Citation Nr: 21001633 Decision Date: 01/11/21 Archive Date: 01/11/21 DOCKET NO. 08-03 327 DATE: January 11, 2021 ORDER Entitlement to service connection for a skin disorder, to include as due to herbicide and asbestos exposure, is denied. Entitlement to service connection for a prostate disorder, to include as due to herbicide and asbestos exposure, is denied. Entitlement to service connection for an acquired psychiatric disorder, to include depression and posttraumatic stress disorder (PTSD), is denied. Entitlement to service connection for a lumbar spine disorder is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran's current skin disorder originated in service, manifested within one year of service, or is otherwise etiologically related to the Veteran's active service. 2. The preponderance of the evidence is against finding that the Veteran’s prostate condition began during active service, or is otherwise related to an in-service injury, event, or disease. 3. The preponderance of the evidence is against a finding that the Veteran had a diagnosis of PTSD during the pendency of the appeal, or that his diagnosed depression is due to service. 4. The preponderance of the evidence is against a finding that the Veteran's currently diagnosed spine disability is related to lower back pain symptoms he experienced in service, or that he experienced a continuity of spine symptomology since service. CONCLUSIONS OF LAW 1. The criteria for service connection for skin disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.309. 2. The criteria for service connection for a prostate disability have not been satisfied. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309. 3. The criteria for service connection for an acquired psychiatric disorder, to include depression, and PTSD, have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309, 4.125. 4. The criteria for service connection for spine disability have not been met. 38 U.S.C. §§ 1110, 1112, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1968 to November 1971. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a July 2006 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). These matters were previously before the Board in June 2015, May 2017, June 2018 and January 2020. In June 2015, the Board reopened the Veteran’s claim for a spine disability and remanded all the issues for further development. In May 2017, the issues were again remanded for further development. In June 2018, the Board denied entitlement to service connection for the Veteran’s skin and prostate disorders and remanded the remaining issues for further development. The Veteran appealed this Board decision to the United States Court of Appeals for Veterans Claims (Court). In a July 2019 Memorandum Decision, the Court set aside the Board’s June 2018 decision and the matters of service connection for his skin and prostate disabilities were remanded for further development and readjudication. Subsequently, the Board remanded all four issues in January 2020 for further development. These matters are once again before the Board. The Memorandum Decision As noted above, the Board previously denied the Veteran’s skin and prostate disorder claims in a June 2018 decision. The Veteran appealed this decision to the Court where it was set aside and remanded for additional development and readjudication. In the Memorandum Decision, the Court held that the Board erred by failing to ensure compliance with its prior May 2017 remand directives regarding the Veteran’s Texas National Guard records. The Court stated that a remand was warranted in order for VA to make additional efforts to obtain the Veteran’s Texas Army National Guard records and associate them with his claims file or, if they are unavailable, to notify him that they are unavailable. The Board wishes to make it clear that it is aware of the Court's instructions in Fletcher v. Derwinski, 1 Vet. App. 394 (1991), to the effect that a remand by the Court is not "merely for the purposes of rewriting the opinion so that it will superficially comply with the 'reasons or bases' requirement of 38 U.S.C. § 7104(d)(1). A remand is meant to entail a critical examination of the justification for the decision." The Board's analysis of the Veteran's claim has been undertaken with that obligation in mind. Following the Court’s decision, the Board remanded the Veteran’s claim in order to make additional efforts to obtain the Veteran’s National Guard records. These records were subsequently obtained and associated with the claims file. Service Connection Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated in active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). In general, service connection requires the following: (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). The laws and regulations pertaining to Agent Orange exposure provide for a presumption of service connection due to exposure to herbicide agents for veterans who have any of several diseases and served on active duty in the Republic of Vietnam (Vietnam) during the Vietnam era. