Citation Nr: 21021082 Decision Date: 04/09/21 Archive Date: 04/09/21 DOCKET NO. 16-18 995A DATE: April 9, 2021 ORDER Entitlement to service connection for dyslipidemia is denied. REMANDED Entitlement to service connection for sleep apnea is remanded. Entitlement to service connection for a back disability is remanded. Entitlement to service connection for a right hip disability is remanded. Entitlement to service connection for a left hip disability is remanded. Entitlement to service connection for a right ankle disability is remanded. Entitlement to service connection for a left ankle disability is remanded. Entitlement to service connection for an acquired psychiatric disability is remanded. Entitlement to service connection for an inguinal hernia is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. FINDING OF FACT Dyslipidemia is a laboratory finding and does not qualify as a disability for VA compensation purposes. CONCLUSION OF LAW The criteria for entitlement to service connection for dyslipidemia have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1978 to May 1979. This appeal was previously before the Board in November 2018, at which time the issues were remanded for additional development. Entitlement to service connection for dyslipidemia The Veteran seeks service connection for dyslipidemia. Notably, under applicable regulation, the term “disability” means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. § 4.1 (2017); see also Hunt v. Derwinski, 1 Vet. App. 292, 296 (1991); Allen v. Brown, 7 Vet. App. 439 (1995). The Veteran’s diagnosis of dyslipidemia only represents laboratory findings, and not an actual disability for which VA compensation benefits are payable. See 61 Fed. Reg. 20440, 20445 (May 7, 1996). The record does not reflect any functional impairment or reduction of earning capacity caused by this condition, including abnormal blood chemistry. As dyslipidemia is not a “disability” for VA compensation benefits purposes, i.e., not a “service-connectable” disability entity, the Veteran has not presented a valid claim of service connection. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). There being no competent medical evidence of a diagnosed chronic disability resulting from the Veteran’s dyslipidemia, the preponderance of the evidence weighs against the Veteran’s claim, and the benefit of the doubt rule does not apply. Service connection for dyslipidemia must be denied. 38 U.S.C. § 5107 (b). REASONS FOR REMAND A remand is necessary to obtain adequate medical opinions regarding the following issues on appeal. 1. Entitlement to service connection for sleep apnea is remanded. The Veteran contends that his sleep apnea is the result of active duty service. In October 2019, he underwent a VA examination where he was diagnosed with obstructive sleep apnea. However, the examiner’s negative nexus opinion is inadequate for the Board to adjudicate the claim because the examiner’s rationale is based entirely on the absence of medical records documenting either sleep apnea or its symptoms either in service or within one year of discharge. Remand is needed to obtain a more thoroughly reasoned addendum opinion that takes the Veteran’s lay statements into consideration. 2. Entitlement to service connection for a back disability is remanded. 3. Entitlement to service connection for a right hip disability is remanded. 4. Entitlement to service connection for a left hip disability is remanded. The Veteran contends that he suffers from back and bilateral hip disabilities that are due to his active duty service. In October 2019, he underwent a VA examination where he was diagnosed with degenerative arthritis of the spine and bilateral hip arthritis. However, the examiner’s negative opinions are inadequate for the Board to adjudicate the respective claims. In concluding that it was less likely than not that the Veteran’s back and hip disabilities were incurred in or caused by an in-service event, the examiner stated that imaging studies conducted during the evaluation “correlate with normal and classic findings of aging process.” However, the examiner failed to explain what the imaging results showed that weighed against a finding that the Veteran’s respected disabilities were the result of active service. Remand is needed to obtain more thoroughly reasoned addendum opinions on the etiology of the Veteran’s back and hip disabilities. 5. Entitlement to service connection for a right ankle disability is remanded. 6. Entitlement to service connection for a left ankle disability is remanded. The Veteran contends that he developed bilateral ankle problems as a result of active duty service. In October 2019, he underwent a VA examination where he was diagnosed with bilateral ankle tendonitis. However, the examiner’s negative nexus opinion is inadequate for the Board to adjudicate the claim because the examiner’s rationale is based entirely on the absence of medical records documenting ankle problems during service. Remand is needed to obtain a more thoroughly reasoned addendum opinion that takes the Veteran’s lay statements into consideration. 