Citation Nr: 21069927 Decision Date: 11/22/21 Archive Date: 11/22/21 DOCKET NO. 17-44 865 DATE: November 22, 2021 ORDER Service connection for carpal tunnel of the left hand is denied. Service connection for migraines is denied. Service connection for varicose veins of the left lower extremity is denied. Service connection for gastroesophageal reflux disease (GERD) is denied. Service connection for vertigo is denied. REMANDED An initial compensable rating for a cervical spine disability is remanded. An initial compensable rating for a lumbar spine disability is remanded. An initial compensable rating for the dry eye syndrome is remanded. An initial compensable rating for a right knee disability is remanded. An initial compensable rating for a left knee disability is remanded. An initial compensable rating for a left hip disability is remanded. FINDINGS OF FACT 1. The Veteran's service treatment records (STRs) show that she experienced varicose veins in her left leg, had a past history for carpal tunnel of the left arm and headaches, and two instances of vertigo, but has not been shown to experience any residual disabilities of the aforementioned conditions. 2. The weight of the evidence is against finding that the Veteran had a current diagnosis for carpal tunnel of the left hand, migraines, varicose veins of the left lower extremity, GERD, or vertigo, during the period on appeal. CONCLUSIONS OF LAW 1. The criteria for service connection for carpal tunnel of the left hand have not been met. 38 U.S.C. § 1110, 1131, 5107; 38 C.F.R. § 3.303. 2. The criteria for service connection for migraines have not been met. 38 U.S.C. § 1110, 1131, 5107; 38 C.F.R. § 3.303. 3. The criteria for service connection for varicose veins of the left lower extremity have not been met. 38 U.S.C. § 1110, 1131, 5107; 38 C.F.R. § 3.303. 4. The criteria for service connection for GERD have not been met. 38 U.S.C. § 1110, 1131, 5107; 38 C.F.R. § 3.303. 5. The criteria for service connection for vertigo have not been met. 38 U.S.C. § 1110, 1131, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1988 to November 2014. Service Connection Service connection requires competent evidence showing: (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). Service connection may also be established under 38 C.F.R. § 3.303 (b), where a condition in service is noted but is not, in fact, chronic, or where a diagnosis of chronicity may be legitimately questioned. The continuity of symptomatology provision of 38 C.F.R. § 3.303 (b) has been interpreted as an alternative to service connection only for the specific chronic diseases listed in 38 C.F.R. § 3.309 (a). See Walker v. Shinseki, 718 F.3d 1331 (Fed. Cir. 2013). Service connection may also be established with certain chronic diseases based upon a legal presumption by showing that the disorder manifested itself to a degree of 10 percent disabling or more within one year from the date of separation from service. Such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 1. Service connection for carpal tunnel of the left hand is denied. 2. Service connection for migraines is denied. 3. Service connection for varicose veins of the left lower extremity is denied. 4. Service connection for GERD is denied. 5. Service connection for vertigo is denied. The Veteran asserts that she is entitled to service connection for left hand carpal tunnel, migraines, varicose veins in her left leg, GERD, and vertigo. However, she has not explained why she believes service connection is warranted for the aforementioned claimed conditions. The Veteran's STRs show that she had two instances of vertigo, in 2006 and in 2013. See Report of Medical History dated August 22, 2014. The STRs do not show any complaints or treatment for carpal tunnel, but showed a past history of carpal tunnel of the left side, but does not state when she had it. See STR dated November 23, 2014. She was also noted to have varicose veins on both legs. See STR dated September 23, 2009. Lastly, the STRs showed that she consistently denied having headaches during her active-duty service, but was noted in 2010 to have a past history of migraine headaches. See STR dated February 3, 2010. Approximately nine months after her separation from the military, the Veteran was afforded separate VA examinations for peripheral nerve conditions, ear conditions, artery and vein conditions, esophageal conditions, and for headaches. The Board notes that the same VA examiner performed all of the respective VA examinations and he was able to examine the Veteran in-person and reviewed her claims file. Regarding the left-hand carpal tunnel, the Veteran reported a history of left cubital and carpal tunnel syndrome, which she was prescribed a brace for that improved the symptoms. There were no current symptoms reported. Muscle strength testing showed normal strength on the left side. Further, reflex, sensory, and a clinical evaluation of the median nerve all showed normal results. The examiner reported that there was no objective evidence in the medical record to support a current diagnosis for a chronic condition. Regarding migraines, the Veteran denied a chronic condition. The examiner acknowledged that the Veteran had headache pain that usually lasted less than a day and affected both sides of the head. However, the examiner noted that there was no objective evidence to support a current diagnosis for a headache or migraine condition. Regarding varicose veins, the examiner noted the chronic history of varicose veins of the right lower extremity. The examiner reported that the Veteran had asymptomatic varicose veins of the right leg, but noted no symptoms on the left leg. Regarding GERD, the Veteran reported being seen for symptoms of GERD, but denied a diagnosis for GERD. There were no reported current signs or symptoms of any esophageal conditions. The