Citation Nr: 20043598 Decision Date: 06/29/20 Archive Date: 06/29/20 DOCKET NO. 18-46 000 DATE: June 29, 2020 ORDER Entitlement to service connection for rheumatoid arthritis of the bilateral hands and fingers, left foot, bilateral wrists, and right elbow is denied. FINDING OF FACT Rheumatoid arthritis of the bilateral hands and fingers, left foot, bilateral wrists, and right elbow is not secondary to service-connected degenerative joint disease, and is not otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for rheumatoid arthritis of the bilateral hands and fingers, left foot, bilateral wrists, and right elbow, to include as due to service or a service-connected disability, are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from January 1983 to October 1992. This matter comes before the Board of Veterans’ Appeals (Board) from a July 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for rheumatoid arthritis of the bilateral hands and fingers, left foot, bilateral wrists, and right elbow The Veteran contends that he is entitled to service connection for rheumatoid arthritis because the claimed disability is the result of active service. More specifically, the Veteran asserts that rheumatoid arthritis may be related to a fracture right arm from wrist to elbow in service. He also claims that the rheumatoid arthritis caused more problems with the left foot. In the alternative, the Veteran alleges that the claimed disability is secondary to service-connected disabilities of degenerative joint disease of the right elbow, status post right elbow lateral epicondylectomy and release with scar, and osteoarthritis with calcaneal spurs, status post residuals of resection of the dorsal tarsal exostosis of the left foot. Service connection may be established for disability resulting from disease or injury incurred in or aggravated during service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. That determination requires a finding of current disability that is related to an injury or disease in service. Watson v. Brown, 4 Vet. App. 309 (1993); Rabideau v. Derwinski, 2 Vet. App. 141 (1992). Service connection may be established for a disability diagnosed after separation, when all the evidence, including that pertinent to service, establishes that the disability is due to disease or injury that was incurred or aggravated in service. 38 C.F.R. § 3.303(d). A disability that is proximately due to or the result of a service-connected disability shall be service-connected. When service connection is established for a secondary disability, the secondary disability shall be considered a part of the original disability. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a nonservice-connected disability which is aggravated by a service-connected disability. In that instance, the Veteran is compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b); Allen v. Brown, 7 Vet. App. 439 (1995). The Veteran was diagnosed with rheumatoid arthritis in 2015. In an August 2018 VA examination, the examiner opined that there was no objective evidence to sustain that the condition was aggravated, in any measurable way by the right elbow lateral epicondylectomy and/or by osteoarthritis with calcaneal spurs, status post resection dorsal tarsal exostosis of the left foot. In June 2019 the claim was remanded for an addendum opinion on direct service connection and aggravation by a service-connected disability. In a December 2019 VA examination, the examiner opined that the claimed disability was less likely than not caused or aggravated by the service-connected degenerative joint disease. The rationale provided was that there was no objective medical evidence to confirm that rheumatoid arthritis was caused by degenerative joint disease. The examiner highlighted that rheumatoid arthritis is an autoimmune disease where the body’s immune system sends inflammation to its own healthy tissue. If the inflammation remains present for a long period of time, it can cause damage to the joint. Therefore, the examiner did not find a nexus between the claimed disability and service including in-service treatment for an injury of the right arm from wrist to elbow while in service; and from when the left foot dorsal tarsal exostosis required treatment including surgery in May 1987. The Board concludes that, while the Veteran has a current diagnosis of rheumatoid arthritis, and evidence shows that the Veteran injured his right arm and his left foot, and underwent foot surgery while in service, the preponderance of the evidence weighs against finding that the diagnosis of rheumatoid arthritis was caused or aggravated by a service-connected disability or began during service or is otherwise related to any injury, event, or disease in service. The Veteran believes his rheumatoid arthritis is related to his degenerative joint disease or an in-service injury, event, or disease. The Veteran in this case is not competent to provide a nexus opinion regarding the issue. The issue is medically complex, as it requires specialized knowledge. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to provide such a medical opinion. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Kahana v. Shinseki, 24. Vet. App. 428 (2011). The December 2019 examiner noted that the cause of rheumatoid arthritis stems from an autoimmune disease and there was no objective medical evidence that it was caused or aggravated by an in-service incident or service-connected disability. The Board assigns more probative weight to the VA examinations of record and finds those opinions more persuasive as they were provided by examiners with medical training, following examination. The Veteran has not submitted any contrary competent evidence that supports a finding that rheumatoid arthritis is related to service, or is caused or aggravated by a service-connected disability. Accordingly, the Board finds that the preponderance of the evidence is against the claim for service connection for rheumatoid arthritis, and the claim for service connection must be denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Department of Veterans Affairs 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.