Citation Nr: 21013988 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 19-34 900 DATE: March 11, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. Entitlement to service connection for diabetes mellitus is denied. Entitlement to service connection for erectile dysfunction (ED) is denied. Entitlement to service connection for heart disease is denied. Entitlement to service connection for right upper extremity peripheral neuropathy is denied. Entitlement to service connection for left upper extremity peripheral neuropathy is denied. Entitlement to service connection for right lower extremity peripheral neuropathy is denied. Entitlement to service connection for left lower extremity peripheral neuropathy is denied. FINDINGS OF FACT 1. Bilateral hearing loss had its’ onset in service. 2. The preponderance of the evidence shows that the Veteran did not have service in the Republic of Vietnam, in the demilitarized zone (DMZ) in Korea, at the Pranburi Military Reservation associated with the Replacement Training Center in Thailand, or near the base perimeter for significant periods of time while in Thailand as well as shows that he did not have actual tactical herbicide exposure while on active duty. 3. The preponderance of the evidence shows that diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy were not present in service or until many years thereafter, are not caused by an injury while serving with a Reserve Component, they are not related to service or to an incident of service origin, and they were not caused or aggravated by a service-connected disability. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 101, 106, 1101, 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.6, 3.102, 3.303, 3.304, 3.307, 3.309, 3.385. 2. The criteria for service connection for diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy have not been met. 38 U.S.C. §§ 101, 106, 1101, 1110, 1112, 1113, 1116, 1131, 5107; 38 C.F.R. §§ 3.6, 3.102, 3.303, 3.304, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty with the United States Army from October 1965 to December 1971, from February 1973 to February 1974, and from June 1977 to August 1977. The Veteran also had service with a Reserve Component. In January 2021, the Veteran testified at a hearing before a Veterans’ Law Judge that has since retired. A copy of the hearing transcript has been associated with the claims file. Initially, the Board of Veterans’ Appeal (Board) notes that it has characterized all the issues on appear as initial claim for service connection as opposed to applications to reopen because the record shows that the Veteran timely perfected his appeal as to the December 2009 and February 2015 rating decisions that first adjudicated these claims. See 38 C.F.R. §§ 20.200, 20.302(c) (an appeal requires a notice of disagreement and a timely filed substantive appeal after issuance of a statement of the case). Consequently, this issue is not before the Board. Id. Next, record reveals that additional evidence was received from the Veteran since the issuance of the October 2019 statement of the case. However, because the Veteran sent in this evidence, agency of original jurisdiction review of it is considered waived. See 38 U.S.C. § 7105(e). The Service Connection Claims Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Additionally, service connection may be granted for disability resulting from disease or injury incurred or aggravated while performing active duty for training (ACDUTRA) or from injury incurred or aggravated while performing inactive duty training (INACDUTRA). 38 U.S.C. §§ 101(24), 106, 1131. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection if the disability is one that is listed in 38 C.F.R. § 3.309. 38 C.F.R. § 3.303(b); see also Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). In addition, service connection may also be granted on the basis of a post-service initial diagnosis of a disease, where the physician relates the current condition to the period of service. 38 C.F.R. § 3.303(d). In addition, service connection may also be granted on the basis of a post-service initial diagnosis of a disease, where the physician relates the current condition to the period of service. 38 C.F.R. § 3.303(d). Other specifically enumerated disorders, including sensor neural hearing loss, will be presumed to have been incurred in service if they manifested to a compensable degree within the first year following separation from active duty. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. However, presumptive periods do not apply to ACDUTRA or INACDUTRA. See Biggins v. Derwinski, 1 Vet. App. 474, 477-78 (1991). Active military, naval, or air service includes any period of ACDUTRA during which the individual concerned was disabled or died from a disease or injury incurred in or aggravated in line of duty, or any period of INACDUTRA during which the individual concerned was disabled or died from injury incurred in or aggravated in line of duty. 38 U.S.C. §§ 101(21) and (24); 38 C.F.R. §§ 3.6(a) and (d). ACDUTRA is, inter alia, full-time duty performed by member of the National Guard of any State. 