Citation Nr: 20046494 Decision Date: 07/13/20 Archive Date: 07/13/20 DOCKET NO. 11-29 562 DATE: July 13, 2020 ORDER Entitlement to service connection for a bilateral ankle disorder is denied. Entitlement to service connection for a bilateral foot disorder is denied. Entitlement to service connection for a bilateral ear disorder is denied. Entitlement to service connection for a skin disorder is denied. FINDINGS OF FACT 1. The Veteran’s bilateral ankle disorder did not manifest in service or within one year thereafter and is not otherwise related to his military service. 2. The Veteran’s bilateral foot disorder did not manifest in service or within one year thereafter and is not otherwise related to his military service. 3. The Veteran has not been shown to have a current ear disorder that manifested in service or that is otherwise related to his military service. 4. The Veteran has not been shown to have a current skin disorder that manifested in service or that is otherwise related to his military service CONCLUSIONS OF LAW 1. A bilateral ankle disorder was not incurred in active service, nor may arthritis be presumed to have been so incurred. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. A bilateral foot disorder was not incurred in active service, nor may arthritis be presumed to have been so incurred. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 3. An ear disorder was not incurred in active service, nor may it be presumed to have been so incurred. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1154; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. 4. A skin disorder was not incurred in active service, nor may it be presumed to have been so incurred. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1154; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1982 to November 1983. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2011 rating decision. In December 2013, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the record. In December 2014 and February 2018, the Board remanded the case to the Agency of Original Jurisdiction (AOJ) for further development. That development has been completed, and the case has since been returned to the Board for appellate review. In addition, the Board notes that the Veteran’s appeal originally included the issue of entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD). However, during the pendency of the appeal, the AOJ granted service connection for PTSD in a March 2020 rating decision. The grant of service connection constitutes a full award of the benefits sought on appeal. See Grantham v. Brown, 114 F. 3d 1156, 1158 (Fed. Cir. 1997). Thus, the matter is no longer in appellate status. See Grantham, 114 F.3d at 1158 (holding that a separate notice of disagreement must be filed to initiate appellate review of “downstream” elements such as the disability rating or effective date assigned). Law and Analysis The Veteran nor his representative has not raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty in the active military, naval, or air service. 38 U.S.C. §§ 1110, 1131. That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease. If there is no showing of a resulting chronic condition during service, then a showing of continuity of symptomatology after service is required to support a finding of chronicity. 38 C.F.R. § 3.303(b). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). 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. As arthritis is considered to be a chronic disease for VA compensation purposes, if chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). In addition, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including arthritis, are presumed to have been incurred in service if they manifested to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information and lay and medical evidence of record in a case and when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the weight of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). Bilateral Ankle Disorder In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran is not entitled to service connection for a bilateral ankle disorder. The Veteran’s service treatment records show that he was treated for a left ankle sprain in September 1983. He injured his ankle while jogging, and he was treated with physical therapy on three occasions from September 1983 to October 1983. In the October 1983 discharge note, the examining medical officer noted that palpation to the left ankle was nonremarkable, swelling was not present, and his range of motion was within normal limits. There was no diagnosis or follow-up treatment, and the remainder of his service treatments are negative for any complaints, treatment, or diagnosis of a left or right ankle disorder. In fact, an October 1983 separation examination found his lower extremities and feet to be normal, and the Veteran denied having a medical history of arthritis, rheumatism, or bursitis; bone, joint, or other deformity; lameness; and foot trouble. With regard to whether arthritis was shown during service or within one year of separation, the Board finds that such a diagnosis was not shown. To determine that a chronic disease was “shown in service,” the disease identity must be established and the diagnosis not subject to legitimate question. 