Citation Nr: 21068570 Decision Date: 11/10/21 Archive Date: 11/10/21 DOCKET NO. 16-15 507A DATE: November 10, 2021 ORDER Entitlement to service connection for residuals of spider bites, other than loss of teeth, is denied. FINDING OF FACT The preponderance of the evidence is against finding that residuals of spider bites, other than loss of teeth, began during active service or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for residuals of spider bites, other than loss of teeth, are not 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 from June 1968 to June 1971 and July 1971 to July 1988. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing conducted by the undersigned Veterans Law Judge in March 2019. A transcript of the hearing has been associated with the claims file. This matter was previously before the Board in October 2019, October 2020, and July 2021 and was remanded for additional development. In October 2020, the Board, in part, denied entitlement to service connection for loss of teeth, claimed as residuals of spider bites. As such, the issue that remains before the Board is entitlement to service connection for residuals of spider bites, other than loss of teeth. Entitlement to service connection for residuals of spider bites, other than loss of teeth The Veteran contends that he has residuals of a spider bite from his time in service. During the March 2019 hearing, the Veteran testified that, during service, he received treatment after being bitten. He testified that he was subsequently placed in isolation and given intravenous (IV) medication but that he was bitten a second time. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The Veteran's service treatment records (STRs) show that he was bitten by a spider in April 1978, which resulted in treatment for an infected spider bite and cellulitis on the right side of his neck. See April 1978 STR. The Veteran was hospitalized for five days but the STRs do not contain any further complaints, treatment, or findings related to a residual condition related to the spider bite, including at his April 1988 separation examination. See April 1978 clinical record and April 1988 reports of medical history and examination. The Board notes that an earlier service record documents treatment for a rash on both of his arms that he reported had persisted for three weeks and was also affecting his wife. The Veteran was diagnosed with tinea cruris and discharged to duty but, notably, he denied being bitten or stung by anything at that time. See February 1977 STR. The Veteran's post-service treatment records include private treatment records from November 2012 indicating that the Veteran reported bug bites to his chest and skin. He was diagnosed with cellulitis and xerosis cutis. In May 2014, the Veteran was noted to have skin lesions on his face and neck. He was diagnosed with skin lesion of face and spontaneous ecchymosis. In a July 2021 VA medical opinion and accompanying August 2021 addendum opinion, a VA examiner opined that the Veteran's spider bite residuals were less likely than not due to his service as a January 2020 VA examination did not reveal an active skin condition. The examiner noted that "spider bites are typically self-limited and are not expected to have residual symptoms of current more than 40 years following onsets and cysts can also represent self-limited/self-resolving conditions." The examiner noted that "cellulitis and xerosis were not initially diagnosed until 2012 were the skin lesions and ecchymoses were not diagnosed until 2014." The examiner explained that "while spider bites can cause a brief episode of cellulitis, it would not be anticipated for a spider bite in 1978 to cause cellulitis manifesting in 2012," adding that "there is no association between a prior spider bite and xerosis, ecchymosis or unspecified skin lesions." The July and August 2021 VA medical opinions are considered the most probative evidence of record regarding whether the Veteran's skin conditions are the result of spider bites incurred during service, as they are based upon all relevant facts, are supported by a well-reasoned rationales and, are consistent with the other evidence of record. Notably, there is no opposing medical opinion or evidence of record which indicates that the Veteran's current skin conditions or other residuals shown during or since service are related to his military service. Therefore, the July and August 2021opinions are afforded significant probative weight. While the Board is sympathetic to the Veteran's claim, considering all the relevant evidence of record, the preponderance of the evidence is against a finding of an etiological relationship between the residuals of spider bites, other than loss of teeth, and his military service. Accordingly, the Board finds that the claim of entitlement to service connection for residuals of spider bites, other than loss of teeth, must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). M. Donohue Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Morrad, 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.