Citation Nr: 21074533 Decision Date: 12/15/21 Archive Date: 12/15/21 DOCKET NO. 19-17 209 DATE: December 15, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is denied. Entitlement to service connection for polysubstance use as secondary to an acquired psychiatric disorder is denied. Entitlement to service connection for a neck disability is denied. Entitlement to service connection for a back disability is denied. Entitlement to service connection for tinnitus is denied. Entitlement to service connection for bilateral hearing loss is denied. FINDINGS OF FACT 1. The Veteran does not have a diagnosis of PTSD based on verified in-service stressors. 2. An acquired psychiatric disorder, to include PTSD, was not documented during active duty service, nor was a psychosis shown within one year of separation from service, and the weight of the evidence is against finding a nexus between a post-service diagnosis of any psychiatric disorder and service. 3. The Veteran's polysubstance use disorder is deemed to be willful misconduct and as such, is not a disability for which service connection may be granted. 4. A neck and/or back disability was not shown in service, it did not manifest to a compensable degree within one year of discharge, and the claimed neck and back disabilities are not shown to be causally or etiologically related to any disease, injury, or incident in service. 5. The weight of the evidence is against a finding that tinnitus had onset in service and it is not otherwise shown to be related to service or any event of service. 6. A bilateral hearing loss disability was not confirmed by VA audiological testing in August 2016 due to invalid test results, and a hearing loss disability for VA purposes has not been shown. CONCLUSIONS OF LAW 1. The criteria for service connection for an acquired psychiatric disorder, to include PTSD, have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.303, 3.304. 2. The criteria for service connection for polysubstance use disorder have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.301, 3.303. 3. The criteria for service connection for a neck disability have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. § 3.303. 4. The criteria for service connection for a back disability have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. § 3.303. 5. The criteria for service connection for tinnitus have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. § 3.303. 6. The criteria for service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1975 to July 1976. In May 2021, the Veteran testified at a video hearing before the undersigned and a transcript of that hearing has been associated with the record. Service Connection Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service, or if preexisting service, was aggravated therein. 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). To establish service connection for a disability, there must be competent evidence of the following: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or nexus between the present disability and the disease or injury incurred or aggravated during service. Horn v. Shinseki, 25 Vet. App. 231, 236 (2010); Shedden, 381 F.3d at 1167; Gutierrez v. Principi, 19 Vet. App. 1, 5 (2004) (citing Hickson v. West, 12 Vet. App. 247, 253 (1999)). In many cases, medical evidence is required to meet the requirement that the evidence be "competent". However, when a condition may be diagnosed by its unique and readily identifiable features, the presence of the disorder is not a determination "medical in nature" and is capable of lay observation. Barr v. Nicholson, 21 Vet. App. 303, 309 (2007). Service connection for certain chronic diseases, including psychosis and hypertension, may be presumed to have been incurred in service by showing that the disease manifested itself to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307(a)(3), 3.309(a). Such a chronic disease is presumed under the law to have had its onset in service even though there is no evidence of that disease during the period of service. 38 C.F.R. § 3.307(a). When a chronic disease is shown in service, sufficient to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. 38 C.F.R. § 3.303 (b). To be "shown in service," the disease identity must be established and the diagnosis must not be subject to legitimate question. Walker v. Shinseki, 708 F.3d 1331, 1335 (Fed. Cir. 2013); see also 38 C.F.R. § 3.303 (b). There is no "nexus" requirement for compensation for a chronic disease which was shown in service, so long as there is an absence of intercurrent causes to explain post-service manifestations of the chronic disease. Walker, 708 F.3d at 1336. Certain evidentiary presumptions - such as the presumption of service incurrence for certain diseases, which manifest themselves to a degree of disability of 10 percent or more within a specified time after separation from service - are provided by law to assist Veterans in establishing service connection for a disability or disabilities. 38 U.S.C. §§ 101, 1112; 38 C.F.R. § 3.304 (b), 3.306, 3.307, 3.309. Service connection may also be granted on a secondary basis for a condition that is not directly caused by the veteran's service. 