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6), 3.309(e). A veteran who, during active military, naval, or air service, served in Vietnam during the Vietnam era shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307(a)(6)(iii). A disease associated with exposure to herbicide agents listed in 38 C.F.R. § 3.309(e) will be considered to have been incurred in service under the circumstances outlined in that section, even if there is no evidence of such disease during the period of service. The Veteran was in the Texas National Guard from March 1978 to March 1982. Pursuant to the January 2020 Board remand, service records from the Texas National Guard were obtained and reviewed. The Texas Army National Guard is only a reserve component “while in the service of the United States.” 10 U.S.C. § 10106. Members of the Army National Guard of the United States and the Air National Guard of the United States are not in active Federal service except when ordered thereto under law. See 10 U.S.C. § 12401. Thus, a member of the National Guard holds a status as a member of the Federal military or the state militia, but never both at once. There is no evidence that the Veteran was ever ordered to federal service by the President while serving in the Texas National Guard. Therefore, the Veteran’s Texas National Guard service does not meet the requirements for a period of active duty, ACDUTRA, or INACDUTRA as defined in 38 C.F.R. § 3.6 and injuries, events, or diseases related to this period cannot be the basis for a grant of service connection. Thus, for the purpose of entitlement to VA compensation, we consider his active duty from November 1968 to November 1971. See 1982 NGB Form 22 received on October 10, 2017 and September 2020. Skin Disorder The Veteran maintains that his conditions are related to service. Specifically, that his exposure to herbicide agents and asbestos caused his skin disorder. With respect to evidence of current disabilities, the record shows the Veteran has been diagnosed with scrotal folliculitis. A current disability has therefore been demonstrated. See January 2006 treatment records Regarding an in-service incurrence; the Veteran’s herbicide exposure has been presumed. However, the Veteran’s asbestos exposure has not been verified. Service treatment records demonstrate that the Veteran sought treatment for acne and dermatophytosis of the groin and perianal area. The Veteran had several bouts of acne and was prescribed medication. See January, August and November 1969, and October 1970. In February 1969, the Veteran was prescribed a medicated lotion for a rash in his scrotal region. The Veteran’s October 1971 separation examination was normal for skin evaluation. An October 2012 VA examiner reported that the Veteran did not present with acne or a rash in the groin area at the examination. Regarding his acne, the Veteran stated that he was treated for acne following service but denied any break outs in recent years. Regarding his scrotal rash, the Veteran stated he had soreness in the groin genital area on and off since service but did not have a rash or related symptoms at the time of the examination. The Veteran reported that when he has a rash, it lasts about two weeks and is treated with over the counter neosporin. The examiner found that the Veteran’s condition was less likely than not incurred in or caused by service. After reviewing the Veteran’s records, the examiner reasoned that the Veteran had no complaints or diagnosis of acne or rash until 2005, over 30 years after service. In July 2016, a VA examiner noted acne in service and dermatophytosis of the groin in service, but the Veteran did not present with the conditions at the time of the examination. The Veteran reported that he has had a scrotal rash off and on since service, occurring between four and five times a year. Additionally, he maintained that he still gets flares of acne, but that it has been between 10 and 15 years since that has occurred. The examiner reported no scarring on the head, face or neck. The examiner concluded that the Veteran’s skin condition was less likely than not incurred in or caused by service. He reasoned that the although the Veteran received treatment in service, the record did not indicate treatment since service and acne and dermatophytosis were not noted at the time of the 2016 examination. In June 2017, a VA examiner again found that the Veteran’s disorder was less likely than not incurred in or caused by service. The examiner reviewed the file and found the January 2006 folliculitis diagnosis did not relate to service. The examiner opined that there was one note of folliculitis, which is caused by an infection of hair follicles and not caused by or the result of his service, acne or dermatophytosis. In light of the foregoing, the Board finds that entitlement to service connection for a skin disability is not warranted. Scrotal folliculitis is not a presumed disease enumerated under the 38 C.F.R. § 3.309. As such, service connection on a presumptive basis is not warrant. The availability of presumptive