Citation Nr: 21002766 Decision Date: 01/14/21 Archive Date: 01/14/21 DOCKET NO. 18-34 056 DATE: January 14, 2021 ORDER New and material evidence having been submitted, the claim of entitlement to service connection for lumbar spine degenerative joint and disc disease (back disability) is reopened. New and material evidence having been submitted, the claim of entitlement to service connection for left hip osteoarthritis (left hip disability) is reopened. New and material evidence having been submitted, the claim of entitlement to service connection for right hip osteoarthritis (right hip disability) is reopened. Entitlement to service connection for lumbar spine degenerative joint and disc disease (back disability) is denied. Entitlement to service connection for left hip osteoarthritis (left hip disability) is denied. Entitlement to service connection for right hip osteoarthritis (right hip disability) is denied. Entitlement to service connection for prostate cancer is denied. Entitlement to service connection for cervical spine disability with degenerative changes (neck disability) is denied. Entitlement to service connection for right upper extremity radiculopathy is denied. Entitlement to service connection for left upper extremity radiculopathy is denied. FINDINGS OF FACT 1. The Veteran filed redundant claims seeking service connection for a back disability, left hip disability, and right hip disability in August 2017, while the Board still had the same issues pending a decision; the RO reopened the claims in an October 2017 rating decision, after the Board issued its denial in September 2017. 2. The Board denied the Veteran’s claims for service connection for a back disability, left hip disability, and right hip disability in a September 2017 decision on the basis there was no competent evidence linking the Veteran’s claimed back disability, left hip disability, and right hip disability to his active service or to a service-connected disability. The Board also concluded the Veteran’s symptoms of arthritis have not been continuous since separation, did not manifest to a compensable degree within one year of separation from service, and were not noted to be chronic during service. 3. The evidence received since the September 2017 final Board decision is neither cumulative nor redundant of prior evidence of record, and it shows a reasonable possibility of substantiating the Veteran’s claim for service connection. 4. The preponderance of the evidence reflects that the Veteran’s back disability is not related to his active service and did not begin within one year of separation. 5. The preponderance of the evidence reflects that the Veteran’s left hip disability is not related to his active service and did not begin within one year of separation. 6. The preponderance of the evidence reflects that the Veteran’s right hip disability is not related to his active service and did not begin within one year of separation. 7. The preponderance of evidence weighs against finding that the Veteran’s prostate cancer was otherwise related to service. 8. The preponderance of the evidence reflects that the Veteran’s neck disability is not related to his active service and did not begin within one year of separation. 9. The preponderance of the evidence is against finding that right upper extremity radiculopathy is secondary to a service-connected disability. 10. The preponderance of the evidence is against finding that left upper extremity radiculopathy is secondary to a service-connected disability. CONCLUSIONS OF LAW 1. The September 2017 Board decision that denied service connection for a back disability and left and right hip disabilities is final. 38 U.S.C. § 7105. 2. The criteria for reopening the previously denied claims for service connection for a back disability and left and right hip disabilities have been met. 38 C.F.R. § 3.156. 3. The criteria for service connection for a back disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for left hip disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 5. The criteria for service connection for right hip disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 6. The criteria for service connection for prostate cancer have not been met. 38 U.S.C. §§ 1110, 1112, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 7. The criteria for service connection for a neck disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 8. The criteria for service connection right upper extremity radiculopathy are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 9. The criteria for service connection left upper extremity radiculopathy are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty with the United States Army from January 1975 to September 1981. This matter comes before the Board of Veteran’s Appeals (Board) on appeal from a September 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran’s claims seeking entitlement to service connection for a back disability and service connection for a bilateral hip disability were previously before the Board in April 2013, September 2016, and September 2017. The April 2013 and September 2016 Board decisions remanded the matters for additional development. While the Veteran’s claims were pending before the Board, the Veteran filed a new redundant claim for entitlement to service connection for a back disability and for entitlement to service connection for left and right hip disabilities in August 2017. The Board subsequently issued their decision in September 2017 denying the Veteran’s claims seeking entitlement to service connection for a back disability and for left and right hip disabilities in the September 2017 rating decision. Then, the RO mistakenly processed the newly filed redundant claims seeking service connection for a back disability and bilateral hip disabilities. In the October 2017 rating decision, the