38 C.F.R. § 3.6(c)(3). In this regard, in order to establish service connection for the claimed disorders, there must be (1) medical evidence of 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 of a nexus between the claimed in-service disease or injury and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999). Service connection for impaired hearing is subject to 38 C.F.R. § 3.385, which provides that impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. The requirements for service connection for hearing loss as defined in 38 C.F.R. § 3.385 need not be shown by the results of audiometric testing during a claimant’s period of active military service in order for service connection to be granted. 38 C.F.R. § 3.385 does not prevent a claimant from establishing service connection on the basis of post-service evidence of hearing loss related to service when there were no audiometric scores reported at separation from service. Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). The regulation does not necessarily preclude service connection for hearing loss that first met the regulation’s requirements after service. Hensley v. Brown, 5 Vet. App. 155, 159 (1993). Thus, a claimant who seeks to establish service connection for a current hearing disability must show, as is required in a claim for service connection for any disability, that a current disability is the result of an injury or disease incurred in service, the determination of which depends on a review of all the evidence of record including that pertinent to service. 38 U.S.C. § 1131; 38 C.F.R. §§ 3.303 and 3.304; Hensley, 5 Vet. App. at 159-60. The Court in Hensley also held that “audiometric testing measures threshold hearing levels (in decibels (dB)) over a range of frequencies (in Hertz (Hz)); the threshold for normal hearing is from 0 to 20 dB, and higher threshold levels indicate some degree of hearing loss.” Hensley, 5 Vet. App. at 157. As to herbicide exposure, VA laws and regulations provide that a Veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the Vietnam war (i.e., January 9, 1962, to May 7, 1975), shall be presumed to have been exposed to an herbicide agent, unless there is affirmative evidence to the contrary. 38 U.S.C. § 1116(a)(3); 38 C.F.R. § 3.307(a)(6)(iii). The last date on which such a Veteran shall be presumed to have been exposed to an herbicide agent shall be the last date on which he served in the Republic of Vietnam during the Vietnam war period. 38 C.F.R. § 3.307. For these Vietnam Veterans, diseases associated with exposure to certain herbicide agents will be presumed to have been incurred in service even though there is no evidence of that disease during the period of service at issue. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307, 3.309. Effective February 24, 2011, VA amended its adjudication regulations to extend a presumption of herbicide exposure to certain Veterans who served in Korea. Specifically, a veteran who, during active military, naval, or air service, served between April 1, 1968, and August 31, 1971, in a unit that, as determined by the Department of Defense (DoD), operated in or near the Korean demilitarized zone (DMZ) in an area in which herbicides are known to have been applied during that period, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the Veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307(a)(6)(iv). As to herbicide exposure due to military service in Thailand, VA has determined that special consideration of herbicide exposure on a factual basis should be extended to veterans whose duties placed them on or near the perimeters of certain Thailand military bases where herbicide may have been sprayed. In this regard, VA in a Memorandum entitled Herbicide Use in Thailand During the Vietnam Era, reported as follows: The DoD list indicates only that limited testing of tactical herbicides was conducted in Thailand from 2 April through 8 September 1964. Specifically, the location identified was the Pranburi Military Reservation associated with the Replacement Training Center of the Royal Thai Army, near Pranburi, Thailand. The Report of these tests noted that 5 civilian and 5 military personnel from Fort Detrick, Maryland conducted the spray operations and subsequent research. This location was not near any U. S. military installation or Royal Thai Air Force Base... Tactical herbicides such as Agent Orange were used and stored in Vietnam, not Thailand... There are records indicating that commercial herbicides were frequently used for vegetation control within the perimeters of air bases during the Vietnam era.... While the Thailand CHECO Report does not report the use of tactical herbicides on allied bases in Thailand, it does indicate sporadic use of non tactical (commercial) herbicides within fenced perimeters. Therefore, if a veteran’s MOS (military occupational specialty) or unit is one that regularly had