Citation Nr: 21002591 Decision Date: 01/14/21 Archive Date: 01/14/21 DOCKET NO. 17-28 649 DATE: January 14, 2021 ORDER Entitlement to service connection for malaria, including residuals, is denied. FINDING OF FACT The Veteran does not have a current diagnosis of malaria, or residuals of such. CONCLUSION OF LAW The criteria for entitlement to service connection for malaria, including residuals, have not been met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active naval service from May 1965 to June 1968. This matter comes to the Board of Veterans Appeals (Board) on appeal from a July 2015 rating decision of the department of Veterans Affairs (VA) Regional Office (RO). In March 2020, the Veteran testified at hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. This case was previously before the Board in April 2020, at which time the issues currently on appeal were remanded for additional development. The case has now been returned to the Board for further appellate action. The Board notes that the issues of entitlement to service connection for a left finger disability and tinea pedis were also remanded in April 2020 for additional development. However, in a November 2020 rating decision, the Veteran was granted entitlement to service connection for a left finger disability and tinea pedis. As the Veteran has not disagreed with the effective dates or ratings assigned for those disabilities in that decision, it constitutes a full grant of the benefits sought on appeal. therefore, the Board has limited its consideration accordingly. Service Connection-Malaria The Veteran contends that he had malaria while serving in the Republic of Vietnam, and that he has continued to experience periodic episodes during which he has a fever and chills, which he feels are residuals of his in-service bout of malaria. The service treatment records are silent for complaints of, or treatment for symptoms consistent with malaria. However, the Veteran has reported that he was diagnosed with, and treated for malaria while in active service. He has reported that he cannot recall the type of medication that he receives as treatment. The Board notes that the Veteran is competent to report that he was diagnosed with, and treated for, malaria while he was in active service. Moreover, the Board finds the Veteran to be credible in that regard. Heuer v. Brown, 7 Vet. App. 379 (1995); Falzone v. Brown, 8 Vet. App. 398 (1995); Caldwell v. Derwinski, 1 Vet. App. 466 (1991). Post-service medical evidence of record is silent for a current diagnosis of malaria. In a February 2012 private treatment record, the Veteran was noted to have a history of typhoid fever and malaria while serving in the Republic of Vietnam. However, there was no indication from that record that the Veteran had a current diagnosis of malaria, or current residuals of an in-service infection. In a March 2015 VA Medical Center treatment note, the Veteran reported of having a history of malaria with an in-service onset. There was no indication of a current diagnosis at that time. In an April 2015 VA treatment note, the Veteran was noted to be seen for complaints of right testicular swelling. He reported at that time that he had a “malaria fever” on the prior Saturday. There was no diagnosis of malaria made at that time, and the examining treatment provider did not provide further comment on any potential malaria. In September 2020, the Veteran was afforded a VA examination. At that time, the VA examiner found that the Veteran did not have a current diagnosis of malaria. In so finding, the examiner noted that blood smears conducted in conjunction with the VA examination were negative for malaria and other parasites. The examiner found that the Veteran did not have a current diagnosis of malaria. The examiner opined that the current claimed condition was less likely as not caused by the claimed in-service injury, event, or illness. In so finding, the examiner noted that malaria was not generally a chronic condition, and there was no known medical consensus that malaria could live dormant or inactive in the human body for decades. Rather, the examiner noted that without additional, repeated exposures to malaria, and with appropriate treatment, malaria generally only lasted, at most, a few years. The examiner noted that even then, malaria would only last that long if the patient had hepatic malaria, and even still, there was no evidence supporting decades long infections. In support of those findings, the examiner cited to medical literature compiled by the United States Centers for Disease Control and Prevention (CDC). The examiner noted that presuming the Veteran did have malaria during service, he reported receiving malaria “pills” to treat the episode. Further, he had, at other points in his life, received Clindamycin, Doxycycline, or other similar class antibiotics for any given bacterial infection, and that would have effectively treated any untreated malaria. The examiner noted that while she could not explain the Veteran’s described symptoms of random fever, chills, and shaking, as she was not present during those events, it was far less likely that such events were being caused by malaria rather than another transient acute illness. In conclusion, the examiner noted that as malaria is not known to be a lifelong condition, and the Veteran has not current symptoms of, or notable infection of malaria as evidence by the negative malaria smear, she could not medically substantiate the Veteran’s current claimed condition of malaria. The Board finds that the September 2020 VA medical opinion is adequate. In this regard, the examiner thoroughly reviewed and discussed the relevant evidence, considered the contentions of the Veteran, and provided a supporting rationale for the conclusions reached. Barr v. Nicholson, 21 Vet. App. 303 (2007); Stefl v. Nicholson, 21 Vet. App. 120 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). As there is no medical opinion of record to the contrary, the Board finds that the September 2020 VA medical opinion is the most probative evidence of record. While the Veteran is competent to report observable symptoms, he is not competent to provide a diagnosis of malaria, or to diagnose residuals of an in-service infection, as that requires medical expertise and is outside the realm of common knowledge of a layperson. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Therefore, the Veteran is not competent to provide a diagnosis in this case. For a disability to be service connected, it must be present at the time a claim for VA disability compensation is filed or during, or proximate to, the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). Here, there is no evidence of record showing the Veteran to have a current diagnosis of with malaria, or any residuals of an in-service diagnosis of such. Congress has specifically limited entitlement to service-connected benefits to cases where there is a current disability. In the absence of proof of a present disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223 (1992). (Continued on the next page)   Accordingly, the Board finds that the preponderance of the evidence is against the claim, and entitlement to service connection for malaria is not warranted. 38 U.S.C. § 5107(b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Ivan Franklin 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.