38 C.F.R. § 3.303(b); Walker, 708 F.3d at 1331. The evidence does not show that the Veteran had arthritis or any other bilateral ankle disorder at the time he separated from service or within one year thereafter. Arthritis must be objectively confirmed by x-ray. 38 C.F.R. § 4.71, Diagnostic Code 5003. Indeed, the post-service medical records do not document any complaints, treatment, or diagnosis of any ankle disorder for many years after his military service, and August 1992 ankle x-rays were negative for any abnormalities. Thus, the Veteran is not entitled to service connection for arthritis of the bilateral ankles on a presumptive basis, either as a chronic disease during service or within one year of service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307(a)(3), 3.309(a); Walker, 708 F.3d 1335 -37. Therefore, chronicity is not established in service or within a year of separation. Furthermore, the evidence does not establish continuity of symptomatology since service. 38 C.F.R. § 3.303(b). In this regard, the medical evidence does not document any complaints, treatment, or diagnosis of a left or right ankle disorder for years after his military service. The Board does acknowledge the Veteran’s statements that he has had ankle problems since his military service. The Board notes that the Veteran is competent to report his experience and symptoms in service and thereafter. Layno v. Brown, 6 Vet. App. 465, 469 (1994); Barr v. Nicholson, 21 Vet. App. 303 (2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). A veteran can attest to factual matters of which he or she has first-hand knowledge, e.g., experiencing pain in service, reporting to sick call, being placed on limited duty, and undergoing physical therapy. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). The Federal Circuit has held that lay evidence is one type of evidence that must be considered, and competent lay evidence can be sufficient in and of itself. The Board, however, retains the discretion to make credibility determinations and otherwise weigh the evidence submitted, including lay evidence. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006). Once evidence is determined to be competent, the Board must determine whether such evidence is also credible. See Layno v. Brown, 6 Vet. App. 465 (1994) (distinguishing between competency (“a legal concept determining whether testimony may be heard and considered”) and credibility (“a factual determination going to the probative value of the evidence to be made after the evidence has been admitted”)); see also Barr v. Nicholson, 21 Vet. App. 303 (2007). In this case, although the Veteran is competent to report symptoms since service, the Board finds that such statements are not reliable or credible. His reports are inconsistent with the contemporaneous record. As previously noted, the Veteran’s service treatment records do show that he sprained his left ankle, but the separation examination found his lower extremities to be normal. Thus, there was actually affirmative evidence showing that he did not have an ankle disorder at the time of his separation from service (as opposed to the mere absence of evidence). The Veteran also denied having any medical history of arthritis, rheumatism, or bursitis; bone, joint, or other deformity; lameness; and foot trouble. Moreover, he did not report any left or right ankle issues at the time of the October 1983 separation examination, despite reporting other numerous past or present medical problems, including a painful left shoulder, recurring low back pain, frequent colds, and difficulty sleeping. See AZ v. Shinseki, 731 F.3d 1303, 1318 (Fed. Cir. 2013) (recognizing the widely-held view that the absence of an entry in a record may be considered evidence that the fact did not occur if it appears that the fact would have been recorded if present). For these reasons, the Board finds that the Veteran’s reported history regarding the onset and continuity of the disorder to be not reliable or credible. In addition to the lack of evidence showing that the claimed disorder manifested during active duty service or within close proximity thereto, the evidence of record does not link any current left or right ankle disorder to the Veteran’s military service. VA treatment records show that the Veteran sprained his left ankle after twisting it getting into his semi-truck in March 1996. He also fractured his right ankle in February 2018. The Veteran was afforded a VA examination in September 2015 at which time he was diagnosed with arthritic changes of the bilateral ankles. The examiner acknowledged the Veteran’s reports that his bilateral ankle disorder began during his military service when he sprained his left and right ankles within a few months of one another while running. He reported experiencing recurrent ankle sprains since service. The examiner opined that the Veteran’s current bilateral ankle disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In so finding, he stated that the Veteran’s October 1983 separation examination report was silent for any ankle complaints. He also noted that an August 1992 VA orthopedics examination mentioned