Citation Nr: 21001202 Decision Date: 01/07/21 Archive Date: 01/07/21 DOCKET NO. 16-39 062 DATE: January 7, 2021 ORDER Entitlement to service connection for hypertension is granted. Entitlement to service connection for hyperlipidemia is denied. REMANDED Entitlement to service connection for gout is remanded. FINDINGS OF FACT 1. The Veteran’s hypertension is etiologically related to his service-connected diabetes mellitus. 2. Hyperlipidemia is not a disability for VA benefits purposes. CONCLUSIONS OF LAW 1. The criteria to establish service connection for hypertension have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. 2. The criteria for service connection for hyperlipidemia are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from March 1972 to March 1974. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2016 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO), which denied the Veteran service connection for hypertension, hyperlipidemia, and gout. A Board hearing was held in December 2020. A transcript is of record. Service Connection A Veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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, the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Under section 3.310(a) of VA regulations, service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show: (1) a current disability; (2) a service-connected disability; and (3) a nexus between the current disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1988). As to the third Wallin element, the current disability may be either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). 1. Entitlement to service connection for hypertension is granted. The Veteran contends that his hypertension is caused by his diabetes mellitus (DM). See Board hearing Tr. at 5. The Veteran has hypertension. See April 2016 VA examination report. The Veteran is service connected for DM. The first two Wallin elements are met. Thus, the narrow issue before the Board is whether the Veteran’s hypertension was caused or aggravated by his service-connected DM. A VA medical professional, J.P., opined that the Veteran’s hypertension was caused by his service-connected DM. See May 2016 J.P. correspondence. As rationale, J.P. explained that DM and hypertension are often associated in their progression. Id. Additionally, J.P. has been providing treatment to the Veteran since April 2000, has an intimate understanding of the Veteran’s medical history, and relied on medical principles in the development of his opinion. Id.; see also May 2020 VA treatment records. The Board finds his opinion probative. Thus, the third Wallin element is met. Accordingly, the Board finds there is evidence of record establishing a link between the Veteran’s hypertension and his service-connected DM. 2. Entitlement to service connection for hyperlipidemia is denied. The Veteran contends he is entitled to service connection for hyperlipidemia. See Board hearing tr. at 3-4. During his hearing, he stated that hyperlipidemia does not affect his work or home life. Id. VA treatment records show that the Veteran has a current diagnosis of hyperlipidemia. See May 2020 VA treatment records. However, VA has determined, in its rulemaking capacity, that hyperlipidemia and elevated cholesterol are simply laboratory findings and do not, in and of themselves, constitute a disability for which VA benefits may be awarded. See 61 Fed. Reg. 20440, 20445 (1996). In the absence of proof of a present disability, to include symptoms that cause functional impairment of earning capacity, there can be no valid claim. Degmetich v. Brown, 104 F.3d 1328, 1332 (1997), Wait v. Wilkie, ___ Vet.App. ____ (2020). In the absence of proof of a current disability for which service connection may be granted, there is no valid claim; therefore, the claim is denied. REASONS FOR REMAND 1. Entitlement to service connection for gout is remanded. The Veteran contends that his gout is caused by exposure to herbicide agents in service. See Board hearing Tr. at 5. Alternatively, he contends that his gout is caused by his service-connected DM. The Veteran has gout. See May 2020 VA treatment records. As discussed above, the Veteran is service connected for DM. Moreover, a presumptive exposure to herbicide agents was established with his award of service connection for DM. See April 2016 rating decision, January 2020 VA Memo. The record does not show that the Veteran has been afforded a VA examination. Consistent with VA’s duty to assist, VA must provide a medical examination when there is evidence of (1) a current disability; (2) an in-service injury; (3) some indication that the claimed disability may be associated with the established injury; and (4) insufficient competent evidence of record for VA to make a decision. See McLendon v. Nicholson, 20 Vet. App. 79, 84 (2006). The third prong, which requires evidence that the claimed disability or symptoms “may be” associated with the established event, has a low evidentiary threshold. Id. There is insufficient competent evidence of record for the Board to determine whether the Veteran’s gout is related to his active duty service or service-connected DM. Therefore, the low evidentiary standard is met, and a VA examination is necessary to determine if the Veteran’s gout is related to his time on active duty or his service-connected DM. The matter is REMANDED for the following action: 1. Obtain any outstanding VA and/or private treatment records relevant to treatment the Veteran received for his gout that are not already of record. All obtained records should be associated with the evidentiary record. If any identified records are not obtainable (or none exist), the Veteran and his representative should be notified, and the record clearly documented. 2. Then, schedule the Veteran for an examination to determine the nature and etiology of his gout. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. The examination must include a notation that this record review took place. After the record review and examination of the Veteran, the examiner is asked to respond to the following inquiries: A. Is it at least as likely as not that the Veteran’s gout was incurred in, or is otherwise related to, his time on active service, to include his exposure to herbicide agents? B. Is it at least as likely as not that the Veteran’s gout was (a.) caused or (b.) aggravated by his service-connected disabilities, to include diabetes mellitus? In rendering these opinions, the examiner is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The examiner is not to improperly discount the Veteran’s lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the examiner must provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. (Continued on the next page)   3. After the above has been completed to the extent possible, readjudicate the claims. If any benefit sought remains denied, provide the Veteran and his representative with a supplemental statement of the case (SSOC), and return the case to the Board. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Strickland 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.