision loss have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.310. 3. The criteria for service connection for speech disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.310. 4. The criteria for service connection for loss of motor function have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.310. 5. The criteria for service connection for cognitive disorder have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty in the United States Navy from September 1952 to October 1955. This matter is on appeal to the Board of Veterans’ Appeals (Board) from a September 2017 rating decision of a regional office of the Department of Veterans Affairs (VA). Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection requires competent evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for a disability that is proximately due to or the result of an established service-connected disorder. 38 C.F.R. § 3.310. This includes a disability made chronically worse by service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995). 1. Entitlement to service connection for stroke/TIA. The Board finds service connection for TIA on a secondary basis is warranted. To that end, the record shows a favorable August 2019 VA contract medical opinion, which the Board finds highly probative. Based on a review of the Veteran’s extensive medical history, the examiner opined that “it is more likely than not that the TIAs are the result of his arteriosclerotic disease and dyslipidemia.” In the rationale, the examiner explained, “TIA’s are due to a brief blockage in supply of blood to the brain secondary to the buildup of cholesterol containing fatty deposits in an artery that supplies blood or nutrients to the brain.” See Medical Opinion Disability Benefits Questionnaire (DBQ) dated August 2019. The Board observes that the favorable August 2019 medical opinion was based on the examiner’s review of the Veteran’s claims file, medical history, and clinical examination of the Veteran. Resolving all reasonable doubt in the Veteran’s favor, the Board finds that service connection for TIA has been established, and the claim is granted. 2. Entitlement to service connection for vision loss. 3. Entitlement to service connection for speech disability. 4. Entitlement to service connection for loss of motor function. 5. Entitlement to service connection for a cognitive disorder. Although service connection for TIA has been established above, the Board finds that the weight of the evidence is against a finding of a present disability of vision loss, speech disability, loss of motor function, or cognitive disorder (claimed as residuals from stroke). The existence of a current disability is the cornerstone of a claim for VA disability compensation. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Here, the record shows that the Veteran had two episodes of TIA in June and July 2017. However, there is no evidence of any recurrent symptoms related to the claimed residuals from stroke. A January 2018 VA examination for Aid and Attendance shows that the Veteran “lives an active lifestyle and is independent of activities of daily living (ADL)” and able to prepare meals. Although the examiner noted that he ambulates with the assistance of a walker for long distances and a cane for shorter, the examiner found normal gait, and that he drove himself to the exam. The examiner commented that the Veteran “lives an active lifestyle for his age which involves going to the Gym 5 days per week for water therapy, he dines out and plays cards with his friends almost on a daily basis.” The examination documents normal muscle strength to bilateral upper and lower extremities. There were no findings of memory loss, vision loss or impairment, or functional impairments. See VA examination for Aid and Attendance of January 2018. A January 2019 VA examination for Aid and Attendance shows that the Veteran operates a motorized vehicle and lives independently in his own home. The examiner at the time observed the Veteran’s speech to be “coherent, conversation was clear and relevant,” and noted that he was “independent in completion of daily activities of living, including toileting self, bathing self, ambulating without assistance, food preparation.” There were no findings related to memory loss, speech disability, or vision impairment. The examiner found that the criteria for Aid and Attendance was not met. See VA examination for Aid and Attendance of January 2019. VA treatment record of June 2019 shows that the Veteran denied symptoms of stroke such as slurred speech or numbness on one side and denied recent or recurrent falls. Another notation that same month in June 2019 shows no slurred speech, no dizziness or falls, no memory deficit and no visual impairment. Notably, the August 2019 VA contract examiner that rendered a favorable nexus opinion for the Veteran’s TIA specifically indicated that the Veteran had no pertinent physical findings, signs or symptoms attributable to the condition. Specifically, there was no evidence of any muscle weakness, neurologic effects, functional impact, or mental health manifestations due to the condition or treatment. The examiner indicated normal speech, normal gait, and all normal muscle strength retained for both upper and lower extremities. Although a walker for support was identified, there was no functional loss or impairment indicated. See Central Nervous System and Neuromuscular Diseases DBQ of August 2019. As detailed above, the objective medical records do not show a diagnosis of vision impairment, speech disability, loss of motor function, or cognitive disorder at any point during the course of this appeal. Meaning, there is no indication of a present disability manifested by residuals from stroke. The medical professionals that examined the Veteran in 2018 and 2019 consistently documented normal speech, normal gait, and normal muscle strength. Moreover, there were no reports by the Veteran during treatment or clinical findings related to vision loss, memory deficit, cognitive impairment or functional impairment. Therefore, the Board finds that the record is absent for a current disability for which entitlement for service connection can be established. To the extent that the Veteran claims he has a current chronic disability manifested by residuals from stroke, his lay assertions are not considered competent medical evidence. Although he is certainly capable of describing the history in this case and competent to report symptoms which are within the realm of his personal experience, he is not competent to render a medical diagnosis of a right ankle disability, as this requires medical expertise. Davidson v. Shinseki, 581 F.3d 1313 (2009). For this purpose, the Veteran’s statements, standing alone, have little probative value, and the Board assigns more weight to the objective medical evidence of record including the VA examiner’s opinions from January 2018, January 2019 and August 2019. Based on a review of the foregoing evidence and the applicable laws and regulations, the Board finds that the preponderance of the evidence is against the Veteran’s claim for service connection for vision loss, speech disability, loss of motor function, or cognitive disorder (claimed as residuals from stroke). The benefit-of-the-doubt doctrine is not for application, and this claim must be denied. 38 U.S.C.§ 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. A., 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.