Citation Nr: 21000229 Decision Date: 01/04/21 Archive Date: 01/04/21 DOCKET NO. 19-26 116 DATE: January 4, 2021 ORDER 1. Entitlement to service connection for a neck disability is denied. 2. Entitlement to service connection for a right wrist disability is denied. 3. Entitlement to service connection for a left wrist disability is denied. 4. Entitlement to service connection for a right hip disability is denied. 5. Entitlement to service connection for a left hip disability is denied. 6. Entitlement to service connection for a left knee disability is denied. 7. Entitlement to service connection for a right knee disability is denied. 8. Entitlement to service connection for a right ankle disability is denied. 9. Entitlement to service connection for a left ankle disability is denied. 10. Entitlement to service connection for a left foot disability is denied. 11. Entitlement to service connection for a right foot disability is denied. 12. Entitlement to service connection for a right shoulder disability is denied. 13. Entitlement to service connection for a left shoulder disability is denied. 14. Entitlement to service connection for a left elbow disability is denied. 15. Entitlement to service connection for a right elbow disability is denied. FINDING OF FACT Any neck, right wrist, left wrist, right hip, left hip, left knee, right knee, right ankle, left ankle, left foot, right foot, right shoulder, left shoulder, left elbow, right elbow disability was not manifested in service, arthritis of any of those joints was not manifested within a year following the Veteran’s separation from active duty service; and any current such disability is not shown to be etiologically related to the Veteran’s service. CONCLUSION OF LAW Entitlement to service connection for neck, right or left wrist, right or left hip, left or right knee, right or left ankle, left or right foot, right or left shoulder, and/or +left or right elbow disabilities is not warranted. 38 U.S.C. §§ 1110, 1112, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309(a). REASONS AND BASES FOR FINDING AND CONCLUSION The appellant is a Veteran who served on active duty from November 1965 to October 1967 and from February 2003 to April 2004 and had additional Army Reserve service. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a February 2019 rating decision. In February 2020 these matters were remanded for additional development. Service Connection Service connection may be established for disability due to disease or injury that was incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish service connection for a claimed disability, there must be evidence of: (i) a present claimed disability; (ii) incurrence or aggravation of a disease or injury in service; (iii) and a causal relationship between the present disability and the disease or injury in service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and an evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303 (a). Certain chronic diseases (to include arthritis) may be presumed to be service connected if manifested to a compensable degree within a specified period following separation from service (one year for arthritis). 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307, 3.309. For chronic diseases listed in 38 C.F.R. § 3.309 (a), nexus to service may be established by showing continuity of symptomatology. Walker v. Shinseki, 708 F.3d 1331, 1338-40 (Fed. Cir. 2013). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that it was incurred in service. 38 C.F.R. § 3.303 (d); See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a layperson. 38 C.F.R. § 3.159 (a)(2). Competent medical evidence is necessary where the determinative question requires medical knowledge. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Competent medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. Competent medical evidence may also mean statements conveying sound medical principles found in medical treatises. Competent medical evidence may also include statements contained in authoritative writings, such as medical and scientific articles and research reports or analyses. 38 C.F.R. § 3.159 (a)(1). When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. A claim will be denied only if the preponderance of the evidence is against the claim. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). The Veteran’s STRs do not show any mention of complaints, findings, or a diagnosis pertaining to any disability at issue herein. In an October 1967 service discharge (ETS) report of medical history, he reported he was in excellent health, and denied having painful or trick shoulder or elbow, trick or locked knee, or foot trouble. On October 1967 ETS medical examination, his neck, upper extremities, lower extremities, and feet were normal on clinical evaluation. On August 1982 examination for enlistment in the Reserves, the Veteran’s neck, upper extremities, lower extremities, and feet were normal on clinical evaluation. In his report of medical history, at eh time, the Veteran reported that he was in good health and not taking any medication. He denied painful or trick shoulder or elbow, trick or locked knee, and foot trouble. In February 2016 correspondence, the Veteran’s private physician opined (without rationale or review of the Veteran’s records) that the Veteran’s musculoskeletal disabilities are secondary to service. In December 2018, the Veteran was seen with complaints of left foot arthralgias. The provider noted a swollen ankle and swollen big toe joints. In April 2020 correspondence, the Veteran responded that he did not have any additional information or evidence to submit. 1. – 15. Entitlement to service connection for neck, right and left wrist, right and left hip, left and right knee, right and left ankle, left and right foot, right and left shoulder, and right and left elbow disabilities is denied. At the outset, the Board finds that there has been substantial compliance with its February 2020 remand directives in these matters. The service department has certified that no further pertinent STRs are available; The Veteran has not identified any pertinent Reserve Service Medical records that are or may be available for VA obtain on his behalf. The Veteran was asked to provide authorization to VA to secure any private records of any such treatment for his claimed disabilities. He did not submit any identifying information or authorizations, and in April 2020 correspondence stated that he had no further information or evidence to submit. VA treatment records have been associated with the record. See February 2020 CAPRI. Such records do not show any of the claimed disabilities (or that any may be related to service) so as to necessitate development for an examination/opinion under VA’s duty to assist. The only indication that the Veteran has current disabilities of the chronic cervical spine pain, degenerative joint disease of the shoulders, elbows, wrists, hips, knees, ankles and feet is listed in February 2016 correspondence from the Veteran’s private physician (which does not identify any specific diagnosed musculoskeletal disability or any clinical data supporting the conclusion). As noted above, the Veteran has declined to cooperate with VA’s attempts at development for medical information in support of the claims. The record does not contain any indication he has received treatment for any of the claimed disabilities. Notably, any such disabilities were not manifested in service, musculoskeletal injuries in service are not shown, and arthritis of the neck, wrists, hips, knees, ankles, feet, shoulders, or elbows is not shown to have been manifested within a year following service. Accordingly, service connection for any current musculoskeletal disabilities on the basis that they became manifest in service and persisted, or on a presumptive basis (for arthritis as a chronic disease under 38 U.S.C. § 1112) is not warranted. Although unconfirmed by medical evidence of record, because arthritis is a disease listed in 38 C.F.R. § 3.309 (a), service connection for arthritis may be established by showing continuity of symptomatology. See 38 C.F.R. § 3.303 (b); Walker v. Shinseki, 708 F.3d. 1331 -1338-40 (Fed. Cir. 2013). However, continuity of symptomatology is simply not shown. The earliest pertinent medical notation is the record is in the February 2016 correspondence from the Veteran’s private physician, and as noted is nonspecific, and cursory 9and the Veteran has not co-operated with VA’s attempts to follow up. The only evidence submitted in support of these claims, is the February 2016 private physician who opined (without rationale or review of the Veteran’s record) that his musculoskeletal disabilities are secondary to service. Because the provider did not identify the specific “musculoskeletal” disabilities, did not identify the basis for any conclusion that they exist, and did not include any rationale explaining how the “musculoskeletal” disability may be related to service, the opinion is conclusory, appears to be based solely on the Veteran's subjective reports, and does not merit any probative value in these matters. The preponderance of the evidence is against these claims. Accordingly, the appeal in these matters must be denied. GEORGE R. SENYK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Staskowski, 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.