Citation Nr: 21076934 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 17-04 769A DATE: December 28, 2021 ORDER Entitlement to service connection for a chronic disorder claimed as breathing problems, including sleep apnea is denied. Entitlement to service connection for ulcerative colitis is denied. Entitlement to service connection for pre-colon cancer condition is denied. Entitlement to service connection for epigastric hernia is denied. Entitlement to service connection for migraine headaches is denied. FINDINGS OF FACT 1. The Veteran did not have chronic bronchitis in service; he does not have a current disorder manifested by breathing problems and his sleep apnea is not related to service. 2. The Veteran did not have a chronic disorder in service manifested by abdominal pain; his ulcerative colitis did not originate during service and is not otherwise related to any incident of service. 3. The Veteran does not have a pre-colon cancer condition that originated during service or that is related to any incident of service. 4. The Veteran's epigastric hernia did not originate during service and is not related to any incident of service. 5. The Veteran's migraine headaches did not originate during service or until years thereafter, and are not related to any incident of service. CONCLUSIONS OF LAW 1. The criteria for service connection for a chronic disorder claimed as breathing problems to include sleep apnea are not met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. § 3.303. 2. The criteria for service connection for ulcerative colitis are not met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. § 3.303. 3. The criteria for service connection for a pre-colon cancer condition are not met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. § 3.303. 4. The criteria for service connection for epigastric hernia are not met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. § 3.303. 5. The criteria for service connection for migraine headaches are not met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from October 1981 to October 1985. In June 2019 he testified at a videoconference hearing before the Board of Veteran's Appeals (Board). A transcript of the hearing is of record. In December 2019, the Board remanded the issues for further development. Since then, service connection has been granted for service connection for tinnitus, a right ankle disability, residual right ankle scar, a right knee disability, and a cervical spine neck disability with associated radiculopathy. The Veteran has not initiated an appeal with respect to the ratings or effective dates assigned and has provided no additional argument. The Agency of Original Jurisdiction's (AOJ) grant of service connection for these issues constitutes a full award of benefits sought on appeal. See Grantham v. Brown, 114 F.3d 1156, 1158 (Fed. Cir. 1997); see also 38 C.F.R. §§ 3.2400, 19.2. Therefore, these issues are no longer before the Board. Shoen v. Brown, 6 Vet. App. 456 (1994). Service Connection The Veteran seeks service connection for breathing problems, ulcerative colitis, a pre-colon cancer condition, an epigastric hernia, and headaches. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (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 - the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Certain chronic diseases are subject to presumptive service connection if manifest to a compensable degree within one year from separation from service even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307 (a)(3), 3.309(a). Continuity of symptomatology may also provide a basis for a grant of service connection for those diseases defined as "chronic" by VA. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, any reasonable doubt is resolved in favor of the Veteran. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. breathing problems The Veteran asserts that he developed breathing problems due to dust or "something in the climate conditions" following his overseas assignment in Egypt. See January 2017 VA Form 9; June 2019 Board hearing transcript; and April 2021 VA examination report. Service treatment records show the Veteran was treated for mild bronchitis in March 1982. There are no records of follow-up evaluations or additional clinical findings related to this episode. The Veteran continued to serve the remaining three years of service until his separation in 1985 with no additional respiratory complaints. At his separation physical, the chest and lungs were normal on clinical evaluation and a chest X-ray was within normal limits with no defects noted. The Veteran did not indicate any specific respiratory complaints and there are no references to breathing problems or respiratory impairment of any sort. This evidence weighs against a finding that the Veteran's breathing problems were chronic during service. Service records do not otherwise indicate any complaints or findings suggestive of a chronic sleep disorder including specific complaints of disordered sleep, snoring, shortness of breath, fatigue, excessive daytime sleepiness, or other signs indicative of sleep apnea. There is also insufficient evidence of continuity of symptoms in the immediate years after service to enable an award of service connection under the provisions pertaining to "chronic diseases." Walker, 708 F.3d at 1338. Post service VA and private treatment records dated from 2004 to 2020 show no specific treatment for