38 C.F.R. § 3.310. In order to prevail under a theory of secondary service connection, the evidence must demonstrate an etiological relationship between (1) a service-connected disability or disabilities and (2) the condition said to be proximately due to the service-connected disability or disabilities. Buckley v. West, 12 Vet. App. 76, 84 (1998); see also Wallin v. West, 11 Vet. App. 509, 512 (1998). In addition, secondary service connection may also be found in certain instances when a service-connected disability aggravates another condition. See Allen v. Brown, 7 Vet. App. 439 (1995); 38 C.F.R. § 3.310(b). In general, however, no compensation shall be paid for a disability that is a result of the veteran's own willful misconduct or abuse of alcohol or drugs. See 38 U.S.C. § 1110 (emphasis added). This includes conditions resulting, or secondary, to the alcohol abuse. Gabrielson v. Brown, 7 Vet. App. 36 (1994). A limited exception from this 38 U.S.C. § 1110 willful misconduct "bar" was carved out by the Federal Circuit in its precedential decision in Allen v. Principi, 237 F.3d 1368 (2001). Therein, the Federal Circuit held that a veteran was not precluded from receiving compensation for alcohol or drug-related disabilities arising secondarily from a service-connected disability, or from using alcohol or drug-related disabilities as evidence of the increased severity of a service-connected disability. In other words, compensation may be awarded only "where there is clear medical evidence establishing that alcohol or drug abuse is caused by a veteran's primary service-connected disability, and where the alcohol or drug abuse disability is not due to willful wrongdoing." Allen, 237 F. 3d at 1381. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 1. Entitlement to service connection for an acquired psychiatric disorder including PTSD 2. Entitlement to service connection for polysubstance use disorder The Veteran seeks service connection for an acquired psychiatric disorder, to include PTSD. He asserts that his substance abuse is secondary to his PTSD. Service connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). If a stressor claimed by a veteran is related to a veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of PTSD, and that a veteran's symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of a veteran's service, a veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. Fear of hostile military or terrorist activity means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veteran's response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror. 38 C.F.R. § 3.304(f)(3). When the evidence does not establish that a veteran is a combat veteran, his assertions of service stressors are not sufficient to establish the occurrence of such events. Rather, his reported service stressors must be established by official service record or other credible supporting evidence. 38 C.F.R. § 3.304(f); Pentecost v. Principi, 16 Vet. App. 124 (2002). When the claimant does not submit evidence of service or the evidence submitted does not meet the requirements of this section, VA shall request verification of service from a service department. 38 C.F.R. § 3.203. The United States Court of Appeals for Veterans Claims (Court) has held that a service department determination as to an individual's service shall be binding on VA. Duro v. Derwinski, 2 Vet. App. 530 (1992); Dacoron v. Brown, 4 Vet. App. 115, 120 (1993). The Veteran does not allege that he engaged in combat or that his stressor to support a diagnosis of PTSD is combat-related. Rather, he asserts that during his active duty service, he experienced persistent physical and mental abuse from his shipmates and was the target of ethnic/racial discrimination. Reportedly, he was beaten repeatedly and sexually assaulted. He attributes his long history of substance abuse to PTSD as a means of coping with military trauma. The Veteran's service personnel records document numerous references to disciplinary problems. In December 1975 he was charged with a violation of UCMJ Article 92 for failure to obey a lawful order. In May 1976, and twice in June 1976, he was charged for violation of UCMJ 86 for unauthorized absences. In June 1976, his commanding officer noted that the Veteran had been repeatedly counseled and given numerous second chances with repeated violations of the UCMJ throughout his service career. It was determined that the Veteran could not accept the military or its regulations. He was discharged with a general discharge Under Honorable Conditions. Service treatment records are entirely negative for complaints, treatment or diagnosis of a psychiatric disorder or document any reports of the stressful incidents, including injuries sustained from fights or beatings. On separation from service in in June 1976, no mental health impairment was reported. VA treatment records from 1985 to 1986, and since 1999, show intermittent treatment for polysubstance abuse with periods of remission. In 2003, a history of inpatient treatment in 1990 and 2001 for polysubstance abuse was noted. In 2007, it was reported that he was hospitalized for drug use in 2006. In 2015 the Veteran was referred for