service connection for a disability based on exposure to herbicide agents does not preclude a veteran from establishing service connection with proof of direct causation. Stefl v. Nicholson, 21 Vet. App. (2007); see also Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Accordingly, the Board has considered whether entitlement to service connection can be granted on a direct basis for his skin disability and found that service connection on a direct basis is also not warranted. The preponderance of the evidence indicates that the Veteran’s skin condition is not related to service. To the extent the Veteran’s scrotal rash is related to asbestos exposure, the Board finds that there is no indication of a nexus aside from the Veteran’s lay statements. The Veteran maintains that he was exposed to asbestos while using hand tools to remove paint from ship bulkheads. The Board notes the Veteran’s contentions that he was exposed to asbestos during his occupational duties in the service, but finds additional development unwarranted because the Veteran’s claimed conditions are not a diagnosed disability that has been associated with in-service asbestos exposure. See generally M21-1, Part IV, Subpart ii, 2.C.2.c. (listing specific diseases that may result from exposure to asbestos). The Board acknowledges the Veteran may sincerely believe that his skin condition is related to active service, to include claimed asbestos exposure, but notes that he is not competent to address a medical question that is beyond the purview of lay knowledge and requires medical expertise. See Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). The Veteran’s skin condition has not otherwise shown to be related to asbestos exposure. In furtherance of his claim, the Veteran has undergone three examinations. The Board finds the VA opinions more probative than the Veteran’s unsupported statements. The VA opinions were made by medical professionals with consideration of the specific facts in this case and after examination of the Veteran. The examiners’ opinions are probative, because they are based on an accurate medical history and provide explanations that contain clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The June 2017 examiner’s finding that that the Veteran’s current skin disorder has a different etiology than the condition he had in service is highly probative. Thus, entitlement to service connection for a skin disorder, to include as due to herbicide and asbestos exposure, is not warranted. The Board has considered the benefit-of-the-doubt doctrine; however, the preponderance of the evidence is against the claim, the doctrine is not applicable, and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Prostate Disorder The Veteran contends his prostate condition is a result of his service. Specifically, that his exposure to herbicide agents and asbestos caused his prostate disorder. With respect to evidence of current disabilities, the record indicates that the Veteran was diagnosed with benign prostate hypertrophy (BPH) beginning in 2002. Benign prostate hyperplasia/hypertrophy is defined as an age-associated enlargement of the prostate. See Dorland's Illustrated Medical Dictionary ("Dorland's") The Veteran stated that was told that he had cancer, but a review of the record does not reveal a prostate cancer diagnosis. In fact, in February 2008, the Veteran denied having prostate cancer and stated he had an enlarged prostate. See February 2008 treatment records. The Veteran’s service treatment records do not demonstrate any diagnosis or treatment for the prostate. Additionally, there is no evidence of an ongoing prostate disability on the Veteran’s October 1971 separation examination. A July 2016 VA examiner found the Veteran’s prostate condition less likely than not related, incurred in or caused by service. The examiner reasoned that there were no records or documentation demonstrating that the condition developed prior to 2002; that BPH is caused by changes in hormone balance and cell growth and is part of the normal aging process in men (noting that it occurs in almost all men as they age). The examiner specifically noted that BPH is not cancer. The Board concludes that, while the Veteran has a current diagnosis of benign prostatic hypertrophy and evidence shows that the Veteran is presumed to have been exposed to herbicides in service, the preponderance of the evidence weighs against finding that the Veteran’s disability began during service or is otherwise related to an in-service injury, event, or disease. The Board acknowledges the Veteran’s statements that his prostate disability is related to his presumed herbicide exposure or claimed asbestos exposure. As noted above, the Veteran in this case is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of the etiology and pathology of prostate disorders. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau, supra. Consequently, the Board gives more probative weight to the July 2016 VA medical opinion which establishes that Veteran’s prostate condition is attributable to the natural aging process. The Board observes that the July 2016 VA examiner reported that BPH is not on the list of presumptive diagnoses due to herbicide or agent orange exposure. The Board recognizes that it is inappropriate to "permit the denial of direct service connection simply because there is no presumptive” of service connection for BPH. See Polovick v. Shinseki, 23 Vet. App. 48, 55 (2009). However, the examiner’s opinion was not based solely on the fact that BPH is not a presumptive disability as the report notes that BPH occurs in almost all men as they age and is caused by changes in hormone balance and cell growth as a result of the aging process. Further, aside from the Veteran’s own statements, there is no evidence suggesting that his BPH is related to his presumed in-service exposure to tactical herbicide agents or asbestos. As noted, aside from the Veteran's own statements, the evidence of record does not contain any evidence suggesting a link between his benign prostatic hypertrophy and his exposure to herbicides or asbestos in service. The Board also notes the examiner’s statement that benign prostatic hypertrophy is clearly distinct from prostate cancer, and BPH is not one of the diseases enumerated as presumptive; thus, service connection on a presumptive basis due to tactical herbicide exposure is not warranted. 38 C.F.R. §§ 3.307, 3.309(e). Accordingly, the Board finds that the preponderance of the evidence is against a finding of service connection for a prostate disability and the claim must be denied. In denying such rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5170; 38 C.F.R. §§ 4.3, 4.7. Acquired Psychiatric Disorder Here, the Veteran claims that entitlement to service connection is warranted for an acquired psychiatric disorder, to include depression and PTSD. There are particular requirements for establishing service connection for PTSD that are separate from those for establishing service connection generally. See 38 C.F.R. § 3.304(f); Arzio v. Shinseki, 602 F.3d 1343, 1347 (Fed. Cir. 2010). Service connection for PTSD requires the following: (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); (2) a link, established by medical evidence between current symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. §§ 3.304(f). Regarding a current disability; the Veteran was diagnosed with a depression in a December 2010 VA examination. Therefore, a current diagnosis has been demonstrated. The Board acknowledges the Veteran’s positive PTSD screening test; however, a diagnosis was not confirmed. Regarding an in-service incurrence; the Veteran’s service treatment records do not contain any indication of reports of, or treatment for, a mental health disorder. In fact, in his October 1971 separation examination, the Veteran was noted as normal on his psychiatric evaluation. Also of record is the Veteran’s March 1978 enlistment examination for the Texas Army National Guard. The Veteran self-reported that he did not suffer from depression, excessive worry, nervous trouble or been treated for a mental condition. See March 1978 Report of Medical History. Regarding his in-service stressor; the Veteran maintained that he was responsible for the safety and security of nuclear warheads in his ship and his duty involved placing his own life above all else. He stated he lived in constant alertness and hypervigilance regarding the security of the nuclear warheads and their successful deployment. The Veteran also stated that the daily notifications of pilots lost caused feelings of guilt and depression. See August 2006 Stressor Questionnaire. In furtherance of his claim, the Veteran underwent several examinations. In December 2010 a VA examiner diagnosed the Veteran with depression not otherwise specified, finding that it was not related to service. Additionally, the examiner determined that the Veteran did not meet the stressor criteria for PTSD. The examiner reported that the Veteran described some symptoms related to PTSD on his questionnaire, however the Veteran did not meet the stressor criteria for PTSD. The Veteran reported his trauma as being scared while on board a ship in the waters if Vietnam due to his inability to swim. While the Veteran reported a history of combat experience on his ship, the examiner determined that the Veteran was never in actual combat. The examiner also noted that Veteran first sought psychiatric treatment in 2007, after the dissolution of his 25-year marriage. The Veteran reported working most of his life, until 2003 when he sustained a back injury. The examiner found no social impairment. In July 2016, the Veteran underwent an additional VA mental health evaluation. The examiner found it was less likely than not that the Veteran had a diagnosis of PTSD or any other acquired psychiatric disability related to or caused by fear of hostile military or terrorist activity. The examiner found that the Veteran’s self-reported stressors were not consistent with criterion A under DSM-5. The examiner reviewed the records and determined that there was no PTSD diagnosis or