Citation Nr: 21013091 Decision Date: 03/08/21 Archive Date: 03/08/21 DOCKET NO. 19-07 047 DATE: March 8, 2021 ORDER Entitlement to service connection for Parkinsonism is denied. REMANDED The issue of entitlement to a compensable rating for bilateral hearing loss is remanded. FINDING OF FACT The preponderance of the evidence is against finding that Parkinsonism began during active service or is otherwise related to an in-service event, injury or disease. CONCLUSION OF LAW The criteria for service connection for Parkinsonism have not been satisfied. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1954 to October 1957. These matters come before the Board of Veterans’ Appeals (Board) on appeal from rating decisions issued by a Department of Veterans’ Affairs (VA) Regional Office (RO). In January 2021, a hearing was held before the undersigned Veterans Law Judge. Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an 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. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran has current Parkinsonism. See January 2021 Private Treatment Letter. Thus, the remaining question is whether the current Parkinsonism is related to service. Service treatment records show no complaints, diagnosis, or treatment related to Parkinsonism. As the Veteran reported other ailments during service, and symptoms of Parkinsonism, such as tremors of hands, arms, legs, jaw and face or stiffness of extremities, are the type that a reasonable person would report while in the military with access to medical care, the Board would expect the Veteran to have reported this symptoms during service if present at that time. During the September 1957 separation examination, evaluation of the upper and lower extremities, to include feet, were normal, as was neurological evaluation. In a corresponding report of medical history, the Veteran specifically denied having had arm, leg or foot trouble and noted his health was excellent. If stiffness or tremors in the Veteran’s extremities were present during service, the Board would expect the Veteran would have responded “yes” when asked if he had any trouble with his extremities or neuritis at separation because a reasonable person would have interpreted the question to include symptoms of foot, arm, or nerve problems. Moreover, the Veteran responded affirmatively when asked whether he had other conditions at separation and the Board would thus expect the Veteran to have also responded affirmatively to having problems with his extremities, to include nerve issues. Parkinsonism is not shown by medical evidence until approximately June 2018, more than 60 years after the Veteran’s separation from service. See July 2018 VA Examination. The Board notes the statement made by the Veteran’s daughter during the hearing that the Veteran was very active until 3 years ago. See January 2021 Hearing Transcript. The daughter stated the Veteran lived a healthy lifestyle and walked for exercise and was very active socially. See also March 2020 Private Treatment Letter (noting that the Veteran’s health has declined over the past year). These statements are consistent with the lack of treatment records for Parkinsonism pre-September 2018. A medical opinion was submitted on the Veteran’s behalf by his private doctor, who has been treating the Veteran since September 2018. See January 2021 Private Treatment Letter. In the letter, Dr. D.I. opined that the Veteran’s imbalance is predominantly caused by Parkinson’s disease, but offered that peripheral nerve damage could contribute to imbalance. He noted it was certainly possible that exposure to cold temperature during service could cause peripheral nerve damage. Doctor D.I.’s letter does not speak to the etiology of Parkinsonism and rather focuses on nerve damage caused by cold weather being a possible contributing factor to imbalance. The Board notes that the Veteran had previously applied for cold injury residuals to his extremities and was denied service connection. That issue is not before the Board. Overall, service connection must be denied as the evidence does not show that the Veteran’s Parkinsonism, diagnosed decades after service, is in any way related to an in-service event, injury, or disease. The Board recognizes the Veteran has suggested that his Parkinsonism may be related to exposure to radar or radio frequencies; however, no competent evidence has been submitted which suggests such a connection in this case. Moreover, Parkinsonism is not a condition which VA recognizes as related to radiation and the Veteran is not shown to have participated in a radiation-risk activity. See 38 C.F.R. §§ 3.309(d), 3.311. While Dr. D.I. discusses the Veteran’s exposure to cold weather, he does not suggest that such exposure is in any way related to the Veteran’s Parkinsonism, as opposed to peripheral nerve damage. No other competent evidence makes this connection either. As there is no competent evidence suggesting a relationship between the Veteran’s service and his Parkinsonism, no medical opinion is necessary and service connection must be denied. 38 C.F.R. §§ 3.303, 3.159(c)(4)(i); see also McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). The Board has considered the Veteran’s statements, to include his assertions that the cold weather he experienced while stationed in Japan led to the onset of his current Parkinsonism. See January 2021 Hearing Transcript. As the Veteran is not shown to have medical education or experience, he is a lay person and is competent to report (1) symptoms that are observable to a layperson, e.g., tremors or stiffness; (2) symptoms at the time supporting a later diagnosis by a medical professional; or (3) a contemporaneous medical diagnosis. See Davidson v. Shinseki, 581 F.3d 1313 (2009). The Veteran is not competent to independently render a medical diagnosis or opine as to the specific etiology of a condition as these are medically complex issues. Thus, his lay assertions do not constitute evidence upon which service connection can be granted. Again, no competent evidence has been submitted suggesting a link between any event, injury, or disease during service and the current Parkinsonism. For the above reasons, the preponderance of the evidence is against the claim and service connection is denied. REASONS FOR REMAND During his January 2021 hearing, the Veteran indicated his hearing had worsened since his last examination. Given the suggestion that the Veteran’s disability picture has changed since his 2017 VA examination, a new VA examination is warranted. This matter is REMANDED for the following action: Schedule the Veteran for a VA audiological examination to determine the current symptoms, level of severity, and functional impairment associated with his bilateral hearing loss. The claims file should be reviewed by the examiner. Nathan Kroes Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Jarman, 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.