Citation Nr: 21024311 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 15-42 105 DATE: April 22, 2021 ORDER 1. Entitlement to service connection for a bilateral hearing loss disability is denied. 2. Entitlement to service connection for tinnitus is denied. 3. Entitlement to service connection for a middle finger and right hand damage disability is denied. 4. Entitlement to service connection for shin splints is denied. 5. Entitlement to service connection for a left foot disability is denied. 6. Entitlement to service connection for a right foot disability is denied. 7. Entitlement to service connection for a muscle disability is denied. 8. Entitlement to service connection for a joint pain disability is denied. 9. Entitlement to service connection for sleep disturbances is denied. 10. Entitlement to service connection for colon syndrome is denied. 11. Entitlement to service connection for a penile disability is denied. 12. Entitlement to service connection for a bowel disability and/or irritable bowel syndrome is denied. 13. Entitlement to service connection for a digestive disability is denied. 14. Entitlement to service connection for a groin disability is denied. 15. Entitlement to service connection for a jaw disability is denied. 16. Entitlement to service connection for a left arm disability is denied. 17. Entitlement to service connection for a cervical spine disability is denied. 18. Entitlement to service connection for a lumbar spine disability is denied. 19. Entitlement to service connection for a prostate grand disability is denied. 20. Entitlement to service connection for a stomach disability is denied. 21. Entitlement to service connection for a prolapsed esophageal sphincter is denied. 22. Entitlement to service connection for a bladder disability is denied. 23. Entitlement to service connection for headaches and/or migraines is denied. REMANDED 24. Entitlement to service connection for a psychiatric disorder, previously claimed as anxiety, nervousness, stress, and posttraumatic stress disorder (PTSD), is remanded. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran meets the VA criteria for a bilateral hearing loss disability that had an onset during his active service. 2. The preponderance of the evidence is against finding that tinnitus had an onset in service, manifested to a compensable degree within one year of service discharge, or is otherwise related to service. 3. The preponderance of the evidence is against finding that a middle finger and right hand damage disability had its onset in service or is otherwise related to service. 4. The preponderance of the evidence of record is against finding that the Veteran has had shin splints, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 5. The preponderance of the evidence of record is against finding that the Veteran has had a left foot disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 6. The preponderance of the evidence of record is against finding that the Veteran has had a right foot disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 7. The preponderance of the evidence of record is against finding that the Veteran has had a muscle disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 8. The preponderance of the evidence of record is against finding that the Veteran has had a joint disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 9. The preponderance of the evidence of record is against finding that the Veteran has had sleep disturbances, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 10. The preponderance of the evidence of record is against finding that the Veteran has had colon syndrome, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 11. The preponderance of the evidence of record is against finding that the Veteran has had a penile disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 12. The preponderance of the evidence of record is against finding that the Veteran has had a bowel disability and/or irritable bowel syndrome, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 13. The preponderance of the evidence of record is against finding that the Veteran has had a digestive disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 14. The preponderance of the evidence of record is against finding that the Veteran has had a groin disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 15. The preponderance of the evidence of record is against finding that the Veteran has had a jaw disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 16. The preponderance of the evidence of record is against finding that the Veteran has had a left arm disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 17. The preponderance of the evidence of record is against finding that the Veteran has had a cervical spine disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 18. The preponderance of the evidence of record is against finding that the Veteran has had a lumbar spine disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 19. The preponderance of the evidence of record is against finding that the Veteran has had prostate gland disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 20. The preponderance of the evidence of record is against finding that the Veteran has had a stomach disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 21. The preponderance of the evidence of record is against finding that the Veteran has had prolapsed esophageal sphincter, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 22. The preponderance of the evidence of record is against finding that the Veteran has had a bladder disability, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. 