respiratory complaints and there are no such complaints documented in "active problem lists" or in any report of past medical history. In addition, the Veteran's medication lists do not include any of the commonly prescribed medications used to treat bronchitis or other respiratory disorders. VA treatment records show sleep apnea was first diagnosed during a sleep study in April 2019. The report does not suggest that sleep apnea originated during military service and there is no indication that the Veteran related his symptoms to service or any event of service at that time. See clinical records from the Rocky Mountain Regional VA Medical Center. When examined by VA in April 2021 the Veteran reported a history of intermittent shortness of breath since 1984 and that he uses an inhaler when needed. After examination and review of the record, the examiner concluded that based on the provided medical records, physical, and reported history, the Veteran's claimed breathing problems are less likely than not related to service since there were no findings, signs, or symptoms to support a diagnosis. The examiner noted the Veteran's in-service treatment for bronchitis in March 1982 but found there was no evidence that this episode became chronic during service or after service. See Respiratory Conditions (Other Than Tuberculosis and Sleep Apnea) Disability Benefits Questionnaire (DBQ) and Medical Opinion DBQ. The Board finds that the weight of the evidence reflects that the Veteran does not have current disorder manifested by breathing problems. Under applicable regulation, the term "disability" means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. § 4.1; Hunt v. Derwinski, 1 Vet. App. 292 (1991); Allen v. Brown, 7 Vet. App. 439 (1995); Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (the term "disability" as used in 38 U.S.C. § 1110 refers to the functional impairment of earning capacity). The objective evidence does not show a respiratory disorder at the time of the filing of the claim or during the pendency of the claim. The Veteran has also not described or presented evidence of any specific functional loss or impairment due to breathing problems. The existence of a current disability is the cornerstone of a claim for VA disability compensation. See Degmetich v. Brown, 104 F. 3d 1328 (1997) (holding that the VA's and the Court's interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary and therefore the decision based on that interpretation must be affirmed); see also Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). So, without competent evidence of a chronic respiratory disorder, or a showing of chronic functional impairment, service connection cannot be awarded. The Board is also unable to attribute the Veteran's sleep apnea to military service. He did not experience chronic sleep disorder symptoms in service and there is no evidence of symptoms until 2019, decades after service. While not a dispositive factor, the significant lapse in time between service and post-service medical treatment may be considered as part of the analysis of a service connection claim. See Maxson v. West, 12 Vet. App. 453 (1999), aff'd, 230 F.3d 1330 (Fed. Cir. 2000). There is also no evidence linking sleep apnea to service. However, since service and post-service treatment records provide no basis to grant sleep apnea, and in fact provide evidence against it, the Board finds no basis to obtain a VA examination or medical opinion. Duenas v. Principi, 18 Vet. App. 512, 519 (2004) (holding that VA is not obligated to provide an examination for a medical nexus opinion where, as here, the supporting evidence of record consists only of a lay statement). Although the Veteran is competent describe symptoms that are typical of sleep apnea, the Board notes determining etiology (as distinguished from merely reporting the presence of symptoms) is a complex medical matter that falls outside the realm of common knowledge of a lay person. As the Veteran is not shown to be other than a layperson, without the appropriate training and expertise, he is not competent to render a probative (i.e., persuasive) opinion on the medical matter upon which this claim turns. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007) (noting that lay persons not competent to diagnose certain complex internal processes, such as cancer). Accordingly, the preponderance of the evidence is against the claim, and there is no reasonable doubt to be resolved. 38 U.S.C. § 5107(b). ulcerative colitis pre-colon cancer condition The Veteran is seeking service connection for ulcerative colitis and pre-colon cancerous condition which he asserts are due to stomach problems and dysentery from contaminated drinking water while on an overseas assignment in Egypt. See October 16, 2013 Correspondence; January 2017 VA Form 9; and April 2021 VA examination report. At his June 2019 Board hearing the Veteran testified that he was treated for paracytic dysentery during service and after service had precancerous colitis that had to be removed. He also noted that he has had several bowel blockages and anal fissures that required surgical repair. Because there is similar medical history and evidence related to these cardiovascular claims, as well as similar disposition of the issues, the Board will address them in a common discussion. Service treatment records in April 1983 show the Veteran complained of abdominal cramps after having consumed several