mental health treatment after he reported using heroin, cocaine and LSD. The Veteran was admitted at a private facility for substance abuse. His discharge summary noted the Veteran's report of PTSD associated with traumatic incidents in service, to which he attributed his addiction problems. VA treatment records in February 2015, show that the Veteran reported that he was the victim of sexual abuse at age four. He also endorsed military sexual trauma (MST) and described feeling scared when one morning he awoke to find a naked guy on his bed during active duty service. His treating psychiatrist diagnosed opioid use disorder per DSM-5. The psychiatrist also noted a history of depression and substance abuse due to personal problems. In April 2015, in connection with treatment, the Veteran denied a history of MST. A history of depression associated with his substance abuse was noted. DSM-5 diagnoses of opiate use disorder, cocaine use disorder and a history of PTSD were recorded. Identified stressors included occupational and financial problems. In September 2015, the Veteran reported being sexually abused while he was deployed during service. He stated that he woke up naked and feeling drugged and unable to recall what had transpired. He denied ever notifying his superiors of the incident. In a statement in October 2015, the Veteran reported that he was repeatedly beaten by other shipmates and on one occasion they almost broke his back. He further stated that on March 15, 1976, he was drugged and sexually abused by shipmates after having an argument about his race. On VA examination in August 2015, the Veteran reported a long history of drug use that preceded service. He stated that he was kicked out of school for smoking marijuana and being in a gang. During service, he had multiple military offenses. His personnel records showed that ultimately his commanding officer determined that despite continuous counseling, instructing and disciplining, the Veteran was incapable of accepting the military or its regulations as evinced by his repeated violations throughout his service career and he was discharged from service. After service, the record showed an extensive history of treatment for polysubstance abuse, including heroine and cocaine, starting in 1985. At the time he was diagnosed and treated for polysubstance abuse. Concerning the claimed stressors, the Veteran reported that he was sexually assaulted several times by different people while serving aboard a Navy vessel. He reported that he found another sailor in bed with him one morning and he was naked. They started laughing and acted like it was a joke. He did not report the incident. The Veteran also described being the target of racial/ethnic harassment and being called racial slurs. He had to fight other shipmates in self-defense. On one occasion, about 10 of his shipmates beat him, stripped him and stuck a stick up his rectum while laughing. Finally, he reported the death of his brother after he was hit by two cars as a pedestrian. The examiner determined that the reported stressors did not meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD). None of the stressors were related to fear of hostile military or terrorist activity, nor were the stressors related to personal assault, including MST. The examiner further found that the Veteran's symptoms did not meet the diagnostic criteria for PTSD under DSM-5 criteria. Instead, the examiner diagnosed opioid abuse disorders and cocaine use disorder. The examiner noted that the Veteran had a long history of polysubstance abuse and determined that the misconduct recorded in service was not consistent with the claimed sexual trauma, which could not be corroborated. The examiner further found that the Veteran's behavior pattern, which did not conform to social or military expectations, as well as his drug abuse, preceded his military service. The Board must find this medical opinion to be of great probative weight. In a February 2016 statement, the Veteran's mother reported that he changed after he returned home from service. She described him as withdrawn and as a drug addict. Reportedly, a year later he told her things that happened to him during service. In a May 2021 statement, the Veteran described being constantly harassed and targeted for being Hispanic during service. On one occasion, he was beaten by six or seven sailors who raped him with a stick. He did not get a look at his assailants and never reported the incident. At the May 2021 Board hearing, the Veteran testified that he was the constant target of ethnic discrimination aboard the USS Manitowoc. He would hide from other shipmates and otherwise had to fight to defend himself. On one such incident he was beaten up by six or seven sailors and his pants were removed and they inserted a stick in his rectum. He screamed at no avail. At the time, he did not report the incident. Another time, the Veteran reportedly injured his back and neck when a sailor twice his size bent him over his knee in an attempt to break his back. The Veteran testified that as a result of these incidents, he self-medicated with drugs and had problems maintaining employment. Initially, the Board notes that the Veteran's