Citation Nr: 21066470 Decision Date: 11/01/21 Archive Date: 11/01/21 DOCKET NO. 17-38 038 DATE: November 1, 2021 ORDER Entitlement to service connection for chronic venous insufficiency of the bilateral lower extremities is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, his chronic venous insufficiency of the bilateral lower extremities is at least as likely as not related to service. CONCLUSION OF LAW The criteria for service connection for chronic venous insufficiency of the bilateral lower extremities are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty with the United States Marine Corps from August 1986 to May 1990, and again from February 1991 to March 1991. In March 2021, the Veteran testified before the undersigned at a Board hearing held via videoconference. A transcript of that hearing is of record. 1. Entitlement to service connection for chronic venous insufficiency of the bilateral lower extremities is granted Service connection may be granted 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. That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease. In order to prevail on the issue of service connection there must be competent evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in-service occurrence or aggravation of a disease or injury; and competent evidence of a nexus between an in-service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). An April 2015 VA Artery and Vein conditions examination noted a current diagnosis of chronic venous insufficiency of the bilateral lower extremities. Additionally, at his March 2021 hearing, the Veteran testified that he believes his current chronic venous insufficiency was incurred during or caused by his period of active service. The Veteran testified that during his active service as a member of an Marine Corps infantry unit, he routinely participated in extended runs, marches, military exercises, and forced troop movements that caused his feet to swell. At issue in the present case is whether the Veteran's current venous insufficiency of the bilateral lower extremities was incurred during or caused by his period of active service. Following the April 2015 VA examination, the examiner opined that it was less likely than not that the Veteran's chronic venous insufficiency was incurred during or caused by his period of active service. Although the examiner concluded that the Veteran's disability was not related to service, the rationale supports service connection. The examiner reasoned: The [V]eteran does have a history for feet and ankle swelling going back to active duty which is likely an early manifestation of venous insufficiency, but has no relationship to any of the vaccinations administered to him including anthrax. His subsequent worsening of venous insufficiency over time is complicated and more than likely due to multiple factors, including occupational aggravation, lack of available medical care, and slow natural progression of the underlying condition first manifested by leg edema while on active duty. A supplemental medical opinion obtained in May 2015 noted that it was less likely than not that the Veteran's chronic venous insufficiency was caused by a left knee edema during his period of active service. During the Veteran's March 2021 hearing, the Veteran clarified that he did not contend that his chronic venous insufficiency was caused by vaccinations received during his active service, but rather the extreme physical demands of his military occupational specialty as a radio operator in an infantry unit. The April 2015 VA examiner found that it was "likely" that his feet and ankle swelling in service was an early manifestation of his current disability. Even though the worsening of the disability is related to multiple factors, the examiner found that it was likely that it first manifested in service. There is no medical opinion to the contrary. The preponderance of the probative evidence of record weighs in favor of the claim of service connection for chronic venous insufficiency of the bilateral lower extremities. Service connection for chronic venous insufficiency of the bilateral lower extremities is granted. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Riordan, 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.