examiner noted that there was no objective evidence to support a current diagnosis for GERD. Regarding vertigo, the Veteran reported two episodes of acute vertigo, without any residuals. There were no reported current symptoms of vertigo. The examiner indicated that the Veteran did not have any signs or symptoms of any ear conditions. On physical examination, there were no signs of abnormality of the external ear, the ear canal, or the tympanic membrane. Romberg and limb coordination testing also showed normal results. Here, the VA examiner was able to examine the Veteran in-person and review the claims file to ascertain whether she currently had carpal tunnel syndrome, migraines, varicose veins of the left leg, GERD, or vertigo. However, the VA examiner reported that there were no current diagnoses for any of the aforementioned claimed conditions because the objective evidence of record did not support such findings. The August 2015 VA examiner's respective findings are unchallenged by any medical evidence to the contrary and the STRs from that time period do not show any diagnoses for any of the claimed conditions. The Board notes that post-service treatment records have not been identified. However, the Veteran applied for service connection within a year of her separation from the military and she was afforded specific in-person VA examinations to determine whether she had a current disability for any of the aforementioned conditions at that time. Further, the Veteran reported at the respective VA examinations that she did not have any current symptoms for carpal tunnel; denied chronic headaches; denied GERD symptoms; denied a chronic ear condition; and no symptoms were found related to left leg varicose veins. As such, the record does not show any current diagnosis for carpal tunnel of the left hand, migraines, varicose veins of the left leg, GERD, or vertigo. In the absence of proof of a current disability, there can be no valid claim for service connection. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (indicating service connection presupposes a current diagnosis of the condition claimed). The requirement that a current disability be present is satisfied "when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim...even though the disability resolves prior to the Secretary's adjudication of the claim." McClain v. Nicholson, 21 Vet. App. 319 (2007). Here, despite a medical examination for each of the claimed conditions, no disabilities were diagnosed. Rather, the VA examiner explained that the objective evidence of record did not support a diagnosis for any of the claimed conditions. The Board has considered the Veteran's assertions that she is entitled to service connection for the aforementioned claims. Although laypersons are competent to provide opinions on some medical issues, diagnosing the claimed conditions falls outside the realm of common knowledge of a layperson. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). The Board acknowledges that the Veteran is competent to observe varicose veins. However, as previously discussed, on examination, the VA examiner found no evidence of asymptomatic or any other indication of left leg varicose veins. As a layperson, the Veteran has not been shown to possess the medical expertise to diagnose any of the other claimed conditions. The Veteran reported what she experienced to the examiner, and the examiner provided their medical findings. The Veteran's claims file does not contain any medical records showing a diagnosis for any of the claimed conditions. Here, there is no evidence, medical or otherwise, to support the Veteran's statements. As such, as previously stated, the medical evidence of record is only against the Veteran's claims for service connection. Accordingly, service connection for carpal tunnel of the left hand, migraines, varicose veins of the left leg, GERD, and vertigo is not warranted because the Veteran has not satisfied the first requirement of service connection, i.e., a current diagnosis of a disability. 38 C.F.R. § 3.303; Brammer v. Derwinski, 3 Vet. App. 223 (1992) 3 Vet. App. at 225. REASONS FOR REMAND 1. An initial compensable rating for a cervical spine disability is remanded. 2. An initial compensable rating for a lumbar spine disability is remanded. 3. An initial compensable rating for the dry eye syndrome is remanded. 4. An initial compensable rating for a right knee disability is remanded. 5. An initial compensable rating for a left knee disability is remanded. 6. An initial compensable rating for a left hip disability is remanded. The Veteran asserts that she is entitled to initial compensable ratings for a bilateral knee disability, a cervical spine disability, a lumbar spine disability, dry eye syndrome, and a left hip disability. The Veteran was last examined in August 2015, and is no longer considered sufficiently contemporaneous to evaluate the disabilities. The matters are REMANDED for the following action: 1. Contact the Veteran and request her to identify any medical treatment she has received since service. Seek to obtain any identified records. 2. Schedule the Veteran for a VA examination of the cervical spine to determine the current nature and severity of the disability. 3. Schedule the Veteran for a VA examination of the lumbar spine to determine the current nature and severity of the disability. 4. Schedule the Veteran for a VA examination of the eyes to determine the current nature and severity of the dry eye syndrome. 5. Schedule the Veteran for a VA examination of the knees to determine the current nature and severity of the disability. 6. Schedule the Veteran for a VA examination of the left hip to determine the current nature and severity of the disability. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Fu, 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.