Citation Nr: 21032392 Decision Date: 05/26/21 Archive Date: 05/26/21 DOCKET NO. 17-40 285 DATE: May 26, 2021 ORDER An evaluation in excess of 10 percent for left wrist disability is denied. An evaluation in excess of 10 percent for left ulnar nerve impairment is denied. Service connection for low back condition is denied. Service connection for Wolff-Parkinson-White Syndrome is denied. FINDINGS OF FACT 1. The Veteran's left wrist disability is not productive of ankylosis or its functional equivalent. 2. The Veteran's left ulnar nerve impairment is not productive of the equivalent of complete paralysis or incomplete paralysis that is moderate or severe. 3. The Veteran's low back condition was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury or disease. 4. The Veteran does not have a current disability of Wolff-Parkinson-White Syndrome at any time during or approximate to the pendency of the claim. CONCLUSIONS OF LAW 1. The criteria for a disability rating in excess of 10 percent for a left wrist disability are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5215 (2020). 2. The criteria for a disability rating in excess of 10 percent for left ulnar nerve impairment are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8516 (2020). 3. The criteria for service connection for low back condition are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2020). 4. The criteria for service connection for Wolff-Parkinson-White Syndrome are not 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 April 1988 to January 2003. This appeal is before the Board of Veterans' Appeals (Board) from a December 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. In February 2020, the Veteran testified at a video conference hearing before the undersigned Acting Veterans Law Judge. A copy of the hearing transcript has been associated with the electronic claims file. The matter was most recently before the Board in April 2020, at which time it was remanded for further development, to include obtaining outstanding treatment records; schedule the Veteran for a VA examination for his left wrist condition, to include peripheral nerve; obtain a medical opinion for low back condition from the same November 2017 VA examiner, and if that examiner is unavailable document that fact in the record, and arrange to obtain an addendum opinion; and schedule the Veteran for an examination for a heart condition, to include Wolff-Parkinson-White Syndrome. The RO complied with these instructions, and VA examinations were conducted in January 2021 and February 2021. Although the remand requested a medical opinion for low back condition from the same examiner as the November 2017 VA, a different examiner was obtained in February 2021. Further, it is not documented whether or not the November 2017 examiner was unavailable. Nonetheless, the Board notes that substantial compliance, not strict compliance, is required of remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). Remands which would only result in unnecessarily imposing additional burdens on VA with no benefit flowing to the claimant are to be avoided. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). In the case at hand, the February 2021 medical opinion which the Board has relied on in making its decision was authored by a fully licensed physician who provided an addendum opinion. Accordingly, the Board finds that all of its prior remand directives have been substantially complied with. See Stegall, 11 Vet. App. at 271. Increased rating Disability evaluations are determined by application of the criteria set forth in the VA's Schedule for Rating Disabilities, which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. An evaluation of the level of disability present must also include consideration of the functional impairment of the Veteran's ability to engage in ordinary activities, including employment. 38 C.F.R. § 4.10. When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. Consideration must also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or § 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a (musculoskeletal system) or § 4.73 (muscle injury); a separate or higher rating under § 4.40 or § 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a [or § 4.73] criteria."). When a question arises as to which of two ratings apply under a particular diagnostic code, the higher evaluation is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. The Veteran's entire history is to be considered when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). 1. Entitlement to an evaluation in excess of 10 percent for left wrist disability 2. Entitlement to an evaluation in excess of 10 percent for left ulnar nerve impairment The Veteran contends his left wrist disability warrants higher initial evaluations. Records indicate that he is right-handed; as such, only the criteria for the nondominant extremity are discussed below. The Veteran's disability is currently rated at 10 percent under 38 C.F.R. § 4.71a, Diagnostic Code 5215, limitation of dorsiflexion of the wrist to less than 15 degrees or limitation of palmar flexion of the wrist in line with the forearm is rated at 10 percent. No higher ratings are available under this code. 38 C.F.R. §4.71a. Alternative and additional Diagnostic Codes for the wrists are available under 38 C.F.R. § 4.71a. as follows: Under 38 C.F.R. § 4.71a, Diagnostic Code 5003, degenerative arthritis is rated on the basis of limitation of motion of the specific joint involved. When limitation of motion is noncompensable, a 10 percent rating is for application for each major joint. In the absence of limitation of motion, a maximum schedular 20 percent rating is assigned for degenerative arthritis of two or more major joints or two or more minor joint groups, with occasional incapacitating episodes. Under 38 C.F.R. § 4.71a, Diagnostic Code 5214, favorable ankylosis of the wrist in 20 to 30 degrees of dorsiflexion is rated at 20 percent in the nondominant extremity. Ankylosis of the wrist in any position neither favorable nor unfavorable is rated at 30 percent in the nondominant extremity. Unfavorable ankylosis of the wrist in any degree of palmar flexion or with ulnar or radial deviation is rated at 40 percent in the nondominant extremity. The Veteran is also in receipt of a 10 percent rating for paralysis of the ulnar nerve under 38 C.F.R. § 4.124a, Diagnostic Code 8516. Under this code, mild incomplete paralysis is rated as 10 percent. Moderate incomplete paralysis is rated at 20 percent. Severe incomplete paralysis is rated at 40 percent. Complete paralysis is rated at 60 percent. 