Citation Nr: 21069708 Decision Date: 11/19/21 Archive Date: 11/19/21 DOCKET NO. 16-33 384 DATE: November 19, 2021 ORDER Entitlement to service connection for degenerative joint disease (DJD) bilateral ankles is denied. Entitlement to service connection for bilateral shoulder, elbow, wrist, hip, knee, and neck disabilities is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran has a bilateral ankle disability at any time during or approximate to the pendency of the claim. 2. The Veteran's bilateral shoulder, elbow, wrist, hip, knee, and neck disabilities, were not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disabilities are not otherwise etiologically related to an in-service injury or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral ankle DJD have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for bilateral shoulder, elbow, wrist, hip, knee, and neck disabilities, have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1964 to October 1968. On his July 2016 VA Form 9, the Veteran requested a Board hearing. However, in February 2019, he withdrew his hearing request. Thus, the Veteran's hearing request is deemed withdrawn, and the Board may proceed with appellate review. 38 C.F.R. § 20.7048(e). In May 2021, the Board remanded the claims for further development. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge when all the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). To establish service connection on a direct basis, the record must contain: (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 or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Alternately, service connection may be established under 38 C.F.R. § 3.303(b) by (a) evidence of (i) the existence of a chronic disease in service or during an applicable presumption period under 38 C.F.R. § 3.307 and (ii) present manifestations of the same chronic disease, or (b) when a chronic disease is not present during service, evidence of continuity of symptomatology. Certain chronic diseases, to include arthritis, although not shown in service, may be presumed to have incurred in or aggravated by service if they become manifested to a compensable degree within one year of separation from active duty. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. A layperson is competent to report on the onset and continuity of his or her current symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge). When a claimant seeks benefits and the evidence is in relative equipoise, the claimant prevails. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The preponderance of the evidence must be against the claim for benefits to be denied. See Alemany v. Brown, 9 Vet. App. 518 (1996). Entitlement to service connection for bilateral ankles, shoulder, elbow, wrist, hip, knee, and neck disabilities The Veteran contends that his disabilities are due to military service. The Veteran has been diagnosed with bilateral shoulder, elbow, wrist, hip, and knee DJD and degenerative arthritis of the neck. As such, element one under Shedden is met. The Veteran's service treatment records (STRs) do not document complaints, treatments, or diagnoses for degenerative arthritis and/or DJD of the joints. During his October 1964 Report of Medical History: Enlistment exam, the Veteran noted that he did not have swollen or painful joints, arthritis, painful or trick shoulder or elbow, or trick or locked knee. During his April 1966, and March and October 1967 Flying examination and during his June 1968 Report of Medical Examination, Separation exam, the Veteran's upper and lower extremities, and other musculoskeletal systems were clinically normal. During his April, October, and June examinations, the Veteran noted that he did not have swollen or painful joints, arthritis, or painful or trick shoulder or elbow, or trick or locked knee. In March 2005, the Veteran was seen for neck pain. The Veteran stated that he had a knot on the back of his neck. In May 2011, the Veteran's VA treatment records, medical problem list, noted a history of musculoskeletal arthritis. In October 2020, the RO requested a VA medical opinion to determine the nature and etiology of his DJD. The examiner opined that the Veteran's DJD was at least as likely as not (50 percent or greater probability) incurred in, caused by, proximately due to, or the result of the claimed in-service injury, event, or illness. However, the examiner stated that he was unable to determine if the Veteran's DJD is related to service, and he was unable to answer the question based on a record review. He stated that DJD is usually a progression of an injury. He suggested the Veteran be sent for an examination. In July 2021, the Veteran was afforded VA examinations to determine the nature and etiology of his joint disabilities. The examiner diagnosed the Veteran with mild degenerative changes in the hip joints; bilateral shoulder mild degenerative changes in the glenohumeral joint with asymmetric worse left AC joint degenerative changes; bilateral wrist minimal negative ulnar variance, slight widening right scapholunate interval, and mild degenerative changes in the trapezium-thumb articulation, bilateral; mild age-related degenerative changes, bilateral knee; and minimal degenerative changes in the elbow joints. The examiner opined that the Veteran's disabilities are less likely than not incurred in or caused by the claimed in-service injury, event, or illness, to include heavy lifting and marching with body armor. The examiner stated that there is no evidence of acute or chronic care for joint DJD during service nor was there medical evidence of in-service evaluations noted for bilateral hip, shoulder, wrist, knee, and elbow DJD and/or degenerative changes. The examiner stated that there is a lack of objective in-service medical evidence confirming an acute or chronic condition for joint DJD. Moreover, more than 30 years had lapsed since the Veteran's active duty. The examiner stated, considering the X-rays which revealed mild degenerative changes in the hips, shoulders, wrists, knees, and elbow, the Veteran's present conditions cannot be related to service, including heavy lifting, and marching with body armor. The examiner diagnosed the Veteran with degenerative arthritis and spondylolisthesis. The Veteran stated that he had had neck pain for years. The examiner opined that the Veteran's claimed condition is less likely than not incurred in or caused by the claimed in service injury, event, or illness. The examiner stated that the Veteran had no neck complaints at