bilateral ankle and foot pain; however, on examination, he was found to have normal x-rays of the ankles. The VA examiner indicated that current x-rays of the bilateral ankles showed minimal or mild degenerative findings. He opined that the Veteran’s minimal or mild degenerative joint disease was less likely than not related to a documented or claimed injury to either ankle during service based on the fact that minimal to mild degenerative findings some 30-plus years after the fact would be an expected normal finding in a 51 year-old person who has worked labor, manufacturing, and commercial driving jobs through the intervening years. A December 2019 VA examiner also opined that the Veteran’s bilateral ankle disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In rendering her opinion, the examiner acknowledged that the service treatment records indicated that the Veteran had a mild left ankle sprain during service that occurred within a few months of his separation from service. She noted that the service treatment records showed that he was evaluated and referred to physical therapy. She also observed that the Veteran followed up with physical therapy within one week and that he reported that his symptoms had resolved. The VA examiner related that the Veteran did not mention any ankle concerns on his report of medical history at separation that was completed within one week of his last physical therapy appointment. She also noted that there was no other documentation of any ankle complaints or treatment found in the Veteran’s service treatment records that would be indicative or predictive of ankle problems after service. The VA examiner noted that the Veteran’s post-service records indicated that he had a left ankle sprain in 1996, which was 13 years after service, and a right ankle fracture in 2018, which was 35 years after service. Therefore, she concluded that it is less likely than not that the Veteran’s current bilateral ankle disorder was incurred in or caused by his active miliary service. The Board affords substantial probative weight to the VA examiners’ opinions. The opinions are based on an accurate review of the claims file, fully address the etiology of the Veteran’s bilateral ankle disorder, and consider the medical and lay evidence of record. The opinions are also supported by clear and adequate rationale. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). There is no medical opinion otherwise relating the Veteran’s current bilateral ankle disorder to his military service. The Board acknowledges the Veteran’s lay statements that his current bilateral ankle disorder is related to an injury in service. Although lay persons are competent to provide opinions on some medical issues, Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), as to the specific issues in this case, the diagnosis and etiology of a bialteral ankle 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 not competent to diagnose cancer). The questions of diagnosis and etiology in this case go beyond a simple and immediately observable cause-and-effect relationship, particularly considering the delayed onset of the disorder. Moreover, even assuming the lay assertions regarding etiology are competent, the Board nevertheless finds the VA medical opinions to be more probative, as they are based on a review of the record and the examiner’s own medical expertise, training, and knowledge. The examiners supported their conclusions with rationale and considered the Veteran’s medical history, including his own statements. Based on the foregoing, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for a bilateral ankle disorder. Because the preponderance of the evidence is against the Veteran’s claim, the benefit of the doubt provision does not apply. Accordingly, the Board concludes that service connection for a bilateral ankle disorder is not warranted. Bilateral Foot Disorder In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran is not entitled to service connection for a bilateral foot disorder. The Veteran’s service treatment records show that he was treated for complaints of bilateral foot numbness and sore big toes. It was noted that the Veteran had improper fitting shoes and secondary blisters. There was no diagnosis or follow-up treatment, and the remainder of his service treatments are negative for any complaints, treatment, or diagnosis of a left or right foot disorder. In fact, an October 1983 separation examination found his lower extremities and feet to be normal, and the Veteran denied having a medical history of arthritis, rheumatism, or bursitis; bone, joint, or other deformity; lameness; and foot trouble. With regard to whether arthritis was shown during service or within one year of separation, the Board finds that such a diagnosis was not shown. To determine that a chronic disease was “shown in service,” the disease identity must be established and the diagnosis not subject to legitimate question. 