Citation Nr: 21025678 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 15-09 208 DATE: April 28, 2021 ISSUE Entitlement to service connection for arthritis of the arms. ORDER Entitlement to service connection for arthritis of the arms is denied. FINDING OF FACT The preponderance of competent and credible evidence weighs against a finding that arthritis of the arms was manifest during service, manifest within one year of separation from service, or is otherwise related to service. CONCLUSION OF LAW The criteria for service connection for arthritis of the arms have not been met. 38 U.S.C. §§ 1101, 1110, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1966 to May 1969. He had additional service in the Air Force Reserve. This case comes to the Board of Veterans’ Appeals (Board) on appeal from a November 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Houston, Texas. The Veteran testified before the undersigned during an April 2018 videoconference hearing. A copy of the transcript is of record. When this case was previously before the Board in February 2021, it was decided in part and remanded in part for additional evidentiary development. The Board finds that there has been substantial compliance with the remand directives. See Stegall v. West, 11Vet. App.268, 271 (1998). Duty to Notify and Assist The Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5102, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2017). The Veteran in this case has not referred to any deficiencies in either the duties to notify or assist; therefore, the Board may proceed to the merits of the claim. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed.Cir. 2015, cert denied, U.S.C. Oct.3, 2016) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board....to search the record and address procedural arguments when the [appellant] fails to raise them before the Board”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to an appellant’s failure to raise a duty to assist argument before the Board). The Board has reviewed all of the evidence in the Veteran’s claims file. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the Veteran or obtained on his behalf be discussed in detail. Rather, the Board’s analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the claims file shows, or fails to show, with respect to the claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-130 (2000). Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. In order to establish service connection for the claimed disorder, there must be (1) medical 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) evidence of a nexus between the claimed in-service disease or injury and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999). Arthritis is a chronic disease listed under 38 C.F.R. § 3.309 (a); however, the Veteran does not contend that his arthritis manifested within one year of separation from active duty. Therefore, service connection on a presumptive basis is not warranted. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). 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. As detailed above, in order to establish service connection for a claimed condition, there must be (1) medical evidence of a current disability; (2) evidence of the in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between (1) and (2). See Hickson, 12 Vet. App. at 253. In this case, the Veteran has a diagnosis of degenerative arthritis of the acromioclavicular joint, both. Private treatment records also show diagnoses of osteoarthritis (OA) and polyarthritis. Accordingly, Hickson element (1) is therefore satisfied. With regard to Hickson element (2), evidence of an in-service incurrence of a disease or injury, the Veteran testified before the undersigned that the arthritis in his arms was related to an incident that occurred during his Air Force Reserve service when he was adjusting a pallet and fell. He testified that when he went to see the clinic, they put him in a sling and told him not to do anything for about two or three days. The Veteran also provided more detail as to how the arthritis of the arms is related to his active duty service duties of working with and lifting heavy equipment on tanks. The Veteran’s DD Form 214 shows that he was a track vehicle repairman. Service treatment records also show that in June 1984 he was placed in an arm sling due to a muscle strain in his left upper arm and tricep; it was noted that he was lifting a pallet that was stuck. In July 1998 he also complained of left arm pain. Accordingly, Hickson element (2) is satisfied. The Veteran was afforded a VA examination in October 2019 in which the examiner opined that the condition claimed was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner stated that there was no evidence of any shoulder injuries or chronic complaints noticed in the service treatment records; the separation examination was negative for joint problems with a normal physical examination of the joints. The examiner stated that there was no evidence of any line of duty “LOD” or shoulder injuries under active duty as a reservist shown on available medical records. The examiner stated that the initial evidence of a diagnosis of degenerative arthritis of the right acromioclavicular joint was from 2011 and the diagnosis of degenerative arthritis of the left acromioclavicular joint was from 2019. The examiner stated that based on the medical evidence and due to the time gap between discharge from active duty and the evidence of the date when the diagnoses of the current claimed conditions were established, with the lack of symptoms during active duty, the current claimed conditions were less likely than not incurred in or caused by the active duty service, active duty for training, inactive duty for training, or otherwise etiologically related to service to include the aforementioned complaints and diagnoses in service. In this case, as to the issue of the etiology of the Veteran’s claimed arthritis of the arms, the Board finds that the VA examiner made it clear that it was his opinion that the disabilities were not related to service. The Board finds that the VA examiner’s opinions are competent and probative as they were rendered after an evaluation of the Veteran, review of the Veteran’s history, and consideration of medical principles by licensed medical professionals. To this point, the Board notes that medical reports must be read as a whole, and the Board is permitted to draw inferences based on the overall report so long as the inference does not result in a medical determination. Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012). Accordingly, the Board concludes that the VA opinions carry significant weight. No other competent opinion providing a positive nexus between the arthritis of the arms and service has been presented. The Board acknowledges that the Veteran is competent to testify as to his beliefs that his arthritis of the arms is related to service. However, there is nothing in the record to suggest that the Veteran has the appropriate training, experience, or expertise to render a medical opinion regarding etiology. See 38 C.F.R. § 3.159 (a)(1) (2017) (setting forth that competent medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions). While the Veteran is competent to report what he has experienced, he is not competent to ascertain the etiology of any current condition, as the causative factors for such are not readily subject to lay observation. See Charles v. Principi, 16 Vet. App. 370, 374-75 (2002); Layno v. Brown, 6 Vet. App. 465 (1994). The Board finds the VA examiner opinions are competent and probative as they were rendered after an evaluation of the Veteran, review of the Veteran’s history, and consideration of medical principles by licensed medical professionals. Therefore, a nexus between the Veteran’s arthritis of the arms and service cannot be established, and the criteria of Hickson element (3) are not met. In reaching this determination, the Board acknowledges that VA is statutorily required to resolve the benefit-of-the-doubt in favor of the Veteran when there is an approximate balance of positive and negative evidence regarding the merits of an outstanding issue. That doctrine, however, is not applicable in this case because the preponderance of the evidence is against the Veteran’s claim. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990); 38 U.S.C. § 5107(b) (West 2014). MICHAEL A. PAPPAS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R.M.K., 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.