Citation Nr: 21068218 Decision Date: 11/09/21 Archive Date: 11/09/21 DOCKET NO. 14-28 500 DATE: November 9, 2021 ORDER Entitlement to service connection for a disorder characterized by swelling, claimed as phlebitis and lymphedema, is denied. FINDING OF FACT The preponderance of the evidence is against finding that any disorder characterized by swelling, to include phlebitis and lymphedema, began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for a disorder characterized by swelling, to include phlebitis and lymphedema, have not been 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 in the U.S. Air Force from August 1964 to August 1968. He died in September 2016. The appellant is his surviving spouse. This matter comes to the Board on appeal of a rating decision by a U. S. Department of Veterans Affairs (VA) Regional Office (RO). In November 2019, the RO substituted the appellant into the claims that were pending on appeal at the time of the Veteran's death. Entitlement to service connection for a disorder characterized by swelling, claimed as phlebitis and lymphedema The appellant contends that the Veteran incurred a disorder characterized by swelling, claimed as phlebitis and lymphedema, during his active military service and she seeks service connection. Turning to the record, the Veteran's service treatment records (STRs) are silent as to any diagnosis or treatment for any disorder characterized by swelling, including phlebitis and lymphedema, during active service. At the time of separation in July 1968, the examiner noted that the Veteran had full range of motion in his bilateral lower extremities. Additionally, the examiner noted that on the Veteran's Statement of Family History, he reported swollen or painful joints. However, the examiner noted that there were no records of treatment in the record, nor were there any findings upon physical examination. In December 2020, a VA medical opinion was obtained in connection with the Veteran's claim. With respect to swelling in the lower extremities, the examiner found that the Veteran had a diagnosis of chronic lymphedema left lower extremity, not associated with blood clots. Further, the Veteran had an acute episode of right superficial thrombophlebitis, resolved. The examiner opined that it was less likely than not that these diagnoses were caused by, related to, or aggravated beyond a natural progression by the Veteran's military service. Specifically, the examiner explained that these disorders were neither noted nor treated during the Veteran's period of active service. Additionally, the December 2020 VA examiner went on to explain that there was insufficient evidence to warrant or to confirm a diagnosis of a chronic disorder or its residuals with respect to any diagnosis of phlebitis or blood clots that would be caused by swelling in the lower extremities during the Veteran's active military service. Specifically, there was no evidence of functional limitations. Moreover, the Veteran had a diagnosis of acute right lower extremity thrombophlebitis post service, which resolved. Therefore, the examiner opined that it was likely than not caused by, related to, or aggravated beyond its natural progression by the Veteran's active military service. Next, a VA addendum medical opinion was obtained in July 2021. The examiner highlighted that the July 1968 separation examination noted that the Veteran had normal lower extremity examination. Moreover, the examiner found that a Report of Medical History was negative for complaints suggestive of a lower extremity vascular disorder. However, the Veteran was noted to have pain in his feet from prolonged standing. Further, the examiner discussed the Veteran's report of swelling over various parts of the body occurring only at night. In particular, the examiner explained that swollen or painful joints referred to a question on the Standard Form 89. Also, there was no record of treatment in the medical records and no findings on physical examination reported by the attending physician. Therefore, the examiner determined that there remained no evidence of lymphedema in service, and that even if the Veteran was hospitalized for "swollen and painful joints," this is not consistent with a diagnosis of lymphedema. Further, examiner maintained that the Veteran's diagnosis of lymphedema was less likely than not caused by, related to, or aggravated beyond natural progression by military service. The Board finds this medical opinion is fully adequate. Here, the opinion writer fully addressed the nexus question. The opinion reflects that the writer reviewed the file, provided full citation to medical literature (UptoDate) in explaining the nature of lymphedema and provided an informed opinion fully responsive to the question at issue. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). This opinion is valuable and is afforded great weight. In light of the evidence as discussed above, the Board finds that service connection for a disorder characterized as swelling, to include phlebitis and lymphedema, is not warranted. Specifically, there are no findings of any disorder characterized by swelling, phlebitis, or lymphedema during the Veteran's active service. Neither did any examiner find that any indications that the Veteran had limitation of motion during his active military service. Moreover, the VA examiner from December 2020 and July 2021 explained that any reported swollen and painful joints during active military service is not consistent with a later diagnosis of lymphedema. Equally, the December 2020 and July 2021 VA examiner found that the Veteran experienced acute right lower extremity thrombophlebitis post-service, which the examiner found would not have been a residual of swollen joints during the Veteran's active military service. (Continued on the next page) The Board acknowledges that the appellant has claimed that the Veteran had a disorder characterized by swelling, to include phlebitis and lymphedema, that is directly related to his active service. However, while the appellant and the Veteran are competent to report (1) symptoms observable to a layperson, e.g., swelling; (2) a diagnosis that is later confirmed by clinical findings; or (3) a contemporary diagnosis, neither is competent to independently render a medical diagnosis or opine as to the specific etiology of a condition. See Davidson v. Shinseki, 581 F.3d 1313 (2009). Consequently, the appellant's and the Veteran's lay assertions of medical diagnosis or etiology are afforded little probative value and cannot constitute evidence upon which to grant the claim for service connection. Lathan v. Brown, 7 Vet. App. 359, 365 (1995). Accordingly, for the reasons stated above, the Board finds that the preponderance of the evidence is against the claim for service connection for a blood clotting disorder, to include phlebitis and lymphedema. As the evidence is not in relative equipoise, the benefit of the doubt rule does not apply. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Emily Tamlyn Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Scanlan, Associate 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.