RO found the Veteran had submitted new and material evidence and reopened the claims but denied service connection for the back disability and bilateral hip disabilities. While the RO improperly reopened the claims in the October 2017 rating decision, the RO addressed the claims again in a May 2018 statement of the case (SOC) and the Veteran timely filed his substantive appeal to the Board (VA Form 9) in June 2018, stating he is appealing all issues included in the SOC and requesting a hearing. Then, in July 2019, the RO sent correspondence to the Veteran advising the claims for a back disability and left and right hip disabilities were not on appeal as the RO had erroneously taken the issues up and the issues in the October 2017 rating decision were in error. The RO improperly reopened the issues but given the RO fully developed the matters and issued a SOC including the redundant issues and obtained a Form 9 from the Veteran, the Board concludes it can be inferred from the record the Veteran thought the matters were on appeal. Given the RO’s actions, the Veteran has reason to believe that this matter remains on appeal, the Board is now obligated to consider this issue. See 38 C.F.R. § 20.202; Percy v. Shinseki, 23 Vet. App. 37 (2009). In October 2020, the Veteran testified at a virtual hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the claims file. The undersigned Veterans Law Judge took testimony on the issues that were improperly reopened in the October 2017 rating decision and therefore the Board can adjudicate them in this decision. Of note, at his October 2020 hearing, concern over having all the Veteran’s VA treatment records was raised. The Veteran reported he had been seen at many VA treatment facilities and he confirmed he was seen at Orlando, Phoenix, Las Vegas, Washington, D.C., San Diego, and Loma Linda. The Board confirms these records from the noted locations are of record. Additionally, records from Dayton VA medical center for the Veteran were also of record. All records were reviewed by the Board. The Board also notes that the Veteran requested to have his appeal advanced on the docket due to financial hardship and homelessness in July 2019. At the Veteran’s hearing, the undersigned Veterans Law Judge determined the case has been advanced on the docket based pursuant to 38 U.S.C. § 20.800 (c) due to the Veteran’s severe financial hardship. New and Material Evidence 1. New and material evidence having been submitted, the claim of entitlement to service connection for a back disability is reopened. 2. New and material evidence having been submitted, the claim of entitlement to service connection for left hip disability is reopened. 3. New and material evidence having been submitted, the claim of entitlement to service connection for right hip disability is reopened. Rating actions are final, and binding based on evidence on file at the time the claimant is notified of the decision and may not be revised on the same factual basis except by a duly constituted appellate authority. 38 C.F.R. § 3.104(a). Generally, a claim which has been denied in an unappealed Board decision or an unappealed AOJ decision may not thereafter be reopened and allowed. 38 U.S.C. §§ 7104(b), 7105(c). The exception to this rule is 38 U.S.C. § 5108, which provides that if new and material evidence is presented or secured with respect to a claim which has been disallowed, the Secretary shall reopen the claim and review the former disposition of the claim. New evidence means existing evidence not previously submitted to agency decisionmakers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). As noted above, the Veteran’s claims for service connection for a back disability and left and right hip disabilities were denied in a September 2017 Board decision. In that decision, the Board found the Veteran was diagnosed with osteoarthritis of both hips in a May 2008 VA treatment record and diagnosed with lumbar spondylosis in a June 2008 VA treatment record and found the first element of service connection had been met. The Board therefore concluded that the preponderance of the evidence was against finding that the Veteran’s current disability was related to his active service Accordingly, to reopen the claims, the Veteran generally must introduce evidence that shows a disability and an in-service incurrence, or that relates his current disability to his active service. The Veteran provided testimony at his hearing about in-service events he contends caused his back disability and left and right hip disabilities. The Veteran also raised the theory of his bilateral hip disability being related to his back disability. The Veteran’s hearing testimony provided a more complete picture of his in-service duties. As this testimony was not of the record at the time of the earlier denial, it is new. It speaks to at least one reason for the previous denial, it is also material. Accordingly, new and material evidence having been submitted, the Veteran’s claims for service connection for a back disability and left and right hip disabilities is considered reopened. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also 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). Establishing service connection generally requires competent, credible evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus, or link, between the current disability and the in-service disease or injury. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may also be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310 (a). Service connection for certain chronic disabilities may be presumed if they are manifested to a compensable degree within a specified period of time post-service. 