Citation Nr: 21067262 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 16-41 114 DATE: November 3, 2021 ORDER Entitlement to service connection for a hernia is denied. FINDING OF FACT The preponderance of the evidence of record reflects that the Veteran's hernia was not incurred in, and is not otherwise related to, his active-duty service. CONCLUSION OF LAW The criteria for service connection for a hernia are not met. 38 U.S.C. §§ 1110, 1111, 5107; 38 C.F.R. §§ 3.102, 3.303(a), (c). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Marine Corps from December 2000 to December 2004. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) rating decision dated in November 2014. This issue was previously before the Board in November 2019, at which time, the issue was remanded to the AOJ for additional development. This case has now been returned to the Board for further appellate action. On remand and in a May 2021 rating decision, the AOJ granted service connection for posttraumatic stress disorder (PTSD) (claimed as depression) and service connection for bilateral hearing loss. As these grants represent a full grant of benefits sought on appeal with respect to these service connection claims, the issues are no longer on appeal and before the Board. Service Connection 1. Entitlement to service connection for a hernia The Veteran seeks service connection for a hernia, which he asserts is related to service. Service connection will be granted if the evidence demonstrates that current disability resulted from an injury or disease incurred in active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first 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). The Board has carefully reviewed the evidence of record and finds that, based upon a preponderance of the evidence, the criteria for service connection for a hernia on any basis are not met. At the outset, the Board notes that a current diagnosis of umbilical hernia has been established. See March 2021 VA examination. Service treatment records are silent as to any complaints, treatment or clinical diagnosis for a hernia. See also July 2000 and September 2014 service treatment records. Post-service treatment records reflect that the Veteran was initially treated for a hernia from at least 2010. See June 2019 private treatment record. Pursuant to the November 2019 Board remand, the Veteran was afforded a VA examination in March 2021, which reflects a diagnosis of umbilical hernia. The Veteran reported that he noticed the condition in 2003 after he returned from Iraq. The Veteran reported that it was reducible, and he would notice a clicking noise when he would reduce it. The Veteran reported that he underwent a surgical procedure in September 2010, and reported that he currently had discomfort at the surgical site. The VA examiner opined that the Veteran's hernia was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. See March 2021 VA examination. The examiner noted that based on the current examination, the Veteran had a diagnosis of umbilical hernia, with residual symptoms of a well healed scar. The examiner noted that review of the service and military medical records showed no records regarding complaints, diagnosis or treatment of a hernia condition while on active duty from December 2000 to December 2004. The examiner noted that after service, the Veteran had umbilical hernia repair surgery in September 2010. The examiner found that based upon the current examination and review of medical records, they were unable to establish a nexus to military service; therefore, the examiner opined that the diagnosed umbilical hernia was less likely than not incurred in or caused by the claimed in service injury, event, or illness. Based on a preponderance of the evidence, the Board finds that there is no nexus between the Veteran's hernia and service. The Board acknowledges the testimony and statements of the Veteran in support of his claim, and notes that lay statements may be competent to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331, 1336-1337 (2006); Layno v. Brown, 6 Vet. App. 465, 469 (1994). As noted, the Veteran asserts that he noticed his hernia condition in 2003, after he returned from service in Iraq. See March 2021 VA examination. At a June 2019 Board hearing, the Veteran testified that during service he noticed what he thought was a hernia in service and was able to push it back in place. The Veteran reported that during service he lifted a lot of weight and equipment, including radio equipment. See also June 2019 private treatment record; August 2021 Representative Statement. In the instant case, the question of whether the Veteran's hernia is related to service is not something that can be determined by mere observation. Nor is this question simple, as it requires clinical testing and medical training to understand the nature and etiology of a hernia in light of the treatment records and the reported symptoms. The record does not indicate that the Veteran has such skill or expertise to make such a complicated determination. As such, the Board finds that the Veteran's statements as to whether he actually had a hernia in service as well as whether a post-service diagnosed hernia is related to service are not competent evidence on this issue. While the Veteran believes his hernia is related to service the Board affords more probative weight to the opinion provided by the VA examiner. It is based on current examination results, the Veteran's reported history, and a review of the medical records, including examinations prior to and after service. This fact is particularly important, in the Board's judgment, as the references make for a more convincing rationale. See Bloom v. West, 12 Vet. App. 185, 187 (1999); Prejean v. West, 13 Vet. App. 444, 448-9 (2000). The March 2021 VA opinion establishes that the Veteran's hernia is not related to service. The March 2021 VA examiner's opinion combined with the other evidence of record including the service treatment records and post-service treatment records establish that the Veteran's hernia is not related to service. There is no competent, credible and probative contrary opinion of record. In reaching the above conclusions, the Board has considered the applicability of the benefit of the doubt doctrine. The Board notes that under the provisions of 38 U.S.C. § 5107(b), the benefit of the doubt is to be resolved in the claimant's favor in cases where there is an approximate balance of positive and negative evidence in regard to a material issue. However, as the preponderance of the evidence is against the Veteran's claim, that doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). S. L. Kennedy Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Johnson 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.