Citation Nr: 21015527 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 11-08 129 DATE: March 17, 2021 ORDER Entitlement to service connection for chronic fatigue syndrome (CFS) is denied. Entitlement to service connection for fibromyalgia is denied. Entitlement to service connection for arthralgia is denied. Entitlement to service connection for a skin condition is denied. Entitlement to service connection for hiatal hernia is denied. FINDINGS OF FACT 1. The Veteran served in the Southwest Asia theater of operations during the Persian Gulf War. 2. The Veteran’s fatigue symptoms have been attributed to known diagnosed conditions, including his service-connected posttraumatic stress disorder (PTSD) and non-service-connected obstructive sleep apnea. 3. The Veteran has not been diagnosed with fibromyalgia or arthralgia, and his symptoms have been attributed to known diagnosed conditions, including his service-connected lumbosacral sprain with IVDS and arthritis, right knee condition, bilateral lower extremity radiculopathy, right wrist condition, and bilateral hip condition. 4. Throughout the period on appeal, the Veteran has not had a diagnosed skin condition. 5. Throughout the period on appeal, the Veteran has not had a diagnosis for hiatal hernia. CONCLUSIONS OF LAW 1. The criteria for service connection for chronic fatigue syndrome have not been met. 38 U.S.C. §§ 1110, 1112, 1117, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.317. 2. The criteria for service connection for fibromyalgia have not been met. 38 U.S.C. §§ 1110, 1112, 1117, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.317. 3. The criteria for service connection for arthralgia have not been met. 38 U.S.C. §§ 1110, 1112, 1117, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.317. 4. The criteria for service connection for a skin condition have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. 5. The criteria for service connection for hiatal hernia have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1985 to August 1996. The Veteran had additional service with the Army National Guard with confirmed periods of active duty for training (ACDUTRA) from June 1979 to September 1979 and November 2004 to March 2005. This matter is before the Board of Veterans’ Appeals (Board) on appeal from April 2010 (CFS, fibromyalgia, arthralgia, skin) and July 2012 (hernia) rating decisions by a Department of Veterans Affairs Regional Office (RO). In March 2017, the Veteran testified at a Board videoconference hearing before the undersigned. A copy of the transcript of that hearing has been associated with the claims file. At that time, the Board held the record open for 60 days for the Veteran to submit additional medical evidence. This case was remanded in October 2017. In November 2019, the Board remanded this case for the Agency of Original Jurisdiction (AOJ) to consider additional evidence added to the claims file related to the service connection claims for CFS, fibromyalgia, arthralgia and skin condition and to issue a supplemental statement of the case (SSOC). The Board notes that the AOJ issued a SSOC in July 2020. Accordingly, after reviewing the actions of the AOJ, the Board finds there was substantial compliance with the requested development. Dyment v. West, 13 Vet. App. 141 (1999); Stegall v. West, 11 Vet. App. 268 (1998). During the pendency of the appeal, a July 2020 rating decision granted service connection for tension headaches. Therefore, as the RO granted the benefit sought on appeal, that issue is no longer before the Board. Shoen v. Brown, 6 Vet. App. 456 (1994). Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. In order to establish entitlement to service connection, there must be (1) 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) a causal connection between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). The Board notes that the Veteran served in the Southwest Asia theater of operations during Operation Desert Storm from January 1991 to March 1991. See Military Personnel Record Received August 2018. Regulation 38 C.F.R. § 3.317 pertains to compensation for certain disabilities occurring in Persian Gulf veterans. For purposes of 38 C.F.R. § 3.317, there are three types of qualifying chronic disabilities: (1) an undiagnosed illness; (2) a medically unexplained chronic multi-symptom illness; and (3) a diagnosed illness that the Secretary determines in regulations prescribed under 38 U.S.C. § 1117(d) warrants a presumption of service connection. 38 C.F.R. § 3.317(a)(2). A medically unexplained chronic multi-symptom illness is one defined by a cluster of signs or symptoms, and specifically includes chronic fatigue syndrome, fibromyalgia, and functional gastrointestinal disorders (e.g. irritable bowel syndrome). A medically unexplained chronic multi-symptom illness means a diagnosed illness without conclusive pathophysiology or etiology that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. Chronic multi-symptom illnesses of partially understood etiology and pathophysiology, such as diabetes and multiple sclerosis, will not be considered medically unexplained. 