alleged stressors are of a non-combat nature; as such, there must be credible supporting evidence to corroborate his alleged stressor events in service (on which his diagnosis of PTSD is based). Here there is no evidence to corroborate any of the reported stressors. While the Veteran is competent to testify as to events that occurred in the past, consideration must be given as to whether such statements are self-serving and compensation driven. If a claimed stressor is not related to combat or fear of hostile or military activity, as is the case here, a veteran's lay statements alone are not sufficient to establish the occurrence of the alleged stressor. Moreau v. Brown, 9 Vet. App. 389, 395-396 (1996); Dizoglio v. Brown, 9 Vet. App. 163, 166 (1996). Rather, the record must contain service records or other corroborative evidence substantiating the veteran's testimony or statements as to the occurrence of the claimed stressor. See West (Carlton) v. Brown, 7 Vet. App. 70, 76 (1994); Zarycki v. Brown, 6 Vet. App. 91, 98 (1993). In this case, the Veteran's accounts of what happened simply are not supported by any corroborating evidence of record and, to a degree, refuted by the evidence of record. Specifically, the service records fail to document any mental health disorders or stressful incidents, including sexual assault or injuries sustained in fights or as a result of beatings. Although the service personnel records documented numerous references to disciplinary problems, these appear to have had onset prior to service. In this regard, it is noteworthy that the Veteran himself reported on VA examination in August 2015, that he had a history of drug use prior to service and he was kicked out of school for drug use and being in a gang. While the service personnel records show disciplinary problems, and poor conduct and efficiency, these were evident throughout his military career and there is no indication of behavioral change, but rather a continuation of his preservice patterns. Notably, he was charged with UCMJ violations starting as early as December 2, 1975, approximately within a month from service induction, and prior to his deployment aboard the USS Manitowoc, where reportedly his alleged stressor incidents occurred. The evidence also reflects that the Veteran was repeatedly counseled and given numerous second chances, but the violations of the UCMJ continued up to the time of his discharge. The Board has reviewed this case in some detail. The Veteran's statements, over time regarding what did and did not happen to him in service have changed. After service, the Veteran was provided mental health treatment numerous times, both on an outpatient and inpatient basis starting in 1985, yet the records fail to document any reports of in-service trauma, including MST, nor did he present any mental health complaints or symptoms other than those associated with polysubstance abuse. The Veteran initially reported the claimed in-service stressors in 2015, months before initiating his claim for VA benefits. Significantly, the Veteran's description of the in-service stressors, particularly his claimed military sexual assault, has not been consistent and has evolved over the course of this claim. While initially being vague about the claimed sexual assault in service, he subsequently reported that he woke up naked with a shipmate on his bunk. He later stated that he may have been drugged. Reportedly, he both felt fear and laughed it off as a joke. In April 2015, the Veteran denied a history of MST. Then the Veteran reported being sexually assaulted by several shipmates due to a racial argument. After 2016, he described being beaten and raped with a stick by numerous unidentified shipmates. Significantly, the VA examiner considered the Veteran's reported stressors, including the reported MST and racial harassment, which were uncorroborated, and determined that the reported stressors did not meet the criteria adequate to support the diagnosis of PTSD under the DSM. Overall, based on a detailed review of the record, the Veteran's testimony, and all evidence of record, the Board must unfortunately find that the Veteran's statements regarding what happened to him during service are not credible. As the Veteran's lay statements alone are not sufficient to verify his claimed stressors, and he has not provided sufficient information to permit the verification of such, to the extent the record may contain a diagnosis of PTSD based on the in-service reported stressors, such diagnosis is based on the Veteran's unsupported history of alleged stressor events that have not been confirmed. A medical opinion premised upon an unsubstantiated account is of no probative value and does not serve to verify the occurrences described. See Swann v. Brown, 5 Vet. App. 229, 233 (1993); see also Moreau, 9 Vet. App. at 395-396 (an opinion by a mental health professional based on a post-service examination of the Veteran cannot be used to establish the occurrence of a stressor). Therefore, the claim for PTSD based on the uncorroborated in-service stressors must be denied. The Board has also considered the February 2016 lay statement the Veteran's mother describing the change in the