Citation Nr: 21076421 Decision Date: 12/23/21 Archive Date: 12/23/21 DOCKET NO. 16-31 434 DATE: December 23, 2021 ORDER Entitlement to service connection for recurrent urinary tract infections (UTIs) is denied. FINDING OF FACT The probative evidence of record does not indicate that the Veteran's carries a current diagnosis of recurrent UTIs nor do her UTIs have a functional impact. CONCLUSION OF LAW The criteria for service connection for recurrent UTIs are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on activity duty from February 1991 to February 2011. The claim was remanded by the Board for further development in October 2018 and July 2021 to obtain private treatment records and to obtain a VA examination. This development was completed and the claim has returned to the Board. Service connection for recurrent UTIs The Veteran filed her claim for service connection for recurrent UTIs during service in May 2011, shortly after her discharge from service. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). 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 Veteran. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Analysis While the Veteran's service treatment records (STRs) document UTIs, the Board does not find that the Veteran has a current diagnosis of recurrent UTIs. In the absence of proof of a present disability, there is no valid claim for service connection; an appellant's belief that he or she is entitled to some sort of benefit simply because he or she had a disease or injury while on active service is mistaken, as Congress has specifically limited entitlement to service connection to cases where such incidents have resulted in a disability at any point during the claim or appeal period. See Brammer v. Derwinski, 3 Vet. App. 223 (1992) As explained above, the Veteran applied for service connection for recurrent UTIs in May 2011. A September 2011 VA examination noted her last UTI was in 2005, that she does not have chronic UTIs, and that there is no dysfunction or incontinence. There was no effect on her activities of daily living (ADLs). In her June 2013 notice of disagreement, the Veteran asserted she had recent UTIs in 2013. In her June 2016, form 9 "Appeal to the Board", the Veteran argued that cysts on her kidneys caused the recurrent UTIs. The Veteran was afforded a VA examination in October 2021. The clinician stated that the Veteran does not meet diagnostic criteria for recurrent/chronic UTIs. In support thereof, the clinician stated as follows: "It looks like they started out frequent, but the time between infections became longer increasing to about every 4 years and after 2013. There are none documented in her C-file or the records she brought in, since 2013. Her [current urine tests] show positive for UTI, but the presence of squamous epithelial cells means contamination (the specimen should not show epithelial cells as those are skin cells and would not be sterile as urine is). In light of the contamination, I did render a diagnosis of UTI, but it might not be a true diagnosis with a contaminated specimen. Additionally, a review of the literature shows that in order to be considered chronic/recurrent, a UTI must occur 3 times in a 12-month period. A UTI may be recurrent when it follows the complete clinical resolution of a previous UTI. A threshold of 3 UTIs in 12 months is used to signify recurrent UTI." Given the above, the clinician found the Veteran's claimed UTIs did not meet the diagnostic criteria for recurrent UTIs. The Board gives the opinion great probative weight because it is based on a review of the medical record and cites research in support of its position. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Board has considered whether the Veteran's description of symptomology alone would demonstrate a functional impact. Where the evidence shows that symptoms reach the level of a functional impairment of earning capacity, a disability for VA compensation purposes exists, even if there is no underlying diagnosis. See Saunders v. Wilkie, 886 F.3d 1356 (2018). However, the Board does not find a functional impairment of earning capacity because the infrequency of the UTI symptoms would not impact the Veteran's functioning. Given the above, the Board finds the Veteran does not have a disability. Lay witnesses are competent to provide testimony or statements relating to symptoms or facts of events that the lay witness observed and is within the realm of his or her personal knowledge, but not competent to establish that which would require specialized knowledge or training, such as medical expertise. Layno v. Brown, 6 Vet. App. 465, 470 (1994). The Board finds that rendering a diagnosis of recurrent UTIs requires medical expertise and for that reason gives great probative weight to the opinion of the VA examiner. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Because the Veteran does not have a diagnosis of recurrent UTIs, the Board will not address her theory that a kidney cyst caused the disability. Thus, the weight of the evidence is against the claim for service connection for recurrent UTIs. Accordingly, the claim is denied. Absent a relative balance of the evidence for and against the claim, the evidence is not in equipoise and the benefit of the doubt doctrine does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. C. Casey Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. M. Hitchcock 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.