Citation Nr: 21029177 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 16-19 600 DATE: May 12, 2021 ORDER Service connection for vascular disease, to include stroke and cerebrovascular accident (CVA) is denied. Service connection for hypertension is denied. Service connection for a heart condition, to include as secondary to hypertension, is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that vascular disease, to include stroke and CVA began during active service or is otherwise related to an in-service injury or disease. 2. The preponderance of the evidence is against finding that the Veteran's hypertension began during active service or is otherwise related to an in-service injury or disease. 3. The preponderance of the evidence is against finding that a heart condition began during active service or is otherwise related to an in-service injury or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for vascular disease, to include stroke and cerebrovascular accident (CVA) are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for hypertension are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for a heart condition are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from May 1984 to March 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2015 rating decision. The Veteran testified before the undersigned Veterans' Law Judge in May 2019. A transcript of the hearing is of record. The Board remanded the claims for further development in October 2020. The Board finds that there has been substantial compliance with the remand directives. Stegall v. West, 11 Vet. App. 268 (1998). Service Connection 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 is warranted for a disability which is proximately due to, aggravated by, or the result of a service-connected disability. 38 C.F.R. § 3.310. A finding of secondary service connection requires competent medical evidence to connect the asserted secondary disability to the service-connected disability. Wallin v. West, 11 Vet. App. 509, 512 (1998); Velez v. West, 10 Vet. App. 432 (1997). Peripheral Vascular Disease The Veteran contends that he has peripheral vascular disease as a result of his active duty service. The Board finds that service connection is not warranted. The Veteran's medical records show a diagnosis of peripheral vascular disease. Additionally, the Veteran's service treatment records (STRs) show treatment for superficial thrombophlebitis while in service. Therefore, the Board finds that the first two elements of a service connection claim have been met. Regarding the third element, the Veteran underwent a VA examination in November 2020 to determine if a causal relationship between the current disability and the Veteran's military service exists. The examiner ultimately concluded that it was less likely than not that the Veteran's vascular disease was related to the Veteran's active duty service. Specifically, the examiner found that the Veteran's current peripheral vascular disease is related to the same artery where he was treated for superficial thrombophlebitis while in service. However, the superficial thrombophlebitis in-service, the examiner found, had resolved. Rather, the examiner concluded that the peripheral vascular disease is due to inflammation of the vein as superficial thrombophlebitis is a separate and distinct condition without any pathophysiological relationship to peripheral vascular disease. Additionally, the Veteran has claimed that his vascular disease is the result of the anthrax vaccine administered while in-service in southwest Asia. The November 2020 examiner concluded that it was less likely than not that the Veteran's peripheral vascular disease is secondary to environmental hazards experienced while in southwest Asia including burn pits, nerve agents, and the anthrax vaccine. The examiner went on to note that the peripheral vascular disease has a specific etiology, inflammation of the affected vein, not the environmental hazards in southwest Asia. The Board acknowledges the Veteran's contention that his peripheral vascular disease is related to service. However, the Veteran has not shown that he has the requisite medical knowledge to provide a medical nexus opinion for his current disability. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Accordingly, the preponderance of the evidence is against a finding that the Veteran's peripheral vascular disease was incurred in service or caused by in-service superficial thrombophlebitis. Because the preponderance of the evidence weighs against this claim, the benefit-of-the-doubt rule does not apply. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. As such, service connection for peripheral vascular disease is denied. Hypertension Next, the Veteran contends that he has hypertension as a result of his active duty service. The Board finds that service connection is not warranted. The Veteran's medical records show a diagnosis of hypertension. However, there is no evidence of record that shows the Veteran suffered any in-service incurrence or injury related to the Veteran's current hypertension. The Veteran underwent a VA examination in November 2020 to determine the etiology of the Veteran's hypertension. The examiner noted that the Veteran denied being diagnosed or treated for hypertension while in-service. This is confirmed in the Veteran's STRs which are silent for any complaints or treatment for high blood pressure. On the contrary, all blood pressure readings while in-service were noted to be within normal limits. The Veteran submitted a private medical opinion dated May 2016 that states that the Veteran's hypertension is more likely than not related to the Veteran's service. However, this opinion fails to provide any reasoning for such a conclusion. As such, the Board finds the opinion to be inadequate and affords it little probative weight. The Board acknowledges the Veteran's contention that his hypertension is related to service. However, the Veteran has not shown that he has the requisite medical knowledge to provide a medical nexus opinion for his current disability. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Accordingly, the preponderance of the evidence is against a finding that the Veteran's hypertension was incurred in service. Because the preponderance of the evidence weighs against this claim, the benefit-of-the-doubt rule does not apply. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. As such, service connection for hypertension is denied. Heart Condition Lastly, the Veteran contends that he has heart condition as a result of his hypertension that he developed in service. For the following reasons, the Board finds that service connection is not warranted. During the pendency of the appeal the Veteran was receiving treatment for left ventricular hypertrophy. As discussed above, the Veteran is not service connected for hypertension. Therefore, he cannot be granted service connection on a secondary basis when he is not service connected for the disability that causes the second. However, this does not preclude the Veteran from service connection on a direct basis. The November 2020 VA examination confirmed a diagnosis of left ventricular hypertrophy satisfying the first element of a service connection claim. The examiner then opined that it was less likely than not that the Veteran's left ventricular hypertrophy is related to the Veteran's service. Specifically, the examiner stated that left ventricular hypertrophy is the result of long-standing hypertension not his active duty service. As discussed previously, the Veteran submitted a private medical opinion dated May 2016 that states that the Veteran's heart condition is more likely than not related to the Veteran's service. However, this opinion fails to provide any reasoning for such a conclusion. As such, the Board finds the opinion to be inadequate and affords it little probative weight. The Board acknowledges the Veteran's contention that he has had heart problems since service. However, the Veteran has not shown that he has the requisite medical knowledge to provide a medical nexus opinion for his current disability. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Accordingly, the preponderance of the evidence is against a finding that the Veteran's heart condition was incurred in service. Because the preponderance of the evidence weighs against this claim, the benefit-of-the-doubt rule does not apply. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. As such, service connection for a heart condition is denied. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jorge Barroso, 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.