Citation Nr: 21015497 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 15-36 329 DATE: March 17, 2021 ORDER Entitlement to service connection for hypertension is denied. Entitlement to service connection for a left-hand disorder is denied. Entitlement to service connection for a right ankle disorder is denied. Entitlement to service connection cataracts is denied. Entitlement to service connection for a groin area strain is denied. Entitlement to service connection for a left ankle disorder is denied. Entitlement to service connection for a right-hand disorder is denied. FINDINGS OF FACT 1. The Veteran's hypertension is not related to active duty service and the competent and credible evidence weighs against an etiological relationship between his current hypertension disability and active service. 2. The Veteran does not have a right-hand disability for VA purposes. 3. The Veteran does not have a left-hand disability for VA purposes. 4. The Veteran's cataracts are not related to active duty service and the competent and credible evidence weighs against an etiological relationship between his current cataracts’ disability and active service. 5. The Veteran does not have a groin disability for VA purposes. 6. The Veteran's right ankle condition is not related to active duty service and the competent and credible evidence weighs against an etiological relationship between his current right ankle disability and active service. 7. The Veteran does not have a left ankle disability for VA purposes CONCLUSIONS OF LAW 1. The criteria for service connection for hypertension have not been met. 38 U.S.C. §§ 1110, 1111, 1131, 1132, 5103(a), 5103A; 38 C.F.R. §§ 3.159, 3.303, 3.304. 2. The criteria for service connection for right hand condition have not been met. 38 U.S.C. §§ 1101, 1110, 1131, 1154; 38 C.F.R. § 3.303, 3.304. 3. 5. The criteria for service connection left hand condition have not been met. 38 U.S.C. §§ 1101, 1110, 1131, 1154; 38 C.F.R. § 3.303, 3.304. 4. The criteria for service connection for cataracts have not been met. 38 U.S.C. §§ 1110, 1111, 1131, 1132, 5103(a), 5103A; 38 C.F.R. §§ 3.159, 3.303, 3.304. 5. The criteria for service connection for groin condition have not been met. 38 U.S.C. §§ 1101, 1110, 1131, 1154; 38 C.F.R. § 3.303, 3.304. 6. The criteria for service connection for a right ankle condition have not been met. 38 U.S.C. §§ 1110, 1111, 1131, 1132, 5103(a), 5103A; 38 C.F.R. §§ 3.159, 3.303, 3.304. 7. The criteria for service connection for a left ankle condition have not been met. 38 U.S.C. §§ 1110, 1111, 1131, 1132, 5103(a), 5103A; 38 C.F.R. §§ 3.159, 3.303, 3.304 REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The appellant is a Veteran who served on active duty from January 1983 to May 1983, from February 1991 to April 1992, from May 1992 to January 1995, from May 2003 to February 2005, and from September 2005 to January 2007. He had service in Southwest Asia from December 2005 to December 2006. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2014 rating decision by the San Diego, California, Regional Office (RO) of the Department of Veterans Affairs (VA). The claims were remanded by the Board in December 2018. Service Connection To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). In addition, certain diseases, such as arthritis, are presumed to have been incurred in service if manifested to a compensable degree within one year after service. The presumption is rebuttable by probative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). When chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support a claim for such diseases. 38 C.F.R. § 3.303 (b); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).   1. Entitlement to service connection for hypertension The Veteran contends that he has hypertension to his military service. The question for the Board is whether the Veteran has hypertension that is etiologically related to, or aggravated by, an in-service disease or injury. The Board finds that competent, credible, and probative evidence is against a finding that the Veteran’s hypertension is related to his military service. The Veteran’s service treatment records (STRs) does not reflect a diagnosis or treatment for hypertension or high blood pressure. In an October 2019 VA medical opinion, the examiner opined that the Veteran’s current hypertension is less likely than not incurred in or caused by his military service. The examiner explained that after reviewing the claims folder, there is no sufficient medical evidence to support an in-service related event to development of hypertension. The Board finds that the claim must be denied. In this case, there is no competent medical evidence that supports the conclusion that the Veteran’s hypertension was incurred in or aggravated by his service. The Board notes that the Veteran may sincerely believe that he has hypertension causally related to active service. However; the most probative clinical etiology opinion with regard to the Veteran’s claimed condition is against such a finding. The Veteran has not been shown to have the experience, training, or education necessary to make an etiology opinion to the claimed disability. Although lay persons are competent to provide opinions on some medical issues, the Board finds that a lay person is not competent to provide a probative opinion as to the specific issue in this case in light of the education and training necessary to make a finding with regard to the complexity of the claimed condition for VA purposes. The Board finds that such etiology findings fall outside the realm of common knowledge of a lay person. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). 