Citation Nr: 21023562 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 15-24 340 DATE: April 21, 2021 ORDER Service connection for a kidney disorder is denied. FINDINGS OF FACT 1. The Veteran served on active duty from April 1969 to April 1971. 2. A kidney disorder was not shown in service, was not continuous since service or shown to a compensable degree within one year of separation from service, was not shown for many years after service, and is not causally or etiologically related to service. CONCLUSION OF LAW A kidney disorder was not incurred in service and may not be presumed to have been incurred in service. 38 U.S.C. §§ 1101, 1110, 1112, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309, 3.310 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSION In February 2019, the Board remanded the appeal for additional development. The case has now been returned to the Board for further appellate action. Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. The Veteran asserts that he has a kidney disorder which began during active duty and was manifested by back pain, changes in his urine, and swelling of his hands and feet. Alternatively, he suggests that his kidney disorder began within one year of service. Initially, his treatment records show that he was diagnosed with renal disease in 1994. Thus, a current diagnosis is shown, and the first element of service connection is met. As to an in-service incurrence, the service treatment records (STRs) are silent as to any treatment for, diagnosis of, or complaints of a kidney disorder or reasonably attributable symptoms during service. Specifically, the clinical evaluation of all systems was normal at the April 1971 separation examinations. The Veteran reported no symptoms of kidney disorders and a urinalysis at separation was normal. Nonetheless, the Veteran filed a claim for service connection within one year of separation from active duty. He has also reportedly asserted, and his wife has submitted statements corroborating, that he had complained of kidney issues since 1971. To the extent that the Veteran asserts a medical nexus between his current diagnosis of renal disease and active duty, an October 2019 VA examiner diagnosed the Veteran with a kidney transplant, dating to 2005, nephrosclerosis, dating to 1994, and chronic renal disease, dating to 1994. After examining the Veteran and reviewing his treatment records, the examiner opined it was less likely than that the Veteran’s current disorder was due to service. The examiner reasoned that a review of the STRs and private medical records did not reveal evidence of onset during active duty. The examiner noted that the Veteran and his wife supported the history obtained from the records at all points. The examiner stated that the Veteran did not receive a diagnosis for renal disease until 1994 and that there was no indication of renal disease from 1969 to 1971, during his period of active duty. This evidence weighs against the appeal. In January 2020, a VA examiner opined it was less likely than not that the Veteran’s renal disease was due to active duty. The examiner reasoned that the Veteran’s May 1968 induction examination was normal, and his urine was negative at that time with no signs of protein. The examiner reflected that the April 1971 separation examination was also normal, with normal urine without protein. The examiner noted that the Veteran was diagnosed with a probable urinary tract infection (UTI) in April 1971, with a follow up urinalysis and an intravenous pyelogram (IVP) was also negative in May 1971. The examiner stated that given the normal urine findings at the start of his service and again when separated, it was unlikely that renal disease began in service. Specifically, the examiner noted that a healthy kidney did not let protein pass into the urine from the blood, while a damaged kidney lets some protein pass into the urine. Thus, since the urinalysis and IVP were negative at the time of discharge, this proved no evidence of kidney damage during service. The Board finds that the examination was adequate for evaluation purposes. Specifically, the examiners reviewed the claims file, interviewed the Veteran, and conducted a physical examination. There is no indication that the VA examiner was not fully aware of the Veteran’s past medical history or that he misstated any relevant fact. Moreover, the examiner has the requisite medical expertise to render a medical opinion regarding the etiology of the disorder and had sufficient facts and data on which to base the conclusion. Further, there is no contradicting medical evidence of record. Therefore, the Board finds the VA examiner’s opinion to be of great probative value. Turning to presumptive service connection based on chronicity and continuity, the medical evidence does not reveal that the Veteran developed a renal disorder within one year of his discharge from service. In this regard, treatment and diagnosis are not seen until 1994, more than 20 years following separation from service. This is outside the one-year presumption period and not shown to a compensable rating within one year of discharge. Despite filing a claim in 1971, no medical evidence was presented at that time suggesting that service connection was warranted. Next, the record does not establish continuity of symptomatology under 38 C.F.R.§ 3.309 (a). As noted above, the medical evidence shows that that the Veteran’s kidney disorder began in 1994, more than 20 years after separation from service. Therefore, a kidney disorder was not shown until 1994 with documentation beginning at the same time. In light of the above, the medical evidence weighs against presumptive service connection based on chronicity or continuity of symptomatology. The Board has also considered the Veteran’s lay statements that his disorder was caused by service. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his current disorder due to the medical complexity of the matter involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claim for service connection and there is no doubt to be otherwise resolved. As such, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Yacoub 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.