Citation Nr: 21022874 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 12-24 379A DATE: April 19, 2021 ORDER Service connection for hypertension is denied. Service connection for herpes is denied. FINDINGS OF FACT 1. Symptoms of hypertension did not start in service, were not continuous since service, and did not manifest to a compensable degree within one year of service separation. 2. Herpes was not incurred during service nor did it manifest therefrom. CONCLUSIONS OF LAW 1. The criteria to establish service connection for hypertension have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. 2. The criteria to establish service connection for herpes have not been met. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Army from November 1983 to September 1990, served with the National Guard from September 1990 to October 1992, and with the Army Reserve from October 1992 to April 2015. In December 2020, the Board remanded the appeal because the Veteran did not waive review of newly submitted evidence by the agency of original jurisdiction (AOJ). The AOJ reviewed the evidence and readjudicated the appeals in a December 2020 supplemental statement of the case (SSOC). Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009). Service connection may also be established for a current disability on the basis of a presumption that certain chronic diseases that manifested to a compensable degree within a certain time after service must have had their onset in service. 38 U.S.C. §§ 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309(a). Service connection for a recognized chronic disease can also be established through continuity of symptomatology. Walker v. Shinseki, 708 F.3d 1331 (2013); 38 C.F.R. §§ 3.303(b), 3.309. For chronic diseases shown as such in service or within the applicable presumptive period, subsequent manifestations of the same chronic disease at any later date are service-connected unless attributable to an intercurrent cause. 38 C.F.R. § 3.303(b). For a chronic disease to be considered to have been "shown in service," there must be a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings. Id. When the condition noted in-service or within the presumptive period is not a chronic disease, a showing of continuity of symptomatology after discharge is required. Id. VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154(a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Lay evidence cannot be determined to be not credible merely because it is unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). However, the lack of contemporaneous medical evidence can be considered and weighed against a Veteran's lay statements. Id. Further, a negative inference may be drawn from the absence of complaints or treatment for an extended period. Maxson v. West, 12 Vet. App. 453, 459 (1999), aff'd sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b). 1. Service connection for hypertension is denied. For VA purposes, the term “hypertension” means that the diastolic blood pressure is predominantly 90 mm or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160 mm or greater with a diastolic blood pressure of less than 90 mm. See 38 C.F.R. § 4.104, Diagnostic Code 7101, Note (1). A diagnosis of hypertension requires two or more readings on at least three different days. Id. Multiple blood pressure readings to be taken over multiple days as specified in Note (1) of diagnostic code 7101 applies to confirming the existence of hypertension. Gill v. Shinseki, 26 Vet. App. 386, 391 (2013). The Veteran’s service treatment records (STRs) do not indicate any treatment for, complaints of, or diagnoses related to hypertension. An April 1984 STR indicates a blood pressure reading of 116/68. A May 1985 STR indicates a blood pressure reading of 100/82. An April 1987 STR indicates a blood pressure reading of 104/64. A May 1987 STR indicates a blood pressure reading of 109/80. A June 1987 STR indicates a blood pressure reading of 120/80. A February 1989 STR indicates a blood pressure reading of 108/60. In the October 1992 report of medical history at entrance into the Army Reserve, the Veteran denied then having or ever having had high or low blood pressure. In the June 1997 report of medical history during reserve service, the Veteran denied then having or ever having had high or low blood pressure. A May 2002 report of medical examination during reserve service indicates a blood pressure reading of 127/78. In a May 2002 report of medical history, the Veteran denied then having or ever having had high or low blood pressure. An October 2007 report of medical examination during reserve service indicates a blood pressure reading of 120/76. A March 2009 periodic health assessment during reserve service indicates reported high blood pressure, which was treated with medication. Medical records for the remainder of the Veteran’s reserve service show treatment for high blood pressure with medication. A June 2010 VA examination indicates that the Veteran had a positive history of hypertension, which was controlled by continuous treatment with Lisinopril. In a November 2019 VA examination, the Veteran reported that he was diagnosed with hypertension in 1990 after his active service, but that he did not seek medical treatment for his symptoms. The examiner opined that the Veteran’s hypertension was not incurred in or caused by his active service. The examiner noted that the Veteran’s STRs do not contain a diagnosis of hypertension in service. The Veteran is not competent to opine that his current hypertension is due to an event, injury, or disease during service. He has not been shown to have the medical expertise to provide such an opinion. Further, there is no competent evidence of record showing a possible link between the Veteran’s current hypertension and his active service. Although the Veteran contends that he was diagnosed with hypertension shortly after his active service, the evidence does not corroborate his contention. As recently as October 2007, his blood pressure readings were normal and he repeatedly stated that he did not have, nor had he ever had, high blood pressure. He did not report high blood pressure until March 2009. There was no in-service injury, event, or disease of which his hypertension is related, and the evidence does not establish that his hypertension had its onset within one year of his discharge from active service. The most probative evidence does not show a continuity of symptomatology. Therefore, service connection for hypertension is not warranted and the appeal is denied. 2. Service connection for herpes is denied. The Veteran’s STRs contain multiple complaints of and treatment for facial rash related to shaving. March 1987 and May 1989 STRs show treatment for gonorrhea. However, his STRs do not show treatment for herpes in service. The report of a June 2010 VA examination states that the Veteran had a history of genital herpes, but that he had never been treated for the disease. The Veteran reported that he had the disease in service while stationed in Germany. The Veteran was afforded a VA examination in November 2019. The examiner noted that the Veteran reported onset of genital herpes in approximately 1989 or 1990. The examiner noted that the Veteran’s symptoms are intermittent, and that he is not cured. The examiner opined that the Veteran’s herpes was not incurred in or caused by service. The examiner stated that the Veteran was treated for gonorrhea, not herpes, in service, and there is no indication of a diagnosis of herpes in service. Although the Veteran reported that herpes began in service, he is not competent to make a medical diagnosis of a disease because he does not have the requisite medical training or knowledge. His STRs indicate that he had a different disease: gonorrhea. The only competent opinion of record is that of the November 2019 examiner who concluded that herpes did not begin in service. (Continued on the next page)   Therefore, service connection for herpes is not warranted and the appeal is denied. Jacqueline E. Miller Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Timothy T. Emmart 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.