38 C.F.R. § 3.303(b); Walker, 708 F.3d at 1331. The evidence does not show that the Veteran had arthritis or any other bilateral foot disorder at the time he separated from service or within one year thereafter. Arthritis must be objectively confirmed by x-ray. 38 C.F.R. § 4.71, Diagnostic Code 5003. Indeed, the post-service medical records do not document any complaints, treatment, or diagnosis of any ankle disorder for many years after his military service. August 1992 bilateral foot x-rays showed very mild hallux valgus of the big toes, but unremarkable feet otherwise. Thus, the Veteran is not entitled to service connection for arthritis of the bilateral feet on a presumptive basis, either as a chronic disease during service or within one year of service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307(a)(3), 3.309(a); Walker, 708 F.3d 1335 -37. Therefore, chronicity is not established in service or within a year of separation. Furthermore, the evidence does not establish continuity of symptomatology since service. 38 C.F.R. § 3.303(b). In this regard, the medical evidence does not document any complaints, treatment, or diagnosis of a left or right foot disorder for years after his military service. The Board does acknowledge the Veteran’s statements that he has had foot problems since his military service. The Board notes that the Veteran is competent to report his experience and symptoms in service and thereafter. Layno v. Brown, 6 Vet. App. 465, 469 (1994); Barr v. Nicholson, 21 Vet. App. 303 (2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). A veteran can attest to factual matters of which he or she has first-hand knowledge, e.g., experiencing pain in service, reporting to sick call, being placed on limited duty, and undergoing physical therapy. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). The Federal Circuit has held that lay evidence is one type of evidence that must be considered, and competent lay evidence can be sufficient in and of itself. The Board, however, retains the discretion to make credibility determinations and otherwise weigh the evidence submitted, including lay evidence. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006). Once evidence is determined to be competent, the Board must determine whether such evidence is also credible. See Layno v. Brown, 6 Vet. App. 465 (1994) (distinguishing between competency (“a legal concept determining whether testimony may be heard and considered”) and credibility (“a factual determination going to the probative value of the evidence to be made after the evidence has been admitted”)); see also Barr v. Nicholson, 21 Vet. App. 303 (2007). In this case, although the Veteran is competent to report symptoms since service, the Board finds that such statements are not reliable or credible. His reports are inconsistent with the contemporaneous record. As previously noted, the Veteran’s service treatment records do show that he was treated for complaints of foot numbness attributed to ill-fitting shoes, but the separation examination found his lower extremities to be normal. Thus, there was actually affirmative evidence showing that he did not have a bilateral foot disorder at the time of his separation from service (as opposed to the mere absence of evidence). The Veteran also denied having any medical history of arthritis, rheumatism, or bursitis; bone, joint, or other deformity; lameness; and foot trouble. Moreover, he did not report any left or right foot issues at the time of the October 1983 separation examination, despite reporting other numerous past or present medical problems, including a painful left shoulder, recurring low back pain, frequent colds, and difficulty sleeping. See AZ v. Shinseki, 731 F.3d 1303, 1318 (Fed. Cir. 2013) (recognizing the widely-held view that the absence of an entry in a record may be considered evidence that the fact did not occur if it appears that the fact would have been recorded if present). For these reasons, the Board finds that the Veteran’s reported history regarding the onset and continuity of the disorder to be not reliable or credible. In addition to the lack of evidence showing that the claimed disorder manifested during active duty service or within close proximity thereto, the evidence of record does not link any current left or right foot disorder to the Veteran’s military service. VA treatment records show that the Veteran sustained trauma that caused tendon or neural damage to the right dorsum of his foot in 1991. An August 1992 VA bone scan of the feet showed minimal hyperexemia with superficial focal increased delayed activity in the medial left tarsal region compatible with degenerative joint disease. In a September 2011 VA podiatry note, the Veteran was evaluated for bilateral foot pain. He was diagnosed with suspected plantar fasciitis, pes planus, and tarsal tunnel syndrome. The podiatrist also noted that he suspected neuroma versus capsulitis versus metatarsalgia. He stated that the it was difficult to sort things out definitively on examination due to the Veteran’s hypersensitivity and pain in his feet. A June 2018 VA treatment note indicated that the Veteran presented to the emergency room with complaints of bilateral foot pain for one month. He was diagnosed with foot pain likely related to pes planus. The Veteran was afforded a VA examination in December 2019. The examiner diagnosed the Veteran with bilateral pes planus and osteoarthritis. She noted that the Veteran was a poor historian and that he could not