Citation Nr: A20009341 Decision Date: 05/27/20 Archive Date: 05/27/20 DOCKET NO. 190808-19406 DATE: May 27, 2020 ORDER Entitlement to service connection for a high blood pressure disability is denied. Entitlement to service connection for high cholesterol (hyperlipidemia) is denied. FINDINGS OF FACT 1. The preponderance of the evidence does not reflect that the Veteran has a current diagnosis of high blood pressure. 2. Hyperlipidemia (high cholesterol) is not a disability for which service-connected compensation may be considered. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a high blood pressure disability have not been met. 38 U.S.C. §§ 1131, 5107 (2019); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310 (2018). 2. The criteria for entitlement to service connection for a high cholesterol have not been met. 38 U.S.C. §§ 1131, 5107 (2019); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service with the U.S. Air Force from October 1968 to October 1972.  During this time, he was awarded Vietnam Campaign Medal, the Vietnam Service Medal, the Air Force Good Conduct Medal, and the National Defense Service Medal.     On August 23, 2017, the President signed into law the Veterans Appeals Improvement and Modernization Act, Pub. L. No. 115-55 (to be codified as amended in scattered sections of 38 U.S.C.), 131 Stat. 1105 (2017), also known as the Appeals Modernization Act (AMA).  This law creates a new framework for veterans dissatisfied with VA’s decision on their claim to seek review.  This decision has been written consistent with the new AMA framework.     This matter is on appeal from a July 2019 rating decision.  In August 2019, the Veteran timely appealed this decision to the Board and selected the evidence review lane.  All evidence submitted during the subsequent 90-day window provided for submission of additional evidence has been reviewed.  Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). In addition, disorders diagnosed after discharge may also still be service-connected if all the evidence, including pertinent service records, establishes the disorder was incurred in service. 38 C.F.R. § 3.303(d). Generally, service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service - the “nexus” requirement. Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. §§ 1110, 1131; see Degmetich v. Brown, 104 F.3d 1328 (1997). In the absence of proof of a present disability there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Service connection requires a finding of the existence of a current disability and a determination of a relationship between that disability and an injury or disease incurred in service. Watson v. Brown, 4 Vet. App. 309, 314 (1993); Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000). There is no categorical rule that medical evidence is required when the determinative issue is either medical etiology or a medical nexus. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). Therefore, the Board will assess the competence and credibility of lay statements as well. Barr v. Nicholson, 21 Vet. App. 303, 308 (2007). In adjudicating claims for VA benefits, the burden of proof only requires an approximate balance of the evidence for and against a claim. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1991). This low standard of proof is unique to the VA adjudicatory process, and the nation, in recognition of our debt to our veterans, has taken upon itself the risk of error in awarding such benefits. Wise v. Shinseki, 26 Vet. App. 517, 531 (2014) (citing Gilbert, 1 Vet. App. at 54). A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102 (providing, in pertinent part, that reasonable doubt will be resolved in favor of the claimant). When the evidence supports the claim or is in relative equipoise, the claim will be granted. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990); see also Wise v. Shinseki, 26 Vet. App. 517, 532 (2014). If the preponderance of the evidence weighs against the claim, it must be denied. See id.; Alemany v. Brown, 9 Vet. App. 518, 519 (1996). In this vein, the Board must determine, as a question of fact, both the weight and credibility of the evidence. Equal weight is not accorded to each piece of evidence contained in a record; every item does not have the same probative value. The Board must account for the evidence which it finds to be persuasive or unpersuasive, analyze the credibility and probative value of all material evidence submitted by and on behalf of a claimant, and provide the reasons for its rejection of any such evidence. See, e.g., Struck v. Brown, 9 Vet. App. 145, 152 (1996); Gabrielson v. Brown, 7 Vet. App. 36, 40 (1994); Abernathy v. Principi, 3 Vet. App. 461, 465 (1992); Simon v. Derwinski, 2 Vet. App. 621, 622 (1992); Hatlestad v. Derwinski, 1 Vet. App. 164, 169 (1991). 1. Entitlement to service connection for a high blood pressure disability The Veteran asserts that he has a high blood pressure disability that is related to his active service. A review of the Veteran’s service treatment records, including his enlistment and separation examinations, are otherwise silent for any complaints, treatment, or diagnosis related to high blood pressure. See, e.g., September 1968 Report of Medical Examination (examining the Veteran for enlistment purposes and recording a blood pressure reading of 132/72); October 1972 Report of Medical Condition (examining the Veteran for separation purposes and recording a blood pressure reading of 112/74). A review of the Veteran’s post-service medical treatment records does not reflect a current diagnosis of high blood pressure. A letter written by the Veteran’s primary care physician notes that the Veteran does not have a family history of hypertension but does not provide a specific diagnosis of hypertension. See August 2019 Dr. P.C. Letter. To reiterate, the existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110; Degmetich, 104 F. 3d at 1332. In the absence of proof of a current disability, there can be no valid claim. Brammer, 3 Vet. App. at 225. With respect to the Veteran’s general assertions that he has high blood pressure, although lay persons are competent to provide opinions on some medical issues, determining a diagnosis for the nature and etiology of such a condition falls outside the realm of common knowledge of a lay person. In this regard, while the Veteran can competently report symptoms of high blood pressure, any opinion regarding the diagnosis regarding the nature and etiology of those symptoms requires medical expertise that the Veteran has not demonstrated. See Jandreau, 492 F. 3d at 1376. The weight of the evidence does not show that the Veteran currently has a diagnosis of high blood pressure. Thus, the preponderance of the evidence is against the Veteran’s claim for entitlement to service connection for high blood pressure, and the benefit-of-the-doubt doctrine is inapplicable. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 49. Accordingly, the claim for entitlement to service connection for a high blood pressure disability is denied. 2. Entitlement to service connection for a hyperlipidemia disability The Veteran also maintains that he has a high cholesterol disability that is related to his active service. Hyperlipidemia, also referred to as high cholesterol, is “a general term for elevated concentrations of any or all of the lipids in the plasma, including hypertriglyceridemia, hypercholesterolemia, etc.” Dorland’s Illustrated Medical Dictionary 891 (32nd ed. 2012). Hyperlipidemia and elevated cholesterol are laboratory findings and are not disabilities in and of themselves for which VA compensation benefits are payable. See 61 Fed. Reg. 20,440, 20,445 (May 7, 1996) (diagnoses of hyperlipidemia, elevated triglycerides, and elevated cholesterol are actually laboratory results and are not, in and of themselves, disabilities. They are, therefore, not appropriate entities for the rating schedule). There is no case law to the contrary. See Neary v. Shinseki, No. 11-1407, 2012 WL 3641438 (Vet. App. Aug. 24, 2012) (declining to address argument that hyperlipidemia is not a disability but a laboratory finding that manifests itself only in laboratory test results and finding Board’s reasons and bases adequate). See also Bethea v. Derwinski, 2 Vet. App. 252, 254 (1992) (single judge decisions may be relied upon for any persuasiveness or reasoning they contain). In this case, although the Veteran’s medical treatment records reflect that he has hyperlipidemia, given the above definitions and position of VA with regard to the nature of hyperlipidemia and elevated cholesterol, the Board finds that the condition for which the Veteran is claiming service connection is a laboratory finding that manifests itself only in laboratory test results and thus is not a disability for which service connection can be granted. As such, the claim for entitlement to service connection for a high cholesterol disability must be denied. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Raj, 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.