Citation Nr: 21012069 Decision Date: 03/03/21 Archive Date: 03/03/21 DOCKET NO. 17-65 362 DATE: March 3, 2021 ORDER Entitlement to service connection for diabetes mellitus II (diabetes) is denied. Entitlement to service connection for a liver condition is denied. Entitlement to service connection for a kidney condition is denied. FINDINGS OF FACT 1. The Veteran’s diabetes is not related to service. 2. The Veteran has not had a liver condition diagnosis at any time during the appeal period. 3. The Veteran has not had a kidney condition diagnosis at any time during the appeal period. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for diabetes have not been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for entitlement to service connection for a liver condition have not been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for entitlement to service connection for a kidney condition have not been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served active duty service from October 1975 to October 1978. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2016 rating decision by the Department of Veteran Affairs (VA) Regional Office (RO). This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.902 (c). 38 U.S.C. § 7107 (a)(2). In the October 2020 Board remand, the RO was requested to provide VA examinations for the Veteran’s conditions. VA examinations were provided in October 2020. These examinations were adequate because the Veteran was examined, and the VA examiner provided rationales for the etiologies of his conditions. Therefore, there has been substantial compliance with the Board’s remand directives. See Stegall v. West, 11 Vet. App. 268 (1998); Dyment v. West, 13 Vet. App. 141, 146-47 (1999). Neither the Veteran nor his representative have raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first 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). A veteran is entitled to the benefit of the doubt, standard of proof for benefit claim decisions. 38 U.S.C. § 5107(b). The benefit of the doubt is applicable when there is an approximate balance of positive and negative evidence. 38 C.F.R. § 3.102. When a veteran seeks benefits and the evidence is in relative equipoise, the veteran prevails. Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). The preponderance of the evidence must be against the claim for benefits to be denied. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). As a preliminary matter, the Veteran contends that while serving in Korea, he was exposed to herbicides. A Veteran who, during active military, naval, or air service, served in or near the Korean Demilitarized Zone (DMZ), during the period beginning September 1, 1967, and ending on August 31, 1971, shall be presumed to have been exposed to herbicide agents, unless there is affirmative evidence that he was not exposed. 38 U.S.C. § 1116B. The Veteran had active service from October 1975 to October 1978 and therefore he is not presumed to have been exposed to herbicides. Additionally, he has not described the circumstances under which he believes he was exposed to herbicides. When asked about his exposure, at his hearing, he stated “[t]hat’s what I’ve been told by lots of people.” The Board finds that he was not exposed to herbicides in Korea. The Veteran also stated that he served in the Republic of Vietnam but at his hearing he stated that this was while he was serving in the Korean Army, not the United States Army. Therefore he is not presumed exposed to herbicides in the Republic of Vietnam for the purposes of entitlement to VA benefits. 1. Entitlement to service connection for diabetes is denied. The Veteran contends his diabetes is related to service. He has consistently stated his diabetes began after his in-service helicopter fall. A June 1977 service treatment record (STR) corroborates that he fell from a helicopter and was hospitalized for 12 days. In the October 2020 VA examination, the VA examiner opined that the Veteran’s diabetes was less likely as not incurred in or caused by the helicopter fall during service. The VA examiner reasoned that the claim is “medically implausible” and explained, “trauma induced chronic diabetes is a complication of massive injury, which would have been radiographically apparent… and would not have resulted in type II diabetes.” In support of this opinion, the VA examiner noted that in April 2020 the Veteran’s pancreas was “within normal limits.” The Veteran has provided the lay opinion that his diabetes is due to his in-service fall. However, determining the etiology of the Veteran’s diabetes requires medical inquiry into biological processes, pathology, and anatomical relationships. Such internal processes are not readily observable and are not within the competence of the Veteran in this case, who has not been shown to have the skills, experience, or medical training necessary to render a competent opinion. King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). Based upon review of the record, the Board finds the Veteran’s diabetes is not related to service. The October 2020 VA medical opinion is probative because it was based upon examining the Veteran and reviewing his complete medical record. Further, the VA examiner provided a sufficient rationale based upon clinical experience. Also, there is no other medical opinion nor medical record that relates the Veteran’s diabetes to service. Given that the preponderance of the evidence is unfavorable to the claim, VA’s benefit-of-the-doubt doctrine is not for application. 38 U.S.C. § 5107(b); 38 C.F.R. § 4.1. Accordingly, the Board finds the preponderance of the evidence is against the claim and service connection is denied. 2. Entitlement to service connection for a liver condition is denied. 3. Entitlement to service connection for a kidney condition is denied. The Veteran contends he has liver and kidney conditions that are related to service. Like his diabetes, he has consistently insisted that these conditions began after his in-service helicopter fall. VA and private treatment records indicate prescriptions for preventive liver damage and notes kidney failure/damage. In the October 2020 VA examination, the VA examiner determined that the Veteran does not have diagnoses for these conditions. The VA examiner reasoned that VA treatment records and comprehensive review of VA tests is not supportive of the claims for diagnosed conditions. Further, it was noted that the Veteran was unable to specify any medical diagnoses nor conditions. In addition to not having a diagnosis of a liver condition, the Veteran has not reported experiencing liver symptoms that cause functional impairment of earning capacity. He also does not have a diagnosis of a kidney condition. At his hearing, he testified that he wakes up five to six times per night to urinate. Although he is competent to report how many times he needs to urinate at night, and his statement is credible, he does not have the medical expertise or training needed to provide a competent opinion that this is a kidney problem. Additionally, he has not shown that this causes a functional impairment of earning capacity. The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110; see Degmetich v. Brown, 104 F. 3d 1328, 1332 (1997) (holding that 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). In the absence of proof of a current disability, there can be no valid claim. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Accordingly, the Board finds the preponderance of the evidence is against the claims and service connection is denied. See Alemany v. Brown, 9 Vet. App. 518, 519 (1996); 38 C.F.R. § 3.102. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Willoughby, 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.