38 C.F.R. § 3.317(a)(2)(i). The Board must determine whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either case, or whether the preponderance of the evidence is against the claim, in which case, service connection must be denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 1. Chronic Fatigue Syndrome (CFS) The Veteran seeks entitlement to service connection for CFS. Specifically, the Veteran asserts that he developed CFS as a result of his service in the Southwest theater of operations. See December 1997 Claim, December 2009 Claim, and March 2017 Board Hearing Transcript. The evidence of record includes the Veteran’s service treatment records (STRs) showing he denied frequent trouble sleeping during his April 1979 enlistment examination and September 1979 separation examination. A September 1985 enlistment examination also shows the Veteran denied frequent trouble sleeping. He did report frequent trouble sleeping during his July 1996 separation examination. The examining clinician noted that the Veteran reported frequent trouble sleeping and loss of memory since he returned from Operation Desert Shield. The Veteran underwent a VA neurological disorder examination related to his claim for Gulf War Syndrome in March 1998. The Veteran reported impaired memory. The examiner noted episodic numbness and forgetfulness of unclear etiology. A neurological examination was noted as essentially normal. The examiner noted that the Veteran did not complain of fatigue. A September 2004 Army National Guard enlistment examination shows the Veteran denied any frequent trouble sleeping. VA medical records show that in January 2006, the Veteran was seen for an initial evaluation during which he complained of a sleep disorder for several years. Additionally, a February 2006 VA medical record shows that fatigue was found as a current symptom related to the Veteran’s psychiatric disorder (depression). A December 2009 VA mental health record noted symptoms of depression including feeling tired with low energy nearly every day. Another December 2009 VA medical record shows the Veteran was diagnosed with anxiety disorder and depressive disorder. See VA Medical Records Received October 2018 A June 2010 VA depression screen shows the Veteran reported feeling tired or having little energy nearly every day. See VA Medical Records Received October 2018. The Veteran underwent a VA sleep study in October 2010. He was diagnosed with mild sleep apnea with mildly reduced sleep efficiency. See VA Medical Records Received June 2012. At a March 2017 Board hearing, the Veteran testified that a year or two after he returned from Iraq he noticed symptoms related to CFS including tiring easily and having no energy. A May 2018 private medical record noted a past medical history for chronic fatigue fibromyalgia syndrome and that the Veteran had concerns regarding Gulf War Syndrome. PTSD and recurrent major depressive disorder were also noted as medical conditions. In August 2018, the Veteran submitted private treatment records from Dr. Powderly. Those records show that in April 2017, the Veteran was noted to have active problems including chronic fatigue. An August 2018 VA medical record noted active problems including insomnia. It was noted that a follow-up would be made with mental health. A September 2018 VA medical record shows the Veteran reported that he snored and woke up tired and not refreshed. The record also shows that an optional sleep study referral was discussed. See VA Medical Records Received October 2018. A December 2018 VA Gulf War medical examination noted a psychiatric diagnosis for PTSD. The examiner found no evidence for an undiagnosed illness, a diagnosable but medically unexplained chronic multi-symptom illness of unknown etiology, or a diagnosable chronic multi-symptom illness with a partially explained etiology. Instead, the examiner found that all of the Veteran’s medical conditions were consistent with diseases with clear and specific etiologies and diagnosis and that all conditions were not related to a specific exposure event experienced during service in Southwest Asia. The Veteran also underwent a VA PTSD examination in February 2020. The examiner noted a diagnosis for PTSD. The Veteran reported insomnia with frequent waking and the examiner noted sleep disturbance and chronic sleep impairment as related symptoms. Lastly, the Board notes that a July 2020 rating decision granted service connection for PTSD. A review of that rating decision shows the Veteran was assigned a 30 percent evaluation based, in part, upon symptomatology including chronic sleep impairment. After a review of the evidence of record, the Board finds that entitlement to service connection for CFS is not warranted. Initially, the Board notes that the Veteran has not been diagnosed with CFS. While the Board notes a private medical record documenting a past medical history for chronic fatigue fibromyalgia syndrome, a review of that