Veteran's personality after he left service and his reported military trauma. This statement is an observation of the Veteran's behavior from 40 years earlier, and it does not change the outcome of the claim. It is also unclear from her statement what military trauma the Veteran related to his her at that time. Moreover, this lay statement has no probative value in establishing an in-service stressor as it is based on the Veteran's own statements, which the Board finds not credible. Even assuming, without conceding, that any of the claimed stressors occurred, the evidence fails to show that the Veteran met the criteria for a diagnosis of PTSD. Here, the VA examiner in August 2016, found that the Veteran did not meet the criteria for a diagnosis for PTSD or a mental disorder that conformed to the DSM-5 criteria, other than opioid abuse disorders and cocaine use disorder. Significantly, the Veteran's VA treating psychiatrist who also considered the Veteran's reports of MST, diagnosed opioid use disorder per DSM-5. Although VA treatment records after 2015 noted an impression of, or medical history of, PTSD, no mental health diagnosis conforming to the DSM-5 criteria is shown. To the extent he has been diagnosed with PTSD related to military service, such diagnoses have been based primarily on his reported in-service MST, which the Board has not found to be credible. Therefore, the Board concludes that such medical findings are of no probative value. Reonal v. Brown, 5 Vet. App. 458 (1993). On the other hand, the Board finds the VA examiners' opinion to be thorough and reliable and affords them greater probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 303-304 (2008). The VA examiner found the Veteran did not have PTSD, finding his reported symptomatology and clinical presentation did not support a diagnosis of PTSD. The examiner discussed the relevant history and military stressors and/or trauma. Additionally, the opinion is consistent with the other medical evidence of record, to include the Veteran's service and post-service medical records. As the record is absent a finding of PTSD related to an in-service stressor, service connection is not warranted for PTSD. With regard to service connection for a psychiatric disorder, other than PTSD, it is acknowledged that no psychiatric disability was diagnosed during service, and there is no indication that psychosis had its onset during or within one year of separation from service. 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307, 3.309. Treatment records after 2015 document complaints of anxiety and depression associated with substance abuse disorder and situational stressors including occupational and financial problems. The weight of the most competent, probative, and persuasive medical evidence does not show a valid, current DSM-5 psychiatric disability other than primary substance abuse disorders. To the extent that the Veteran seeks entitlement to service connection for the documented, primary substance abuse disorders as directly related to service, the claim is denied as a matter of law because these are not disabilities for the purposes of VA compensation. See 38 U.S.C. § 105(a); 38 C.F.R. §§ 3.1(m), 3.301(d); see also Allen v. Principi, 237 F.3d 1368, 1381 (Fed. Cir. 2001) ("the legislative history is quite clear that Congress intended to ... preclude recovery for a primary alcohol abuse disability..."). To the extent the Veteran seeks service connection for substance abuse as secondary to his depression and/or anxiety, or as a symptom of his depression/anxiety, as outlined above, no compensation can be awarded for a disability that is a result of the Veteran's own willful misconduct or abuse of alcohol or drugs, unless the substance abuse arises secondarily from a service-connected disability. There must be "clear medical evidence establishing that alcohol or drug abuse is caused by" the primary disability and not a result of willful wrongdoing. Allen, 237 F.3d at 1381. In this case, the Board finds the preponderance of the evidence shows that the Veteran's anxiety and depression are the result of the primary abuse of drugs and that the exception carved out by the Federal Circuit does not apply here. The Veteran has used opiates and stimulants, including heroin and cocaine, for the majority of his life. The Veteran's mental health providers have attributed the Veteran's depression and anxiety to his drug abuse and not the other way around. In any event, with respect to the Veteran's assertion that his substance abuse is secondary to his psychiatric disability (i.e., a coping mechanism), the claim must also fail on this other premise since, for the reasons and bases already discussed, he does not have a service-connected psychiatric disability. Thus, he cannot use his psychiatric disability as a pathway to relate his alcohol and drug dependency to his military service. 