Citation Nr: 21028352 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 19-33 285 DATE: May 11, 2021 ORDER Entitlement to service connection for a headache disorder is denied. Entitlement to service connection for tinea cruris is denied. Entitlement to service connection for tinea pedis is denied. REMANDED Entitlement to service connection for bilateral hearing loss is remanded. FINDINGS OF FACT 1. A headache disorder was not shown in service or many years thereafter; and, the preponderance of the evidence fails to establish that a headache disorder is etiologically related to active service. 2. The preponderance of the evidence is against finding that tinea cruris is etiologically related to active service. 3. Tinea pedis was not shown in service or many years thereafter; and, the preponderance of the evidence fails to establish that tinea pedis is etiologically related to active service. CONCLUSIONS OF LAW 1. The criteria for service connection for a headache disorder are not met. 38 U.S.C. § 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for tinea cruris are not met. 38 U.S.C. § 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for tinea pedis are not met. 38 U.S.C. § 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the Air Force from October 2007 to October 2011. The appeal originates from an April 2016 decision of a Department of Veterans Affairs (VA) Regional Office. The Veteran appeared for a hearing before the undersigned in February 2021. The transcript is of record. 1. Entitlement to service connection for a headache disorder. 2. Entitlement to service connection for tinea cruris. 3. Entitlement to service connection for tinea pedis. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease initially diagnosed after service 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 for a disability requires evidence of: (1) a current disability; (2) a disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). The Veteran contends that he has a headache disorder and skin conditions of the groin and feet, which had their onset in service. See February 2021 Hearing Transcript. The April 2016 VA headache examination reflects a diagnosis of atypical headaches. A February 2016 VA skin examination indicates dermatophytosis tinea cruris and pedis. Element (1) of Shedden is met. Service treatment records are silent as to complaints, treatment, or diagnosis of tinea pedis. Though the Veteran contends that he had tinea pedis in service, his reports are deemed credible (see discussion below.) He complained of a slight headache in December 2010 but otherwise denied having headaches and was not treated or diagnosed with a headache disorder in service. As to tinea cruris, he was diagnosed and treated for the condition in September 2009, and it was noted to have resolved in December 2009. A report of medical assessment completed for separation in June 2011 was negative for headache, tinea cruris, or tinea pedis. The Veteran was treated for "hives" in August 2011 but was not found to have other skin rash at that time or a few weeks later. The notations of headache and tinea cruris are sufficient to meet Shedden element (2) but not for tinea pedis. Regarding Shedden element (3) or a nexus, the October 2016 examiner opined that a headache disorder, tinea cruris, and tinea pedis are less likely as not related to service. The examiner determined that there was no pathophysiologic relationship between the Veteran's diagnoses and service. The examiner found that there was no medical evidence to indicate that the headache and skin conditions did not resolve without residuals. The examiner noted that headache, tinea cruris, and tinea pedis were not listed on the June 2011 separation assessment or on a chronic problems list in August 2011. Recognition is given to the fact that the examiner did not specifically address the Veteran's assertions that he developed a headache disorder from exposure to fuel and fumes or skin disorders from contaminated water. See February 2021 Hearing Transcript. However, this is unnecessary as the Veteran is not competent to make these assertions and offers no competent evidence to support the proposed linkages. The Board notes the April 2016 VA opinion indicating that tinea cruris and pedis were incurred in service. No explanation was offered for this finding. With respect to tinea pedis, the opinion was apparently based on the Veteran's assertion that he had the condition in service (which is not credible), as the service treatment records do not show tinea pedis. Although tinea cruris was noted in service, service treatment records show that the condition resolved, and the October 2016 examiner found no evidence of residuals. For these reasons, the April 2016 opinion is outweighed by the October 2016 opinion. Consideration is given to the Veteran's testimony that he had headaches, tinea cruris, and tinea pedis beginning in service and continuously thereafter. See February 2021 Hearing Transcript. He described having multiple migraines a week for which he self-medicated, being treated for tinea cruris following the initial diagnosis for many years, and having tinea pedis during training, which was later "treated in the field" and required self-medication. Such is belied by his own reporting during service. The Veteran did not offer any complaint of headache, tinea cruris, or tinea pedis in the June 2011 separation assessment. In an August 2011 report of medical history, he denied having any diseases or conditions not mentioned, precluding headache, tinea cruris, or tinea pedis. The fact that the Veteran was noted at that time to have multiple health complaints including the residuals of a hemangioma of the right frontal scalp, which he is service connected for, undermines his more recent report of having chronic headaches or skin conditions of the feet or groin in service. Put another way, had the chronic headaches or skin conditions of the feet or groin in service, the Board believes that such would have been reported at that time. Service treatment records also contain many post-deployment medical assessments in which the Veteran reported being seen zero times for a medical issue and denied having any medical problems during deployments. The Board affords greater weight to contemporaneous evidence as it is more likely an accurate reflection of his symptom history than later contradictory statements. Consideration is given to the personal assertions of the Veteran that a headache disorder, tinea cruris, and tinea pedis are related to service. However, while lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), the specific issues in this case fall outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). The disabilities at issue are not readily amenable to probative lay comment regarding etiology. The Veteran is competent to report observable symptoms, but there is no indication that he is competent to etiologically link any such symptoms to a current diagnosis. He is not shown to possess the requisite medical training, expertise, or credentials needed to render a diagnosis or a competent opinion as to medical causation. Nothing in the record demonstrates that he received any special training or acquired any medical expertise in evaluating his disorders. See King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). Accordingly, the lay evidence does not constitute competent medical evidence and lacks probative value. The lay opinion is also outweighed by the October 2016 VA opinion. As such, the claims must be denied. REASONS FOR REMAND Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends that he developed bilateral hearing loss from in-service exposure to noise from aircraft. See February 2021 Hearing Transcript. Service treatment records show that hearing was evaluated as normal on a July 2007 entrance examination, though an audiogram reflected a measurement of 35 dB in the right ear at the 4000Hz frequency. The Veteran was afforded a VA examination in March 2016, at which time he was found to have right-ear sensorineural hearing loss and normal left ear hearing. The examiner found that right ear hearing loss preexisted service but was unable to provide an opinion on aggravation without resort to speculation due to the absence of audiograms for many years following entry to service. This seems to suggest that the presumption of soundness was not rebutted, yet there is no opinion of record addressing direct service connection. Therefore, remand is necessary for this development. The matter is REMANDED for the following action: Request an addendum opinion from the March 2016 audiological examiner. The examiner is asked to opine whether it is at least as likely as not that right ear hearing loss had its onset in service or within a year of service discharge or is otherwise etiologically related to active service. The examiner is advised that the current right ear hearing loss for VA purposes should not be considered a preexisting disability. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Alhinnawi 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.