Citation Nr: 20049984 Decision Date: 07/28/20 Archive Date: 07/28/20 DOCKET NO. 17-05 497 DATE: July 28, 2020 ORDER Service connection for scalp disability to include alopecia areata, to exclude folliculitis, is granted. Service connection for chronic neck pain (“neck disability”) is denied. FINDINGS OF FACT 1. The probative evidence is in relative equipoise as to whether the Veteran’s alopecia areata had its onset in service. 2. The most probative evidence does not demonstrate that the Veteran’s currently diagnosed neck disability manifested during, or as a result of, active military service, or that it manifested within a year of active service. CONCLUSIONS OF LAW 1. The criteria for service connection for alopecia areata have been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for neck disability have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The scalp disability claim includes two claims—one for alopecia and one for folliculitis. Entitlement to service connection for folliculitis was originally on appeal as well. However, in a May 2020 rating decision, the RO granted service connection for this claim, representing a full grant of benefits. Accordingly, this issue is no longer before the Board. The only remaining issues on appeal are listed on the title page. The Board remanded the matter in November 2018 for additional development. The Board finds that the remand directives have been substantially complied with and therefore will proceed with the appeal. Stegall v. West, 11 Vet. App. 268. Service Connection The Veteran had honorable active service from February 1988 to October 2001 and active service characterized as dishonorable for VA purposes from October 2001, to July 2010. An April 2014 Administrative Decision details the period of dishonorable service. In February 2007 the Veteran was given a general court martial for immoral conduct. The Veteran’s service from October 26, 2001, to July 20, 2010, is dishonorable for VA purposes. Insanity is not an issue. This designation is a bar to VA benefits for the dishonorable period of service. VA benefits are not payable unless the period of service upon which the claim is based was terminated by discharge or release under conditions other than dishonorable. 38 U.S.C. § 5303; 38 C.F.R. § 3.12(a). The term “veteran” means a person who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable. 38 C.F.R. § 3.1(d). The threshold question to be answered in every claim for VA benefits concerns the adequacy of the claimant’s service for purposes of establishing basic eligibility. Applicable laws and regulations provide that most VA benefits are not payable unless the period of service upon which the claim is based was terminated by discharge or release under conditions other than dishonorable. 38 U.S.C. §§ 101(2), 101(18), 5303; 38 C.F.R. § 3.12(a). Regulations further provide that a discharge or release for certain offenses is considered to have been issued under dishonorable conditions. 38 C.F.R. § 3.12(d). A discharge from military service as a result of a general court martial conviction is deemed dishonorable. 38 C.F.R. § 3.12(d). However, a discharge under dishonorable conditions will not constitute a bar to benefits if the individual was insane at the time of the commission of the offense(s) resulting in the discharge. 38 C.F.R. § 3.12(b). See also 38 U.S.C. § 5303(b); 38 C.F.R. § 3.354(b). Generally, to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Arthritis is considered a chronic disease. See 38 C.F.R. § 3.309(a). Thus, service connection may be based on credible evidence of continuity of symptomatology alone under 38 C.F.R. § 3.303(b). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the Veteran. 38 U.S.C. § 5107(b). Alopecia areata The record shows a current diagnosis of alopecia areata, with the diagnosis date listed as 2007. See September 2019 VA skin diseases disability benefits questionnaire (DBQ). The diagnosis date was listed as 2007. As such, the medical evidence of record shows a current diagnosis, so the question before the Board is whether such disability is related to service, during his period of honorable service (from February 1988 to October 25, 2001). The entrance examination shows that the Veteran was healthy. His health was described as “good.” There is no indication of symptoms related to a skin disability. As such, he is considered healthy upon entrance. There are several treatment records that indicate treatment for and complaints of a scalp disability, specifically for folliculitis. There are service treatment records dated during the time of dishonorable service that document complaints of and treatment for alopecia areata. There is one service treatment record that falls within the Veteran’s active duty service that shows alopecia areata. A service treatment record dated August 8, 2000 shows the Veteran presented with rings of the scalp and reported loss of hair for the past three weeks. He was diagnosed with alopecia areata. A VA examiner provided performed an examination of the Veteran and provided a medical opinion in September 2019. He opined that the Veteran’s alopecia areata is not related to service. The examiners’ rationale was based on the fact that there were no service treatment records dated within the honorable period of service. The Board acknowledges that the claims file is heavy with service treatment records and notes it is plausible that the examiner failed to see the August 2000 service treatment record. There is a