Citation Nr: 21068782 Decision Date: 11/12/21 Archive Date: 11/12/21 DOCKET NO. 18-13 567 DATE: November 12, 2021 ORDER Service connection for a kidney disorder, including as secondary to the service-connected hypertension, is denied. FINDING OF FACT The Veteran does not have a current chronic kidney disability. CONCLUSION OF LAW The criteria for service connection for a kidney condition have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran, who is the Appellant, served on active duty from March 23, 2015 to August 31, 2015. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2016 rating decision from the Regional Office (RO), which, in pertinent part, denied service connection for a kidney condition. In January 2021, the Veteran testified at a Board virtual hearing before the undersigned Veterans Law Judge. The hearing transcript has been associated with the record. This case was previously before the Board in February 2021 and July 2021, where the issue on appeal was remanded for a VA examination and medical opinion. The Board finds that the Agency of Original Jurisdiction (AOJ) substantially complied with the Board Remand directives. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999) (remand not required under Stegall v. West, 11 Vet. App. 268 (1998), where the Board's remand instructions were substantially complied with), aff'd, Dyment v. Principi, 287 F.3d 1377 (Fed. Cir. 2002). The Board finds that the duties to notify and assist in this case have been fulfilled. Neither the Veteran nor the evidence has raised any specific contentions regarding the duties to notify or assist. 1. Service Connection for a Kidney Condition The Veteran contends that the stress of basic training caused a kidney disorder, as she collapsed during physical training due to stomach and back pain. The Veteran reports receiving outpatient care for pain at sick call on two or three occasions before going to the hospital and being told the kidneys were abnormal. The Veteran testified that she was scheduled for a follow up appointment with a nephrologist but was released from active duty before she could make the appointment. During the September 2021 VA examination, the Veteran reported that the kidney condition comes and goes and described cramps in the flank area and lower back. Alternatively, the Veteran asserts that her kidney condition was caused by (is secondary to) the service-connected hypertension. See January 2021 Board Hearing Transcript, March 2018 VA Form 9; see also September 2021 VA examination report. Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, service connection for a disability requires evidence of: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. Service connection may be established, on a secondary basis, for disability that is proximately due to or the result of a service-connected disease or injury. See 38 C.F.R. § 3.310. Secondary service requires evidence demonstrating that the disability is either (1) proximately due to or the result of a service-connected disease or injury or (2) aggravated by an already service-connected disease or injury. See Allen v. Brown, 7 Vet. App. 439, 448 (1995); 38 C.F.R. § 3.310. The requirement of a current disability is satisfied when a veteran has a disability at the time of filing a service connection claim, during the pendency of that claim, or just prior to the filing of a claim, even if the disability resolves prior to adjudication of the claim. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). In the absence of proof of a current disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). After reviewing all the medical and lay evidence, the Board finds that the weight of the evidence is against finding a current kidney disability. A review of the service treatment records reveals that the Veteran was seen for lower abdominal pain in August 2015, which was managed with Naproxen and Ibuprofen but progressed thereafter. Upon further work up the same month, a computed tomography (CT) of the abdomen showed nonspecific fullness of the bilateral kidneys with decreased renal cortical attenuation, and an abdomen and pelvis ultrasound showed increased echogenicity of the renal cortices consistent with intrinsic renal disease. A diagnostic impression of acute kidney injury most likely due to NSAID use was provided. A follow up appointment with nephrology was scheduled for September 2015, prior to discharge from the hospital, but the Veteran was separated from service in August 2015 and did not attend the follow up nephrology appointment thereafter. See September 2015 service treatment records. Post-service treatment records are silent for additional symptoms, complaints, diagnosis, or treatment of a chronic kidney disorder. Private and VA treatment records reflect symptoms and treatment of low back pain, but those symptoms have been attributed to a non-service-connected musculoskeletal condition as an x-ray and MRI have shown scoliosis and multilevel facet arthropathy with varying degrees of mild interfacet edema, which were deemed the likely cause of the back pain. See August 2017 private treatment record, October 2018 VA treatment record. Post-service records otherwise show that the Veteran's renal functioning is within normal limits per laboratory studies. Additionally, the Veteran denied abdominal pain, as well as genitourinary and urologic complaints such as dysuria, frequency, incontinence, urgency, hematuria, and nocturia. See August 2018, October 2018, January 2020, May 2021 VA treatment records. VA examinations and medical opinions were provided in December 2015, May 2021, and July 2021. Physical examination and diagnostic studies in December 2015 and July 2021 indicated that the Veteran is not on medication or otherwise receiving any treatment for a kidney condition. Additionally, there was no evidence of renal dysfunction as the Veteran's BUN, creatinine, and eGFR were all within normal limits per laboratory studies. Examination of the abdomen was also normal. See December 2015 and July 2021 VA examination reports. Upon review of the claims file, physical examinations, and laboratory studies, the VA examiners each assessed that the Veteran does not have a current chronic kidney disability. The VA examiners assumed as a fact that the Veteran had an acute kidney injury during service and, notwithstanding this assumption, still found no current kidney disability. With regard to recent symptoms and evidence of a kidney disorder, the Veteran's current symptoms are subjective only, as there is no evidence of chronicity of care, and objective examination was normal, leading to the VA examiners' conclusion that there was no pathology to render a diagnosis of a current kidney disorder. See December 2015, May 2021, and July 2021 VA examination reports. Overall, while the Board has considered the Veteran's subjective reports of flank and back pain that comes and goes, the service treatment records only show an acute kidney injury and post-service records do not reveal a chronic kidney disorder, to include any reports of symptoms, treatment, or diagnosis of a current kidney disability. Neither the Veteran not the evidence suggests any functional impairment attributable to a kidney condition despite the Veteran's report of abdominal pain (which the Veteran consistently denied in post-service treatment notes) and back pain (which has been attributable to a non-service-connected musculoskeletal condition) that comes and goes. The weight of the evidence shows no current chronic kidney disability, including based on functional impairment, at any time during the pendency of this claim or in the time period just prior to the filing of this claim. In the absence of proof of a current disability, there can be no valid claim for entitlement to service connection for a kidney disability on either a direct, secondary, or any other basis. In view of the foregoing, the Board concludes that the preponderance of the evidence is against the claim for service connection for a kidney condition; therefore, the claim must be denied. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moore, Shanna 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.