record shows that the condition was noted in connection with the Veteran’s concern regarding Gulf War Syndrome and not as a condition diagnosed by the treating physician. In this regard, the Board notes no associated diagnostic studies, and the notation appears based solely on the Veteran’s reports of having CFS. Instead, the probative evidence of record shows that the Veteran’s reports of fatigue and related symptoms have been attributed to known diagnosed conditions, including his service-connected PTSD. In this regard, during his February 2020 VA PTSD examination he reported insomnia with episodes of waking. The examiner also noted sleep disturbance and chronic sleep impairment as related symptoms. This finding is further supported by the record. Specifically, the record shows that when the Veteran began reporting symptoms of a sleep disorder in 2006, symptoms of fatigue were found related to his depression. See February 2006 VA Medical Record. Additionally, a December 2009 VA mental health record noted a diagnosis for depression including related symptoms of feeling tired and having low energy nearly every day. The record further shows that the Veteran has been diagnosed with sleep apnea, a condition for which he is not service connected. Therefore, as the medical evidence of record does not show that the Veteran has had a separate diagnosis for CFS during the appeal period, and in consideration that his symptoms have been attributed to known diagnoses, including conditions for which he is already service-connected, the Board finds that the Veteran does not have an undiagnosed disability or a medically unexplained chronic multi-symptom illness pursuant to 38 C.F.R. § 3.317. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine cannot be applied. The claim is denied. 38 U.S.C. § 5107(b); Gilbert v, Derwinski, 1 Vet. App. 49, 53-56 (1990). 2.-3. Fibromyalgia and Arthralgia The Veteran seeks entitlement to service connection for fibromyalgia and arthralgia. Specifically, the Veteran asserts that he developed fibromyalgia and arthralgia as a result of Gulf War Syndrome. See December 1997 Claim, December 2009 Claim, and March 2017 Board Hearing Transcript. The evidence of record includes STRs showing the Veteran was found to have normal feet, spine, other musculoskeletal and upper and lower extremities during his April 1979 enlistment and September 1979 separation examinations. He denied any swollen or painful joints, arthritis, painful or trick shoulder or elbow, recurrent back pain or foot trouble. A September 1985 enlistment examination also noted normal feet, spine, other musculoskeletal and upper and lower extremities. The Veteran reported having had broken bones in his left wrist and he denied any swollen or painful joints, arthritis, recurrent back pain, trick or locked knee or foot trouble. In-service examinations conducted in September 1987 and September 1991 also noted normal spine and other musculoskeletal and upper and lower extremities. In January 1991, a STR shows the Veteran reported that he had fallen 15-feet onto sand and struck his lower back and right hip. The Veteran also reported that his right leg bent under him when he fell. Another January 1991 STR noted continued complaints of non-radiating muscular low back pain. In November 1992, the Veteran complained of pain, numbness and tingling in the fingers of his left hand. He was assessed with a possible poor circulation problem. An April 1993 STR shows the Veteran reported that he injured his lower back while moving a howitzer after it became stuck. In August 1993, the Veteran complained of chronic lower back pain and that his military occupational specialty (MOS) required heavy lifting. The Veteran also complained of a stiff neck. In October 1993, the Veteran was seen for a follow-up for complaints of lower back pain. The clinician noted mechanical lower back pain with mid-sacral pain, and occasional shooting pain into the right mid-thigh. He was issued a physical profile for mechanical lower back pain in November 1993. In February 1994, the Veteran was treated related to complaints of right knee pain. The Veteran reported trauma when he struck his knee on the trailer of a 155 MM howitzer. The Veteran was assessed with a contusion. An August 1994 CT scan of the lumbar spine revealed mild degenerative changes. The Veteran was treated again for back pain in August 1994. The clinician noted a profile for a back injury and the Veteran reported reinjuring his back but was unsure how. Additionally, other August 1994 STRs noted that low back pain radiated into the Veteran’s legs and which sometimes shot up to his neck. In August 1995, the Veteran complained of pain in his neck and shoulder the past few days. He denied any history of neck trauma. Range of motion was noted as decreased in the neck and left arm area. The Veteran was assessed with a possible pinched nerve and muscle strain. A December 1995 STR shows the Veteran was treated for a swollen hand and he reported being hit with a hatchet. He also reported pain in