Citation Nr: 21065540 Decision Date: 10/26/21 Archive Date: 10/26/21 DOCKET NO. 17-53 559 DATE: October 26, 2021 ORDER Entitlement to service connection for degenerative arthritis of the right ankle is denied. FINDING OF FACT Currently diagnosed degenerative arthritis of the right ankle did not manifest on active duty service or within the first post-service year, and is not otherwise related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for a right ankle disability have not been met. 38 U.S.C. § 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from October 1961 to August 1962. The Veteran had additional periods of National Guard service. This case is before the Board of Veterans' Appeals (Board) on appeal from an August 2017 rating decision of the agency of original jurisdiction (AOJ) of the United States Department of Veterans Affairs (VA). In June 2021, the Board remanded the issue for a VA examination on the nature and etiology of the Veteran's arthritis, specifically to address the Veteran's contention that his duties as a motor vehicle maintenance technician caused strain on his right ankle. The claim is once again before the Board. Substantial compliance with the Board's prior remand orders is demonstrated. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999); Stegall v. West, 11 Vet. App. 268, 271 (1998). With respect to the Veteran's claims decided herein, VA has met all statutory and regulatory notice and duty-to-assist provisions. See 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326. Neither the Veteran nor his representative has advanced any procedural arguments in relation to VA's duty to notify and assist. See Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015) (holding that "absent extraordinary circumstances...we think it is appropriate for the Board and the Veterans Court to address only those procedural arguments specifically raised by the veteran...."). Service connection is awarded for disability that is the result of a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Service connection requires competent evidence showing: (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 (Fed. Cir. 2004). Lay assertions may serve to support a claim for service connection by establishing the occurrence of observable events or the presence of disability or symptoms of disability that are subject to lay observation. 38 U.S.C. § 1153(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006). Some chronic diseases, including arthritis, may be presumed to have been incurred in service, if they become manifest to a degree of ten percent or more within the applicable presumptive period. 38 U.S.C. §§ 1101(3), 1112(a); 38 C.F.R. §§ 3.307(a), 3.309(a). For those listed chronic conditions, a showing of continuity of symptoms affords an alternative route to service connection. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The applicable presumptive period for arthritis is one year from separation. The Veteran's personnel records show his military occupational specialty (MOS) as a motor vehicle maintenance technician. The Veteran states that his current right ankle disability is related to the duties of his in-service occupation. The Veteran specifically noted certain activities affected his joints including, but not limited to, climbing up on and jumping off of two and half ton trucks, lifting and manipulating heavy parts into place, and replacing tires and wheels weighing 90 pounds. In 1983, the Veteran was medically discharged due to an embolism to his left middle cerebral artery; his separation exam included notes on degenerative arthritis of the right knee, healed fracture of his right wrist, and nerve surgery. There are no records of a right ankle injury and no records of treatment for complaints of right ankle pain in Veteran's service treatment records (STRs). The Veteran's separation physical examination is negative for any right ankle condition. The earliest medical evidence of post-service right ankle disability is a November 2019 private treatment record diagnosing Veteran with arthritis and posterior tibialis tendinitis of the right ankle. The doctor noted that Veteran's ankle pain was a new issue. Veteran's diagnosis was confirmed via x-ray. In July 2021, the Veteran was afforded a VA ankle examination. The Veteran reported experiencing pain in his ankle and occasional flare-ups of sharp pain. Veteran stated that his pain began approximately 30 years ago and gradually worsened. The examiner opined that the onset of Veteran's right ankle pain was "likely a few years prior to 2019" and noted that the condition was "mild" at this time. Regarding the Veteran's statements that his in-service duties caused arthritis of the right ankle, the examiner noted that there was no continuity of symptoms. In August 2021, the VA examiner completed an addendum opinion to clarify whether the Veteran's right ankle disability had its onset in or was related to service to include his duties as a vehicle maintenance technician. The examiner opined that while heavy labor can cause physical issues, it is not medically reasonable that manifestation of the physical issue would occur decades later. He stressed that the lack of continuity of symptomatology referenced not only the absence of findings in treatment or routine examination, but also in the Veteran's reported complaints over the years. The Veteran asserts there is a nexus between his currently diagnosed right ankle disability and service. However, he has offered no evidence in support of this belief. While a lay person is competent to testify about their symptoms, or to report what a doctor has told him, only a medical professional is competent to provide a diagnosis. As a lay person, the Veteran is not competent to render an opinion as to the etiology of his claimed right ankle disability as he is a layperson lacking the necessary training and knowledge to do so. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). Additionally, no health care professional has supported his position. The Board finds the August 2021 opinion that the Veteran's arthritis of the right ankle did not have its onset in-service and is not related to his duties as a vehicle maintenance technician is probative and supported by the evidence of record. The first documented indication of right ankle pain in treatment records occurred approximately 37 years after Veteran's separation from service. STRs do not indicate any complaints; Veteran's separation exam noted no problems regarding his right ankle. After a careful review of the record, the Board finds that the evidence does not support a determination that arthritis of the right ankle is etiologically related to his active-duty service. Because there is no competent evidence which links the Veteran's right ankle disability to service, direct service connection is not warranted, and as there is no diagnosis within one-year post-separation, presumptive service connection is not warranted. As there is no evidence to support any finding of a nexus between service and Veteran's current of arthritis of the right ankle, service connection is not warranted. In reaching this conclusion, the Board has considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the Veteran's claim for service connection for hypertension, the doctrine is not applicable. 38 C.F.R. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Lauren Barletta 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.