Citation Nr: 21067511 Decision Date: 11/04/21 Archive Date: 11/04/21 DOCKET NO. 14-14 876 DATE: November 4, 2021 ORDER Entitlement to service connection for aortic aneurysm is denied. FINDINGS OF FACT 1. The record evidence shows that the Veteran earned his Parachute Badge during active service; thus, his lay statements and Board hearing testimony concerning participation in multiple parachute jumps during service is deemed credible because it is consistent with the facts and circumstances of his active service. 2. The record evidence shows that, since his service separation, the Veteran has been diagnosed as having and treated for aortic aneurysm. 3. The record evidence shows that the Veteran's aortic aneurysm is not related to active service or any incident of service, including as due to an in-service parachute jump. CONCLUSION OF LAW The criteria for service connection for aortic aneurysm have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.303, 3.304 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran had active service in the U.S. Army from August 1981 to August 1985. This appeal has a long procedural history. It comes before the Board of Veterans' Appeals (Board) on appeal from a November 2012 rating decision which denied the currently appealed claim. A Central Office Board hearing was held in May 2018 before the undersigned Veterans Law Judge and a copy of the hearing transcript has been added to the record. The Board has remanded this appeal on multiple occasions to the RO for additional development, most recently in September 2021. A review of the claims file shows that there has been substantial compliance with the Board's September 2021 remand directives. The Board concluded that an August 2021 VA medical nexus opinion (incorrectly identified as an August 2020 VA medical nexus opinion) was inadequate for VA adjudication purposes. Because there is no medical evidence dated in August 2020, the Board concludes that the reference in the September 2021 remand to an August 2020 VA medical nexus opinion is a typographical error. The Board then directed that the RO obtain another opinion concerning the nature and etiology of the Veteran's aortic aneurysm. This opinion was obtained in October 2021. See Stegall v. West, 11 Vet. App. 268 (1998); see also Dyment v. West, 13 Vet. App. 141 (1999) (holding that another remand is not required under Stegall where the Board's remand instructions were substantially complied with), aff'd, Dyment v. Principi, 287 F.3d 1377 (2002). The Board also remanded a claim of service connection for a respiratory disability in September 2021. Following the Board's September 2021 remand, the RO granted service connection for sinusitis and for asthma in a rating decision issued in October 2021. Accordingly, an issue relating to service connection for a respiratory disability is no longer in appellate status. See Grantham v. Brown, 114 F .3d 1156 (1997). The Board finds that the preponderance of the evidence is against granting the Veteran's claim of service connection for aortic aneurysm. The Veteran essentially contends that he incurred aortic aneurysm during active service, specifically as a result of participating in multiple parachute jumps and incurring injuries as a result of these jumps. The record evidence does not support his assertions regarding an etiological link between aortic aneurysm and active service or any incident of service, including as due to an in-service parachute jump. It shows instead that, although he participated in multiple parachute jumps during active service, they did not cause or contribute to his current aortic aneurysm. The Veteran's DD Form 214 shows that he earned the Parachute Badge. Thus, the Board finds that his statements concerning participation in multiple in-service parachute jumps to be credible because they are consistent with the facts and circumstances of his active service. The available service treatment records show that, on May 18, 1983, he reported to the emergency room with complaints of landing on his buttocks during a parachute landing fall and low back pain. Objective examination showed tenderness in the sacral area but otherwise within normal limits and a full range of motion. The diagnosis was a low back contusion. The next day, on outpatient treatment on May 19, 1983, his complaints included tail bone pain. He reported that he got entangled with his jumper during a parachute jump and landed on his lower lumbar region. His feet did not come into contact with the ground when he landed. Physical examination showed a full range of motion, a narrow, stable gait, no palpable spasm, tenderness in the bilateral gluteus maximus, and negative straight leg raising bilaterally. The impression was deep gluteus bruise. The Board notes that the absence of contemporaneous records does not preclude granting service connection for a claimed disability. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (finding lack of contemporaneous medical records does not serve as an "absolute bar" to the service connection claim); Barr v. Nicholson, 21 Vet. App. 303 (2007) ("Board may not reject as not credible any uncorroborated statements merely because the contemporaneous medical evidence is silent as to complaints or treatment for the relevant condition or symptoms"). The post-service evidence also does not support granting service connection for aortic aneurysm. Despite the Veteran's lay assertions and Board hearing testimony to the contrary, it shows that his current aortic aneurysm is not related to active service or any incident of service, including as due to a parachute jump. For example, on private outpatient treatment in May 2006, he "states that he has known about [his] thoracic aneurysm for six or seven years and has had it checked annually with a [computerized tomography (CT)] scan." He denied any chest pain, syncope, or abdominal pain. The impression was ascending thoracic aortic aneurysm. A private CT scan of the Veteran's chest taken in July 2007 showed a mild ascending aorta. The radiologist concluded that this finding was "not significantly changed from a study going back to" December 2005. On private outpatient treatment in October 2011, his complaints included an aneurysm of the ascending aorta. He first was diagnosed with an aneurysm in 2002. "There is no history of hypertension, but he did suffer some trauma when he was a paratrooper in the Army." The impressions included a history of ascending aortic aneurysm. The Veteran testified at his May 2018 Board hearing that his aortic aneurysm initially was diagnosed in 2002. See Board hearing transcript dated May 9, 2018, at pp. 5. He also testified to feeling chest tightness during service and complaining of the same tightness which had worsened progressively in 2002 when he was diagnosed as having aortic aneurysm. He testified further that he had been told that a chest injury following an in-service parachute jump could have been the cause of his aortic aneurysm. Id., at pp. 6-8. The Board acknowledges here that multiple opinions concerning the nature and etiology of the Veteran's aortic aneurysm were obtained prior to the most recent opinion dated in October 2021. The Board has explained in detail in each of the prior remands of this appeal why all of the medical opinions dated prior to the most recent opinion in October 2021 were inadequate for VA adjudication purposes. Simply put, each of the opinions dated prior to October 2021 were inadequate for VA adjudication purposes because they relied on the lack of contemporaneous records documenting complaints of or treatment for aortic aneurysm as support for the negative medical nexus opinions provided concerning the contended etiological relationship between aortic aneurysm and active service. It is well-settled that the lack of records is insufficient support for a medical nexus opinion. See Buchanan, 451 F.3d at 1337, and Barr, 21 Vet. App. at 303. None of the opinions which the Board previously found inadequate for VA adjudication purposes were reviewed or relied upon in adjudicating the currently appealed claim. In an October 2021 opinion, a VA clinician opined that it was less likely than not that the Veteran's aortic aneurysm is related to active service, including as due to an in-service parachute jump. The rationale for this opinion was based on a review of the claims file. The rationale also was based on a review of relevant medical literature which did not support finding that a diagnosis of aortic aneurysm can be attributed to a parachute jump. The clinician noted that the Veteran had been diagnosed as having a thoracic aortic aneurysm. This clinician stated, "The most common cause of a thoracic aortic aneurysm is hardening of the arteries. This condition is more common in people with high cholesterol, long-term high blood pressure, or who smoke." Contrary to the Veteran's lay assertions and Board hearing testimony, the record evidence shows that his aortic aneurysm is not related to active service or any incident of service, including as due to an in-service parachute jump. It is undisputed that he participated in multiple parachute jumps and earned his Parachute Badge during active service. His available service treatment records also show that he incurred an injury following a parachute jump fall in May 1983 when he was diagnosed as having a deep gluteus bruise. There is no indication that his aortic aneurysm, initially diagnosed several decades after his service separation, is related to active service, including as due to an in-service parachute jump, however. The October 2021 VA clinician specifically opined that it was less likely than not that the Veteran's aortic aneurysm is related to active service, including as due to an in-service parachute jump. This opinion was fully supported. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (finding that a medical opinion "must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). He otherwise has not identified or submitted any evidence demonstrating his entitlement to service connection for aortic aneurysm. In summary, the Board finds that service connection for aortic aneurysm is not warranted. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael T. Osborne, 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.