38 C.F.R. § 3.310; Allen, supra. The Veteran believes he has an acquired psychiatric disability, including PTSD, that was incurred in service and that his polysubstance abuse is the result of said disability. However, unlike disabilities that may be observable as to both their incurrence and their cause, the cause of a psychiatric disability is not readily apparent to lay observation. Indeed, psychiatric diagnoses are generally the province of medical professionals. See Clemons v. Shinseki, 23 Vet. App. 1, 6 (2009). In reaching the above conclusions the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the claims for service connection for an acquired psychiatric disorder, to include PTSD, and substance abuse, that doctrine is not applicable in this case. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 55-57. 3. Entitlement to service connection for a neck disability 4. Entitlement to service connection for a back disability The Veteran seeks service connection for residuals of back and neck injuries incurred aboard the USS Manitowoc. Reportedly, he was beaten on numerous occasions by other shipmates. He testified that on one occasion a shipmate twice his size bent him over the knee in an attempt to break his back and the condition remained symptomatic since that time. The competent evidence of record confirms that the Veteran has been shown to have degenerative changes of the cervical spine. The record contains no evidence of a back disability. The discussion below will assume (but not concede) for purposes of argument that the Veteran has a back disability. For reasons noted above, the Veteran's statements regarding what happened to him in service have been found to be not credible. The service treatment records contain no complaints, history or findings consistent with a neck or back disability or injury. On separation from service in in June 1976, showed that the Veteran's spine was clinically evaluated as normal and no back or neck problems were recorded. After service, an October 2012 private treatment note recorded complaints of persistent neck pain following a lifting injury in August 2012. Such a record only further undermines the Veteran's credibility with the Board overall. An October 2012 MRI revealed mild to moderate degenerative changes of the cervical spine. Although the Veteran is competent to report that he received various injuries during service, as noted above, the Board finds that the Veteran's account is not credible. Even assuming, without conceding, for discussion purposes that the credibility of the Veteran's account of back and/or neck injuries during service more than 40 years ago, the record is insufficient to link his current neck disability to that an alleged injury (which does not seem to have occurred), or to any other aspect of his service. Additionally, arthritis of the spine was not shown in service or within one year following discharge from active-duty service, as such, service connection cannot be established for arthritis on a presumptive basis. 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307, 3.309. The Board notes that the first documented evidence of neck or back complaints was initially noted more than 35 years after the Veteran's discharge from service. In so noting, the Board recognizes that the mere absence of medical records is not dispositive as to the question of continuity; the lay evidence must be considered as well. See Buchanan v. Nicholson, 451 F.3d at1335. If, however, it is determined based on reliable evidence, that there was an extended period of time after service without any manifestations of the claimed condition, then that tends to weigh against a finding of a connection between the disability and service. See Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). To the extent the Veteran asserted continuity of symptomatology from service, the Board finds such statements inconsistent with the overall record, to include the service treatment records. Thus, the Veteran did not adequately show that his post-service complaints of neck or back symptoms continued since service. Here, there is no competent and credible evidence of a nexus between the Veteran's claimed neck and back disorders and service. The only evidence of record in support of such a nexus is the Veteran's lay opinion. To the extent the Veteran believed that his claimed neck and back disorders were related to service, to include any injuries incurred therein, as a lay person, the Veteran did not have the specialized training sufficient to render such an opinion. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). The diagnoses and/or etiology of spine disorders require medical testing and expertise to determine. Moreover, whether the symptoms the Veteran experienced in service or following service are in any way related to his claimed disorders, is a matter that requires medical expertise to determine. See Clyburn v. West, 12 Vet. App. 296, 301 (1999) ("Although the Veteran is competent to testify to the pain he has experienced since his tour in the Persian Gulf, he is not competent to testify to the fact that what he experienced in service and since service is the same condition he is currently diagnosed with."). Thus, the Veteran's assertions regarding the etiology of the neck and back complaints, initially noted many years after service, and service, are of little probative value. In this regard, it is important for the Veteran to understand that the service and post-service treatment records provide particularly