contact with the base perimeter there was a greater likelihood of exposure to commercial pesticides including herbicides. Security police units were known to have walked the perimeters, especially dog handlers. However, as noted above there are no records to show that the same tactical herbicides used in Vietnam were used in Thailand... If the veteran s claim is based on servicing or working on aircraft that flew bombing missions over Vietnam, please be advised that there is no presumption of ‘secondary’ exposure based on being near or working on aircraft that flew over Vietnam or handling equipment once used in Vietnam. Aerial spraying of tactical herbicides in Vietnam did not occur everywhere and it is inaccurate to think that herbicides covered every aircraft and piece of equipment associated with Vietnam. Additionally the high altitude jet aircraft stationed in Thailand generally flew far above the low and slow flying UC 123 aircraft that sprayed tactical herbicides over Vietnam during Operation RANCH HAND. Also there are no studies that we are aware of showing harmful health effects for any such secondary or remote herbicide contact that may have occurred... If the veteran’s claim is based on general herbicide use within the base, such as small scale brush or weed clearing activity along the flight line or around living quarters, there are no records of such activity involving tactical herbicides only the commercial herbicides... Based on the manual and supporting material it is generally presumed that herbicide was hand sprayed around the perimeter of identified bases in Thailand during certain periods of the Vietnam War era. See 38 C.F.R. § 19.5. VA has not extended the same special consideration to all service members who had contact with a Thai base perimeter. Those with periodic or occasional contact with the perimeter, such as the Veteran, but whose duty stations were not located there, are not entitled to special consideration. Therefore, the evidence must show that the Veteran’s duties placed him on or near the base perimeter for a significant period of time. The list of diseases associated with exposure to certain herbicide agents is as follows: parkinsonism, bladder cancer, hypothyroidism, AL amyloidosis, chloracne or other acneform disease consistent with chloracne, type 2 diabetes (also known as Type II diabetes mellitus or adult-onset diabetes), Hodgkin’s disease, ischemic heart disease (including, but not limited to, acute, subacute, and old myocardial infarction; atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass surgery; and stable, unstable and Prinzmetal’s angina), all chronic B–cell leukemias (including, but not limited to, hairy-cell leukemia and chronic lymphocytic leukemia), multiple myeloma, non–Hodgkin’s lymphoma, Parkinson’s disease, early-onset peripheral neuropathy, porphyria cutanea tarda, prostate cancer, respiratory cancers (cancer of the lung, bronchus, larynx, or trachea), and soft-tissue sarcoma (other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma). 38 C.F.R. § 3.309(e). For purposes of applying the herbicide presumption, “service in Vietnam” includes service in the waters offshore or service in other locations if the conditions of service involved duty or visitation to Vietnam from January 9, 1962, to May 7, 1975. 38 U.S.C. § 1116(a)(3); 38 C.F.R. §§ 3.307(a)(6)(iii); 3.313(a). The availability of presumptive service connection for a disability based on exposure to herbicides does not preclude a Veteran from establishing service connection with proof of direct causation. Stefl v. Nicholson, 21 Vet. App. 120 (2007); see also Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). The requirement of a current disability is “satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim.” See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). In evaluating the evidence, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. Owens v. Brown, 7 Vet. App. 429, 433 (1995). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Bilateral hearing loss The Veteran claims, in substance, that his current bilateral hearing loss, is due to his military service. Specifically, the Veteran claims that it, like his already service-connected tinnitus, is due to his exposure to small arms fire, tank cannon fire, and barking guard dogs while on active duty. Initially, the Board finds that the Veteran has a diagnosis of bilateral hearing loss as defined by VA. See, e.g., VA examination dated in October 2014. Next, the Veteran’s DD 214’s and service personnel records shows he served as a Tank Commander from February 1973 to February 1974 and an Armour Crewmember from June 1977 to August 1977. They also show that his badges include the Sharpshooter and Expert Qualification badges for the M-14 rifle. Additionally, the Board finds the Veteran both competently and credibly reported being exposed to small arms and tank cannon fire while serving as a Tank Commander and later as an Armour Crewmember in the United States Army. See Davidson, supra. Clearly, the Veteran was exposed to very loud noised during service. Moreover, the Veteran’s service treatment records document ear pain diagnosed as otitis media in February 1969 and contain September 1966, June 1970, and March 1977 audiological examinations in which he had elevated auditory thresholds. Additionally, based on substantially the same evidence, the regional office (RO) granted the Veteran service connection for tinnitus in the February 2015 rating decision. Given this record and granting the Veteran the benefit of any doubt in this matter, the Board concludes that he had an injury (i.e., acoustic trauma) while on active duty. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert, supra. Further, given the nature of the Veteran’s service it is reasonable for the Board to find that he had problems difficulty hearing during and since being exposed to tank cannon and small arms fire while on active duty. See Davidson, supra; Owens, supra. However, the October 2014 VA examiner opined that the Veteran’s hearing loss was not due to his military service. In this regard, because symptoms of hearing loss in and since service are observable by a lay person, because the examiners did not appear to filly consider the Veteran’s competent and credible lay claims regarding in-service acoustic trauma due to his exposed to small arms and tank cannon fire while serving as a Tank Commander and later as an Armour Crewmember in the United States Army as well as the fact that VA granted the appellant service connection for tinnitus because of the same acoustic trauma, the Board finds that the Veteran’s claim of having observable symptoms of hearing loss in and since service is just as probative as the VA examiner’s opinion. See Davidson, supra; Owens, supra. Therefore, the Board finds that the evidence, both positive and negative, as to whether the Veteran had problems with bilateral hearing loss since service is at least in equipoise. Under such circumstances and granting the Veteran the benefit of any doubt in this matter, the Board concludes that he did. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert, supra. Accordingly, the Board finds that service connection for bilateral hearing loss is warranted. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy The Veteran claims, in substance, that his current diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy are due to his military service to include his exposure to herbicides while serving in Thailand. Specifically, the Veteran in writings to VA and/or at his January 2021 personal hearing stated that he was exposed to herbicides: living in barracks with only screens for windows for the two years he served in Thailand; serving as a guard on the base perimeters at bases in Korat and Udon Thailand; handling locally grown produce; and/or because the guard dogs he helped out with while at Korat, Thailand were exposed to herbicides on the base perimeter. See, e.g., statements in support of claim dated in October 2009, May 2010, March 2014, July 2014, and August 2015; notice of disagreement dated in January 2016; and VA Form 9 dated in November 2019. As to the erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy, he also claims they are due to his diabetes mellitus. Initially, the Board notes that the record shows the Veteran being diagnosed with diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy. See, e.g., Kaiser treatment records dated in February 2007 and July 2020; VA treatment records dated in September 2009 and July 2010. Moreover, the Veteran’s service personnel records confirm that he served in Thailand from July 1967 to July 1969 with an occupational specialty of Food Inspector. Next, the Boards finds that the Veteran is competent to report on the events he experiences while on active duty as well as manifestations of his disabilities. See Davidson, supra. a. 38 C.F.R. § 3.309(a) As to service connection for diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy based on the presumptions found at 38 C.F.R. § 3.309(a), the Veteran does not claim and the record does not show that any of his disabilities manifest to a degree of 10 percent or more in the first year following his separation from service. Therefore, the Board finds that these presumptions do not apply to the current appeal. b. 38 C.F.R. § 3.309(e) As to service connection for diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy based on the presumptions found at 38 C.F.R. § 3.309(e), the Veteran does not claim and the record does not show that he served in the Republic of Vietnam during the Vietnam War or had service in the DMZ in Korea. Therefore, the Board finds that these presumptions also do not apply to the current appeal. c. 38 C.F.R. § 3.303 As to establishing service connection for diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy based on proof of direct causation under 38 C.F.R. § 3.303 (see Stefl, supra), the Board will first address the Veteran claims he was exposure to Agent Orange while on active duty in Thailand (i.e., proof of actual herbicide exposure). Specifically, as noted above, the Veteran in writings to VA and/or his personal hearing stated that he was exposed to herbicides by living in barracks with only screens for windows for the two years he served in Thailand as well as serving as a guard on the base perimeters at Korat and Udon Thailand, handling locally grown produce, and while stationed in Korat helping out with his units’ guard dogs who had been exposed to herbicides in the base perimeter. Initially, the Board notes that the Veteran does not claim, and the record does not show, that he served at the Pranburi Military Reservation associated with the Replacement Training Center in Thailand. Next, for the purpose of this decision, the Board will concede that the Veteran sometimes had guard duty while serving in Thailand, helped out with the guard dogs while at Korat, Thailand, and as a Food Inspector handled local produce while in Thailand. However, the Board notes that the Veteran’s statements to VA alone are not enough to establish his herbicide exposure. Moreover, the Board finds that none of the above conceded temporary duties for a Food Inspector would place his duty station primary in the base perimeter. Therefore, the Board finds that the Veteran had no more than periodic or occasional contact with the base perimeter while serving in Korat and Udon Thailand and is not entitled to special consideration. See 38 C.F.R. § 19.5. Tellingly, the Board is bound by service department findings and in this appeal, there is no service department findings that this appellant had actual herbicide exposure due to his duties while stationed in Thailand. See 38 C.F.R. § 3.203(a); Spencer v. West, 13 Vet. App. 376, 380 (2000) (VA is bound by service department findings); Duro v. Derwinski, 2 Vet. App. 530, 532 (1992) (“service department findings are binding on VA for purposes of establishing service in the U.S. Armed Forces”). Accordingly, the Board finds that the preponderance of the evidence is against the Veteran’s claims that he had actual exposure to tactical herbicide agents while on active duty in Thailand. See Owens, supra. Next, the Board notes that the Veteran’s service and Reserve Component treatment records, including the September 1966, June 1970, and March 1977 examinations, are negative for injuries, complaints, treatment for symptoms, and/or a diagnosis of diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy. In fact, at the September 1966, June 1970, and March 1977 examinations the Veteran denied a history of dizziness, heart trouble, sugar or albumin in urine, neuritis, and paralysis. Moreover, when examined in September 1966, June 1970, and March 1977 it was opined that his upper and lower extremities as well as his neurological examination were normal with negative sugar and Albumin. This medical opinion is not contradicted by any other medical evidence of record. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991) (VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions). Similarly, Reserve Component medical records are negative for injuries, complaints, treatment for symptoms, and/or a diagnosis of diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy. Accordingly, the Board finds that the most probative evidence of record shows that the Veteran did not develop diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy due to a disease or injury while on active duty or due to an injury while serving with a Reserve Component. 38 U.S.C. §§ 101, 106, 1110, 1131; 38 C.F.R. § 3.303(a); Colvin, supra. In this regard, the Board must note that as the September 1966, June 1970, and March 1977 examinations shows that even the Veteran did not think he had diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy when on active duty. See Owens, supra. Next, the Board will consider whether the Veteran is entitled to service connection for diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy due to continuity of symptomatology under 38 U.S.C. §§ 101, 106, 1110, 1131; 38 C.F.R. § 3.303(b). In this regard, and as noted above, at the September 1966, June 1970, and March 1977 examinations, the Veteran denied having a history of dizziness, heart trouble, sugar or albumin in urine, neuritis, and paralysis and the examiner opined his upper and lower extremities as well as his neurological examination were normal with negative sugar and Albumin. See Colvin, supra. Likewise, and more important than the above, the Board notes that the Veteran has never claimed and the record does not show that diabetes mellitus, erectile dysfunction, heart disease, and right and left upper and lower extremity peripheral neuropathy started while on active duty and continued since service. In fact, as to diabetes mellitus, erectile dysfunction, and heart disease, the Veteran testified that he was first diagnosed with these disorders in 1990, almost 20 years after his 1971 separation from his first period of active duty and at least 13 years after his last period of Reserve Component