recall any specific diagnoses related to his feet. When asked what problems he has had since service, the Veteran reported that his feet burned if he sat too long and that his feet hurt when he walked a lot. The VA examiner opined that the Veteran’s foot disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. She noted that the Veteran had several diagnoses over the past years, including pes planus; however, his enlistment and separation examinations were silent for findings related to pes planus. In addition, his service treatment records were silent for complaints related to pes planus. The examiner indicated that the Veteran was treated in service for complaints related to his great toes and that he was found to have inappropriate fitting shoes. She related that no further complaints or concerns were found after the Veteran’s shoes were changed. She further noted that the Veteran’s mild left ankle sprain during service, which appeared to have resolved within several days, would not cause pes planus or any other foot disorder. The examiner explained that, for an ankle to cause any foot problems, the sprain would have to be serious enough to cause long term gait alterations, and those problems would usually resolve as the ankle improved. She found that this was not the case for the Veteran, as he denied any further ankle concerns within a week after his initial treatment for his left ankle sprain. The examiner further noted that the Veteran was also diagnosed with plantar fasciitis in 1992, which was nine years after he separated from service. In addition, she indicated that more recent x-rays showed mild osteoarthritic changes, which she found were more consistent with aging. The examiner concluded that no information was found in the available service treatment records that would be indicative or predictive of foot problems after service. The Board affords substantial probative weight to the VA examiner’s opinion. The opinion is based on an accurate review of the claims file, fully addresses the etiology of the Veteran’s bilateral foot disorder, and considers the medical and lay evidence of record. The opinion is also supported by clear and adequate rationale. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). There is no medical opinion otherwise relating the Veteran’s current bilateral foot disorder to his military service. The Board acknowledges the Veteran’s lay statements that his current bilateral foot disorder is related to an injury in service. Although lay persons are competent to provide opinions on some medical issues, Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), as to the specific issues in this case, the diagnosis and etiology of a bialteral ankle 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 not competent to diagnose cancer). The questions of diagnosis and etiology in this case go beyond a simple and immediately observable cause-and-effect relationship, particularly considering the delayed onset of the disorder. Moreover, even assuming the lay assertions regarding etiology are competent, the Board nevertheless finds the VA medical opinion to be more probative, as it is based on a review of the record and the examiner’s own medical expertise, training, and knowledge. The examiner supported her conclusions with rationale and considered the Veteran’s medical history, including his own statements. Based on the foregoing, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for a bilateral foot disorder. Because the preponderance of the evidence is against the Veteran’s claim, the benefit of the doubt provision does not apply. Accordingly, the Board concludes that service connection for a bilateral foot disorder is not warranted. Bilateral Ear Disorder In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran is not entitled to service connection for a bilateral ear disorder. The Board has reviewed the claims file, to include the service treatment records, post-service medical records, and lay statements; however, there is no indication of a bilateral ear disability during the appeal period or within close proximity thereto. The Board notes that a separate claim for service connection for bilateral hearing loss has been adjudicated. See July 2018 rating decision. The Veteran’s service treatment records show that he was treated for bilateral otitis media and otitis externa in March 1983 and for right otitis externa and otitis media in September 1983. There was no diagnosis or follow-up treatment, and the remainder of his service treatments are negative for any complaints, treatment, or diagnosis of a left or right ear disorder. In fact, an October 1983 separation examination found his ears to be normal. In the October 1983 separation report of medical history, the Veteran indicated that he had ear, nose, and throat trouble. However, the examining medical officer noted that the Veteran reported frequent colds since he arrived in England in January 1983, but that he was treated with decongestants with good results. Following service, in October 1983, the Veteran was treated for a left ear infection. However, subsequent VA treatment records dated in October 1983 showed that the Veteran had normal ears. In a June 1992 VA treatment note, the Veteran complained of pressure in his ears and head for weeks. He was diagnosed with tonsillitis and treated. In an August 1992 VA treatment note, it was noted that the Veteran’s right ear canal was slightly erythematous. The Veteran was provided a VA ear conditions examination in October 2015. The examiner diagnosed the Veteran with resolved left otitis externa. On examination, the Veteran’s ears were normal. The examiner noted that the Veteran was evaluated and treated for left otitis externa during service, which resolved without residuals. He noted that there were no current findings of an ear condition or the residuals of an in-service episode of left otitis externa. 