Citation Nr: 20057749 Decision Date: 09/01/20 Archive Date: 09/01/20 DOCKET NO. 12-33 097 DATE: September 1, 2020 ORDER Entitlement to service connection for allergies is denied. Entitlement to service connection for hypertension is denied. FINDINGS OF FACT 1. The medical evidence of record indicates that the Veteran had preexisting allergies that were not aggravated beyond the natural progression during his period of service. 2. The evidence indicates that the Veteran’s hypertension is not related to or aggravated by a service-connected disability, and there is no evidence of complaint of or treatment for hypertension during service or within one year of separation from service. CONCLUSIONS OF LAW 1. The criteria for service connection for allergies have not been met. 38 U.S.C. §§ 1153, 5107(b); 38 C.F.R. §§ 3.303, 3.306. 2. The criteria for service connection for hypertension have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served active duty in the United States Army from August 1973 to August 1976. In April 2017, the Veteran testified before the undersigned Veterans Law Judge at a Video Conference hearing. A copy of the transcript has been associated with the claims file. In September 2017 and February 2019, the Board remanded the appeal for further development. Service Connection 1. Service connection for allergies The Veteran contends that his allergies are due to his period of service. The Board finds that the Veteran had preexisting allergies that were noted upon entry, and the allergies were not aggravated during service such that service connection would be warranted. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if preexisting such service, was aggravated thereby. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may be established for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that disease was incurred in service. 38 C.F.R. § 3.303(d). If a preexisting disorder is noted upon entry into service, a veteran cannot bring a claim for service connection for that disorder, but the veteran may bring a claim for service-connected aggravation of that disorder. 38 U.S.C. § 1153; 38 C.F.R. § 3.306; see Wagner v. Principi, 370 F.3d 1089 (Fed. Cir. 2004). In that case, 38 U.S.C. § 1153 applies and the burden falls on the veteran to establish an increase in severity. See Jensen v. Brown, 19 F.3d 1413, 1417 (Fed. Cir. 1994). If the presumption of aggravation under § 1153 arises, the burden shifts to the government to show a lack of aggravation by establishing “that the increase in disability is due to the natural progress of the disease.” See 38 U.S.C. § 1153; see also 38 C.F.R. § 3.306; Jensen, 19 F.3d at 1417; Wagner, 370 F. 3d at 1096. Significantly, clear and unmistakable evidence is required to rebut the presumption of aggravation where the preservice disability underwent an increase in severity during service. 38 C.F.R. § 3.306(b). Aggravation may not be conceded where the disability underwent no increase in severity during service on the basis of all the evidence of record pertaining to the manifestations of the disability prior to, during, and subsequent to service. 38 C.F.R. § 3.306(b). Temporary or intermittent flare-ups of a preexisting injury or disease are not sufficient to be considered “aggravation in service” unless the underlying condition as contrasted to symptoms is worsened. See Jensen. At the outset, the Board notes that, based on the January 2018 VA examination, a current diagnosis of allergies (allergic rhinitis) has been confirmed. Therefore, the first element of service connection has been met. The Veteran’s service treatment records note hay fever treated with medication in the August 1973 entry examination. Therefore, as the Veteran’s pre-existing allergies were noted at entry, the presumption of soundness does not attach. See 38 U.S.C. § 1111; Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004) (noting that a veteran is presumed to have been sound upon entry into the military, except as to conditions noted at the time of the acceptance, examination, or enrollment). In an April 2017 Board hearing, the Veteran reported worsening symptoms during service, stating that his symptoms seemed to get worse during winter. In a September 2019 VA examination, the examiner opined that the Veteran’s allergies, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness. The examiner explained that, upon entering the military, the Veteran endorsed having hay fever (also known as seasonal allergies) on his August 1973 enlistment physical. The examiner stated that the natural course of seasonal allergies is to intermittently flare up with exposure to stimuli. The examiner noted that during the Veteran’s period of service, there were no other reports of significant allergy symptoms. The examiner further noted that the Veteran did not seek evaluation for allergic eye symptoms until 25 years after separation from service. The examiner reported that medical records show multiple visits afterwards between 2002-2008 reflecting allergic rhinitis and asthma symptoms. The examiner noted an instance in October 2002 in which the Veteran was hospitalized for one day for shortness of breath and chest pain thought to be related to severe allergic rhinitis with