service treatment record showing a diagnosis of alopecia areata and symptoms related to alopecia, such as hair loss. The Veteran has consistently reported the onset of symptoms as occurring in service, there is a showing of this report in service (including a notation during his honorable period of service), and he has complained about similar symptoms post-service. The September 2019 VA examination confirms that he has a current diagnosis of alopecia areata. There is positive and negative evidence addressing the etiology of the Veteran’s alopecia areata. Based on the unique facts of this Veteran’s service, the Board finds the evidence is equipoise as to whether his current alopecia areata is related to his honorable period of service. Service connection is warranted for alopecia areata. Neck disability The record shows a current diagnosis of cervical degenerative disc disease (DDD) and intervertebral disc syndrome (IVDS), with the diagnosis date listed as September 2019. See September 2019 VA neck conditions (DBQ). As there is a current neck disability the questions before the Board is whether such disability is related to an event, injury, or disease incurred during active service, during his period of honorable service (from February 1988 to October 25, 2001). The entrance examination shows that the Veteran was healthy. His health was described as “good.” The exam shows the Veteran did not know whether he ever had or at that time had a head injury. There is no indication of symptoms related to a neck disability. As such, he is considered healthy upon entrance. An April 1997 service treatment record describes the motor vehicle accident (MVA). The Veteran was hit from behind, causing his head to whip back. An April 1997 service treatment record shows he received treatment for the neck injury he sustained in the MVA two days prior. He was examined and the diagnosis is nearly illegible. The only legible portion reads as “strain.” A June 1997 service treatment record states the diagnosis as status-post MVA, mild soft tissue injury. A June 1999 service treatment record shows treatment related to the Veteran’s neck injury. His neck pops and cracks. His injury was treated with physical therapy and exercise. This treatment has yielded good results. A September 2004 treatment record shows his chief complaint was neck pain he had been experiencing for the last two days. There is no diagnosis listed and no symptoms reported to indicate his neck pain had anything to do with his April 1997 MVA. The September 2019 VA examiner opined that the Veteran’s neck disability is less likely than not incurred in or caused by an in-service injury, event, or disease. The rationale provided was that there was scant documentation of follow up over the remainder of the active duty period, with but a single note in September 2004 for neck pain not attributable to cervical lymphadenopathy. There is no documentation of treatment sought for the neck following separation from active duty military service. Due to the lack of evidence and an inability to establish chronicity, it is less likely than not that the Veteran’s cervical DDD was incurred during active duty service. Available service treatment records and medical records do not show any evidence of signs, symptoms, diagnosis, treatments, nor a chronic disability pattern to support a diagnosis of a neck disability, to include cervical DDD, during active duty period, nor within a year after separation from active duty. The Veteran’s neck disability was incurred several years after active duty—18 years after the end of his honorable service. The long-time elapse since the separation from active duty and the development of the condition is against an etiological nexus between the two. The Board notes that cervical DDD may be considered a form of arthritis and therefore a chronic disease. However, as stated above, the record shows that this did not develop until nearly two decades post service. As such, this presumption is not applicable. The Board finds the September 2019 VA opinion to be of high probative value. The examiner indicated review of the file, accounted for the Veteran’s contentions, and provided clear, detailed rationale. Given the probative medical evidence of record, the Board finds that service connection is not warranted, as the Veteran’s neck disability is unrelated to service. The Board notes that the Veteran is competent to report symptoms such as pain. He is not competent to attribute this symptom to an event, injury, or disease in service, as he has not demonstrated that he has the requisite medical expertise in determining its etiology and is a layperson in this regard. The Board acknowledges the Veteran’s contentions that his April 1997 neck injury is related to his current neck disability. However, as stated above he is not competent to diagnose a neck disability, nor is he not competent to attribute symptoms to a neck disability. Lastly, the September 2019 VA medical opinion far outweighs the Veteran’s contentions, and is the only competent evidence of record regarding the nexus element. The preponderance of the evidence establishes that the Veteran does not have a current disability related to service. There is no probative evidence of record to show a connection between an event, injury, or illness in service and the Veteran’s neck disability. As such, the claim is denied. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Talamantes 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.