beers and shots of tequila. The assessment shows suspected alcoholic pancreatitis and "parasitic." He was treated with Compazine given by intramuscular injection and by mouth 5mg by mouth and returned to duty. The Veteran was not diagnosed with colitis or any other gastrointestinal disorder and there are no records of follow-up evaluations or clinical findings related to this episode. Instead, the Veteran continued to serve until his separation in 1985 with no additional stomach complaints. At his separation physical, the abdomen and viscera, were normal on clinical evaluation with no defects or diagnoses were noted. The Veteran did not indicate any specific gastrointestinal complaints and there are no references to stomach problems or impairment of any sort. This evidence weighs against a finding that the Veteran's stomach problems were chronic during service. There is also insufficient evidence of continuity of symptoms in the immediate years after service to enable an award of service connection under the provisions pertaining to "chronic diseases." Walker, 708 F.3d at 1338. Private treatment records beginning in 2004 show the Veteran had a family history of benign polyps of the large intestines, but there is no indication of any complaints, findings, or treatment related to a pre-cancerous condition. However, these records do show the Veteran reported a history of loose bowels and had been evaluated for left upper quadrant pain since February. He was recently hospitalized for gastroenteritis and a March 2004 CT scan of the abdomen showed a renal cyst and mild diverticulosis. See clinical records from the Clark-Holder Clinic. In June 2004 the Veteran underwent an elective partial colectomy with ileal J-pouch and temporary loop ileostomy for chronic ulcerative colitis. The pathology report showed mild specific chronic inflammation but no acute cryptitis, discreet granulomas, glandular disarray glandular dysplasia or malignancy. In August 2004, the Veteran underwent a loop ileostomy and small bowel resection. The pathology report again showed no malignancy. See clinical records from Saint Joseph's Hospital of Atlanta. Subsequently dated records show the Veteran was treated for a bowel obstruction in 2006 and an anal fissure in August 2010. These records also include a March 2014 pathology report which shows results from a colon biopsy were negative for malignancy. See clinical records from St. Francis Center Surgical Care and St. Francis Center Digestive Disorders. These clinical records do not suggest that the colitis, bowel obstruction, or anal fissure originated during military service and there is no evidence of record to suggest their presence prior to the indicated date of diagnoses. While not a dispositive factor, the significant lapse in time between service and post-service medical treatment may be considered as part of the analysis of a service connection claim. Maxson, 12 Vet. App. at 459, aff'd sub nom. Maxson, 230 F.3d at 1333. In this case, the Veteran has not presented any factors that would explain the gap in time. In support of his claim the Veteran submitted a medical opinion from his private physician who reported the Veteran had been under his care since 2004 and had a history of amoebic dysentery during service in 1983. Since then, the Veteran has had ongoing gastrointestinal symptoms that culminated in ulcerative colitis in 2004 requiring a total colectomy. The physician opined that the Veteran's ulcerative colitis may be the direct result of amoebic dysentery treated during military service. See medical opinion from R.M. Stout, M.D., dated April 25, 2012. When examined by VA in April 2021 the Veteran reported that in 1984 while serving in Egypt, he was exposed to contaminated water that caused issues within his digestive system and colon. He states he started to have severe abdominal pain and alternating diarrhea that progressed over the years and that he was misdiagnosed with IBS. The report shows that other than colitis, there were no additional diagnoses pertaining to intestinal conditions and no related benign or malignant neoplasm or metastases. After examination and review of the record, the examiner concluded that the Veteran's ulcerative colitis is not related to an in-service injury, event, or disease. It was explained that ulcerative colitis is a chronic inflammatory disease of the large intestine that affects the lining of the colon and causes small sores, or ulcers, to form. Those ulcers produce pus and mucous, which cause abdominal pain and the need to frequently empty the colon. The examiner noted that the medical records support that while the Veteran had an acute episode of abdominal cramping in 1983 after drinking beer and alcohol, there is no evidence of a chronic abdominal condition during service or for years after service. See Intestinal Conditions (Other Than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative Colitis, and Diverticulitis) and Medical Opinion DBQs. The examiner also found that based on the provided medical records, physical and history the Veteran's claimed condition of pre-cancer of the colon is less likely than not related to service since there were no findings, signs, or symptoms to support a diagnosis. The examiner noted the Veteran's in-service treatment for severe abdominal pain and cramping assessed as alcoholic pancreatitis parasitic but found there was no evidence that this condition became chronic during service