negative evidence against the claims. A VA medical opinion regarding the etiology of the Veteran's neck and back disabilities is not indicated as there is no suggestion that the claimed disorders may be associated with service. Again, there is no competent evidence of a chronic neck or back disorder in service or within one year following discharge from service. Moreover, there is no competent and probative evidence to show that the Veteran had a neck or back disability during or contemporaneous with service and no competent and probative evidence that his claimed neck and back disorders are related to his service. See McClendon v. Nicholson, 20 Vet. App. 79 (2006). The best evidence in this case, as noted above, provides evidence against these claims. In sum, the record does not reflect that a neck or back disorder was shown during active duty service or within one year of separation thereof. Finally, the record is negative for any competent medical evidence in support of the claims, to include any medical opinions relating the Veteran's claimed neck and back disabilities to any incident of service. Thus, the Board must conclude that the preponderance of the evidence is against the claims and service connection is not warranted. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. 5. Entitlement to service connection for tinnitus The Veteran contends that he developed tinnitus due to acoustic trauma from firearms, helicopters, engines and tanks, without hearing protection during service. Reportedly, he experienced tinnitus since service. With regards to tinnitus, the Veteran is considered competent to report the presence of tinnitus. See Charles v. Principi, 16 Vet. App. 370, 374 (2002) ("ringing in the ears is capable of lay observation"). Here, a VA examiner in August 2016 indicated that a diagnosis of tinnitus was not appropriate because the Veteran denied having tinnitus. Nonetheless, the discussion below will assume (but not concede) for purposes of argument that the Veteran has tinnitus. The Veteran' DD 214 shows that his military occupational specialty was seamanship. However, even if the Veteran was exposed to acoustic trauma during service, this is not the same as having sustained the type of injury that causes tinnitus and having resulting chronic disability. The service and post-service treatment records do not document any complaints, history or findings consistent with tinnitus, and VA treatment records since 2007 show that no hearing difficulties or tinnitus were reported or noted. After service, the Veteran reported tinnitus in 2015, in connection with the current claim for VA benefits. This multi-year gap between reports of tinnitus and service is one factor, among others, weighing against a finding of continual symptoms since service. See Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (lengthy period of absence of medical complaints for condition can be considered as one factor in resolving a claim); Mense v. Derwinski, 1 Vet. App. 354, 356 (1991) (affirming Board's denial of service connection where Veteran failed to account for lengthy time period between service and initial symptoms of disability). There a clear foundation, based on the Veteran noncredible statements over time, that supports the finding that he did not have any of the problems he had indicated he has since service. See Horn v. Shinseki, 25 Vet. App. 231, 239 (2012). The Board acknowledges that symptoms, not treatment, are the essence of any evidence of continuity of symptomatology. To the extent the Veteran asserts that that his tinnitus had onset and continued since service, the Board does not find the Veteran credible as the contemporaneous medical evidence does not support his contentions (the Board has reviewed this case, and the Veteran's statements over time, in some detail). In addition, for reasons cited above, the Veteran's credibility is in serious question in this case. There are no complaints of tinnitus reflected in service or until 2015, many years after service, and hence no continuity or chronicity. The Court has determined the Board may properly assign more probative value to lay statements in contemporaneous medical records than subsequent statements made for compensation purposes. Accordingly, the Board finds the Veteran's contemporaneous medical records that fail to show any complaints of tinnitus until at least 2015 more probative than his statements that he had experienced tinnitus since service made in the course of filing a claim for benefits. See Dalton v. Nicholson, 21 Vet. App. 23, 37 (2007). The Board further finds that the weight of the evidence demonstrates that the current tinnitus is not otherwise related to active service, to include any in-service noise exposure. As noted, on VA examination in August 2016 the Veteran denied having tinnitus and there is no competent medical evidence that associates his reported tinnitus with service. The Veteran has contended throughout the course of this appeal that the current tinnitus was caused by the in-service noise exposure. Under the facts of this case that include no continuous post-service symptoms, the Board finds that the Veteran does not have the requisite medical knowledge, training, or