Citation Nr: 21069010 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 16-50 263 DATE: November 17, 2021 ORDER Service connection for a cardiovascular (CV) disorder is denied. Service connection for a vascular disorder is denied. Service connection for a respiratory disorder is denied. FINDINGS OF FACT 1. The Veteran served on active duty from March 1972 to March 1976. 2. A CV disorder, diagnosed as congestive heart failure (CHF) and coronary artery disease (CAD), was not shown in service, was not shown to a compensable degree within one year of service, and symptoms were not continuous since service; a current CV disorder is not causally or etiologically related to service. 3. A vascular disorder, diagnosed as deep vein thrombosis (DVT), was not shown in service and is not causally or etiologically related to service. 4. A respiratory disorder, diagnosed as chronic obstructive pulmonary disease (COPD), was not shown in service and is not causally or etiologically related to service. CONCLUSIONS OF LAW 1. A CV disorder was not incurred in service and is not presumed to have been incurred in service. 38 U.S.C. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309 (2021). 2. A vascular disorder was not incurred in service. 38 U.S.C. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303 (2021). 3. A respiratory disorder was not incurred in service. 38 U.S.C. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303 (2021). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year. Cardiovascular Disorder Turning to the medical evidence, the clinical treatment records reflect a current diagnosis of CHF and CAD. Accordingly, a CV disorder has been shown and the first element of service connection has been met. As to in-service incurrence, the service treatment records (STRs) do not reflect complaints of, treatment for, or a diagnosis of a heart disorder. Importantly, the January 1976 separation examination indicated a normal clinical evaluation of the heart and showed no history of heart trouble. Accordingly, the medical evidence does not support the in-service incurrence of a heart disorder. Further, there are no medical opinions of record which establish a nexus between a current heart disorder and service. Accordingly, the medical evidence does not support the claim for service connection on a direct basis. Next, CAD is a chronic disease listed under 38 C.F.R. § 3.309(a) and presumptive service connection will be considered. As noted above, a review of the record shows that no chronic heart disease was shown in service. The STRs and separation examination are silent for treatment of or a diagnosis of a CV disorder. Therefore, the medical evidence does not support presumptive service connection on a "chronic disease or injury shown in service" basis. In addition, the medical evidence does not support presumptive service connection based on continuity of symptomatology since service. Specifically, the clinical treatment records show that CHF was newly diagnosed in 2015. The medical evidence does not show a CV disorder prior to this time. As the Veteran was discharged in 1976 and symptoms of a CV disorder were not identified until 2015, the medical evidence does not support service connection on a "continuity of symptomatology" basis. Further, the disorder did not manifest itself to a degree of 10 percent or more within one year from the date of separation from service. The Veteran separated from service in 1976 but did not note symptoms of a CV disorder until 2015, nearly 40 years after discharge. While not dispositive, this lengthy period between separation and treatment weighs against the claim. Therefore, the evidence does not support presumptive service connection on a "manifest within one-year from separation" basis. Accordingly, the medical evidence does not support presumptive service connection on any basis. Vascular Disorder The Veteran contends that he is entitled to service connection for blood clots of the legs. Turning to the medical evidence, the clinical treatment records reflect a current diagnosis of DVTs and peripheral vascular disease. Accordingly, a current vascular disorder has been shown and the first element of service connection has been met. As to in-service incurrence, the STRs do not reflect complaints of, treatment for, or a diagnosis of DVTs or any related conditions. In addition, the January 1976 separation examination showed a normal clinical evaluation of the vascular system and lower extremities. Therefore, the medical evidence does not support the in-service incurrence of vascular disorder. Further, there are no medical opinions of record which establish a nexus between DVTs and active duty. As such, the medical evidence does not support the claim for service connection. Respiratory Disorder The Veteran has claimed entitlement to service connection for shortness of breath. Turning to the medical evidence, clinical treatment records show that he has been diagnosed with COPD. Accordingly, a respiratory disorder related to shortness of breath has been shown and the first element of service connection is met. As to in-service incurrence, the STRs do not reflect complaints of, treatment for, or a diagnosis of a respiratory disorder. Notably, the January 1972 separation examination reflected a normal clinical evaluation of the lungs and chest. As such, the medical evidence does not support the in-service incurrence of a respiratory disorder. In addition, there are no medical opinions of record which establish a nexus between shortness of breath and service. Accordingly, the medical evidence does not support the claim for service connection. The Board has considered the Veteran's lay statements that his disorders were caused by service. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his current disorders due to the medical complexity of the matters involved. Such competent evidence has been provided by the service records and clinical evidence obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claims for service connection and there is no doubt to be otherwise resolved. As such, the appeals are denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Kokolas, 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.