2. Entitlement to service connection for a left-hand disorder 3. Entitlement to service connection for a right-hand disorder The Veteran contends that he has a right and left condition related to his military service. The question for the Board is whether the Veteran has any hand condition that is etiologically related to, or aggravated by, an in-service disease or injury. The Board finds that competent, credible, and probative evidence is against a finding that the Veteran has a hand condition for VA purposes. An October 2019 VA medical examination reflect the Veteran with no hand condition, either left or right, upon examination. The Board notes that the Veteran reported bilateral hand pain. However, the examiner did not find any functional impairment. The Board acknowledges that without an underlying diagnosis, pain can still constitute a current disability, for VA compensation purposes, if it reaches the level of a functional impairment of earning capacity. See Saunders v. Wilkie, No. 17-1466, 2018 U.S. App. Vet. Claims LEXIS 8467 (Apr. 3, 2018). However, the Veteran has not alleged, and the evidence does not show that there has been any functional impact of earning capacity-thus, there can be no valid claim, on either a direct or secondary basis. See Brammer v. Derwinski, 3 Vet. App. 223 (1992); Saunders, 2018 U.S. App. Vet. Claims LEXIS 8467. Even in light of Saunders, the Veteran still does not have a present disability for his right and left hand as he does not have a diagnosis, and treatment records do not show any functional loss or functional impairment. Based on such evidence, the Board finds that this case is distinguished from Saunders. The Veteran is competent to attest to factual matters of which he has first-hand knowledge (e.g., experiencing pain). However, he has not been shown to be competent to provide a diagnosis regarding the claimed condition for VA purposes, as that is based on specific objective findings. The Board finds that the clinical evidence of record is more probative than the lay statements. Although lay persons are competent to provide opinions on some medical issues, the Board finds that a lay person is not competent to provide a probative opinion as to the specific issue in this case in light of the education and training necessary to make a finding with regard to the complexities of the claimed condition for VA purposes. The Board finds that such etiology findings fall outside the realm of common knowledge of a lay person. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); see Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). As explained above, the Veteran must have a disability during the appeal. Based on the given facts, the preponderance of the evidence is against a finding that the Veteran currently has a hand condition for VA purposes. Thus, service connection for such cannot be granted. The Board has considered the doctrine of giving the benefit of the doubt to the appellant, under 38 U.S.C. § 5107 and 38 C.F.R. § 3.102 but does not find that the evidence is of such approximate balance as to warrant its application. Gilbert v. Derwinski, 1 Vet. App. 49, 54-56 (1990) 4. Entitlement to service connection for a right ankle disorder The Veteran contends that he has a right ankle condition to his military service. The question for the Board is whether the Veteran has a right ankle condition that is etiologically related to, or aggravated by, an in-service disease or injury. The Board finds that competent, credible, and probative evidence is against a finding that the Veteran’s right ankle conditions are related to his military service. In an October 2019 VA medical opinion, the examiner opined that the Veteran’s current right ankle tendonitis and right ankle calcaneal spur are less likely than not incurred in or caused by his military service. The examiner explained that after reviewing the claims folder, there is not sufficient medical evidence or reported in service events to support that the current conditions incurred in service. The Board notes an in-service foot spur removal; however, the examiner explained it is of no significance to the Veteran’s current right ankle conditions. The Board finds that the claim must be denied. In this case, there is no competent medical evidence that supports the conclusion that the Veteran’s right ankle condition incurred in or aggravated by his service. The Board notes that the Veteran may sincerely believe that he has a right ankle condition causally related to active service. However; the most probative clinical etiology opinion with regard to the Veteran’s claimed condition is against such a finding. The Veteran has not been shown to have the experience, training, or education necessary to make an etiology opinion to the claimed disability. Although lay persons are competent to provide opinions on some medical issues, the Board finds that a lay person is not competent to provide a probative opinion as to the specific issue in this case in light of the education and training necessary to make a finding with regard to the complexity of the claimed condition for VA purposes. The Board finds that such etiology findings fall outside the realm of common knowledge of a lay person. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). 5. Entitlement to service connection for a left ankle disorder The Veteran contends that he has a left condition related to his military service. The question for the Board is whether the Veteran has a left ankle condition that is etiologically related to, or aggravated by, an in-service disease or injury. The Board finds that competent, credible, and probative evidence is against a finding that the Veteran has a left ankle condition for VA purposes. An October 2019 VA medical examination reflect the Veteran with no left ankle upon examination. The Veteran complained of pain, but the examination noted no functional impairment regarding the Veteran’s bilateral ankle. The Veteran is competent to attest to factual matters of which he has first-hand knowledge (e.g., experiencing pain). However, he has not been shown to be competent to provide a diagnosis regarding the claimed condition for VA purposes, as that is based on specific objective findings. The Board finds that the clinical evidence of record is more probative than the lay statements. Although lay persons are competent to provide opinions on some medical issues, the Board finds that a lay person is not competent to provide a probative opinion as to the specific issue in this case in light of the education and training necessary to make a finding with regard to the complexities of the claimed condition for VA purposes. The Board finds that such etiology findings fall outside the realm of common knowledge of a lay person. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); see Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). As explained above, the Veteran must have a disability during the appeal, and even without a diagnosable disability, the pain from the condition much show that it impacts functional earning capacity. This is not the case. Based on the given facts, the preponderance of the evidence is against a finding that the Veteran currently has left ankle condition for VA purposes. Thus, service connection for such cannot be granted. The Board has considered the doctrine of giving the benefit of the doubt to the appellant, under 38 U.S.C. § 5107 and 38 C.F.R. § 3.102 but does not find that the evidence is of such approximate balance as to warrant its application. Gilbert v. Derwinski, 1 Vet. App. 49, 54-56 (1990). 6. Entitlement to service connection cataracts The Veteran contends that he has an eye condition related to his military service. As a preliminary matter, the Board notes that during the pendency of this appeal, the Veteran was granted service connection for right eye pterygium and pinguecula of the bilateral eyes in a September 2020 rating decision. The Veteran’s current cataracts was denied service connection in a September Supplemental Statement of the Case (SSOC). The question for the Board is whether the Veteran has cataracts that is etiologically related to, or aggravated by, an in-service disease or injury. The Board finds that competent, credible, and probative evidence is against a finding that the Veteran’s cataracts is related to his military service. The Veteran’s service treatment records (STRs) does not reflect a diagnosis or treatment for cataracts. In an October 2019 VA medical opinion, the examiner opined that the Veteran’s current cataracts is less likely than not incurred in or caused by his military service. The examiner explained that the Veteran’s cataracts is due to normal aging and had its onset within the past few years. The Board finds that the claim must be denied. In this case, there is no competent medical evidence that supports the conclusion that the Veteran’s cataracts were incurred in or aggravated by his service. The Board notes that the Veteran may sincerely believe that he has cataracts causally related to active service. However; the most probative clinical etiology opinion with regard to the Veteran’s claimed condition is against such a finding. The Veteran has not been shown to have the experience, training, or education necessary to make an etiology opinion to the claimed disability. Although lay persons are competent to provide opinions on some medical issues, the Board finds that a lay person is not competent to provide a probative opinion as to the specific issue in this case in light of the education and training necessary to make a finding with regard to the complexity of the claimed condition for VA purposes. The Board finds that such etiology findings fall outside the realm of common knowledge of a lay person. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Board has considered the doctrine of giving the benefit of the doubt to the appellant, under 38 U.S.C. § 5107 and 38 C.F.R. § 3.102 but does not find that the evidence is of such approximate balance as to warrant its application. Gilbert v. Derwinski, 1 Vet. App. 49, 54-56 (1990). 7. Entitlement to service connection for a groin area strain The Veteran contends that he has a groin condition related to his military service. The question for the Board is whether the Veteran has a groin condition that is etiologically related to, or aggravated by, an in-service disease or injury. The Board finds that competent, credible, and probative evidence is against a finding that the Veteran has a groin condition for VA purposes. An October 2019 VA medical examination reflect the Veteran with no groin strain or muscle injury of the groin upon examination. The examination further noted that subjective complaint of pain does not result in functional impairment. The Veteran is competent to attest to factual matters of which he has first-hand knowledge (e.g., experiencing pain). However, he has not been shown to be competent to provide a diagnosis regarding the claimed condition for VA purposes, as that is based on specific objective findings. The Board finds that the clinical evidence of record is more probative than the lay statements. Although lay persons are competent to provide opinions on some medical issues, the Board finds that a lay person is not competent to provide a probative opinion as to the specific issue in this case in light of the education and training necessary to make a finding with regard to the complexities of the claimed condition for VA purposes. The Board finds that such etiology findings fall outside the realm of common knowledge of a lay person. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); see Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). As explained above, the Veteran must have a disability during the appeal, or pain that causes functional earning capacity. See Saunders. This is not the case. Based on the given facts, the preponderance of the evidence is against a finding that the Veteran currently has a groin condition for VA purposes. Thus, service connection for such cannot be granted. (Continued on the next page)   The Board has considered the doctrine of giving the benefit of the doubt to the appellant, under 38 U.S.C. § 5107 and 38 C.F.R. § 3.102 but does not find that the evidence is of such approximate balance as to warrant its application. Gilbert v. Derwinski, 1 Vet. App. 49, 54-56 (1990). Saudiee Brown Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Brandon A. Williams, 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.