his shoulder that did not occur by trauma. The clinician noted that pain in the arm prevented normal motion and bending of the arm. The Veteran was assessed with a contusion to the 2nd metatarsal and tendonitis in the right elbow. A January 1996 STR shows the Veteran was treated by physical therapy for chronic lower back pain that radiated into the supralateral area of the right knee. The Veteran was issued a physical profile for back pain in April 1996. Other physical profiles were issued in May and August 1996 for chronic lower back pain. A review of the Veteran’s July 1996 separation examination shows he reported swollen or painful joints, cramps in his legs, recurrent back pain and foot trouble. The Veteran denied any arthritis. The clinician noted chronic lower back pain and that the Veteran had been diagnosed with mechanical lower back pain. The clinician noted foot trouble involving ingrown toenails. The Veteran underwent a VA general examination in September 1996. A spinal portion of the examination diagnosed the Veteran with lumbosacral sprain with contusion, chronic back pain, and sprained ligaments of the right knee. The Veteran underwent physical therapy in August 1996 for chronic mechanical lower back pain and muscle spasms. Post-service evidence includes a March 1998 VA general examination showing the Veteran reported having been diagnosed with fibromyalgia in either 1991 or 1992, and that he had had intermittent aches and pains all over his body since that time. The examiner noted a diagnosis for fibromyalgia by history. The Veteran underwent a VA joint examination in May 2004. The Veteran reported injuring his right wrist during service when an artillery shell fell on it. He reported that his wrist locked up and he complained of stiffness. He was diagnosed with right wrist arthralgia. He was also diagnosed with traumatic arthritis of the right knee and the Veteran reported having injured his knee three to four times during service. In addition, the Veteran reported injuring his back during an air assault repelling maneuver when he fell from a rope, and when trying to lift a gun out of a truck. Back pain was reported as constant. An X-ray study revealed very mild degenerative changes at L2-L3 and L3-L4, and degenerative changes at L5-S1. He was diagnosed with traumatic arthritis of the lumbosacral spine. A September 2004 Army National Guard enlistment examination noted normal feet, spine, other musculoskeletal and upper and lower extremities. The Veteran denied any painful shoulder, elbow or wrist, recurrent back pain, numbness or tingling, foot trouble, impaired use of arms, legs, hands or feet, swollen or painful joints, or knee trouble. In March 2005, the Veteran was treated related to an injury to his neck, back, right hip and right shoulder following hand to hand combat training. A January 2006 VA medical record noted arthralgias affecting the wrist and elbows. See VA Medical Records Received October 2018. In April 2008, a private medical record shows the Veteran underwent arthroscopy of the right knee with partial medial meniscectomy and debridement of cartilaginous loose bodies along with chondroplasty of the medial femoral condyle. See Private Medical Records Received August 2010. A February 2013 VA medical record noted no joint pain. The record did note a history of lumbar spine DDD, right knee pain and a meniscal tear. See VA Medical Records Received April 2018. A February 2015 private medical record noted a history for arthralgia. No current musculoskeletal joint pain was noted. See Private Medical Records Received January 2020. In August 2018, the Veteran submitted private treatment records from Dr. Powderly. Those records show that in April 2017, the Veteran was noted to have active problems including fibromyalgia syndrome and neuropathic pain. An April 2017 private medical record noted a history for chronic fatigue fibromyalgia syndrome. The Veteran reported feeling well with no complaints. The Veteran noted concern regarding Gulf War syndrome. He was referred to rheumatology. An August 2018 VA medical record noted low back pain which the Veteran reported began in 1985 during service with associated pain radiating to the legs. Chronic musculoskeletal pain was also noted in the elbows and knees. See VA Medical Records Received October 2018. Another August 2018 VA medical record noted chronic musculoskeletal pain affecting the elbows, back and knees. See VA Medical Records Received July 2020. A December 2019 VA Gulf War medical examination shows the Veteran reported a musculoskeletal condition involving his lumbar spine. The examiner found no evidence for an undiagnosed illness, a diagnosable but medically unexplained chronic multi-symptom illness of unknown etiology, or a diagnosable chronic multi-symptom illness with a partially explained etiology. Instead, the examiner found all of the Veteran’s medical conditions were consistent with diseases with a clear and specific etiology and diagnosis, and that all conditions were not related to a specific exposure