Citation Nr: 21010192 Decision Date: 02/24/21 Archive Date: 02/24/21 DOCKET NO. 15-43 228 DATE: February 24, 2021 ORDER Entitlement to service connection for a bacterial infection, to include purified protein derivative (PPD) conversion is denied. Entitlement to service connection for a right little finger disability is denied. REMANDED Entitlement to service connection for vertigo is remanded. Entitlement to service connection for a disability manifested by short-term memory loss is remanded. FINDINGS OF FACT 1. The preponderance of the evidence does not support that the Veteran has a current disability associated with PPD conversion. 2. The preponderance of the evidence does not support that the Veteran has a current disability of the right little finger. CONCLUSIONS OF LAW 1. The criteria for service connection for a bacterial infection, to include purified protein derivative (PPD) conversion have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a right little finger disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from February 1983 to November 2011. This matter initially came before the Board of Veterans’ Appeals (Board) on appeal from a November 2013 rating decision issued by the Agency of Original Jurisdiction (AOJ). The matter was previously before the Board in September 2018. The appeal was remanded to obtain relevant treatment records from the United States Naval Hospital Yokosuka. The medical records were associated with the file in October 2019 and October 2020. Thus, the Board determines that there has been substantial compliance with the September 2018 remand directives, and further remand is not required. See Stegall v. West, 11 Vet. App. 268 (1998). Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish entitlement to service-connected compensation benefits, 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. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may be granted for any disease initially diagnosed after service 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). 1. Entitlement to service connection for a bacterial infection, to include purified protein derivative (PPD) conversion The Veteran contends that he should be service connected for increased risk of contracting tuberculosis due to PPD conversion. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Veteran’s service treatment records indicate that he has had positive tuberculin skin tests since 1998. However, the Veteran’s subsequent treatment records do not contain complaints or a diagnosis of tuberculosis. The Board concludes that the Veteran does not have a current disability associated with PPD conversion and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Board is sympathetic to the Veteran’s concerns about future tuberculosis infection. While a “disability” for the purposes of awarding VA disability benefits is not only a disease or an injury, but also any “other physical or mental defect”, here the evidence does not reflect any diagnosis or treatment for tuberculosis. Entitlement to service connection is not warranted. Palczewski v. Nicholson, 21 Vet. App. 174, 181 (2007) (“Without a current disability, of course, there can be no service connection and, thus, no disability compensation”). This does not preclude the Veteran from establishing service-connection for any future disability that could arise as a result of PPD conversion, to include tuberculosis. Lacking a current diagnosis, service connection for a bacterial infection, to include PPD conversion cannot be established, and the claim must be denied. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (a current disability is the cornerstone of a service connection claim). 2. Entitlement to service connection for a right little finger disability The Veteran contends that he has a disability of the right little finger which he claims is related to a door slamming on the finger in service. The Veteran was afforded a general examination in April 2013. The examiner found the Veteran did not have any current deformities of the right little finger. The Board acknowledges the recent Federal Circuit decision in Saunders v. Wilkie in which the Court found that where pain causes functional impairment, a disability for VA compensation purposes exists, even if there is no underlying diagnosis. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). Therefore, the Board has considered whether a current disability may be established on this basis. However, the record does not contain any reports by the Veteran of pain or functional loss, and no such complaints were noted in the examination report. Therefore, no disability exists relating to the Veteran’s right little finger for which VA compensation can be awarded. In the absence of a current disability, the Veteran does not meet the cornerstone element of service connection. Brammer v. Derwinski, supra. As such, an assessment of the remaining elements is not necessary, and service connection for a right little finger condition is denied. REASONS FOR REMAND Vertigo and short-term memory loss are remanded. The Veteran reported that he suffers from persistent or recurrent symptoms of dizziness and memory loss. He also stated that his symptoms began during service. The Veteran is competent to describe his symptoms and the events that occurred during service. See Layno v. Brown, 6 Vet. App. 465 (1994). The Veteran was last afforded a general medical examination in April 2013. The examiner found no pathology to diagnose disorders associated with dizziness or memory loss. However, the has Veteran continued to report worsening symptoms over the past six years. Therefore, the Board finds a new VA examination is required to determine if the Veteran has a current diagnosis. As the Board lacks sufficient medical evidence to render a decision on the question of nexus, a VA examination is warranted. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. Contact the Veteran and request that he identify the names, addresses, and approximate dates of treatment for all VA and non-VA health care providers who have treated him for his dizziness and memory loss. The Veteran should be requested to sign any necessary authorization for release of medical records to VA, and appropriate steps should be made to obtain any identified records. 2. After completion of the above requested development, schedule the Veteran for VA examinations by appropriate clinicians to determine the nature and etiology of a disability manifested by dizziness and a disability manifested by memory loss. The record must be made available to and reviewed by each examiner. DIZZINESS: The examiner should identify all disabilities of record manifested by dizziness, to include vertigo and any vestibular disabilities. For each condition identified, the examiner must opine whether it is at least as likely as not (fifty percent or greater probability) that the identified disability is related to an in-service injury, event, or disease. The examiner must consider the Veteran’s statements regarding dizziness in service, specifically his report of passing out on the flight deck of his ship. The examiner should also provide an opinion as to whether the Veteran has disability manifested by dizziness that is proximately caused or aggravated by his service-connected migraine headaches. MEMORY LOSS: The examiner should identify any disability manifested by memory loss. For each disability identified the examiner should provide an opinion as to whether it is at least as likely as not (fifty percent or greater probability) that the identified disability is related to the Veteran’s active service. The examiner should also provide an opinion as to whether the Veteran has a memory loss disability that is a symptom of or related to the Veteran’s service-connected migraine headaches. 3. After the above development is completed, re-adjudicate the claims on appeal. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Sherman 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.