7. Entitlement to service connection for an acquired psychiatric disability is remanded. The Veteran contends that he developed bilateral ankle problems as a result of active duty service. In October 2019, he underwent a VA examination where he was diagnosed with unspecified depressive disorder. However, the examiner’s negative nexus opinion is inadequate for the Board to adjudicate the claim because the examiner’s rationale is based entirely on the absence of medical records documenting psychiatric problems during service. Remand is needed to obtain a more thoroughly reasoned addendum opinion that takes the Veteran’s lay statements into consideration. 8. Entitlement to service connection for an inguinal hernia is remanded. The Veteran contends that he developed an inguinal hernia as a result of active duty service. In October 2019, he underwent a VA examination where he was diagnosed with an inguinal hernia. However, the examiner’s negative nexus opinion is inadequate for the Board to adjudicate the claim because the examiner’s rationale is based entirely on the absence of medical records documenting a hernia diagnosis during service. The examiner also failed to explain why service treatment records documenting the Veteran’s treatment for groin pain was not indicative of his presently diagnosed hernia. Remand is needed to obtain a more thoroughly reasoned addendum opinion that takes the Veteran’s lay statements into consideration. 9. Entitlement to a TDIU is remanded. The Veteran’s claim for entitlement to TDIU is inextricably intertwined with his remanded claims for service connection. Therefore, adjudication of this issue will be deferred at this time. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. Provide the Veteran with a new VA examination to help determine the likely etiology of the claimed sleep apnea. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. After review of the record and examination of the Veteran, the examiner is asked to respond to the following: (a) Elicit from the Veteran and the record the history of all signs and symptoms associated with the claimed sleep apnea during service and since separation from service. (b) Opine whether it is at least as likely as not (50 percent probability or greater) that the diagnosed sleep apnea had its onset during service or is otherwise related to it. A complete rationale should be provided for all opinions. 2. Obtain an addendum medical opinion from an appropriate VA examiner to help determine the likely etiology of the claimed back, bilateral hip, and bilateral ankle disabilities. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. After review of the record, the examiner is asked to respond to the following: (a) Identify all currently diagnosed back, right/left hip, and right/left ankle disabilities. (b) For each currently diagnosed disability, opine whether it is at least as likely as not (50 percent probability or greater) had its onset during service or is otherwise related to it. Specifically explain why current findings are/are not related to service. Please note: lack of contemporaneous medical records does not serve as an “absolute bar” to the service connection claim and cannot be used as a rationale in explaining why the current disability is not related to service. 3. Obtain an addendum medical opinion from an appropriate VA examiner to help determine the likely etiology of the claimed acquired psychiatric disorder. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. After review of the record, the examiner is asked to respond to the following: (a) Identify all currently diagnosed acquired psychiatric disorders since the date of claim in 2015. (b) For each currently diagnosed psychiatric disorder, opine whether it is at least as likely as not (50 percent probability or greater) had its onset during service or is otherwise related to it, to include any verified stressors reported by the Veteran. Please note: lack of contemporaneous medical records does not serve as an “absolute bar” to the service connection claim and cannot be used as a rationale in explaining why the current disability is not related to service. 4. Obtain an addendum medical opinion from an appropriate VA examiner to help determine the likely etiology of the claimed inguinal hernia. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. After review of the record, the examiner is asked to respond to the following: Is it at least as likely as not (50 percent probability or greater) that the diagnosed inguinal hernia had its onset during service or is otherwise related to it? A complete rationale should be provided for all opinions. The examiner is asked to specifically address service treatment records showing the Veteran’s complaints of groin pain and its potential relationship to the presently diagnosed hernia. 5. Complete any other development deemed necessary, and readjudicate the issues on appeal, including the inextricably intertwined issue of entitlement to a TDIU. A. Yaffe Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Jack S. Komperda, 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.