event experienced during service in Southwest Asia. In August 2019, a VA medical record shows pain history primarily involving the bilateral hip and lower back. Pain was reported as aching, radiating, sore and tight. Another August 2019 VA medical record noted osteoarthritis affecting the hand, hip and chronic low back pain. See VA Medical Records Received July 2020. Lastly, the Veteran underwent a VA foot examination in February 2020. The examiner noted a diagnosis for bilateral plantar fasciitis. The Veteran reported that he began to have bilateral foot pain in approximately 2012/2013, and that he had a remote history of a prior non-service related right foot injury in August 2014 that resulted in surgery. In this regard, the Board notes that a February 2020 rating decision denied service connection for bilateral plantar fasciitis. After a review of the evidence of record, the Board finds that entitlement to service connection for fibromyalgia and arthralgia is not warranted. Initially, the Board notes that the Veteran is already service connected for several diagnosed musculoskeletal conditions including lumbosacral sprain with IVDS and arthritis, right knee condition, bilateral lower extremity radiculopathy, right wrist condition, and bilateral hip condition. Those conditions have been rated based, in part, on symptoms of pain. Turning to the evidence of record, the Board finds the December 2018 VA Gulf War examination the most probative evidence of record. The examiner determined that the Veteran did not have an undiagnosed illness, and that his symptoms and conditions had clear and specific etiologies. The Board does recognize the Veteran’s private medical records noting a history for fibromyalgia and arthralgia. However, those notations appear based solely on the Veteran’s reports of having those conditions. With regard to the Veteran’s lay statements, lay persons are not categorically incompetent to speak on matters of medical diagnosis or etiology. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). In this vein, the Board must consider the type of condition specifically claimed and whether it is readily amenable to lay diagnosis or probative comment on etiology. Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). The Veteran is competent to report purported symptoms such as pain or whether he has received a diagnosis from a medical professional. 38 C.F.R. § 3.159(a)(2); Barr v. Nicholson, 21 Vet. App. 303 (2007). However, without evidence showing that he has medical training or expertise, he cannot competently provide a current diagnosis for fibromyalgia or arthralgia. 38 C.F.R. § 3.159(a)(1)-(2); Jandreau v. Nicholson, 492 F.3d 1372 (2007). With regard to the private medical records, the past medical history notations are not accompanied by any diagnostic findings. Specifically, the April 2017 private medical record noting the Veteran’s concern regarding Gulf War syndrome and a noted history for “chronic fatigue fibromyalgia syndrome” also noted that the Veteran currently reported feeling well with no current complaints. Accordingly, the Veteran was referred to rheumatology for further analysis with regard to his reported symptoms. Thereafter, there is no record noting fibromyalgia or arthralgia. Instead, an August 2019 VA medical record noted that the Veteran’s pain history primarily involved his bilateral hip and lower back, conditions of known etiology and conditions for which he is already service connected. Another August 2019 VA medical record noted osteoarthritis affecting the Veteran’s hand, hip and low back. The Board finds that the medical evidence of record supports the December 2018 VA examiner’s conclusion that the Veteran’s symptoms are consistent with diseases with clear and specific etiologies and diagnoses. There is no competent evidence to the contrary. Accordingly, as none of the Veteran’s symptoms are considered to be an undiagnosed illness or an indicator of an unexplained multi-symptom illness, they may not be presumed to be related to the Veteran’s service under provisions applicable to undiagnosed illness or unexplained chronic multi-symptom illness. 38 C.F.R. § 3.317. Therefore, the preponderance of the evidence is against the claims and the benefit-of-the-doubt doctrine cannot be applied. The claims are denied. 38 U.S.C. § 5107(b); Gilbert v, Derwinski, 1 Vet. App. 49, 53-56 (1990). 