service in 1977. In this regard, it is important for the Veteran to understand that at this point, it is the Veteran himself that is providing evidence against his own claims. Moreover, while the Veteran testified that he was first diagnosed with diabetes mellitus, erectile dysfunction, heart disease, and/or right and left upper and lower extremity peripheral neuropathy in 1990, the Board notes that the post-service record is negative for complaints, diagnoses, or treatment for any of the claimed disorders until 2007; 36 years after his 1971 separation from his first period of active duty and 30 years after his last period of Reserve Component service in 1977. At this point, the Board finds that the service medical records, Reserve Component examinations, and the post-active duty medical records provide the most probative evidence of record and it is against finding continuity of symptomatology. Id. Therefore, the Board finds that the most probative evidence of record shows that the Veteran did not have a continued problem with diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy in and since his December 1971 separation from his first period of active duty nor since his last period of service with a Reserve Component decades ago even if the Veteran made claims to the contrary. See 38 U.S.C. § 101, 106, 1110, 1131; 38 C.F.R. § 3.303(b). Furthermore, the Board notes that the record does not shows that the Veteran’s diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy are not due to his military service. See 38 U.S.C. §§ 101, 106, 1110; 38 C.F.R. § 3.303(d); also see Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992) (establishing service connection requires finding a relationship between a current disability and events in service or an injury or disease incurred therein). In this regard, the Board notes that the Veteran was not provided a VA examination in connection with these claims. However, the Board finds that the criteria to provide the Veteran with a VA examination to obtain etiology opinions have not been met because the record does not document his complaints, diagnoses, or treatment for these disorders during service or for decades after service. See Duenas v. Principi, 18 Vet. App. 512, 519 (2004) (VA is not obligated to provide an examination for a medical nexus opinion where, as here, the supporting evidence of record consists only of a lay statement). The Board also finds that the Veteran is not competent to provide the missing nexus opinions because he does not have the required medical expertise to provide an answer to this complex medical question (i.e., what caused the current diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy). See Davidson, supra. Likewise, the Board does not find the medical literature provided by the Veteran regarding Agent Orange exposure provides the missing nexus opinions because it is generic texts, which do not address the facts in this particular Veteran’s own case with a sufficient degree of medical certainty and therefore it does not amount to competent medical evidence of causality. See Wallin v. West, 11 Vet. App. 509 (1998); Sacks v. West, 11 Vet. App. 314 (1998); Libertine v. Brown, 9 Vet. App. 521 (1996); Beausoleil v. Brown, 8 Vet. App. 459 (1996). Therefore, the Board finds that the most probative evidence of record shows that the Veteran’s current diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy are not due to a disease or injury while on active duty or an injury while on INACDUTRA. See 38 U.S.C. § 101, 106, 1110, 1131; 38 C.F.R. § 3.303(d). d. 38 C.F.R. § 3.310 Similarly, as to the Veteran’s claim that his erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy are due to his diabetes mellitus, the Board notes that the appellant is not service-connected for diabetes mellitus or heart disease. In fact, the Board notes that the Veteran’s only service-connected disabilities are tinnitus and, as discussed above, bilateral hearing loss. Therefore, the Board finds that the Veteran does not meet the criteria for secondary service connection for erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.310; also see Allen, supra; Wallin, supra; Ward, supra. Conclusion Accordingly, the Board finds that the preponderance of the evidence is against the Veteran’s claims of service connection diabetes mellitus, erectile dysfunction, heart disease, as well as right and left upper and lower extremity peripheral neuropathy. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 1131; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309, 3.310. In reaching all the above conclusions, the Board considered the doctrine of reasonable doubt. 38 U.S.C. § 5107(b). However, as the preponderance of the evidence is against the claims, the Board finds that the doctrine is not for application. See also, e.g., Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001); Gilbert, supra. John J. Crowley Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N.T. Werner, 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.