sinusitis and bronchitis. The examiner stated that the Veteran has intermittently sought treatment for his symptoms over the decades. The examiner concluded that there is no evidence to support that the Veteran has had clear exacerbation of his allergic rhinitis above the expected waxing and waning of symptoms over time. Therefore, the Veteran’s medical records do not support that the claimed allergic rhinitis was aggravated beyond its natural progression by an in-service illness, event, or injury. The Board finds this opinion to be highly probative, as it is based on review of the medical records and is supported by adequate rationale. After review of the record, the Board finds that the evidence of record weighs against a finding of service connection for allergies. The medical evidence indicates that the Veteran had a preexisting allergic rhinitis condition; however, the probative medical evidence does not establish that the preexisting allergies increased in severity beyond the natural progression during the Veteran’s period of service. Therefore, the Veteran’s allergies neither manifested in nor were aggravated by his period of service. Thus, service connection for allergies is not warranted. The Board has considered the Veteran’s contention that his period of service resulted in aggravation of his allergies. Although lay persons are competent to provide opinions on some medical issues, as to the specific issue in this case, determining the etiology of allergic rhinitis requires specialized knowledge that falls outside the realm of common knowledge of a lay person. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). In this regard, while the Veteran can competently report his symptoms, any opinion regarding whether the Veteran’s current allergic rhinitis is related to his service requires medical expertise that the Veteran has not demonstrated. See Jandreau v. Nicholson, 492 F. 3d 1372, 1376 (2007). As such, the Board assigns no probative weight to the Veteran’s assertions that his allergies are related to his military service. 2. Service connection for hypertension The Veteran contends that his hypertension is due to his period of service. Specifically, the Veteran contends that his hypertension is secondary to the medications he takes for his asthma and allergies. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if preexisting such service, was aggravated thereby. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may be established for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that disease was incurred in service. 38 C.F.R. § 3.303(d). Generally, to prevail on a claim of service connection on the merits, there must be competent evidence of (1) current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence or other competent evidence of a nexus between the claimed in-service disease or injury and the present disease or injury. See Hickson v. West, 12 Vet. App. 247 (1999); Jandreau v. Nicholson, 492 F.3d at 1372. Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. The question for the Board is whether the Veteran has a current disability that is proximately due to or the result of or is aggravated beyond its natural progress by service-connected disability. The Board concludes that, while the Veteran has a current diagnosis of hypertension, the preponderance of the evidence is against finding that the Veteran’s hypertension is proximately due to or the result of or was aggravated beyond its natural progression by service-connected disability. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). At the outset, the Board notes that at the writing of the decision, service connection for asthma and allergies has been denied. Therefore, service connection on a secondary basis for either asthma or allergies, or the medications used to treat the aforementioned, is not warranted. Turning the analysis to service connection on a direct basis, a review of the Veteran’s service treatment reports does not reflect any complaints, findings, or treatment for hypertension during the Veteran’s period of service, nor does the Veteran contend that his hypertension started during service. See Hearing Transcript at 9. Therefore, the second element of service connection on a direct basis has not been met. Moreover, the evidence does not establish that the Veteran’s hypertension manifested to a compensable degree within a year of separation from active duty. As the record does not establish that the Veteran incurred his hypertension within a year of separation from service, service connection on a presumptive basis due to a chronic disease under 38 C.F.R. § 3.309(a) is also not warranted. While the Veteran believes that his hypertension is related to his period of service, he is only competent to report symptoms and is not competent to opine on the etiology of hypertension, as this is a medically complex question. The Board reiterates that the preponderance of the evidence weighs against findings that complaint of or treatment for in-service hypertension occurred and there is no evidence that the Veteran’s hypertension is related to a service-connected disability. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Ford 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.