4. Skin Condition The Veteran seeks entitlement to service connection for a skin condition. Specifically, the Veteran asserts that he developed a skin condition as a result of exposure to cleaning solvents. Alternatively, the Veteran asserts that he developed a skin condition due to environmental exposures during his deployment to Iraq. See December 1997 Claim, December 2009 Claim, and March 2017 Board Hearing Transcript. The evidence of record includes STRs showing the Veteran was noted to have normal skin during his April 1979 enlistment and September 1979 separation examinations. Those examinations also show the Veteran denied having any skin diseases. A September 1985 enlistment examination also noted normal skin, and the Veteran denied any skin disease. Normal skin was also noted during September 1987 and September 1991 examinations. In May 1994, the Veteran was seen for chapped feet which he reported had been present for the past month. The Veteran also reported that it started when he was in the field in wet conditions which caused his feet to crack and bleed. The clinician noted cracking of the soles and very dry skin. The Veteran was prescribed skin lotion and foot powder. A May 1994 follow-up STR noted dry cracking skin on his feet in the mid-heel plantar aspect. The Veteran was assessed with presumptive tinea corporis. A July 1996 separation examination noted normal skin and feet. A report of medical history shows the Veteran denied any skin disease. Post-service records include a March 1998 VA general examination noting normal skin. A September 2004 Army National Guard enlistment examination noted normal skin and the Veteran denied any skin diseases. In January 2006, the Veteran was seen for an initial evaluation during which he complained of a chronic axillary and inguinal rash for approximately the past 10 years. Thereafter, a December 2009 VA medical record noted no rashes or breaks in the Veteran’s skin. See VA Medical Records Received October 2018. A February 2013 VA medical record noted no rashes, pruritis or skin lesions. See VA Medical Records Received April 2018. Private medical records dated February, May and August 2015, and March, April, June and December 2016 noted no skin lesions, rashes or itching. See Private Medical Records Received January 2020. At a March 2017 Board hearing, the Veteran testified that he used solvents to clean grease off himself after cleaning cannon guns. The Veteran also testified that every morning the pores under his arms and crotch area opened up and sweat which resulted in blister like sores that scabbed over. In addition, he testified that he had the same condition during service. Following service, the Veteran reported seeing a dermatologist in approximately 1996/1997, but that he was not provided with a diagnosis because the physician did not know what it was. The Veteran further stated that his skin condition could be related to environmental exposure during his deployment to Iraq, including due to burn pits and bug repellant. In August 2018, the Veteran submitted private treatment records from Dr. Powderly. Those records show that in April 2017, the Veteran was noted to have active problems including a rash of unknown cause. An examination of the Veteran’s skin found no lesions, rashes or itching. A rash of unknown cause was noted in a November 2017 private medical record. The current status was noted as inactive. In May 2018, a private medical record noted no skin lesions, rashes or itching. See Private Medical Records Received January 2020. The Veteran underwent a VA skin examination in June 2018. The examiner noted that the Veteran did not have a diagnosed skin condition. The Veteran reported that he developed symptoms of a skin condition between 1997 and 1998, but denied having symptoms during active duty service. In addition, the Veteran reported that he developed big blisters under his arms and in his crotch area when he perspired. He also reported past treatment with creams. The examiner noted that when the Veteran was asked how long his blisters lasted, he answered “They are not blisters. They welt and swell up and get red.” The reported skin condition was noted to last a couple hours and would go away when he cooled down. The examiner noted that the Veteran was actively perspiring during the physical examination and that no active rash was found. The examiner also expressed doubt as to the testimony provided by the Veteran and his spouse regarding receiving treatment in approximately 1996/1997, in which a dermatologist reportedly did not know what type of skin condition he had, or the assertion of a skin condition which reportedly occurred under his arms and in his groin area due to washing this hands with degreaser as those locations would not have come into contact with any solvent. Thereafter, November 2018, February and June 2019, and January 2020 private medical records noted no skin lesions, rashes or itching. December 2018 and February and October 2019 VA medical records show the Veteran denied any purulent skin lesions. See Private Medical Records Received January 2020. Additionally, VA medical records dated in August and October 2019, and January 2020 noted no suspicious lesions. Lastly, a February 2020 VA medical record noted no suspicious lesions over exposed areas. See VA Medical Records Received July 2020. After a review of the evidence of record, the Board finds that entitlement to service connection for a skin condition is not warranted as the Veteran has not been shown to have had a diagnosed skin condition during the pendency of the appeal. In this regard, service connection requires evidence that establishes that the Veteran currently has a disability. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). Additionally, for VA purposes, a current disability exists when a claimant has a disability at the time a claim is filed or at some point during the pendency of that claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Veteran is competent to report purported symptoms such as rashes. 38 C.F.R. § 3.159(a)(2); Barr v. Nicholson, 21 Vet. App. 303 (2007). However, without evidence showing that he has medical training or expertise, he cannot competently provide a medical diagnosis for a skin condition. 38 C.F.R. § 3.159(a)(1)-(2); Jandreau v. Nicholson, 492 F.3d 1372 (2007). With regard to the Veteran’s lay statements, the Board finds him to be an inaccurate historian. Specifically, in January 2006, the Veteran reported having chronic axillary and inguinal rashes for over the past 10 years. Additionally, during his March 2017 Board hearing, the Veteran testified that his skin condition began in approximately 1996 or 1997, during which time he began to see a dermatologist. However, a July 1996 separation examination and a September 2004 Army National Guard enlistment examination shows the Veteran specifically denied having any skin disease. Additionally, during the Board hearing, the Veteran testified that he had the same skin condition during service. However, during his June 2018 VA examination, he denied having symptoms during active duty service. Therefore, the record shows the Veteran has provided conflicting lay statements and the Board provides such statements little probative value. Moreover, there are no records documenting any observable symptoms related to a current skin condition. This includes private medical records which consistently note no skin lesions, rashes or itching. In this regard, while an April 2017 record noted “rash of unknown cause” as an active problem, a physical examination at that time revealed no current skin lesions, rashes or itching. The Board finds it instructive that despite the Veteran’s assertion that his skin condition became active whenever he perspired, during the June 2018 VA examination, the examiner noted that the Veteran was actively perspiring and that no current skin condition was observed. Absent a current diagnosis for a skin condition, the Board finds that the first Shedden requirement has not been met and the probative evidence is against the Veteran’s claim for service connection for a skin condition. The claim is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 58 (1990). 5. Hernia Condition The Veteran seeks entitlement to service connection for hiatal hernia. Specifically, the Veteran asserts that he was diagnosed and treated for a hiatal hernia during service. See July 2013 Notice of Disagreement and March 2017 Board Hearing Transcript. The evidence of record includes an April 1979 enlistment examination showing the Veteran denied any hernia in the report of medical history, but did report having had a hernia at age three in another section. The Veteran also reported having had a hernia condition at age 3 during his September 1979 separation examination. A September 1985 enlistment examination shows the Veteran reported a hernia and the clinician noted an inguinal hernia repair with no reoccurrence. He denied any stomach trouble. The Veteran’s STRs also show the Veteran complained of abdominal cramps the past 2 days in June 1987. He was assessed with gastroenteritis. In October 1987, the Veteran was treated for diarrhea and stomach cramps which was determined to be a viral condition and he was diagnosed as viral gastroenteritis. In May 1988, the Veteran was assessed with possible gastroenteritis with symptoms of abdominal pain. The Veteran was treated for gastroenteritis in October 1988. A June 1989 air contrast barium enema radiological study revealed no significant abnormalities. A September 1991 abdominal radiological examination revealed a normal acute abdominal series. A June 1991 STR shows the Veteran was being treated for abdominal pain and constipation. The Veteran was treated for abdominal pain in April 1995. He also reported that he had not gone to the bathroom in two days. He was assessed with constipation. A July 1996 separation examination shows that the clinician noted the Veteran was negative for a hernia. The clinician further noted the Veteran had been treated for abdominal pain in the emergency room in September 1991 with no sequalae. A September 2004 Army National Guard enlistment examination shows the Veteran denied any hernia. Post-service medical records show the Veteran underwent an upper gastrointestinal study in March 2006 which revealed no convincing evidence for reflex or hiatal hernia. Another March 2006 VA medical record noted an assessment for umbilical hernia. An umbilical hernia assessment was also noted in a December 2009 VA medical record. See VA Medical Records Received October 2018. The Veteran underwent a VA digestive examination in February 2011. The examiner noted a diagnosis for irritable bowel syndrome (IBS). The Veteran also reported a