medication treatment for PTSD. He found no evidence of a chronic disability negatively impacting the Veteran’s social, occupational or functional impairment. The examiner found treatment records demonstrated supportive counseling related to pain management. The examiner noted the inconsistent statements of August 2015, the Veteran denied military trauma, then on October 2015, the Veteran reported possible symptoms during his supportive therapy for pain management. Additionally, the examiner ruled out depressive disorder and alcohol abuse as mental disorders that conformed to the DSM-5 criteria. The examiner reasoned that there was no evidence of a chronic disability negatively impacting the Veteran socially, occupationally, or functionally. the examiner also found that the Veteran self-reported that he initially sought treatment for depression several years after service due to marital issues. In May 2017, the VA submitted a request to the Veteran for his treatment records, to include records from his private psychologist that he reported receiving treatment from during his September 2016 VA examination. Subsequently in May 2017, the Veteran submitted his objection to the request and has not submitted or otherwise provided authorization for the VA to obtain those records. To the extent the Veterans argues that the December 2010 examiner erred by finding that the Veteran was not in combat, the Board finds the examiner’s finding both credible and competent. A finding that the Veteran engaged in combat with the enemy, requires that the Veteran participated in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality, and does not apply to veterans who served in a general “combat area” or “combat zone” but did not themselves engage in combat with the enemy. This is a factual finding determined by the evidence in each case. See VAOPGCPREC 12-99 (October 18, 1999). Here, the Veteran maintains that his deployment was a combat mission, he also states that he was in a combat support role. In support of his contention, the Veteran submitted a declassification narrative of events for the USS Kitty Hawk. See Narrative of events, submitted January 2011. This document states the aircraft carrier only lost one aircraft. In that instance, the pilot ejected and was rescued unharmed. The narrative does not report any other loss of life or aircrafts, or enemy engagement during its 1970 to 1971 combat support deployment. In light of the foregoing, the Board finds that entitlement to service connection for an acquired psychiatric disorder, include depression and PTSD, is denied. At the outset, the Board notes that the Veteran did not have a diagnosis of PTSD in accordance with 38 C.F.R. § 4.125(a) during the pendency of the appeal. As such, entitlement to service connection for PTSD is not warranted. See 38 C.F.R. § 3.304(f). While the Veteran’s treatment records reflect symptoms associated with PTSD and a positive PTSD screening, the Veteran did not meet the diagnostic criteria of PTSD and the Board places greater weight of probative value on the examiner’s opinions which provide detailed reasons and bases for their determination that at diagnosis of PTSD is not warranted. Regarding the etiology of the Veteran's diagnosed acquired psychiatric disorder, the Board finds that the preponderance of the evidence of record is against a finding that his depression is due to service. While the Veteran believes his psychiatric condition is related to service; as noted above, he is not competent to make such determinations because the intricacies in diagnosing psychiatric disabilities and opining regarding their etiology are issues that require the expertise of a medical professional. Jandreau supra. The evidence of record, to include the Veteran’s VA medical treatment records and December 2010 and July 2016 VA medical opinions, support the conclusion that the Veteran sought treatment for depression following personal events not otherwise related to service; specifically, family and marital issues. Accordingly, as entitlement to service connection for an acquired psychiatric disorder, to include depression and PTSD, is not warranted; the Veteran’s claim is denied. Spine Disorder The Veteran maintains that his current back disability is related to service. Regarding an in-service incurrence, the Veteran’s service treatment records show the Veteran was seen in January 1969 for a low back spasm after lifting boxes, he was prescribed pain medication and told not to do any heavy lifting for a week. In June 1969, the Veteran sought treatment for low back pain due to lifting and was prescribed heat treatment and pain relievers. In October 1969 he was seen for low back and knee pain; and in October 1971 the Veteran reported a backache that improved with Tylenol. Also of record are the Veteran’s Texas National Guard records. The March 1978 enlistment examination notes recurrent back pain described as related to his civilian duties of heavy lifting as a mover. The Veteran submitted several letters from Dr. L.T. to an insurance company from October 1977 through