Citation Nr: 21007172 Decision Date: 02/08/21 Archive Date: 02/08/21 DOCKET NO. 14-34 785 DATE: February 8, 2021 ORDER Entitlement to service connection for a heart disability, to include myocardial infarction is denied. Entitlement to service connection for an acquired psychiatric disability, claimed as depression and nervous disorder is denied. Entitlement to service connection for a disability manifested by blackout spells is denied. FINDINGS OF FACT 1. The preponderance of the competent medical evidence is against finding that the Veteran’s heart disability was caused by service, to include exposure to hazardous chemical agents through Project Shipboard Hazard and Defense (SHAD). 2. The preponderance of the evidence of record is against finding that the Veteran has or has had at any time during or approximate to the pendency of the claim a current diagnosis of a psychiatric disability. 3. The most probative evidence is against finding that the Veteran has a disability manifested by blackout spells. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a heart disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. 2. The criteria for entitlement to service connection for an acquired psychiatric disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. 3. The criteria for entitlement to service connection for a disability manifested by blackout spells have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1966 to July 1968. This matter comes before the Board of Veterans’ Appeals (Board) from an August 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In December 2015, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record. In June 2018, the Board remanded this matter for further development. That development having been completed, this matter has returned to the Board for further appellate review. Service Connection 1. Entitlement to service connection for a heart disability The Veteran seeks service connection for a heart disability, which he asserts is related to service. Specifically, the Veteran asserts that his heart disability was caused by his in-service participation in chemical testing, known as Project SHAD. As an initial matter, the Veteran has been diagnosed with a heart disability, to include coronary artery disease, cardiomyopathy, and congestive heart failure, as shown on a December 2019 VA examination report. Thus, the question becomes whether his heart condition was incurred in or caused by active service. After reviewing the record, the Board finds that the preponderance of the evidence is against the claim for service connection for a heart disability. In February 2014, a VA examiner opined that the Veteran had no chronic residuals related to his in-service participation in Project SHAD. In January 2016, the Veteran’s private physician opined that it is more probable than not that some or possibly all of the Veteran’s ailments could have been a direct result of his participation in Project SHAD. The Board notes that neither of these opinions included an adequate supporting rationale. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (“[A] medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions.”). Moreover, the positive opinion was speculative. See Bloom v. West, 12 Vet. App. 185, 187 (1999) (noting that the use of the term “could,” without other rationale or supporting data, is speculative). In accordance with the June 2018 Board remand, the Veteran underwent a VA heart conditions examination in December 2019. The examiner opined that the Veteran’s claimed heart disability was less likely than not caused by his in-service participation in Project SHAD. The examiner noted that the Veteran had a myocardial infarction in 1993 and was diagnosed with coronary atherosclerosis in 1994. As such, the examiner concluded that because the Veteran has several risk factors, including significant family history, high cholesterol, and smoking, which contributed to his initial diagnosis, the progression of his heart disease is less likely due to the effects of Project SHAD and is caused by the damage of cholesterol and atherosclerosis. While the Veteran believes his heart disability is related to service and his participation in Project SHAD, he has not been shown to have the specialized training sufficient to render such an opinion, as the diagnosis and etiology of heart disabilities are matters not capable of lay observation and require medical testing and expertise to determine. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). Thus, the opinion of the Veteran’s regarding the etiology of his current heart disability is not competent medical evidence. The Board finds the December 2019 VA examiner’s opinion more probative than the lay assertions. In sum, the preponderance of competent and probative evidence is against finding that the Veteran’s heart disability is related to service, and the claim 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 Veteran’s claim, the doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1990). 2. Entitlement to service connection for an acquired psychiatric disability, claimed as depression and nervous disorder Upon review of the record, the Board finds that the most probative evidence does not demonstrate the Veteran has a currently diagnosed psychiatric disability and has not had one at any time during the pendency of the claim or recent to the filing to the claim. In this regard, a February 2014 VA general medical examination does not reference any psychiatric disability or diagnosis. The Veteran’s VA treatment records do not document any complaints or diagnosis of a psychiatric disability during the course of the claim. Moreover, an April 2017 treatment record reveals the Veteran denied depression and PTSD and depression screens were found to be negative. While the Veteran believes he has a current diagnosis of psychiatric disability, as a lay person, he has not been shown to have the requisite medical knowledge and expertise sufficient to render such an opinion. See Jandreau, 492 F.3d at 1377 (noting general competence to testify as to symptoms but not to provide medical diagnosis). In this regard, the diagnosis of psychiatric disorders is a matter not capable of lay observation and requires medical expertise to determine. Accordingly, the opinion of the Veteran regarding the presence of a psychiatric disorder is not competent medical evidence. Thus, the competent and probative evidence of record indicates the Veteran does not have a current diagnosis of a psychiatric disability. See Martinez-Bodon v. Wilkie, 32 Vet. App. 393 (2020) (a diagnosis pursuant to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) is required to establish a current psychiatric disability). In reaching the above conclusion, the Board considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the claim, the doctrine is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert, 1 Vet. App. at 55-56. 3. Entitlement to service connection for a disability manifested by blackout spells The Veteran seeks service connection for a disability manifested by blackout spells. During his December 2015 Board hearing, the Veteran testified that he began having blackout spells during service, after his in-service participation in Project SHAD. Upon review of record, the Board finds that the most probative evidence does not demonstrate the Veteran has a currently diagnosed disability manifested by blackout spells during the course of the appeal. Throughout the period on appeal, VA and private treatment records do not reveal treatment for or a diagnosis of a disability manifested by blackout spells. Additionally, the Veteran denied syncope in private treatment records dated July 2007, October 2015, June 2016, and March 2017. See DORLAND'S ILLUSTRATED MEDICAL DICTIONARY 1818 (32nd ed. 2012) (defining "syncope" as "a temporary suspension of consciousness due to generalized cerebral ischemia). Moreover, a February 2014 VA general medical examination does not reference complaints, findings or diagnosis of a disability manifested by blackout spells. The Board notes that Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability. In the absence of proof of a present disability there can be no valid claim. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Moreover, there is no evidence showing any impairment in earning capacity by any claimed blackout spells. See Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). Accordingly, without evidence of a current diagnosed disability manifested by blackout spells or evidence of symptoms that result in functional impairment of earning capacity, service connection is not warranted, and the claim must be denied. To the extent Veteran believes he suffers from a disability manifested by blackout spells that is related to service, he has not been shown to have the requisite medical knowledge and expertise sufficient to render such an opinion. See Jandreau, 492 F.3d at 1377 (noting general competence to testify as to symptoms but not to provide medical diagnosis). In this regard, the diagnosis and etiology of a disability manifested by blackout spells are matters not capable of lay observation and require medical expertise to determine. In sum, the preponderance of the evidence is against the claim, and service connection is denied. In reaching the above conclusion, the Board considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the claim, the doctrine is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert, 1 Vet. App. at 55-56. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Lance, Associate Counsel 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.