Citation Nr: 21076716 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 17-51 040 DATE: December 27, 2021 ORDER Entitlement to service connection for hernia is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has hernia that had its onset in service or is otherwise related to his military service. CONCLUSION OF LAW The criteria for service connection for hernia have not been 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 active duty from March 1988 to March 1991. In his September 2017 VA Form 9, the Veteran requested a Board hearing. The requested hearing was scheduled for August 17, 2021. However, due to COVID, the hearing was rescheduled for October 6, 2021. The Veterans Appeals Control and Locator System (VACOLS) indicates that the Veteran was a "No Show" for his hearing. Also, he has not requested that his hearing be rescheduled. Under these circumstances, the Board has determined that the Veteran's request for a Board hearing has been withdrawn. 38 C.F.R. § 20.704(e). Entitlement to service connection for hernia A veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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, the so-called "nexus" requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for disability shown after service, when all the evidence, including that pertinent to service, shows that it was incurred in service. 38 C.F.R. § 3.303(d). In Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the United States Court of Appeals for Veterans Claims stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail." To deny a claim on its merits, the preponderance of the evidence must be against the claim. See Alemany v. Brown, 9 Vet. App. 518, 519 (1996) (citing Gilbert, 1 Vet. App. at 54). Analysis The Veteran contends that his disability is due to military service. The Veteran has a current diagnosis of ventral and umbilical hernias. As such, element one under Shedden is met. The Veteran's service treatment records (STRs) document treatments, complaints, or diagnosis for possible inguinal hernia. As such, element two under Shedden is met. The Veteran's January 1988 Report of Medical History, Enlistment Exam, reflected a normal clinical evaluation of the abdomen and viscera which also included an evaluation for hernia. The Veteran noted that he did not have a hernia. In May 1988, the Veteran was seen for bulging on his left side. The examiner noted that the Veteran had a possible occasional intermittent hernia. The Veteran stated that he first noticed a bulging on the left side of his pelvis during BMT. He stated that certain exercises and straining caused the bulging to occur which caused sharp pain. The examiner stated that the Veteran's inguinal triangle was palpated on both sides, but no hernia could be reproduced by straining or position. The Veteran was instructed to return if the symptoms reoccurred. There appears to be no separation exam of record. In March 2016, the Veteran was seen at the Cons Surgical H&P/Risk Assessment for umbilical/left groin pain. The Veteran stated that it had been bothering him since his time in service. In May 2017, the Veteran was afforded a VA examination to determine the nature and etiology of his hernia. The Veteran stated that he was in special team training performing flutter kicks for special ops group, when he felt a pain and a bulge pop out on his left groin area. The examiner stated, in May 1988 and per the Veteran's STRs, the Veteran was evaluated for a "bulge on his left side." Per the STR notes, the "inguinal triangle was palpated on both sides, but no hernia could be reproduced." The Veteran reported that he continued in the military and that whenever he felt the pain/bulge, he would push the bulge back in, and it would go away until he aggravated it again by lifting something heavy or reaching. The pain/bulging kept getting worse. He never sought medical evaluation until October 2016 at which time he underwent surgery for open bilateral inguinal hernia repair and umbilical hernia repair. He reported continued pain in his left inguinal area. The examiner noted that the Veteran underwent surgery; therefore, he did not now have inguinal hernia. However, the examiner noted healed postoperative ventral hernia repair and umbilical hernia reproduced by head lift. The examiner opined that the claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. The examiner stated that the STRs indicated a "possible recurrent hernia," however, there was no actual diagnosis, and a doctor was unable to reproduce the hernia. The VA examiner stated that there was no follow-up treatment or diagnosis noted in the Veteran's STRs or in the available medical records from the 1988 exam until 2016. Upon leaving the military, the Veteran reported working as a boilermaker which required heavy lifting and working in positions that would also strain the inguinal/umbilical areas. After careful review of the Veteran's medical records in VBMS and CPRS, his history, and the physical exam, the examiner stated that it was her medical opinion that the claimed hernia was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In his September 2017 VA Form 9, the Veteran stated that in May 1988, he complained of a hernia. The Veteran stated that the flight surgeon who examined him told him if he had a reoccurrence of the pain and bulging in his pelvic area to massage it until the bulge would reduce. The Veteran reported not following up because he was sent to fighter squadron training which was not as strenuous, and he babied himself so it would not bother him. The Veteran felt that the injury weakened the muscle which made him more susceptible to a reoccurrence. Based on the evidence of record, the Board finds that service connection for the Veteran's hernia is not warranted. The Board notes that the Veteran's STRs document complaints, treatments, and diagnosis for a possible hernia. However, the VA examiner opined that the condition claimed was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner noted that the STRs indicated a "possible recurrent hernia," but, there was no actual diagnosis, and a doctor was unable to reproduce the hernia. The VA examiner noted no follow-up treatment or diagnosis was noted in the Veteran's STRs, and he did not seek treatment for a hernia until 2016. The VA examiner attributed the Veteran's hernia to his post-service occupation. The examiner stated that the Veteran worked as a boilermaker which required heavy lifting and working in positions that would also strain the inguinal/umbilical areas. Additionally, after the inservice documentation of possible hernia, the first medical evidence of any hernia was in 2016, i.e., 28 years after discharge from service. The fact that there were no records of any complaints or treatments involving the Veteran's hernia for many years weighs against the claim. 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). Therefore, the Board finds that element three under Shedden has not been met. The Board has considered the Veteran and his representative's statements regarding the etiology of the Veteran's hernia. 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 nexus between the diagnosed condition 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). As such, in the absence of a nexus, the claim for service connection for hernia is denied. In reaching the above conclusion, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the claim, that doctrine is not applicable. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. § 5107(b). 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.