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, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). Evidence must show that the Veteran currently has the disability for which benefits are being claimed. Because the evidence does not show that Veteran has a current bilateral ear disability during the appeal period, the Board concludes that service connection is not warranted, and no discussion of the remaining elements is necessary. See Coburn v. Nicholson, 19 Vet. App. 427, 431 (2006) (the absence of any one element will result in denial of service connection). As the weight of the evidence is against the Veteran’s claim for service connection for a bilateral ear disorder, the benefit-of-the-doubt rule does not apply, and the claim is denied. Gilbert, 1 Vet. App. 49, 53. Skin Disorder In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran is not entitled to service connection for a skin disorder. During the December 2013 hearing, the Veteran reported that he developed hives during service and that he continues to break out in hives when he is stressed. The Veteran’s service treatment records are silent for any complaints of, treatment for, or diagnoses of a skin disorder. In fact, in his October 1983 report of medical history at separation from service, the Veteran denied having any skin diseases. In a November 2011 VA treatment note, the physician noted that the Veteran had a diffuse, pruritic rash on his back, arms, and legs. The Veteran denied any known exposures or bites. The physician noted that the Veteran was transient and that the rash was concerning fro mite bites with local reaction. He indicated that the rash was not consistent with scabies or a rash of systemic illness. In a subsequent November 2011 VA treatment note, the Veteran presented to the emergency room with complaints of a rash over most of his body. He indicated that he had it intermittently for years. An examination revealed a scaly rash over the Veteran’s arms and legs, as well as his upper chest and upper back. The Veteran was provided a VA skin diseases examination in December 2019. The examiner noted the Veteran’s report that he broke out periodically during periods of stress, beginning in 1983. The Veteran indicated that he could not recall ever having a dermatology consultation or a skin biopsy. A physical examination of the skin showed no current skin conditions. The examiner opined that a skin disorder was less likely than not proximately due to or the result of the Veteran’s service. She noted that it was beyond her scope to determine the presence of stress during the Veteran’s active duty service. However, she noted that the Veteran’s service treatment notes were silent for any concerns of rashes during active duty. In addition, she indicated that the Veteran denied any skin concerns during his October 1983 separation report of medical history. She related that the first indication of any skin concern was in the 1992 to 1993 timeframe when the Veteran first filed a claim for service connection for a skin disorder. The examiner noted that literature shows that stress can trigger a rash or hives in some people, but it is considered an autoimmune reaction to stress and it is not a separate pathological condition. She reported that most of the Veteran’s stressors occurred after service, including alcohol problems, homelessness, and several jail terms. The examiner stated that these stressors would be consistent with the timeframe after separation until his first claim for service connection for a skin disorder in 1993. She concluded that no information was found in the service treatment records that would be indicative or predictive of skin problems after service. 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, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). Evidence must show that the Veteran currently has the disability for which benefits are being claimed. Because the evidence does not show that Veteran has a current skin disability, the Board concludes that service connection is not warranted, and no discussion of the remaining elements is necessary. See Coburn v. Nicholson, 19 Vet. App. 427, 431 (2006) (the absence of any one element will result in denial of service connection). As the weight of the evidence is against the Veteran’s claim for service connection for a skin disorder, the benefit-of-the-doubt rule does not apply, and the claim is denied. Gilbert, 1 Vet. App. 49, 53. J.W. ZISSIMOS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Osegueda, 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.