or after service. It was explained that the exact mechanism for the development of colon polyps is unknown but contributing risk factors include a family history, diet, genetics, and older age. The examiner noted the Veteran's family history of colon polyps and that medical records are clear about a diagnosis of ulcerative colitis but are not clear about a diagnosis of precancerous polyps. Additionally, the Veteran's pre- and post-op notes for the colon surgery do not give a diagnosis of pre-cancerous polyps. Moreover, if pre-cancerous polyps were present the condition had resolved with the Veteran's colectomy. Id. Based on the evidence in this case, the Board finds that service connection for ulcerative colitis/pre-cancerous colon is not warranted. Although the Veteran clearly received treatment for abdominal pain during service, the symptom was neither chronic nor continuous and did not result in a diagnosis. Furthermore, the VA medical opinions of record do not link the ulcerative colitis including any pre-colon cancer condition to military service. The VA opinions are both probative and persuasive medical evidence in this case, as they are based upon a review of the claims file, including lay statements, and supported by sufficiently clear and well-reasoned medical rationale explaining why the Veteran's ulcerative colitis is not related to service. In providing the rationale, the VA examiner considered the Veteran's in-service history, the onset and course of his gastrointestinal problems, the results of the clinical evaluation, and belief that his ulcerative colitis is a pre-cancerous condition related to his in-service abdominal pain. See Nieves-Rodriguez, 22 Vet. App. 304. Careful consideration has also been given to the private opinion. The Board notes that while the statement provides a plausible positive nexus relating the Veteran's ulcerative colitis to service, it is limited in terms of its ultimate probative value as the physician did not explain what evidence in the Veteran's service records supported this conclusion and did not reference any clinical data or other evidence for the opinion. See Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998) (the failure of a physician to provide a basis for his or her opinion affects the weight or credibility of the evidence); Bloom v. West, 12 Vet. App. 1985 (1999) (holding that the value of a physician's statement is dependent, in part, upon the extent to which it reflects "clinical data or other rationale to support his opinion."). Because there is no indication that the examiner reviewed the service treatment records, his opinion is based largely on the Veteran's description of treatment for dysentery during service as opposed to the contemporaneous evidence documenting that episode. Curry v. Brown, 7 Vet. App. 59, 68 (1994) (contemporaneous evidence has greater probative weight than a history reported by the Veteran); see also LeShore v. Brown, 8 Vet. App. 406 (1995) (the mere transcription of medical history does not transform the information into competent medical evidence merely because the transcriber happens to be a medical professional). Moreover, the speculative terminology used by this physician ("may be" the direct result of amoebic dysentery treated during military service) diminishes the probative value of the opinion and does not provide a sufficient basis upon which to support the claim. See Obert v. Brown, 5 Vet. App. 30, 33 (1993). In this case, the private opinion is inadequate and does not assist the Board or the Veteran in resolving the claim and thus cannot serve as the basis of a grant of service connection. In light of the other evidence of record, the VA opinions are sufficient to satisfy the statutory requirements of producing an adequate statement of reasons and bases where the expert has fairly considered material evidence which appears to support the Veteran's position. Wray v. Brown, 7 Vet. App. 488, at 492-93 (1995). The private opinion, while not discounted entirely, is entitled to less probative weight in view of the remaining evidentiary record. To the extent the Veteran reports experiencing stomach problems during service and continuously since then, the Board finds his account lacks credibility as the statements are not supported by the record. See Macarubbo v. Gober, 10 Vet. App. 388 (1997) (holding that the credibility of lay evidence can be affected and even impeached by inconsistent statements, internal inconsistency of statements, inconsistency with other evidence of record, facial implausibility, bad character, interest, bias, self-interest, malingering, desire for monetary gain, and witness demeanor). The objective contemporaneous medical records stand in sharp contrast to the Veteran's lay reports and are more probative as to the circumstances surrounding the onset of his ulcerative colitis rather than his inconsistent history reported many years thereafter. See Curry, 7 Vet. App. 59. The preponderance of the evidence is against the claim and there is no reasonable doubt to be resolved. 