Citation Nr: 21003230 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 17-13 046 DATE: January 21, 2021 ORDER Entitlement to service connection for hypothyroidism, to include as due to herbicide agent exposure, is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis or manifestations of hypothyroidism. CONCLUSION OF LAW The criteria for service connection for hypothyroidism have not been met. 38 U.S.C. §§ 1110, 5107 (b); 38 C.F.R. §§ 3.102, 3.303 (a), 3.307, 3.309 (e). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1970 to January 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2016 rating decision rendered by the Department of Veterans Affairs (VA) Regional Office (RO) in Portland, Oregon. In July 2019, the Veteran presented testimonial evidence at a videoconference hearing before the undersigned Veterans Law Judge. A transcript is of record. Addressing the relevant procedural history, this case was previously before the Board in November of 2019 at which time it was remanded for an addendum VA opinion and to obtain any outstanding treatment records. The case has now been returned to the Board for further adjudication. Entitlement to service connection for hypothyroidism, to include as due to herbicide agent exposure, is denied. The Veteran contends that he has hypothyroidism as a result of in-service herbicide agent exposure while stationed in the Republic of Vietnam. See e.g. July 2019 Board Hearing Transcript. Specifically, the Veteran has asserted that he was diagnosed with condition by a Dr. [R.] after his first pacemaker was installed in 2002 or 2003. Id. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Generally, the evidence must show: (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, 1166 -67 (Fed. Cir. 2004). The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110; see Degmetich v. Brown, 104 F.3d 1328, 1332 (1997) (holding that interpretation of section 1110 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). In the absence of proof of a current disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). In this case, the Board conceded in its November 2019 remand that the Veteran has documented service in Vietnam and is presumed to have been exposed to herbicide agents, such as Agent Orange, during that time. 38 C.F.R. § 3.307 (a)(6)(iii). However, after a thorough review of the evidence of record, the Board has concluded that the Veteran does not have a hypothyroidism disability and therefore, the analysis need go no further as he cannot be granted service connection for this condition on that basis alone. Turning to the evidence of record, private treatment records from Dr. R.’s office as early as January of 2004 note a diagnosis of hypothyroidism and that he was on 25 micrograms of Levoxyl. However, there are no accompanying testing results and no explanation for the prescribing of this medication. The Board notes that later private treatment records, such as a June 2009 progress note, do not include hypothyroidism as a listed condition even when noting his prescribed 25 micrograms of Levothyroxine. Overall, there appear to be no clinical findings supportive of this specific condition during the period on appeal. In this regard, in May of 2017, a VA examiner opined after a review of the Veteran’s claims file that, “it’s less likely as not that the veteran now meets medical criteria for an affirmative diagnosis of hypothyroidism”. As rationale, the examiner stated that, “[t]he medical record provides commentary that the veteran was started on a miniscule dose of synthroid (0.025mg) in 2003. The rationale behind starting treatment with a miniscule dose of synthroid is not documented. Over time, the veteran’s synthroid dosage has been increased to 0.075mg (low dose synthroid). No actual laboratory testing diagnostic of hypothyroidism is identified, and therefore the medical criteria for a diagnosis of hypothyroidism has not been met.” An additional VA opinion was obtained in January 2020 in order to comply with the Board’s most remand. In undertaking review of the Veteran’s claims file and relevant medical literature and specifically noting that “[t]he additional records provided … were reviewed, as well as the medical records from prior to that time”, the examiner concluded, “a dx of Hypothyroidism, cannot be confirmed”. As rationale, the examiner stated that, “1/8/04 - Cardiology records note dx of Hypothyroidism and that he was on Levoxyl 25 micrograms a day but did not note how this dx was made. A 7/10/03 TSH level was noted to be 4.30 which was in the normal range of (0.46-4.68) per the lab report as best this Examiner can determine as the available records report of these labs was in a different format than usual. Therefore, it is still unclear to this Examiner, as to why the Veteran was noted to be dx with Hypothyroidism by 2004 or why he was started on Thyroid supplementation.” Each VA opinion contains clear conclusions with reliance on the supporting data. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Each opinion also specifically contemplates the Veteran’s prescriptions in emphasizing the overarching importance of the lack of objective findings related to hypothyroidism in the record. Significantly, there are no conflicting opinions of record that would support the Veteran’s assertions. The Board relies on these opinions in finding that the Veteran does not currently have a hypothyroidism disability that would provide a sufficient basis to warrant service connection. In addition, while VA treatment records and private treatment records were associated with the record on remand, these records also do not offer any evidence of a hypothyroidism condition during the period on appeal. For example, the Board notes that VA treatment records from February of 2020 indicate that the Veteran self-reported to a provider that he “now has hyperthyroidism” and “feels his health problems are r/t agent orange”. In contrast, after additional testing the Veteran was informed in May of 2020 that his, “blood sugar, renal function, cholesterol, thyroid, and blood counts all look great”. Overall, the evidence does not definitively show any objective findings that would warrant entitlement for this asserted condition. The Board notes that the Veteran is competent to testify about his symptoms. However, while the Veteran’s contentions are acknowledged and have been considered, the Board reiterates that the threshold requirement for service connection is competent medical evidence of the existence of the claimed disability at some point during or in proximity to a veteran’s appeal. See Degmetich, 104 F.3d 1328, 1332. In the absence of proof of a current disability, there can be no valid claim. Brammer, 3 Vet. App. At 225. Without evidence of a current hypothyroidism disability, the Board need not address the other elements of service connection. The preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine is not for application, and the claim must be denied. 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. at 55 (1990). MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Smith, 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.