23. The preponderance of the evidence of record is against finding that the Veteran has had headaches and/or migraines, to include pain that causes functional impairment that affects earning capacity, at any time during or approximate to the pendency of the claim. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a bilateral hearing loss disability have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2020). 2. The criteria for entitlement to service connection for tinnitus have not been met.38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2020). 3. The criteria for entitlement to service connection for a middle finger and right hand damage disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 4. The criteria for entitlement to service connection for shin splints have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 5. The criteria for entitlement to service connection for a left foot disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 6. The criteria for entitlement to service connection for a right foot disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 7. The criteria for entitlement to service connection for a muscle disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 8. The criteria for entitlement to service connection for a joint pain disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 9. The criteria for entitlement to service connection for sleep disturbances have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 10. The criteria for entitlement to service connection for colon syndrome have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 11. The criteria for entitlement to service connection for a penile disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 12. The criteria for entitlement to service connection for a bowel disability and/or irritable bowel syndrome have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 13. The criteria for entitlement to service connection for a digestive disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 14. The criteria for entitlement to service connection for a groin disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 15. The criteria for entitlement to service connection for a jaw disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 16. The criteria for entitlement to service connection for a left arm disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 17. The criteria for entitlement to service connection for a cervical spine disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 18. The criteria for entitlement to service connection for a lumbar spine disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 19. The criteria for entitlement to service connection for a prostate grand disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 20. The criteria for entitlement to service connection for a stomach disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 21. The criteria for entitlement to service connection for a prolapsed esophageal sphincter have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 22. The criteria for entitlement to service connection for a bladder disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). 23. The criteria for entitlement to service connection for headaches and/or migraines have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 2001 to December 2004 with subsequent enlistment in the National Guard through February 2011. The Board remanded these matters in November 2018 and August 2020 for additional development. In consideration of the appeal, the Board is satisfied there was substantial compliance with the remand directives and will proceed with review. Stegall v. West, 11 Vet. App. 268 (1998). In a January 2021 submission, the Veteran requested that his case be advanced on the docket and stated it was because he has a diagnosis of multiple sclerosis and expressed concern about his financial status. The Board has found good cause for his request to have his case advanced on the docket, and has granted such motion. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by service. See 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. Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection is also warranted for a disability which is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Such secondary service connection is warranted for any increase in severity of a nonservice-connected disability that is proximately due to or the result of a service-connected disability. 38 C.F.R. § 3.310(b). Additionally, where a veteran served 90 days or more of active service, and certain chronic diseases, become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a). 1. Entitlement to service connection for a bilateral hearing loss disability The Veteran asserts that he has a bilateral hearing loss disability that is secondary to a psychiatric disorder. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the claim for service connection for a bilateral hearing loss disability. The reasons follow. Initially, the Board notes that VA has not provided the Veteran with examination or medical opinions in connection with the claim for service connection for a bilateral hearing loss disability. VA must provide a medical examination when there is (1) evidence of a current disability, (2) evidence establishing that an event, injury, or disease occurred in service, or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran’s service, but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this case, as discussed more in detail below, as to the claim for service connection for a bilateral hearing loss disability, the Board finds that the evidence does not show a current bilateral hearing loss disability for VA purposes, nor does the evidence establish that an event, injury, or disease occurred in service or during the applicable presumptive period for which the claimant qualifies. For a VA examination to be warranted, all the McLendon criteria have to be met, and at least one element is not met for each of these claims. Therefore, entitlement to a VA examination is not warranted for this service-connection claim. For the purpose of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz (Hz) is 40 decibels or greater; or when the auditory thresholds for at least three of these frequencies are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. The record does not document that the Veteran meets the criteria for a bilateral hearing loss disability for VA purposes. The Veteran was not provided an examination, nor is an examination warranted, as noted above, but the Veteran has also not submitted evidence or any statements endorsing that he experiences current hearing loss since filing this claim in July 2013. However, even if filing a claim is sufficient to assume that he experiences some hearing loss, the preponderance of the evidence is against finding that any symptoms of hearing loss had an onset in service or within one year of discharge from active service. The service treatment records (STRs) do not reflect any complaints, treatments, or diagnosis of a hearing loss disability. Rather, on a January 2004 Health History, approximately one year prior to his service discharge, the Veteran did not report experiencing medical problems or symptoms of hearing loss, despite reporting that he had other medical problems and symptoms, including a lump in the right ancillary region. The Veteran also filled out this form with an attention to detail, writing in a smoking history as well as a diet history without being prompted. The Board finds it highly probative that the Veteran did not report symptoms of hearing loss, despite providing such detailed responses throughout the remainder of the form. After discharge from service, the Veteran continued to fill out Health History Questions without mentioning symptoms of hearing loss in August 2005, August 2006, August 2007, August 2008, and January 2009. Additionally, a December 2009 Report of Medical Assessment and hearing examination documented that the Veteran had normal hearing. Though the Veteran was issued hearing protection and the examiner documented a threshold shift, the Veteran specifically denied having difficulty hearing and denied that his hearing was getting worse or that he had any changes to his hearing. Pure tone thresholds, in decibels, for the ears at that time were as follows: HERTZ 500 Hz 1000 Hz 2000 Hz 3000 Hz 4000 Hz RIGHT 5 0 5 10 15 LEFT 10 0 0 10 15 In February 2010, the Veteran reported exposure to loud noises while working on the flight line, but he did not report experiencing symptoms of hearing loss in the Health History Questions. The Veteran has reported exposure to loud noises during service, and the Veteran is competent to report being around loud noises in service, such as engine noise on the flight line. However, the STRs do not document any complaints of hearing loss in service or in the years immediately after his discharge and throughout his National Guard service. Given the aforementioned medical history and lack or reports of symptoms in service and throughout National Guard Service, the Board finds that the preponderance of the evidence is against finding that the bilateral hearing loss disability, to the extent that it may currently exist, had an onset during his active service, within one year following his discharge from active service, or even in the years in which he served in the National Guard, which the Board finds is evidence against continuity of symptomatology. Finally, the Veteran has asserted that his bilateral hearing loss disability is secondary to his claim for service connection for a psychiatric disorder. However, as the record does not show a current diagnosis of a hearing loss disability, and the Veteran has not provided any evidence to support hearing loss onset as secondary to a psychiatric disorder other than a vague assertion, the Board finds that further development as to this claim is not necessary. In reaching the above conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, that doctrine is not applicable where, as here, there is not an approximate balance of positive and negative evidence. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Thus, the claim for service connection for a bilateral hearing loss disability is denied. 2. Entitlement to service connection for tinnitus. The Veteran believes that he has tinnitus that is secondary to a bilateral hearing loss disability. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the claim for service connection for tinnitus. The reasons follow. Throughout the period on appeal, the Veteran has not provided any statement to assert that he current experiences symptoms of tinnitus. However, given that there is not testing to diagnose tinnitus and a diagnosis is provided based solely on reported symptoms, the Board will proceed as though there is a diagnosis of tinnitus. Initially, the Board notes that the Veteran is not service connected for a bilateral hearing loss disability. Thus, the claim for tinnitus as secondary to a bilateral hearing loss disability is denied. Despite not meeting the requirements for service connection on a secondary basis, the Board will still consider service connection on a direct basis or chronic basis. However, as to evidence of a disease or injury in service, the STRs do not show that any current tinnitus had an onset in service or within one