38 U.S.C. § 5107(b). epigastric hernia The Veteran asserts that he developed a hernia from carrying rucksacks and heavy loading/unloading during field training. See January 2017 VA Form 9, June 2019 Board hearing transcript, and April 2021 VA examination report. In a May 2014 statement, his spouse of 37 years stated that due to several intestinal blockages, the Veteran required surgeries and was under a surgeon's care for an existing blockage and hernia. At his 2019 Board hearing, the Veteran testified that his hernia was diagnosed in 2007, however his wife testified that it was visible for years prior to the diagnosis. Service treatment records do not indicate any complaints or findings suggestive of an epigastric hernia. The earliest evidence (documentation) of any pertinent symptoms or complaints is found in private outpatient treatment records beginning in February 2011. At that time the Veteran developed a small hernia following exploratory laparoscopy for bowel obstruction. A CT scan from 2014 shows a ventral hernia in the epigastrium. See clinical records from St. Francis Center Surgical Care and LaGrange Internal Medicine. The records do not suggest that the hernias originated during military service and there is no other evidence of record to suggest its presence prior to the indicated date of diagnoses. While not a dispositive factor, the significant lapse in time between service and post-service medical treatment may be considered as part of the analysis of a service connection claim. Maxson, 12 Vet. App. at 459, aff'd sub nom. Maxson, 230 F.3d at 1333. The Veteran has not indicated any factors that would explain the gap in time. There is also no medical opinion linking the Veteran's hernia to his military service. When examined by VA in April 2021 the Veteran reported a history of recurrent ventral hernias since 2004 which he asserts resulted from heavy lifting while in the military. After examination and review of the record, the examiner found that the Veteran's epigastric hernia is less likely than not related to service since. The examiner noted the Veteran's assertion that the hernia was related to field training and carrying heavy loads in service but explained that a hernia is a result of weakened abdominal muscle and there is no evidence that the Veteran complained of this condition while active. There is also no evidence that the Veteran was found to have a hernia on physical exam during service or that he was treated for or found to have a hernia until many years after service. Although ventral hernias may result from abdominal surgery, the Veteran's surgery was performed years after service and there is no evidence of a preoperative hernia. See Hernias (Including Abdominal, Inguinal and Femoral Hernias) DBQ. Based on the evidence in this case, the Board finds that service connection for epigastric hernia is not warranted. As noted above, service treatment records are entirely negative for hernia complaints or findings and there is a lengthy period between service and the first documented complaints decades later. Also, by his own admission during his 2021 VA examination, the Veteran reported a history of recurrent ventral hernias since 2004, placing its onset well after service. In other words, his own account of the history of his hernia does not indicate a service onset. Moreover, the Board affords significant weight to the VA examiner's opinion that the recurrent hernia is not related to service. The VA opinion is both probative and persuasive as it is based upon a review of the file and supported by sufficiently clear and well-reasoned medical rationale. The examiner considered the relevant medical and other history, including the Veteran's belief that his hernia developed as a result of service military duties. Nieves-Rodriguez, 22 Vet. App. 304. The claims file contains no competent medical evidence refuting it. To the extent the Veteran's statements attempt to provide a nexus opinion between his hernia and military duties, such an assertion treads into the realm of medical expertise. See Jandreau, 492 F.3d at 1377. The Board notes determining the etiology of hernias (as distinguished from merely reporting the presence of symptoms) is not a simple question. Doing so requires knowledge of the potential causes of hernias. It also requires discussion of the inherently medical question of how impact trauma and/or particular activities may have contributed to bring about a hernia many years later particularly in light of the absence of clinical evidence in the interim and so is beyond the scope of knowledge of a lay person. In any event, the probative value of the Veteran's belief is outweighed by that of the examiner, who clearly does have the education, training, and experience to address the etiology of hernias. Accordingly, the preponderance of the evidence is against the claim and there is no reasonable doubt to be resolved. 38 U.S.C. § 5107(b). headaches The Veteran asserts that he has had migraines since service. See January 2017 VA Form 9 and April 2021 VA examination report. At his 2019 Board hearing, he and his wife testified that he incurred head trauma in service including as a result of parachute jumps. He testified that on one occasion he was knocked unconscious and dragged about 150 yards across the landing zone before coming to but did not seek treatment after the incident. Service treatment records in March 1982 show that the Veteran complained of headaches associated with an episode of bronchitis. There are no records of follow-up evaluations or clinical findings related to this episode and the Veteran continued to serve the remaining three years of service until his separation in 1985 with no additional headache complaints. At his separation physical, clinical evaluation was within normal limits with no defects noted. The Veteran did not