Citation Nr: A21020569 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 211105-196222 DATE: December 27, 2021 ORDER Entitlement to service connection for coronary artery disease (CAD) is denied. Entitlement to service connection for an acquired psychiatric disorder, to include depression, is denied. Entitlement to service connection for hypertension is denied. Entitlement to service connection for left knee pain is denied. Entitlement to service connection for right knee pain is denied. Entitlement to service connection for left wrist pain is denied. Entitlement to service connection for a back disability is denied. Entitlement to service connection for a right leg limp is denied. Entitlement to service connection for a right shoulder pain disability is denied. Entitlement to service connection for a left foot disability, to include plantar fasciitis and pain, is denied. FINDINGS OF FACT 1. The Veteran's heart disability was not incurred in or due to his time in service. 2. The Veteran's psychiatric disability was not incurred in or due to his time in service. 3. The Veteran's hypertension was not incurred in or due to his time in service. 4. The Veteran's bilateral knee disability was not incurred in or due to his time in service. 5. The Veteran's left wrist pain disability was not incurred in or due to his time in service. 6. The Veteran's back pain disability was not incurred in or due to his time in service. 7. The Veteran's right leg limp disability was not incurred in or due to his time in service. 8. The Veteran's right shoulder pain disability was not incurred in or due to his time in service. 9. The Veteran's left foot pain disability, to include plantar fasciitis, was not incurred in or due to his time in service. CONCLUSIONS OF LAW 1. The criteria for service connection for a heart disability are not met. 38 U.S.C. § § 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for an acquired psychiatric disability are not met. 38 U.S.C. § § 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for hypertension are not met. 38 U.S.C. § § 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for a bilateral knee disability are not met. 38 U.S.C. § § 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 5. The criteria for service connection for a left wrist disability are not met. 38 U.S.C. § § 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 6. The criteria for service connection for a lower back pain disability are not met. 38 U.S.C. § § 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 7. The criteria for service connection for a right leg limp are not met. 38 U.S.C. § § 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 8. The criteria for service connection for a right shoulder pain disability are not met. 38 U.S.C. § § 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 9. The criteria for service connection for a left foot pain disability are not met. 38 U.S.C. § § 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from June 1960 to June 1963. These matters are on appeal from a September 2021 rating decision by a Department of Veterans Affairs (VA) regional office (RO). In the November 2021 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Generally, to prevail on a claim of service connection on the merits, there must be competent evidence of (1) a current disability, (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury, and (3) medical evidence or other competent evidence of a nexus between the claimed in-service disease or injury and the present disease or injury. See Hickson v. West, 12 Vet. App. 247 (1999); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). To establish service connection on a secondary basis, the evidence must show (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. 38 C.F.R. § 3.310(a)(b) (2016), Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). A claim for service connection for a mental disability may encompass claims for service connection of any mental disability that may reasonably be encompassed by several factors, including the veteran's description of the claim, the symptoms the veteran describes and the information the veteran submits or that the Secretary obtains in support of the claim. Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). Accordingly, the Board has taken an expansive view of the claims for service connection for depression pursuant to Clemons and re-characterized them as shown on the cover page of this decision. The Veteran has been diagnosed with a heart disability, to include CAD, a psychiatric disability, to include depression, hypertension, left wrist arthritis, and has documented pain in his back, knees, and right shoulder. (See e.g. September 2019 treatment records.) The Veteran does not have a formally diagnosed bilateral knee disability, left foot disability, or right leg limp disability. The Veteran's service treatment records (STRs) do not indicate he had any heart, psychiatric, blood pressure, knee, wrist, back, or right shoulder problems while in service. The Veteran's entrance examination did indicate he had pes planus but did not note any plantar fasciitis. Additionally, the Veteran's STRs showed he had problems with his right hand, but do not indicate any associated right wrist problems. In a recent decision, the U.S. Court of Appeals for the Federal Circuit (Court) found that pain alone can qualify as a disability for VA purposes if it amounts to a functional impairment of earning capacity. Saunders v. Wilkie, 886 F.3d 1356, 1367-68 (Fed. Cir. 2018). The Court defined functional impairment as the inability of the body or a part of it "to function under the ordinary conditions of daily life including employment" and found that the term "disability" as used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability." Id. at 1363. However, the Federal Circuit did limit its holding, stating it did not "hold that a Veteran could demonstrate service connection simply by asserting subjective pain...." Id. Accordingly, subjective pain alone will not be enough to establish a current disability, and consideration should be given to the impact, or lack thereof, from the reported pain, focusing on evidence of functional limitation. The Veteran has claimed service connection for right and left knee pain, lower back pain, and right shoulder pain. However, after a review of the Veteran's record, the objective evidence does not indicate the Veteran has been diagnosed with any formal "disability" of these body parts. The Board also finds that the facts of