year of discharge from active service. Rather, on a January 2004 Health History, completed just one year prior to his discharge from active service, the Veteran did not report experiencing medical problems or symptoms of tinnitus, despite reporting that he did have other medical problems and symptoms, including a lump in the right ancillary region. The Veteran also filled out this form with an attention to detail, writing in a smoking history as well as a diet history without being prompted. The Board finds it highly probative that the Veteran did not report any symptoms of tinnitus, despite providing such detailed responses throughout the remainder of the form. After discharge from service, the Veteran continued to fill out Health History Questions without mentioning symptoms of tinnitus in August 2005, August 2006, August 2007, August 2008, January 2009, and February 2010. Furthermore, on a Report of Medical Assessment completed by the Veteran in December 2009, the Veteran specifically denied experiencing ringing in his ears. The first indication in the claims file that the Veteran is presumably experiencing symptoms of tinnitus is the claim the Veteran filed for service connection for tinnitus in July 2013, approximately 9 years after his discharge from active service. Thus, the Veteran does not meet the second element of a service-connection claim, nor does the evidence suggest an onset of tinnitus within one year of service or continuity of symptomatology since service. The Board notes that VA has not provided the Veteran with an examination or medical opinion in connection with the claim for service connection for tinnitus. VA must provide a medical examination when there is (1) evidence of tinnitus, (2) evidence establishing that an event, injury, or disease occurred in service, or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran’s service, but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this case, the Board finds that the evidence does not show an event, injury, or disease occurred in service. For a VA examination to be warranted, all the McLendon criteria have to be met, and at least one element is not met for each of these claims. Therefore, entitlement to a VA examination is not warranted for this service connection claim. In reaching the above conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, that doctrine is not applicable where, as here, there is not an approximate balance of positive and negative evidence. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Thus, the claim for service connection for tinnitus is denied. 3. Entitlement to service connection for a middle finger and right hand damage disability The Veteran reported to the November 2019 VA examiner that he injured his right middle finger in November 2003 while in service and was diagnosed with a subungual hematoma, and he believes that his current right middle finger and right hand pain is related to the November 2003 injury. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the claim for service connection for middle finger and right hand damage disability. The reasons follow. As to evidence of a current disability, a November 2019 VA examination report shows that the Veteran was diagnosed with right middle finger strain. Therefore, the Veteran meets the first element of a service-connection claim. As to evidence of a disease or injury, the STRs show that the Veteran sustained a crush injury to his right middle finger in November 2003. The Veteran was placed on a one-week profile for this injury. Thus, the Veteran meets the second element of a service-connection claim. However, as to evidence of a nexus between the current disability and service, the Board finds that this element of a service-connection claim is not met. The November 2019 VA examiner opined that the current right middle finger strain is not at least as likely as not related to the November 2003 crush injury. The examiner documented that the Veteran, in November 2019, was reporting pain in the DIP and PIP joints of his right middle finger as well as burning pain in the finger, especially during cold weather. The examiner noted that the claims file does not document that the Veteran had follow-up treatment for his right middle finger in surgery, which the examiner notes suggests the injury resolved. Furthermore, the examiner opined that the current pain on his DIP and PIP joints is unlikely related to the in-service hematoma as a hematoma would not affect the DIP and PIP joints of the finger. Thus, the examiner opined that the current examination and reported symptomatology is not consistent with being residual symptomatology of the November 2003 crush injury and resulting hematoma. The Board finds that the November 2019 VA medical opinion is highly probative, as the examiner reviewed the file, listened to the report of history, physically examined the Veteran, and provided a rationale for the opinion that relied on the specific facts of the case, which facts are accurate. This is evidence against a nexus between the current disability and service. There is no competent evidence to weigh against this medical opinion. Thus, the Board finds that the preponderance of the evidence is against finding a nexus between the current right middle finger and hand damage disability and the November 2003 crush injury. The Board also acknowledges the claim that his current right middle finger strain is caused or aggravated by his claimed acquired psychiatric disorder. However, the Veteran has not provided any evidence or argument to support this secondary claim, and the medical evidence in the claims file does not support any connection between the two claims. Thus, the Board finds additional development as to the secondary claim is not warranted. In reaching the above conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, that doctrine is not applicable where, as here, there is not an approximate balance of positive and negative evidence. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Thus, the claim for service connection for a right middle finger and right hand damage disability is denied. 4. – 23. Entitlement to service connection for shin splints, a bilateral foot disability, a muscle disability, a joint pain disability, sleep disturbances, colon syndrome, a penile disability, a bowel disability and/or irritable bowel syndrome, a digestive disability, a groin disability, a jaw disability, a left arm disability, a cervical spine disability, a lumbar spine disability, a prostate gland disability, a stomach disability, a prolapsed esophageal sphincter, a bladder disability, and headaches and/or migraines The Veteran presumably believes that he has shin splints, a bilateral foot disability, a muscle disability, a joint pain disability, sleep disturbances, colon syndrome, a penile disability, a bowel disability and/or irritable bowel syndrome, a digestive disability, a groin disability, a jaw disability, a left arm disability, a lumbar or cervical spine disability, a prostate gland disability, a stomach disability, a prolapsed esophageal sphincter, a bladder disability, and headaches and/or migraines. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the claim for service connection for any of the aforementioned disabilities. The reasons follow. The first element of service connection requires a current disability. After thorough review of the evidence of record, the Board finds the Veteran has not submitted evidence that he has any of these claimed disabilities during the period on appeal. The Veteran has not submitted any medical evidence to support a current disability during the period on appeal, nor has the Veteran submitted any statements, other than filing a claim in July 2013, to support any current disabilities, to note his current symptomatology or functional impairment or to support any connection between his service and his claimed disabilities. The AOJ and the Board have made multiple attempts to obtain this necessary evidence from the Veteran. In April 2014, VA called the Veteran to confirm his claims, noting that many of them seem to be claimed as secondary to other contentions. The Veteran reiterated his claims, many of which were claimed as secondary to a psychiatric disorder, but did not appear to provide any support as to these contentions or to provide any support for his claims other than to reiterate what disabilities he was claiming. Following the issuance of a rating decision, for which all the aforementioned disabilities were denied for a lack of diagnosis, the Veteran submitted a Notice of Disagreement without further supporting his contentions. Following the issuance of a Statement of the Case, the Veteran submitted a VA Form 9 to appeal his claims, but again, the Veteran did not provide any evidence or statements to support that he has a current disability or symptoms related to any of these claims. In November 2018, the Board remanded these claims, in part to attempt to obtain any and all post-service medical care. In August 2019, VA requested that the Veteran complete a VA Form 21-4142 for any private medical treatment since service. The only provider for which the Veteran provided a VA Form 21-4142 was for Barnes Jewish Hospital, Center for Advanced Medicine. These records were obtained by the Board, and a thorough review of these records does not support symptomatology or a current disability for any of the claimed disabilities since the Veteran filed this claim in July 2013. In June 2020, VA called the Veteran to provide him an update as to the status of the appeal. The Veteran was notified that an SSOC had been sent and that he had 30 days to submit any additional evidence. The Veteran did not submit any additional evidence in support of his claims. Despite this, the Board again remanded the claims in August 2020 to request that the Veteran provide additional evidence to support his claims and clearly ask the Veteran to specify each claimed disability, when the disability began, and what he believes caused each disability as well as to obtain additional private treatment records from Dr. H.H.L. at Washington University and the St. Louis School of Medicine’s Division of Urologic Surgery. In August 2020, VA sent the Veteran a letter requesting that he submit a VA Form 21-4142 for the records from Dr. H.H.L, and specifically requested that he submit any additional evidence related to his claims on appeal, which were listed. He was asked to specify each disability, when the disability began, and what he believed caused the disability. Having not received a response, VA made the same request again in September 2020. In December 2020, VA received a July 2011 letter as well as two pages of treatment records that noted that the Veteran had perineal and pelvic symptoms attributed to prostatitis, separate from his hemorrhoid pain. The treatment records were from February 2009. The Veteran filed this claim in July 2013. Thus, these records do not support a finding that the Veteran has a current disability during the period on appeal, nor has the Veteran submitted any statement to suggest he still has this diagnosis or experiences any current symptoms related to it. The Veteran did not respond to the request for statements regarding the claimed disability, their onset, and their relationship to his service. The Veteran has been provided multiple opportunities to submit