38 U.S.C. §§ 1112, 1137; 38 C.F.R. §§ 3.307, 3.309. VA regulations further provide that certain diseases associated with exposure to herbicide agents may be presumed to have been incurred in service even if there is no evidence of the disease in service, provided the requirements of 38 C.F.R. § 3.307 (a)(6) are met. 38 C.F.R. § 3.309 (e). A veteran who, during active service, served between April 1, 1968 and August 31, 1971, in a unit that, as determined by the Department of Defense, operated in or near the Korean Demilitarized Zone (DMZ) in an area in which herbicides are known to have been applied during that period, 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. See 38 C.F.R. § 3.307 (a)(6)(iv). If a veteran was exposed to an herbicide agent during active service, the following diseases shall be service-connected if the requirements of 38 C.F.R. § 3.307 (a)(6) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 C.F.R. § 3.307 (d) are also satisfied: Chloracne or other acneform disease consistent with chloracne; Type 2 diabetes; Hodgkin’s disease; chronic lymphocytic leukemia; B cell leukemia, Parkinson’s disease, multiple myeloma; non-Hodgkin’s lymphoma; early onset peripheral neuropathy; porphyria cutanea tarda; prostate cancer; respiratory cancers; soft-tissue; and ischemic heart disease, shall be service-connected if the requirements of 38 C.F.R. § 3.307 (a)(6) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 C.F.R. § 3.307 (d) are also satisfied. 38 C.F.R. § 3.309 (e). The diseases listed at 38 C.F.R. § 3.309 (e) shall have become manifest to a degree of 10 percent or more at any time after service, except that chloracne or other acneform disease consistent with chloracne, porphyria cutanea tarda, and early onset peripheral neuropathy shall have become manifest to a degree of 10 percent or more within a year after the last date on which the veteran was exposed to an herbicide agent during active military, naval, or air service. 38 C.F.R. § 3.307 (a)(6)(ii). VA has no policy acknowledging residual presence of herbicide agents outside of the presumptive periods prescribed by VA law. Generally, a claimant has the responsibility to present and support a claim for benefits. All information, lay evidence, and medical evidence in a case is to be considered by the Board in deciding the claim. When there is an approximate balance of positive and negative evidence regarding any material issue, the claimant is to be given the benefit of the doubt. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. Lay evidence, if competent and credible, may serve to establish a nexus in certain circumstances. See Davidson v. Shinseki, 581 F.3d 1313 (2009) (noting that lay evidence is not incompetent merely for lack of contemporaneous medical evidence). When considering whether lay evidence may be competent, the Board must determine, on a case by case basis, whether the Veteran’s particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Back and Bilateral Hip Disabilities 4. Entitlement to service connection for back disability is denied. 5. Entitlement to service connection for left hip disability is denied. 6. Entitlement to service connection for right hip disability is denied. The Veteran contends his back disability and bilateral hip disabilities are related to his active military service. He testified at his October 2020 hearing that while in-service, he was required to perform heavy lifting, walking, and running in the infantry. He also testified he suffered from pulled muscles in his lower back in-service and took ibuprofen for the pain. The Veteran also testified his bilateral hip disability may be due to his back disability. First, the Board acknowledges the Veteran’s VA treatment records reflect a diagnosis of lumbar spondylosis and regarding his hips, the Veteran was diagnosed of aseptic necrosis of head and neck of the femur and hip degenerative joint disease. The current disability criterion for a back disability and bilateral hip disability is met. There is, however, no evidence the Veteran sought treatment for or was diagnosed as suffering from a back or bilateral hip disability during his active service. A review of the Veteran’s service treatment records shows no evidence of any treatment or complaints regarding back or hip pain or injury. His service treatment records appear complete and reflect treatment for other medical issues such as rashes, a facial laceration, and allergy issues. The Veteran’s July 1981 report of medical history at separation noted he had hay fever but stated the Veteran was in good overall health. There was no reference of back or hip pain in-service. The Veteran testified at his hearing that he obtained ibuprofen for his alleged in-service back pain, but he stated it was not advisable at the time to seek treatment during active service. The Board does not find that contention to be credible. Again, the Veteran’s service treatment records are silent for such treatment despite having records of other complaints. Considering the lack of corroboration in objective service treatment records (which appear to be complete and do contain evidence of other complaints), the Board finds the Veteran’s statements regarding his in-service injuries not to be credible. Even if the Board were to find the Veteran’s statements credible, there is no evidence relating his back disability or bilateral hip disability to his active service. The only such statements come from the Veteran, who is not shown to have the requisite medical knowledge or training to provide an etiology opinion for disabilities such as those claimed by the Veteran. The Board acknowledges the Veteran has a history of treatment for his back disability and bilateral hip disability. The Board obtained his records from the Social Security Administration (SSA). The Veteran reported walking, standing, squatting, reaching, bending, and sitting up on a bed are very painful in his back and hips and he suffers from muscle spasms. His SSA records reflect his back pain