Citation Nr: 21029151 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 16-19 254 DATE: May 12, 2021 ORDER Entitlement to service connection for a blood stream infection, claimed as secondary to breast cancer is denied. FINDING OF FACT The preponderance of the evidence of record is against finding that the Veteran has had a blood stream infection at any time during or approximate to the pendency of the claim. CONCLUSION OF LAW The criteria for service connection for a blood stream infection are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1987 to September 2007. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2014 rating decision of a Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran testified in March 2019 before the undersigned Veterans Law Judge. A transcript of this hearing has been associated with the claims file. The claim was remanded for additional development in September 2019 and March 2021. That development has been completed, and the case has since been returned to the Board for appellate review. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. As noted in the March 2021 Board decision, the Veteran's claim was previously denied in a May 2010 rating decision. The current appeal stems from a June 2013 claim. She contends that she developed a blood stream infection secondary to her post-service treatment for service-connected breast cancer. After reviewing the evidence of record, the Board concludes that the Veteran does not have a current diagnosis of a blood stream infection and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The record shows that the Veteran was treated for methicillin sensitive staphylococcus aureus (MSSA) bacteremia in April 2009 following breast cancer surgery. She was admitted to the hospital and treated with IV antibiotic therapy. She completed a 28-day course of antibiotics (cefazolin) and in May 2009 there were no signs of recurrent infection. Follow-up blood cultures were negative. She had no apparent side effects from the antibiotics. Follow-up oncology notes from 2009-2010 did not document any MSSA infection. In March 2021, the Board remanded the Veteran's claim and noted that an October 2020 examination report stated that she developed a blood stream infection, sepsis, in 2009, as a result of her lumpectomy performed as part of her treatment for breast cancer. It was noted that the infection had resolved. As a result, the Board remanded the Veteran's claim and requested an examiner comment on whether the Veteran has a current diagnosis of sepsis, any other infection of the blood, or any residuals or impairment resulting from her 2009 diagnosis. In a March 2021 opinion, a VA examiner stated that there is no evidence of residuals from the 2009 infection which was treated with IV antibiotics and resolved. The examiner also noted that the Veteran does not have a current diagnosis of sepsis and/or bacteremia. It was also noted that there were no residuals from the Veteran's infection. Upon review, the Board finds that the record does not contain any competent evidence to the contrary. While the Veteran believes she has a current diagnosis of a blood stream infection, she is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires medical testing to identify the presence of an infection as well as knowledge of the treatment and potential residuals. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. §§ 1110, 1131; see Degmetich v. Brown, 104 F.3d 1328, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). Evidence must show that the Veteran currently has a disability for which benefits are claimed. The evidence shows no current disability or impairment upon which to predicate a grant of service connection, at any time during the claim period. See Brammer, 3 Vet. App. at 225; Rabideau, 2 Vet. App. at 143-44. For these reasons, the Board finds that a preponderance of the evidence is against the Veteran's claim for service connection for a blood stream infection, and the claim must be denied. As the preponderance of the evidence is against the claim for service connection for a blood stream infection, the benefit of the doubt doctrine is not for application. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. M. Donohue Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D.S. Chilcote, Associate 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.