experience to be able to render a competent medical opinion regarding the cause of medically complex disorder such as tinnitus. Tinnitus can have various etiologies, such as acoustic trauma, head trauma, diseases, ototoxic drugs, etc. The ultimate questions in this case are related to an internal medical process which extend beyond an immediately observable cause and effect relationship. While the Veteran is competent to attest to hearing problems, as a lay person, it has not been shown that he had specialized training sufficient to determine the etiology of tinnitus. Jandreau, 492 F.3d at 1377. Simply stated, both the best medical evidence in this case, and the facts of this case, provide highly probative evidence against the claim. In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, the preponderance of the evidence is against the Veteran's claim for service connection for tinnitus. As such, that doctrine is not applicable in the instant appeal, and the claim must be denied. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. 6. Entitlement to service connection for bilateral hearing loss The Veteran contends that he developed bilateral hearing loss due to acoustic trauma from firearms, helicopters, engines and tanks, without hearing protection during service. Reportedly, he experienced hearing loss since service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. Impaired hearing is defined as a disability under VA law when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels (dB) or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. The threshold for normal hearing is from 0 to 20 decibels; higher threshold levels indicate some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). The service treatment records are negative of any complaints and/or treatment for hearing loss and his June 1976 separation audiogram did not show hearing loss pursuant to 38 C.F.R. § 3.385. After service, VA treatment records since 2007 show that the Veteran consistently denied any hearing difficulties and hearing loss for VA purposes has not been shown. 38 C.F.R. § 3.385. The Veteran was afforded a VA examination in August 2016. The examining audiologist explained that the frequencies could not be tested, and the puretone test results were invalid despite repeated attempts and reinstructions. The test results were not reliable and were not suitable for rating purposes. The test results were strongly suggestive of a non-organic hearing loss/hearing loss component. There was variability in responses to pure-tones of up to 15 dB with retest (more than could be expected from test-retest variability), a positive Stenger was obtained at 3000 Hertz for the left ear, and the fair to poor speech recognition scores were inconsistent with observed communication abilities. Simply stated, the examiner appears to be indicating that the Veteran was exaggerating. This finding is consistent with the facts of this case. The use of the word recognition score was also not appropriate for the Veteran because of language difficulties, cognitive problems, inconsistent word recognition scores, etc., that made combined use of puretone average and word recognition scores inappropriate. The examiner diagnosed normal hearing, bilaterally. The examiner indicated that as the test results were unreliable and unsuitable for rating purposes, the audiologist was unable to provide an opinion regarding the etiology of a hearing disability without resort to mere speculation because there were no findings upon which to base an opinion. The Board finds that the explanation for the VA examiner's inability to determine whether the Veteran has hearing loss for VA purposes is adequate. See Jones v. Shinseki, 23 Vet. App. 382 (2010). Where the evidence establishes that a veteran does not currently have a disability for which service connection is sought, service connection for that disability is not authorized under the statues governing veterans' benefits. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 144 (1992). There is no diagnosis of a bilateral hearing loss disability, as defined by 38 C.F.R. § 3.385, at any time post service. Instead, the Veteran produced invalid test results during audiometric testing on a VA examination in August 2016 and could not be tested. In the absence of medical evidence of a current bilateral hearing loss disability as defined for VA purposes, the claim for service connection for bilateral hearing loss must be denied. The Board notes that the Veteran has submitted his own statements that he believes he suffers from bilateral hearing loss. Although he is certainly competent to state that he was exposed to loud noises during service and that he has noticed a difficulty in hearing since discharge from service, the medical evidence does not document hearing loss to the level required to establish service connection. Considering the foregoing, the preponderance of the evidence is against the claim of service connection for bilateral hearing loss, there is no doubt to be resolved, and service connection for bilateral hearing loss is not warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Azizi, T. 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.