began in 2003 and his hip pain started in 2005. The Veteran’s VA treatment records document the Veteran’s ongoing back and bilateral hip issues. In September 2004, a VA physical therapy note stated the Veteran’s low back pain was due to posture and decreased flexibility and strength with osteoarthritis possibly causing hip and groin pain. Throughout 2005, the Veteran’s VA treatment records reflect lower back pain with radicular symptoms to lower extremities and the Veteran was noted to have aseptic necrosis of head and neck of the femur. His VA treatment records reflect treatment of physical therapy, epidural injections, and acupuncture. August 2008 hip x-rays reflect severe bilateral hip degenerative disease with complete loss of joint space. He has consistently reported and been treated for pain in the lower back and hips. His VA treatment records note he has a complicated medical history and is in a wheelchair; his records state he was supposed to have bilateral hip replacement on numerous dates but it was cancelled due to ongoing other medical issues and he has not had the bilateral hip replacement. His VA treatment records detail he has lumbar degenerative changes and bilateral hip osteoarthritis and document his treatment. However, his VA treatment records provide no link of the conditions to service. The Board has considered statements made by the Veteran that his back disability and bilateral hip disability relates to his active service. Lay witnesses are competent to report symptoms because this requires only personal knowledge as it comes to them through their senses. Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, they are not competent to offer opinions as to the etiology of their disabilities due to the medical complexity of the matters involves. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Woehlaert v. Nicholson, 21 Vet. App. 456, 462. Although no VA examination was afforded to the Veteran, the Board finds that no such development is warranted based upon the facts of this case. In pertinent part, there is medical evidence that diagnoses the current disability, but as detailed above, the record does not indicate the Veteran’s disabilities are due to or incurred during service. Only the Veteran’s contentions indicate a relationship with service, which is insufficient to trigger VA’s duty to provide an examination. McLendon v. Nicholson, 20 Vet. App. 79 (2006). In sum, the Veteran’s service treatment records are silent for any complaints or treatment for any back or hip disability. The Veteran’s separation examination is negative for any clinical findings or reports of a back or hip disability. Although the Board has considered the Veteran’s testimony that he was provided ibuprofen for muscle spasms, there is no record of these visits in Veteran’s service treatment records. The Veteran’s service treatment records do show he sought treatment for other ailments. Therefore, the lack of service treatment for his back and hip disabilities is telling. Accordingly, while the Veteran possesses the competence to describe events and facts that occurred during service, the lack of record during service is assigned significant probative weight. The Board has also considered whether service connection is warranted on a presumptive basis. However, the evidence does not show Veteran’s back disability and bilateral hip disability were chronic in service or manifested during a compensable degree within one year from service. Thus, presumptive service connection is not warranted. Additionally, the Veteran reported his bilateral hip condition may be related to or caused by his back disability. However, as his back disability is not service connected, secondary service connection is therefore not for application here. Therefore, the Board finds that the most probative evidence of record shows that the Veteran’s back disability and his bilateral hip disability were not caused by his military service and the evidence does not support a nexus between Veteran’s active service and his back disability or bilateral hip disability. Accordingly, the Board finds that entitlement to service connection for his back disability and bilateral hip disability is not warranted. In reaching this conclusion, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claims, the doctrine is not applicable in the instant appeals. 7. Entitlement to service connection for prostate cancer is denied. The Veteran contends his prostate cancer is related to exposure to herbicide agents during his service in Korea. Specifically, he asserts he was within 100 to 120 miles from the DMZ. He reported he had an uncle stationed at the DMZ and he traveled to see his uncle. He also reported he traveled near the DMZ for his allergies. He estimated his total time in the DMZ area to be approximately one month. The Veteran reported was in Korea from July 1979 to July 1980. A formal finding was issued in October 2017. The formal finding concluded the VA lacked the information required to verify the Veteran’s herbicide exposure in Korea. The Veteran was sent a development letter requesting details of circumstances of exposure to herbicides in Korea along the DMZ. No response was received. The formal finding concluded exposure to herbicides was not conceded. Based on the Veteran’s dates of service and his own lay statements of being at the Korean DMZ for approximately one month and his service in Korea from July 1979 to July 1980, the Veteran is not entitled to presumptive herbicide agent exposure under VA law. As his service occurred after the time period where VA presumes herbicide use in the Korean DMZ, he would have to submit competent and credible evidence that factually showed he was exposed to herbicide agents. This has not been received. Notwithstanding the inapplicability of the presumptive service connection regulations, the Board is obligated to fully consider the Veteran’s service connection claim on a direct basis. Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. As the Veteran has been diagnosed with prostate cancer, the current disability criterion is met. There is, however, no evidence of record that provides support for a relationship between the Veteran’s prostate cancer and his period of active service, including his contention of exposure to herbicide agents. The Veteran’s service treatment records are silent as to complaints regarding his prostate or any related prostate disability; his service treatment records do not reflect a diagnosis of prostate cancer in-service. As noted above, there is no evidence linking the Veteran to exposure to herbicide agents in-service. Additionally, there is no evidence relating the Veteran’s prostate cancer to active service. The Veteran has an extensive and complex medical history. His VA treatment records from the many VA treatment facilities he reported treatment at are of record. Regarding his prostate cancer, his VA treatment records document his diagnosis and treatment. His VA treatment records in September 2003 reflect his prostate was normal upon examination. In December 2006, the Veteran’s prostate was mildly enlarged, he had elevated PSA, and an abnormal digit rectal exam. His VA treatment records document that in January 2009, the Veteran had a colonoscopy which reported polyps and recommended he have a follow up scan in one year. The Veteran was unable to complete the follow up. In December 2010, the Veteran’s prostate was determined to be firm and no masses found. His VA treatment records reflect in January 2013 his prostate was moderately enlarged then imaging in February 2013 noted the prostate to be unremarkable. In January 2014, his prostate was enlarged. In August 2017, his VA treatment records reflect elevated PSA levels, then in September 2017, testing reflected prostate specific abnormal antigen. The Veteran underwent a biopsy in October 2017, the biopsy showed a new diagnosis of a moderate risk of prostate cancer. The Veteran’s recent VA treatment records from May and June 2019 that the Veteran does not want any treatment beyond high-intensity focused ultrasound and was seeking another opinion. While he has an extensive medical history regarding his diagnosis and treatment of prostate cancer, his VA treatment records do not provide a link to the Veteran’s active service. At the Veteran’s October 2020 hearing, he testified his prostate cancer is being monitored. He testified about his proximity to the DMZ and contends exposure to herbicide agents at the DMZ. The Veteran provided his own assertion that his condition is related to his exposure to herbicide agents. While the Board is sympathetic to the Veteran’s cancer diagnosis, the Board finds there is no competent evidence of a relationship between the Veteran’s prostate cancer and his exposure to herbicide agents. His statements alone are not credible or competent evidence of herbicide agent exposure. See Bardwell v. Shinseki, 24 Vet. App. 36, 40 (2010) (holding that a layperson's assertions indicating exposure to gases or chemicals during service are not sufficient evidence to establish that such an event occurred during service). The Veteran is not competent to identify herbicide agents or residuals of their presence. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). The Board finds that the Veteran is not competent to provide an opinion on such a complex medical question. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). While a VA medical opinion was not provided, the Federal Circuit Court of Appeals (Federal Circuit) has recognized that there is not a duty to provide an examination in every case. Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010). Rather, the Secretary’s obligation under 38 U.S.C. § 5103A(d) to provide the Veteran with a medical examination or to obtain a medical opinion is not triggered unless there is an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the Veteran’s service or with another service-connected disability. McLendon, 20 Vet. App. 79. In this case, the Veteran has not specifically indicated that he was treated for prostate cancer during service or that the claimed disability has persisted since service. Moreover, there is no medical evidence of record linking the disability to service. As such, VA’s duty to provide an examination with an opinion is not triggered. Waters, 601 F.3d 1274. There are no reported continuity of symptoms dating back to Veteran’s service, therefore requirements for service connection based on a presumption of chronicity are not met. 38 C.F.R. §§ 3.303(b), 3.307, 3.309. As none of the competent, relevant evidence of record indicates that the Veteran’s prostate cancer either began during, or is otherwise due to his period of service, the Veteran’s claim for direct service connection for prostate cancer must be denied. The Veteran does not meet the criteria for the presumption of chronicity or presumption due to herbicide agent exposure. As the preponderance of the evidence is against the Veteran’s claim, the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107(b). The Veteran’s claim for service connection for prostate cancer must be denied. 