February 1978. These letters evaluated the Veteran’s progress following a work-related injury. Specifically, they state the Veteran experienced a back injury while moving a piano, that the Veteran should stay home from work an additional two weeks, and ultimately, he was cleared to return to work in November 1977. The Texas National Guard noted the injury and found him fit for service. Post-service treatment records demonstrate that the Veteran worked in heavy labor demand occupations which resulted in multiple work related injuries involving his back. The record contains numerous evaluations related to these injures, mostly for the purposes of collecting worker’s compensation benefits related to three major injuries occurring after the October 1977 injury noted above. In September 1983, the Veteran hurt his back at work. The injury resulted in the need for surgery. The Veteran underwent a laminotomy and discectomy in 1984. In September 1988 the Veteran experienced an additional back injury after lifting heavy object at work, that resulted in a laminotomy and discectomy in 1997. In August 2003, the Veteran hurt his back while moving pallets at work, which resulted in a third surgery. The Veteran stopped working due to his back injuries in August 2003. In August 2007, a VA examiner reported that the Veteran’s back condition was less likely than not associated with the Veteran’s service. The examiner reasoned that although he had some treatment related to his back during service, the events were not severe enough to cause damage to his spine; that they appeared to be muscle related and resolved quickly with no residuals. The examiner found the Veteran’s post-service history to be more likely the cause of his current disability. He specifically noted the three separate worker’s compensation injuries (September 1983, September 1988 and October 2003). The Veteran contends that he did have a back injury within a year of discharge that aggravated his back injury from service. To support this contention, the Veteran submitted a statement from a coworker regarding the circumstances of a 1972 back injury. The co-worker stated that in 1972, while working with the Veteran as land surveyors, he was told the Veteran was taken to the emergency room because he suffered from severe back pain that occurred while shoveling snow as part of his duties on the job. The co-worker further stated that their company paid for the Veteran’s medical bills and medication related to the injury that happened while he was at work. While this injury occurred within a year of discharge, the circumstances described by the coworker do not demonstrate that his injury was related to service. Additionally, the Board notes that the coworker has not been shown to be competent to make opinions on the etiology of the Veteran’s spine disorder. In light of the foregoing, the Board finds that entitlement to service connection for the Veteran’s spine disorder is not warranted. Although the evidence of record reflects that the Veteran has a currently diagnosed back disability, and that there is an indication of an in-service incurrence, there is no competent evidence of record to establish a nexus. Further, the preponderance of the evidence does not establish the Veteran’s spine disorder manifested to a compensable degree within one year of separation or demonstrate chronicity and continuity of symptomatology post-separation. Therefore, the Board finds that service connection for a spine disorder on a presumptive basis as a chronic disease is also not supported. Here, the Veteran maintains that he has experienced lower back pain since separation from service. As noted above, the Veteran is competent to report experiencing lower back pain; however, the Board does not find him competent to opine as to the etiology of his currently diagnosed spine disorder. Specifically, due to the multiple possible etiologies of the Veteran's currently diagnosed disability discussed above, the Board does not find that the Veteran possesses the requisite medical knowledge or experience to render a nexus opinion which attributes his back disability to service, as opposed to a post-service incident. Additionally, the August 2007 VA examination that concluded that his back disability was less likely than not related to service is highly probative against the claim. The VA examiner was informed of the relevant evidence, relied on accurate facts, and gave a fully articulated opinion that was supported by sound reasoning. Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). Accordingly, the Board finds the preponderance of the evidence does not support service connection for a spine disability. The probative evidence indicates the Veteran's back disability was not incurred in service and there is no indication of a nexus between the Veteran's current disability and his active duty service. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. 38 C.F.R. § 3.102. M. Donohue Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E.V. Palatt, 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.