Citation Nr: 20037095 Decision Date: 06/01/20 Archive Date: 06/01/20 DOCKET NO. 17-01 905 DATE: June 1, 2020 ORDER Entitlement to service connection for a left-hand skin rash (“skin rash”) is denied. FINDING OF FACT The Veteran’s a left-hand skin rash is not related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for a left-hand skin rash have not been met. 38 U.S.C. §§ 1101, 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1971 to February 1973. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran provided testimony at a September 2019 videoconference hearing before the undersigned Veterans Law Judge at the RO. A transcript of the hearing is associated with the claims folder. The Veteran claims his left-hand skin rash is related to an in-service injury. Specifically, he alleges chemical exposure resulted in the skin rash. For the reasons discussed below, the Board finds the evidence weighs against a finding that the Veteran’s current disability is related to service. Therefore, service connection is not warranted. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection requires: (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In addition, for certain chronic diseases a presumption of service connection arises if the disease is manifested to a degree of 10 percent within one year following discharge from service. 38 C.F.R. §§ 3.307, 3.309(a). When a chronic disease is not shown within one year after service, under 38 C.F.R. § 3.303(b) for the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time. When the fact of chronicity in service is not adequately supported, a showing of continuity after discharge is required to support a claim for such diseases; however, such continuity of symptomatology may only support a claim for those chronic diseases listed under 38 C.F.R. §§ 3.303(b), 3.309(a); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant. Turning to the evidence, service treatment records (STRs) for July 1972 reflected a thumb injury to the left hand. There was a slight abrasion secondary to thumb tenderness. The February 1973 service separation examination did not reveal any complaints or treatment for a left-hand rash. Post service, a July 2016 VA examination report indicated review of the Veteran’s claims file, recounted the Veteran’s history, and recited his complaints. He was diagnosed with chronic hand eczema of the left hand that involves less than 5 percent of the total body area. He reported the condition began during work detail in North Carolina in 1971 when he were splashed with an unknown chemical. The examiner opined the claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. For the rationale the examiner found “the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness because there is no service treatment record of left palm skin condition. The July 20, 1972 service treatment record is for an abrasion to the left thumb-different body part and different diagnosis.” In November 2016, VA treatment records reflected complaints of the left-hand pain. The Veteran reported he was splitting wood with a log splitter before experiencing the left-hand pain. He did not feel any pop and he does not remember any injury. However, the hand was swollen, and the pain was a 10 out of 10. During the September 2019 Board hearing the Veteran testified to working as a machinist in an engine room working with chemicals, oils, helicopter fuel, and helicopter hydraulic oil. He also testified to an incident in 1971 involving a 55-gallon drum. While moving the drum the liquid inside splashed and caused his hand to break out. He was sent to sick hall and after treatment, was instructed to return to work. He has had on-and-off issues with the hand since service. Specifically, his hand swells up, cracks open, and bleeds. The Board has reviewed all of the lay and medical evidence of record in conjunction with the applicable laws and regulations and finds the current disability is not related to service. In this regard, the Board finds the most probative evidence of record is the July 2016 VA examination. The examiner found the disability was not related to service, noting the July 1972 STR is for an abrasion to the left thumb which is a different body part and different diagnosis than the Veteran’s current left-hand rash. There are no competent conflicting medical opinions and the VA opinion is supported by the post service records. Specifically, in November 2016 VA treatment records the Veteran complained of left-hand pain after splitting wood with uncertainty as to an actual injury. The Board finds the failure to mention the alleged ongoing left-hand pain due to an alleged in-service injury is evidence against the allegations. See Buczynski v. Shinseki, 24 Vet. App. 221, 224 (2011) (citing Fed. R. Evid. 803 (7) for the proposition that the absence of an entry in a record may be evidence against the existence of a fact if it would ordinarily be recorded). Therefore, the July 2016 VA opinion is the most probative evidence. Likewise, the Board finds the Veteran’s in-service injury allegation is in direct conflict with the contemporaneous service treatment records. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006) (the lack of contemporaneous medical records is one fact the Board can consider and weigh against the other evidence, although the lack of such medical records does not, in and of itself, render the lay evidence not credible). During the September 2019 Board hearing he testified to unknown chemical exposure to his left-hand resulting in a rash and sick hall visit, however the record is devoid of this in-service treatment or allegation. Although, there is treatment for the left thumb, there are no STRs reflecting complaints or treatment for a skin rash. Additionally, the February 1973 service separation examination did not reveal any complaints or treatment for a left-hand rash. The memory fades and becomes more imperfect with the passage of time, while the documented reports more accurately reflect what actually happened. See Seng v. Holder, 584 F.3d 13, 19 (1st Cir. 2009) (noting that, notwithstanding the declarant’s intent to speak the truth, statement may lack credibility because of faulty memory). Therefore, the Board finds the contemporaneous medical records more credible that the Veteran’s later assertion of an issue since service. Additionally, the Veteran was not treated for a skin rash until 2016, 43 years post service. Such a lapse of time is a factor for consideration in deciding a service connection claim. Maxson v. Gober, 230 F.3rd 1330, 1333 (Fed. Cir. 2000). There are no competent and credible records demonstrating a link between service and the disability other than the Veteran’s lay statements. However, these statements alone do not establish a medical nexus. Indeed, while the Veteran is competent to provide evidence regarding matters that can be perceived by the senses, he is not shown to be competent to render medical opinions on questions of etiology. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); see also Barr v. Nicholson, 21 Vet. App. 303 (2007) (lay testimony is competent to establish the presence of observable symptomatology). As such, as a lay person, he is without the appropriate medical training and expertise to offer an opinion on a medical matter, including the diagnosis, etiology, or causation of a specific disability. The question of diagnosis and causation, in this case, involves complex medical issues that the Veteran is not competent to address. Accordingly, service connection for a left-hand skin rash disability is denied. As the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not applicable. See 38 U.S.C.§5107(b); 38 C.F.R.§ 3.102; see also Gilbert, 1 Vet. App.at 53-56. JONATHAN B. KRAMER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Jackman, 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.