Citation Nr: 21001153 Decision Date: 01/07/21 Archive Date: 01/07/21 DOCKET NO. 17-20 286 DATE: January 7, 2021 ORDER Service connection for high blood pressure is denied. Service connection for a heart disorder is denied. Service connection for a left knee disorder is denied. Service connection for left ear hearing loss is denied. FINDINGS OF FACT 1. The probative evidence of record does not show that the Veteran’s high blood pressure, heart disorder, or left knee disorder originated in service or for many years thereafter or are otherwise related to the Veteran’s active duty service. 2. The preponderance of the evidence is against a finding that the Veteran has left ear hearing loss. CONCLUSIONS OF LAW 1. The criteria for service connection for high blood pressure, a heart disorder, or left knee disorder are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for left ear hearing loss are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1959 to October 1961. The Board previously remanded these matters in May 2019. A June 2020 rating decision granted service connection for the Veteran’s vision disorder. An October 2020 rating decision granted service connection for right ear hearing loss and tinnitus. As this represent a full grant of benefits sought with respect to these claims, the issues of service connection for a vision disorder, right ear hearing loss, and tinnitus are no longer on appeal. However, as to the issue of service connection for left ear hearing loss, as the October 2020 rating decision denied service connection for that issue, and this does not constitute a full grant, this issue remain on appeal. AB v. Brown, 6 Vet. App. 35, 39 (1993). Service Connection Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303(a). High Blood Pressure Specific to claims for hypertension, regulations require that, to qualify as a disability for purposes of VA compensation claim, the veteran's hypertension must meet certain requirements. Hypertension must be confirmed by readings taken two or more times on at least three different days. In addition, the results must be either that (1) diastolic blood pressure is predominantly 90 mm. or greater; or (2) systolic blood pressure is predominantly 160 mm. or greater with a diastolic blood pressure of less than 90 mm. 38 C.F.R. § 4.104, Diagnostic Code 7101, Note (1). In this matter, the Veteran’s service treatment records (STRs) show that he had elevated blood pressure readings at his entrance and separation examinations. In April 1958 his blood pressure was 120/96 when sitting and 128/88 when standing. In his October 1961 examination the Veteran’s blood pressure when sitting was 138/74 and 128/82 when standing. There are no other noted elevated blood pressure reading during the Veteran’s active duty service. At the outset, the Board notes that the Veteran was not diagnosed with hypertension or treated for high blood pressure during his active duty service. Furthermore, the readings noted above do not meet the criteria set forth above for a confirmation of hypertension. What the evidence of record shows is that the Veteran was not diagnosed with and treated for hypertension until well after his service. He stated in his December 2019 VA examination that his diagnosis occurred in the 1970’s – which, would put his diagnosis at over ten years after his active duty service. Additionally, there is no evidence of record which linked the Veteran’s hypertension to his active duty service. None of the Veteran’s private medical records establish or indicated that the Veteran’s high blood pressure or hypertension were related to his active duty service. Additionally, the VA examination in October 2020 stated that the Veteran’s high blood pressure/hypertension was less likely than not related to his active duty service, even considering the elevated readings in his entrance and separation examinations. The examiner noted that these readings did not qualify as hypertension as defined by VA and that the Veteran did not have diagnosis of or treatment for high blood pressure/hypertension either in-service or within any close proximity to service. Also, neither the Veteran nor his representative have identified or introduced any evidence into the record which supports the claim or shows a link between the Veteran’s high blood pressure/hypertension and his active duty service. Thus, the evidence of record does not support a finding that the Veteran’s high blood pressure/hypertension was related to his active duty service. The Board has considered the Veteran and his wife’s lay statements of record. However, while the Veteran and his wife are credible in the relation of the Veteran’s high blood pressure symptoms, they have not been shown to have the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. King v. Shinseki, 700 F.3d 1339, 1345 (Fed.Cir.2012). The Board has concluded that the medical evidence, prepared by skilled professionals, is more probative regarding the etiology of the Veteran’s hypertension. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Heart As to the Veteran’s heart condition, the evidence of record does not show that the Veteran had diagnosis of or treatment for a heart condition during his active duty service or within any proximity to his active duty service. By his own history, the Veteran stated he developed heart problems in the late 1990’s. He also stated that he had a defibrillator implanted over 15 years ago. There is no evidence, including the Veteran’s own reported medical history, which establishes that his heart condition was diagnosed or treated within any proximity to his active duty service. There are also no medical records, including the Veteran’s private treatment records, which show any treatment or diagnosis of a heart condition within any relative timeframe to the Veteran’s active duty service or any relation of his diagnosed heart conditions to his active duty service. Indeed, a December 2019 VA medical opinion and October 2020 addendum found that the Veteran’s heart conditions were less likely than not related his active duty service, finding no complaints or treatment for the conditions either in-service or close to service. Also, neither the Veteran nor his representative have identified or introduced any evidence into the record which supports the claim or shows a link between the Veteran’s heart conditions and his active duty service. Thus, the evidence of record does not support a finding that the Veteran’s heart conditions were related to his active duty service. The Board has again considered the Veteran and his wife’s lay statements of record. However, while the Veteran and his wife are credible in the relation of the Veteran’s heart symptoms and history, they have not been shown to have the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. King, 700 F.3d at 1345. The Board has concluded that the medical evidence, prepared by skilled professionals, is more probative regarding the etiology of the Veteran’s heart conditions. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Left Knee The Veteran’s has stated that he injured his left knee while in-service but did not seek treatment. The Veteran’s STRs do not show that he suffered an in-service left knee injury. The December 2019 VA examination and October 2020 addendum took into consideration the Veteran’s report of his left knee injury in service. The October 2020 examiner found that such an injury would have been acute and transitory, and that the Veteran’s left knee osteoarthritis was a natural ageing process. The examiner noted that there was no documented evidence in the Veteran’s file which showed serious injury or a chronic condition of his left knee immediately after the Veteran’s active duty service. Both examiners’ found the Veteran’s left knee disorder less likely as not related to his active duty service. Also, neither the Veteran nor his representative have identified or introduced any evidence into the record which supports the claim or shows a link between the Veteran’s high blood pressure/hypertension and his active duty service. Thus, the evidence of record does not support a finding that the Veteran’s left knee condition is related to his active duty service, even taking into consideration the Veteran’s report of a left knee injury in-service. The Board has again considered the Veteran and his wife’s lay statements of record. However, while the Veteran and his wife are credible in the relation of the Veteran’s knee symptoms and history, they have not been shown to have the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. King, 700 F.3d at 1345. The Board has concluded that the medical evidence, prepared by skilled professionals, is more probative regarding the etiology of the Veteran’s knee disorder. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Left Ear Hearing Loss For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. The Veteran’s February 2016 VA examination showed that pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 25 20 15 30 45 LEFT 20 15 25 30 30 His Maryland CNC test scores were 96 percent in the right ear and 100 percent in the left ear. As the Veteran’s right ear met the criteria for hearing loss for VA purposes, service connection was granted for that disability. However, the examination did not show that the Veteran has hearing loss in his left ear as defined by VA. Additionally, is no other evidence in the record which supports a finding that the Veteran has left ear hearing loss as defined by VA. The Board concludes that the Veteran does not have a current diagnosis of left ear hearing loss for VA purposes and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Board acknowledges the lay statements regarding the Veteran’s hearing loss. However, while the Veteran believes he has a current diagnosis of left ear hearing loss, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377, n.4 (Fed. Cir. 2007). The Board gives more probative weight to the competent medical evidence which includes medical records and VA examination report which shows no diagnosis of left ear hearing loss. Therefore, the preponderance of the evidence is against the granting of service connection for left ear hearing loss. (Continued on the next page)   As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Parrish, 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.