this appeal are distinguishable from those in Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) because nothing in the record shows that the claimed disorders result in functional impairment that affects earning capacity. Therefore, the Board does not find the Veteran's pain arises to the level of a disability in of itself. While the Veteran may have pain now and then in these joints, this does not indicate a choric "disability" for VA purposes. Even if the Board were to find the Veteran had diagnosed bilateral knee, back, and right shoulder disabilities, the Veteran's STRs do not indicate he had ongoing problems with these conditions while in service and there is no competent medical evidence of record showing these conditions were due to his time in service. The Veteran also does not have a separately diagnosed right limp disability. However, this symptom was mentioned in a May 2021 examination for the Veteran's feet, suggesting that his limp was a symptom of his ankle and foot conditions, rather than a separately diagnosed disability. Similar to the other conditions discussed above, there is no mention of ongoing right limp problems while in service and no other competent medical evidence to suggest this condition may have been due to his time in service. The Veteran had an examination for his right foot in April 2021 in which the examiner saw the Veteran in person, reviewed his file, and noted the Veteran had been diagnosed with right foot disabilities, but did not indicate the Veteran had any left foot disabilities. However, the examiner noted the Veteran had pain in his left foot, swelling on use in both feet, and extreme tenderness of plantar surfaces on both feet. The examiner also noted marked deformity on both feet. The examiner reported the Veteran had not undergone surgical or non-surgical treatment for plantar fasciitis, but did say the Veteran had functional loss in his left foot due to slow and weak movement. The Board notes that this examination was obtained in connection for another claim the Veteran had for his right foot. The examiner stated that "although abnormal findings were found for the Veteran's non-claimed extremity, they are outside the scope of the current exam request." The Veteran's STRs are negative for mention of any ongoing left foot plantar fasciitis. And there is no other competent medical evidence of record indicating a link between this condition and the Veteran's time in service. Therefore, the Board does not find it a duty to assist error that, while an examination was obtained for the Veteran's right foot condition, no examination was conducted for his left foot. Regarding all of his claimed conditions, the United States Court of Appeals for Veterans Claims (Court) has indicated that normal medical findings at the time of separation from service, as well as the absence of any medical records of a diagnosis or treatment for many years after service is probative evidence against the claim. See Mense v. Derwinski, 1 Vet. App. 354, 356 (1991) (affirming Board where it found that Veteran failed to account for the lengthy time period after service for which there was no clinical documentation of low back condition). Here, the Veteran separated from service in June 1963 and the first mention of his claimed conditions came about over 45 years after his separation from service. This evidence, while not in of itself a reason to deny service connection, tends to weigh against the Veteran's claim. The service and post-service medical records provide particularly negative evidence against these claims, indicating problems that began nearly one-half century after service (without any connection to service) or fail to indicate a disability at all. The Board notes the Veteran was not provided a separate examination and opinion as to the current nature and etiology of his claimed conditions by VA. However, VA need not conduct an examination with respect to the claim on appeal, as information and the evidence of record contains sufficient competent medical evidence to decide the claim. See 38 C.F.R. § 3.159(c)(4). Under McLendon v. Nicholson, 20 Vet. App. 76 (2006), VA must provide an examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the Veteran's service or with another service connected disability, but (4) insufficient competent medical evidence on file for VA to make a decision on the claim. Simply stated, the standards of McLendon are not met in this case as the Veteran is not shown to have suffered his condition while in service and there is no other competent medical evidence suggesting an association to service. The service records and post-service records provide evidence against this claim. Based on the above, the claims will be denied. Regarding all the above, the Board acknowledges the Veteran's disabilities cause him pain, discomfort, and stress and that he continues to seek treatment for some of his disabilities. However, while the Veteran is competent to report the symptoms of his disabilities, he is not competent to opine on matters requiring medical knowledge, such as determining the nature and etiology of his medical conditions. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Therefore, the Board provides more weight to the competent medical evidence of record and has weighed it accordingly as discussed above. While the Veteran's file contains evidence pertaining to each of his claimed condition, the evidence does not show that any of the Veteran's claimed conditions meet all requirements necessary in order for there to be a finding of service connection. Regarding any claim by the Veteran that he has had these problems since service (his contentions on this point are unclear) would have to be found to be not credible in light of the evidence. It is important for the Veteran to understand that the facts and medical findings provide highly probative evidence against these claims that the Board cannot, unfortunately, ignore, indicating problems that began well after service, outweighing the Veteran's belief that these problems are the result of service, providing a highly clear basis for the opinion. Regarding all the above, the Board has considered the applicability of the benefit of the doubt doctrine. Because the preponderance of the evidence is against the Veteran's claim, the benefit of the doubt doctrine does not apply. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 55-57(1990). John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Snoparsky 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.