8. Entitlement to service connection for cervical spine disability with degenerative changes (neck disability) is denied. The Veteran contends his cervical spine disability is due to his active service. The Veteran contends he had a pinched nerve in his neck while on active duty. The Board acknowledges the Veteran has a documented history of suffering from a neck disability. His VA treatment records document a diagnosis of cervical spine stenosis, cervical spondylosis, and degenerative anterolisthesis at C4/5. The current disability criterion is met. There is, however, no evidence the Veteran sought treatment for or was diagnosed as suffering from a neck disability during active service. The Veteran testified at his October 2020 hearing. He stated during his service in infantry, he contends he experienced a pinched nerve, he thinks he turned his neck wrong and for a minute, was paralyzed. He stated the pain went away and he did not seek treatment for the claimed pinched nerve in-service. He stated he was waiting for it to occur again and it did not happen again until it reoccurred in the past fifteen years. The Veteran’s service treatment records do not show any evidence of treatment or complaints regarding neck pain or injury. The Veteran testified at his hearing that he did not seek treatment for his alleged in-service neck injury. He stated it was not advisable at the time to seek treatment during active service. His service treatment records appear complete and reflect treatment for other medical issues such as rashes, a facial laceration, and allergy issues. The Veteran’s July 1981 report of medical history at separation noted he had hay fever but was noted to be in good overall health. There was no reference of neck pain or a neck disability in-service. Even if the Veteran were to find the Veteran’s statements credible of an in-service neck injury, there is no evidence relating his disability to active service. His VA treatment records document on-going neck pain and treatment, but there is no link to his active service. The only such statements from the Veteran, who is not known shown to have the requisite medical knowledge or training to provide an etiology opinion for the disability claimed by the Veteran. The Board has considered statements made by the Veteran that his neck disability relates to his active service. Lay witnesses are competent to report symptoms because this requires only personal knowledge as it comes to them through their senses. Layno, 6 Vet. App. 465, 470. However, they are not competent to offer opinions as to the etiology of their disabilities due to the medical complexity of the matters involves. Jandreau, 492 F.3d 1372; Woehlaert v. Nicholson, 21 Vet. App. 456, 462. Although no VA examination was afforded to the Veteran for his neck disability, the Board finds that no such development is warranted based upon the facts of this case. As detailed above, the record does not indicate the Veteran’s disability is due to or incurred during service and only the Veteran’s contentions indicate a relationship with service, which is insufficient to trigger VA’s duty to provide an examination. McLendon, 20 Vet. App. 79. The Board has considered whether service connection is warranted based on a continuity of symptomatology framework. The Veteran did not report he experienced neck pain until many years after he left service. This is consistent with the lack of complaints in his service treatment records. The Board notes the earliest record of complaints of a neck disability was in August 1999 VA treatment records, eighteen years after the Veteran separated from service. The Veteran had imaging done which reflected early degenerative joint disease. Absent evidence of symptoms in-service and continually thereafter, service connection on a continuity of symptomatology basis is not warranted. The Board has considered whether service connection is warranted on a presumptive basis. However, the evidence does not show Veteran’s neck disability was chronic in service or manifested to a compensable degree within one year from service. Thus, presumptive service connection is not warranted. Therefore, the Board finds that the most probative evidence of record shows that Veteran’s neck disability was not caused by his active service and the evidence does not support a nexus between Veteran’s active service and his claimed neck disability. Accordingly, the Board finds that entitlement to service connection for his neck disability is denied. In reaching this conclusion, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim, the doctrine is not applicable in the instant appeal. 9. Entitlement to service connection for right upper extremity radiculopathy is denied. 10. Entitlement to service connection for left upper extremity radiculopathy is denied. The Veteran contends he is entitled to service connection for right upper extremity radiculopathy and left upper extremity radiculopathy secondary to his neck disability. Service connection may be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disease or injury. 38 C.F.R. § 3.310 (a); Allen v. Brown, 7 Vet. App. 439, 448. To establish entitlement to service connection on a secondary basis, the evidence must show (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. Service connection for the Veteran’s neck disability has been denied, his claims for secondary service connection for right upper extremity radiculopathy and left upper extremity radiculopathy are also denied. Absent service connection being granted for the primary disability, a neck disability, the Veteran cannot obtain secondary service connection for these disabilities. Given this straight-forward disposition, the Board makes no findings as to whether the Veteran currently has these disabilities, or regarding any element of his competency or credibility in describing them. Instead, as simply stated, absent the Veteran's primary claimed disability being granted service connection, service connection on a secondary basis for right upper extremity radiculopathy and left upper extremity radiculopathy must fail. There is no evidence or argument regarding a direct relationship between these claimed disabilities and the Veteran’s active service. Without such evidence or argument, an extended discussion on direct service connection is not warranted. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Mouzakis, 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.