Citation Nr: 21061934 Decision Date: 10/05/21 Archive Date: 10/05/21 DOCKET NO. 14-21 258 DATE: October 5, 2021 ORDER Service connection for a left calf disability is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has a left calf disability that is related to active military service or events therein. CONCLUSION OF LAW The criteria for establishing service connection for a left calf disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304 (2021). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Air Force from October 1987 to October 2012, including service in Afghanistan and Iraq, for which his decorations included the Bronze Star Medal. The Veteran testified before the undersigned Veterans Law Judge during a May 2017 hearing and a transcript is of record. These matters are on appeal from a September 2013 rating decision. In a February 2018 decision, the Board remanded the issue being decided below to afford the Veteran an additional VA medical opinion. The Agency of Original Jurisdiction (AOJ) has done so. In a January 2021 decision, the Board remanded this issue again to afford the Veteran an additional VA medical opinion. The AOJ has done so. The May 2021 VA examination for muscle injuries is adequate because it was based upon consideration of the Veteran's pertinent medical history, his lay assertions and current complaints, and explained why he did not have a left calf disability. There was therefore substantial compliance with the remand directives with regard to this issue. See Stegall v. West, 11 Vet. App. 268 (1998). Neither the Veteran nor his representative have raised any issues with the duty to notify or duty to assist with regard to the issue being decided below. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). 1. Left Calf Disability The Veteran contends that he has a left calf disability that is etiologically related to his active duty service. VA received the Veteran's claim for service connection in May 2012, prior to his separation from active duty service, so the entire period after his October 2012 separation is on appeal. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, 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). The benefit of the doubt rule provides that a veteran will prevail in a case where the positive evidence is in a relative balance with the negative evidence. Therefore, the Veteran prevails in a claim when (1) the weight of the evidence supports the claim or (2) when the evidence is in equipoise. It is only when the weight of the evidence is against the claim that the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110. Thus, the threshold question that must be addressed here (as with any claim seeking service connection) is whether the Veteran had the disability for which service connection is sought at any time during the period on appeal. In the absence of proof of a disability during that period, there is no valid claim of service connection. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); see also Degmetich v. Brown, 104 F.3d 1328 (1997). A September 2008 service treatment record notes the Veteran's report of acute left calf pain and inability to bear weight on his left leg after an injury while playing basketball. The treatment provider diagnosed a suspected partial Achilles tendon rupture. The Veteran was afforded a VA examination for ankle disabilities in April 2013. The clinician diagnosed bilateral ankle strain. The Veteran did not report any symptoms specific to his left calf. Because the clinician found no history of an Achilles tendon rupture and did not reconcile this finding with the September 2008 service treatment record noting a suspected rupture, the Board found the clinician's findings inadequate in its February 2018 decision. Those findings are therefore of no probative value and will play no role in the Board's analysis. The Veteran's left ankle strain is already service-connected. He also has service-connected left knee and left hip disabilities. The Veteran was also afforded a VA examination for back disabilities in April 2013. The Veteran did not report radicular pain or any other signs or symptoms due to radiculopathy. Sensory examination of his left lower leg was normal. During the May 2017 hearing, the Veteran testified that his left calf was "not symmetrical with" his right calf and clarified that this asymmetry was "an indentation on [his] calf, where you can tell [the rupture] was." The only left calf symptom he reported was pain with activity. He did not report that the asymmetry or pain caused any functional impairment. The Veteran was afforded an additional VA medical opinion in February 2020, by the same clinician who conducted the April 2013 VA examination. The clinician found "no objective evidence" of a left calf disability based on the April 2013 examination findings. Because the clinician relied entirely on findings the Board had already found inadequate, this opinion is also inadequate. It is therefore also of no probative value and will play no role in the Board's analysis. The Veteran was afforded a VA examination for muscle injuries in May 2021. The clinician explained that they chose this examination because the Veteran's left calf symptoms had no impact on his ankle or knee range of motion. The clinician did not diagnose any left calf disability. The Veteran reported sharp pain, but only with active use of his calf, and that this pain stopped immediately after the movement causing it stopped. The clinician found that this type of pain "does not indicate a true functional loss." On examination, the Veteran's left calf was normal, with the exception of an unspecified deformity in the left medial calf with flexion of the ankle. Neither the Veteran nor the clinician reported that this deformity caused any functional loss or functional impairment of earning capacity. The record contains no medical evidence of a left calf disability during the period on appeal. The Veteran is competent to report on matters observed or within his personal knowledge, such as pain and asymmetry. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). In this case, however, although the Veteran is competent to report left calf symptoms, he has not done so, other than asymmetry and intermittent pain. The Veteran is not competent to provide an opinion as to whether his symptoms warrant any medical diagnosis. The Board must determine on a case-by-case basis whether a particular medical issue is within the competence of a lay person. Kahana v. Shinseki, 24 Vet. App. 428 (2011). The Veteran in this case is not shown to possess any pertinent medical training or expertise that would make him competent to diagnose himself with any particular left calf disability. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Thus, to the extent that the Veteran contends his left calf pain and asymmetry constitutes a disability, it is not a competent medical opinion and it cannot be assigned any probative weight. The Board finds that the May 2021 VA examiner's findings of normal left calf function is of greater probative value than the Veteran's lay assertions. Pain can be a disability in certain circumstances. To establish a disability, the Veteran's pain must amount to functional impairment. To establish the presence of a left calf disability, the Veteran needs "...to show that [his] pain reaches the level of a functional impairment of earning capacity. Saunders v. Wilkie, 886 F.3d 1356, 1367-1368 (Fed. Cir. 2018). The Veteran has reported intermittent left calf pain and his reports are credible. However, the record does not show, nor has the Veteran contended, that he has left calf symptoms that cause a functional impairment of earning capacity. Id. The record does not contain any competent, probative evidence that the Veteran has been diagnosed with or treated for a left calf disability by any examiner or treatment provider during the period on appeal. Additionally, the Veteran has not reported having any left calf symptoms, other than asymmetry and intermittent pain, and has not reported that his asymmetry or intermittent pain causes functional impairment. (Continued on the next page) As the evidence does not establish that the Veteran had a left calf disability during the period on appeal, the Board finds that service connection is not warranted. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007) (holding that current disability requirement is satisfied when a claimant "has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim,"); see also Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013) (holding that the Board must address recent pre-claim evidence in assessing whether a current disability exists, for purposes of service connection, at the time the claim was filed or during its pendency). D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Ryan Frank, 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.