medical evidence supporting that he has current symptomatology or diagnoses of his claimed disabilities, or, in the alternative, to provide lay statements of his current symptomatology or an explanation for why he believes his claimed disabilities are related to service or other service-connected disabilities. The Veteran has not provided this evidence. Thus, the Board finds that the preponderance of the evidence is against finding that the Veteran has a current disability or symptoms causing functional impairment during the period on appeal for shin splints, a bilateral foot disability, a muscle disability, a joint pain disability, sleep disturbances, colon syndrome, a penile disability, a bowel disability and/or irritable bowel syndrome, a digestive disability, a groin disability, a jaw disability, a left arm disability, a lumbar or cervical spine disability, a prostate gland disability, a stomach disability, a prolapsed esophageal sphincter, a bladder disability, and headaches and/or migraines, and service connection is denied. The Board notes that VA has not provided the Veteran with examination or medical opinions in connection with the claims for service connection for shin splints, a bilateral foot disability, a muscle disability, a joint pain disability, sleep disturbances, colon syndrome, a penile disability, a bowel disability and/or irritable bowel syndrome, a digestive disability, a groin disability, a jaw disability, a left arm disability, a lumbar or cervical spine disability, a prostate gland disability, a stomach disability, a prolapsed esophageal sphincter, a bladder disability, and headaches and/or migraines. VA must provide a medical examination when there is (1) evidence of a current disability or symptomatology (2) evidence establishing that an event, injury, or disease occurred in service, or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran’s service, but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this case, as to the claims for service connection for shin splints, a bilateral foot disability, a muscle disability, a joint pain disability, sleep disturbances, colon syndrome, a penile disability, a bowel disability and/or irritable bowel syndrome, a digestive disability, a groin disability, a jaw disability, a left arm disability, a lumbar or cervical spine disability, a prostate gland disability, a stomach disability, a prolapsed esophageal sphincter, a bladder disability, and headaches and/or migraines, the Board finds that the evidence does not show shin splints, a bilateral foot disability, a muscle disability, a joint pain disability, sleep disturbances, colon syndrome, a penile disability, a bowel disability and/or irritable bowel syndrome, a digestive disability, a groin disability, a jaw disability, a left arm disability, a lumbar or cervical spine disability, a prostate gland disability, a stomach disability, a prolapsed esophageal sphincter, a bladder disability, and headaches and/or migraines. For a VA examination to be warranted, all the McLendon criteria have to be met, and at least one element is not met for each of these claims. Therefore, entitlement to a VA examination is not warranted for these service-connection claims. The Board also acknowledges that the Veteran has asserted many of his claims are secondary to other claimed disabilities, most frequently a psychiatric disorder. However, as the Veteran has not met the first element of a service connection claim, which requires a current diagnosis, service connection on a secondary basis is also denied. In reaching the above conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, that doctrine is not applicable where, as here, there is not an approximate balance of positive and negative evidence. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Thus, the claims for service connection for shin splints, a bilateral foot disability, a muscle disability, a joint pain disability, sleep disturbances, colon syndrome, a penile disability, a bowel disability and/or irritable bowel syndrome, a digestive disability, a groin disability, a jaw disability, a left arm disability, a lumbar or cervical spine disability, a prostate gland disability, a stomach disability, a prolapsed esophageal sphincter, a bladder disability, and headaches and/or migraines are denied. REASONS FOR REMAND 24. Entitlement to service connection for a psychiatric disorder, previously claimed as anxiety, nervousness, stress, and PTSD, is remanded. The Veteran was provided a VA examination in November 2019. The examiner noted that the Veteran did not meet the criteria for PTSD as his symptoms did not meet the diagnostic criteria. However, the Veteran was diagnosed with an adjustment disorder with anxiety. The examiner opined that the adjustment disorder with anxiety was not at least as likely as not related to his service because there was “no report of mental health issues during the Veteran’s service time and no consistent report of ongoing mental health problem since military service.” While it is consistent with he claims file that the record is largely silent for mental health treatment since service, the STRs do document that the Veteran was seen in October 2004, just prior to his discharge from active service, for anger problems as well as occupational circumstances and maladjustments. As the examiner’s opinion is based, at least in part, on an inaccurate assessment of the STRs, an addendum opinion is necessary. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the current adjustment disorder with anxiety is at least as likely as not related to active service. If the clinician finds that an in-person examination is warranted, an examination should be scheduled. To assist in a review of the claims file, the examiner is informed of the following facts with citations in the record, when applicable: • The Veteran served on active duty from December 2001 to December 2004. • The Veteran believes he has a psychiatric disorder from his period active duty. He reports that while on active duty, he was called in to the ground control state of the Predator. He was there to fix a piece of equipment. While he was there, there was a mission being executed, where he saw the Predator shoot “hell fire missiles” at an unknown target. Afterward, he reported seeing body parts and rubble all over on a screen. He reported that after such incident, he avoided going in when missions were in operation. His role was to set up the communication system. He was not involved in the firing of the target. See VBMS entry with document type, “C&P Exam,” receipt date 11/11/2019, with “DBQ PSYCH” in the subject field p. 5. • A January 2004 Health History Questions/Interval History shows the Veteran circled, “Yes” to the question of whether he had a high stress job or lifestyle, but then crossed it out and circled, “No.” For the questions of (1) whether he felt he had serious problems dealing with his spouse, parents, children, or friends and (2) whether in the past few months, he had been bothered by feeling down, helpless, panicky, or anxious, he circled, “No.” See VBMS entry with document type, “STR – Medical – Photocopy,” receipt date 09/16/2013, p. 43. • A September 2004 service treatment record shows the Veteran had been prescribed Bupropion. See VBMS entry with document type, “Medical Treatment Record – Government Facility,” receipt date 10/17/2019, p. 7. • In October 2004, the Veteran was seen on two occasions for “counseling for marital and partner problems” and “other occupational circumstances or maladjustment.” The presenting problem was documented as, “Anger.” See VBMS entry with document type, “Medical Treatment Record – Government Facility,” receipt date 10/17/2019, pp. 1, 3, & 4. • VA attempted to obtain more detailed documentation of these two treatment incidents but there are no other records documenting the specifics of the October 2004 treatment. • In August 2005, August 2006, August 2007, and August 2008 Health History Questions/Interval History documents, the Veteran circled, “No” to questions of (1) whether he felt he had a high stress job or lifestyle; (2) whether he felt he had serious problems dealing with his spouse, parents, children, or friends and (3) whether in the past few months he had been bothered by feeling down, helpless, panicky, or anxious. See VBMS entry with document type, “STR – Medical – Photocopy,” receipt date 09/16/2013, pp. 41 (August 2005), 39 (August 2006), 36 (August 2007), and 33 (August 2008). • In the January 2009 Health History Questions/Interval History document, the Veteran responded, “No” to the same three questions. See VBMS entry with document type, “STR – Medical – Photocopy,” receipt date 07/08/2013, with “#3” in the subject field, p. 12. • In the February 2010 Health History Questions/Interval History document, the Veteran circled, “Yes” to the question of whether he had a high stress job or lifestyle, and circled, “No” for whether he felt he had serious problems dealing with his spouse, parents, children, or friends and whether in the past few months he had been bothered by feeling down, helpless, panicky, or anxious. See VBMS entry with document type, “STR – Medical – Photocopy,” receipt date 07/08/2013, with “#3” in the subject field, p. 7. • A November 2019 VA examination report shows the examiner diagnosed the Veteran with adjustment disorder with anxiety. The examiner found that the Veteran did not meet the diagnostic criteria for PTSD under DSM-5. See VBMS entry with document type, “C&P Exam,” receipt date 11/11/2019, with DBQ PSYCH in the subject field. • The November 2019 VA examiner concluded that the Veteran’s adjustment disorder with anxiety was not related to service because there was no report of mental health issues during his service and no consistent report of mental health problems since service. See VBMS entry with document type, “C&P Exam,” receipt date 11/11/2019, with “DBQ Medical Opinion-Psych” in the subject field, p. 2. • In providing the above-described opinion, the November 2019 examiner acknowledged that the September 2004 service treatment record showed the Veteran had been prescribed Bupropion; however, he noted there was no documentation for why it was prescribed, which medication was used for depression, anxiety, smoking cessation, and weight. However, the November 2019 examiner did not acknowledge the October 2004 records described above, which show the Veteran sought treatment for “counseling for marital and partner problems” and “other occupational circumstances or maladjustment.” Hence, the Board is seeking an addendum opinion. • The examiner's review of the record is NOT restricted to the evidence listed above. This list is provided in an effort to assist the examiner in locating potentially relevant evidence. Following a review of the evidence, the examiner is asked whether it is at least as likely as not (50 percent probability or higher) that the Veteran has a psychiatric disorder that had its onset in service from December 2001 to December 2004. In providing this opinion, the examiner is asked to comment on the October 2004 service treatment records that document that the Veteran was seen for “counseling for marital and partner problems” and “other occupational circumstances or maladjustment.” A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Keninger, 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.