enlistment, during service, or at separation. The earliest records of neck complaints were in March 2005, approximately 37 years after service. The examiner stated that 37 years is a long-time gap to establish nexus. Therefore, the current diagnosis of cervical spine condition to include degenerative arthritis is less likely than not incurred in or caused by the heavy lifting and marching with body armor during service. Based on the evidence of record, the Board finds that service connection for bilateral shoulder, elbow, wrist, hip, knee, and neck degenerative arthritis and/or DJD, is not warranted on a direct basis. The Board notes that the Veteran's STRs do not document complaints, treatments, or diagnoses for degenerative arthritis and/or DJD, all joints. On his separation physical, the Veteran's upper and lower extremities, and other musculoskeletal systems were clinically normal. The Veteran himself stated that he did not have swollen or painful joints, arthritis, painful or trick shoulder or elbow, or trick or locked knee. Additionally, the VA examiner opined that the claimed conditions are less likely than not incurred in, related to, or caused by the claimed in-service injury, event, or illness, to include heavy lifting and marching with body armor. Regarding the Veteran's bilateral shoulder, elbow, wrist, hip, and knee, the examiner stated that during service, there was no evidence of acute or chronic care for joint or multi joint DJD nor was there medical evidence of in-service evaluations noted for bilateral hip, shoulder, wrist, knee, or elbow DJD and/or degenerative changes. Moreover, more than 30 years had lapsed since the Veteran's active duty and his diagnoses. The examiner stated, considering the X-rays of the joints which revealed mild degenerative changes, the Veteran's present conditions cannot be related to service, including heavy lifting, and marching with body armor. Regarding the Veteran's neck degenerative arthritis, the examiner stated that the Veteran had no neck complaints at enlistment, during service, or at separation. The earliest records of neck complaints were in March 2005, approximately 37 years after his service. As noted, the first medical evidence of neck and all other joint complaint was in 2005 and 2011, respectively, i.e., 37 and 43 years after discharge from service. The Board notes that the fact that there were no records of any complaints or treatments involving the Veteran's degenerative arthritis and/or DJD for many years weighs against the claims. See Maxson v. West, 12 Vet. App. 453, 459 (1999), affirmed sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (it was proper to consider the veteran's entire medical history, including a lengthy period of absence of complaints). The Board also finds that service connection for degenerative changes on a presumptive basis is not warranted as the record does not show evidence of degenerative changes within one year of separation from active duty. The earliest competent evidence suggestive of degenerative changes was in 2011, i.e., 43 years after his discharge from service. As there is no competent evidence that the disability manifested to a compensable degree within one year of his active service and was not continuous since service, a presumption of service connection under 38 C.F.R. §§ 3.307, 3.309 is not warranted. Therefore, the Board finds that elements two and three under Shedden has not been met. Regarding the Veteran's wrist, the Board notes that along with DJD, the Veteran was also diagnosed with bilateral wrist minimal negative ulnar variance, slight widening right scapholunate interval. The Board acknowledges that the 2021 VA examination report did not specifically address whether the Veteran's disability may be related to service. However, given that the Veteran did not have a diagnosis related to his wrist, or symptoms thereof, while in service; and, there is no competent or credible lay or medical evidence of record indicating a link between the Veteran's bilateral wrist minimal negative ulnar variance, slight widening right scapholunate interval to an in-service event or injury, a medical opinion on that point is not warranted as VA's duty to assist has not been triggered. See McClendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Therefore, the Board finds that element three under Shedden has not been met. Regarding his bilateral ankles, the examiner stated that the Veteran's bilateral ankles were normal. The examiner opined that the claimed condition is less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness, to include heavy lifting, and marching with body armor. The examiner stated that, on the day of the exam, the Veteran's exam was negative for left or right ankle DJD. The Veteran stated that he did not have a problem with his ankles. Based on the evidence of record, the Board finds that there is no record of a current diagnosis for his bilateral ankle condition. The Board notes that the July 2021 examiner opined that the claimed condition is less likely than not incurred in or caused by the claimed in-service injury, event, or illness, to include heavy lifting, and marching with body armor. On the day of the exam, the Veteran's exam was negative for left or right ankle DJD. Additionally, the Veteran stated that he did not have a problem with his ankles. Where the evidence does not support a finding of current disability upon which to predicate a grant of service connection, there can be no valid claim for that benefit. See Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The Board has considered the Veteran and his representative's statements regarding the etiology of the Veteran's bilateral shoulder, elbow, wrist, hip, knee, ankle, and neck disabilities. The Board notes that although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), as to the specific issue in this case, a diagnosis and/or nexus between the bilateral shoulder, elbow, wrist, hip, knee, ankle, and neck disabilities and active service is outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n. 4 (Fed. Cir. 2007) (lay persons not competent to diagnose cancer). Therefore, the preponderance of the evidence is against the claim for service connection for bilateral shoulder, elbow, wrist, hip, knee, ankle, and neck disabilities. Because the preponderance of the evidence is against the Veteran's appeal, the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. MICHAEL LANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moore, Tara-Deen 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.