indicate any specific headache complaints and there are no references to head injury. This evidence weighs against a finding that the Veteran's headaches were chronic during service. Although the Veteran now claims to have experienced ongoing problems with headaches since service, there is insufficient evidence of continuity of symptoms in the immediate years after separation from service. Walker, 708 F.3d at 1338. The earliest evidence (documentation) of any pertinent symptoms or complaints is found in private outpatient treatment records beginning in 2006 which show the Veteran complained of headaches with upper extremity numbness. At that time, he reported a longstanding history of intermittent headaches that began about 30 years ago and would appear with stressful situations. However about 2-3 months the headaches had changed in characteristic and were becoming more frequent. There was no mention of a previous head injury/trauma associated with military service. See clinical records from The Emory Clinic dated February 9, 2006. The prolonged period without complaints or treatment is evidence that there has not been a continuity of symptomatology, which weighs against the claim. See Maxson, 12 Vet. App. at 459, aff'd sub nom. Maxson, 230 F.3d at 1333. The next relevant evidence is in 2011 when the Veteran suffered a series of strokes. He denied any history of headaches/migraines but stated that since his first stroke in June 2011 he has been experiencing diffuse throbbing head pain. His wife confirmed that since his first stroke he has had daily headaches. Again, the Veteran made no mention of his military service during treatment. See TKC Consultation Note dated October 21, 2011. There is also no medical opinion linking the Veteran's headaches to military service. When examined by VA in April 2021 he reported his headaches occurred in 1983 but made no mention of a previous head injury/trauma associated with military service. After examination and review of the record, the examiner concluded that the Veteran's current migraine including migraine variants headaches were less likely than not (less than 50 percent probability) related to service as there is no evidence of continued headaches during service of for years after service and service records are silent for head trauma. The examiner noted the lack of chronic headaches during service and that the Veteran himself reported the onset of headaches after his stroke in 2011, years after military separation. See Headaches (Including Migraine Headaches) and Medical Opinion DBQs. Based on the evidence in this case, the Board finds that service connection for migraine headaches is not warranted. As has been noted, service treatment records contain no complaints of headaches, other than the history of headaches associated with bronchitis. So, although the Veteran clearly experienced headaches in service, the objective evidence of record does not suggest that they were chronic or continuous, but instead completely resolved with the treatment for bronchitis. In other words, the acute nature of the symptoms is evidenced by his separation physical which was clinically normal. Furthermore, the only medical opinion of record does not link the headaches to military service. The VA examiner noted the Veteran's in-service complaints but concluded that the current headaches disorder did not result from it. The VA opinion is both probative and persuasive as it is based upon a review of the file and supported by sufficiently clear and well-reasoned medical rationale. The examiner considered the relevant medical and other history, including lay statements. Nieves-Rodriguez, 22 Vet. App. 304. The claims file contains no competent medical evidence refuting it. More importantly, the Veteran's account of head trauma during service is not supported by the record. It is certainly plausible that he may have sustained some sort of injury during parachute jumps, since his DD 214 Form shows that he was awarded the Parachute Badge. However, the objective contemporaneous medical records stand in sharp contrast to the Veteran's lay reports and are more probative as to the circumstances surrounding the onset of his migraines rather than his inconsistent history reported many years thereafter. See Curry, 7 Vet. App. 59. The Veteran's credibility is further undermined by the fact that during his 2019 hearing he testified that his headaches were related to head trauma during service. However, during post-service outpatient evaluations in 2006 he reported a 30-year history of stress headaches which would place its onset in 1976, several years prior to his active duty. Later post service records from 2011 show the Veteran gave a history of daily headaches following a stroke in 2011, thereby placing the date of onset well after his military service. Unfortunately, these contradictions diminish the probative value of the Veteran's contentions. See Macarubbo, 10 Vet. App. 388. In any event, the probative value of his belief is outweighed by that of the medical examiner who clearly does have the education, training, and experience to address the etiology of migraine headaches. See Jandreau, 492 F.3d at 1377. Accordingly, the preponderance of the evidence is against the claim, and there is no reasonable doubt to be resolved. 38 U.S.C. § 5107(b) Thomas H. O'Shay Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.R. Bryant 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.