childhood surgery to repair a right femoral hernia in 1966. The examiner also noted a small umbilical hernia present without repair with symptoms of tenderness. Private medical records also noted an umbilical hernia without obstruction in March 2016. See Private Medical Records Received January 2020. At a March 2017 Board hearing, the Veteran testified that he was diagnosed with a hiatal hernia during service, sometime between 1988 and 1990. The Veteran underwent a VA esophageal examination in June 2018. The examiner noted a diagnosis for GERD and gastritis with 2009 listed as the date of diagnosis. The Veteran reported being diagnosed with hiatal hernia while stationed in Germany between 1987 and 1990. Reported symptoms included acid reflux, chest pain, dyspnea and midsternal burning. The Veteran reported that his current symptoms occurred daily and that he started medication for acid reflux between 2000 and 2004. He currently reported taking Nexium. An August 2018 VA medical record noted a past surgical history for umbilical hernia repair in 2015. See VA Medical Records Received October 2018. The Veteran underwent a VA intestinal condition examination in February 2020. The examiner noted a diagnosis for gastrointestinal disturbance with diarrhea and IBS. The Veteran reported that he developed GI symptoms when he was stationed in Germany. Symptoms were reported as acute at onset which never resolved. A February 2020 Report of General Information shows the Veteran notified VA that he was not claiming service connection for umbilical hernia. The Veteran last underwent a VA hernia examination in February 2020. The examiner noted diagnoses for ventral (umbilical) hernia and status post repair umbilical hernia with scar. The Veteran reported that his hernia condition began between 1988 and 1989 while he was stationed in Germany and that he developed abdominal pain located above his belly button causing him to pass out and wake up in the hospital. The examiner noted that there had been no treatment for a hiatal hernia during service. The Veteran also reported treatment for an umbilical hernia in 2017 with onset of symptoms reported as sharp pain in his abdomen located above his belly button. The Veteran further stated that he never had an umbilical hernia during service as it developed in 2017, and instead stated that he was treated for a hiatal hernia. The examiner opined that it was “less likely as not (less than 50 percent probability)” that the Veteran had a hiatal hernia etiologically related to service. In support of this opinion, the examiner noted that the Veteran clearly stated he was not claiming service connection for an umbilical hernia. As noted above, service connection requires evidence that establishes that the Veteran currently has a disability. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). Here, the Veteran has consistently asserted entitlement to service connection specific for hiatal hernia. He has also specifically stated that he is not claiming entitlement to service connection for inguinal hernia and that he was never treated for an inguinal hernia during service. See February 2020 Report of General Information and February 2020 VA Examination Report. The Board further notes that the Veteran is already service connected for gastrointestinal disturbance with diarrhea and IBS. With regard to his claim for hiatal hernia, during the period on appeal, the Veteran has not been diagnosed with any such condition, and, instead, has only been diagnosed with an inguinal hernia. In this regard, the Board notes that the Veteran’s July 1996 separation examination shows he was found negative for hiatal hernia, and during his September 2004 Army National Guard enlistment examination he denied having a hernia. Shortly thereafter, a March 2006 VA upper GI study found no evidence for a hiatal hernia and he was thereafter assessed with an umbilical hernia. Subsequent medical records consistently note assessments for umbilical hernia. The Board further finds that the evidence of record contradicts the Veteran’s lay statement that he developed a hiatal hernia during service. Instead, a review of his April 1979 enlistment examination shows that he reported having had a hernia at age 3, and a February 2011 VA medical record shows he reported having childhood surgery to repair a right femoral hernia in 1966. The only abdominal conditions noted during service involved gastroenteritis and constipation. Therefore, with regard to the Veteran’s reports of having developed and been treated for a hiatal hernia during service, the Board finds his lay statements of little probative value. Absent a current diagnosis for a hiatal hernia, the Board finds that the first Shedden requirement has not been met and the probative evidence is against the Veteran’s claim for service connection for that condition. The claim is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 58 (1990). S. HENEKS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Lamb, 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.