38 C.F.R § 4.124a. The words "mild," "moderate," and "severe" as used in the various Diagnostic Codes are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. See 38 C.F.R. §§ 4.123, 4.124. The term "incomplete paralysis" indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at "Diseases of the Peripheral Nerves." The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017). A September 2014 VA examination report for the wrist included the Veteran's diagnoses from 2000, to include left wrist fracture, resection of the left hamate and distal ulna, and left ligament and triangular cartilage tear. The Veteran reported flare-ups that decreased his range of motion, caused weakness and stiffness, and difficulty typing. Palmar flexion was limited to 75 degrees with pain thereat. Dorsiflexion was limited to 70 degrees with no objective evidence of pain. Ulnar deviation was limited to 40 degrees with pain thereat. Radial deviation was limited to 15 degrees with pain thereat. Repetitive testing did not cause further loss of range but caused additional function loss with a contributing factor of pain on movement. There was no localized tenderness in the hand. Muscle strength was full. There was no ankylosis. A 5 cm dorsal ulnar wrist scar and 3.4 cm palmar ulnar wrist scar were noted. The examiner found that the disability did impact his ability to work, to include lifting no more than 100 pounds and limiting the duration of typing at work due to weakness of his left 4-5th digits. The Veteran underwent another VA examination in November 2017. He reported flare-ups causing pain and numbness in the left hand. He described pain with typing or being involved with sports. He stated that he could not type for a long period of time and had to limit his recreational activity. Ranges of motion were all normal. There was no objective evidence of pain, tenderness, or crepitus. There was no loss of range or function with repetitive testing. Muscle strength was full without atrophy. There was no ankylosis. VA treatment records from April 2018 indicated a possible ulnar nerve compression Syndrome at the Guyon's canal. The Veteran underwent another VA examination in January 2021. He reported flare-ups caused by typing for more than five minutes that are moderate to severe, occurring daily, lasting minutes, and are alleviated by rest/changing position. Functional loss and functional impact were reported and described as an inability to swing a bat or golf club, perform quick explosive movements, and type for over five minutes. Palmar flexion was limited to 50 degrees. Dorsiflexion was limited to 60 degrees. Ulnar deviation was limited to 40 degrees. Radial deviation was 20 degrees. Repeated testing did lead to further loss of function or range, specifically dorsiflexion was limited to 30 degrees. The examiner found that flare-ups and repeated use over time led to additional functional loss due to pain which also limited dorsiflexion to 30 degrees. Pain was noted on passive range of motion testing, palmar flexion, ulnar deviation, and dorsiflexion, which led to functional loss. There was evidence of pain with weight bearing, localized tenderness, pain on palpation, and crepitus. There was no ankylosis. Muscle strength was full without atrophy. In accordance with the remand, the Veteran underwent a VA examination in January 2021 for peripheral nerves. He reported tingling and numbness in the left hand 4-5th finger following his latest wrist surgery in 2020. No diagnostic imaging was obtained to confirm nerve compression. He reported mild intermittent pain, moderate paresthesias and/or dysesthesias, and moderate numbness in his left upper extremity. Muscle strength was full without atrophy. Reflexes and sensory were normal. No trophic changes or abnormal gait were reported. Results for Phalen's sign and Tinel's sign were both negative. The ulnar nerve was normal. There was no functional impairment due to peripheral nerve. The examiner found he had normal sensation, strength, and movement, and does not have any findings other than subjective findings. The 4-5th finger corresponds to the ulnar nerve. Subsequently, a February 2021 rating decision granted a separate evaluation for left ulnar nerve impairment apart from residuals of left wrist fracture with an evaluation of 10 percent effective February 1, 2003 under Diagnostic Code 8516. The Board has reviewed all of the lay and medical evidence of record in conjunction with the applicable laws and regulations and finds an initial rating in excess of 10 percent for left wrist musculoskeletal disability is not warranted. His current 10 percent evaluation is assigned for restriction of motion of the wrist characterized by palmar flexion limited in line with the forearm or dorsiflexion less than 15 degrees. This rating is the maximum evaluation permitted under Diagnostic Code 5215. While Diagnostic Code 5214 allows for evaluations up to 40 percent to be assigned for impairments of the nondominant wrist, these ratings require the existence of ankylosis. Here, the range of motion exhibited during the examinations were not the functional equivalent of ankylosis. The evidence of record shows that the Veteran has not exhibited palmar flexion less than 50 degrees or dorsiflexion less than 30 degrees at any point during the period on appeal. The January 2021 VA examiner noted that range of motion was not significantly affected by flare-ups or during repeated use over time. Since there is no evidence of ankylosis or its functional equivalent in the Veteran's left wrist, the provisions of Diagnostic Code 5214 are therefore inapplicable in the present case. For the reasons set forth above, the Board finds that an increased rating is not warranted for the Veteran's left wrist disability. The Board further finds that an evaluation in excess of 10 percent is not warranted for the Veteran's ulnar nerve impairment. His current rating is warranted for the equivalent of mild incomplete paralysis. Higher ratings are available for moderate incomplete paralysis, severe incomplete paralysis, or complete paralysis. The evidence weighs against such findings. Regarding impairment of motor functions, there was no functional impairment due to the peripheral nerve. Muscle strength was full without atrophy. Reflexes and sensory were normal. No trophic changes or abnormal gait were reported. Regarding pain, he reported mild, intermitted pain, moderate paresthesias and/or dysesthesias, and moderate numbness in his left upper extremity. Based on the above, the Board finds that the disability is primarily manifest by paresthesias/dysesthesias and numbness. The Board also finds that the most probative evidence of record is against a finding that the disability is manifest by impairment of motor functions, trophic changes, sensory disturbance/loss of reflexes, muscle atrophy, or complete paralysis. The Board thus finds that the level of impairment is most analogous to mild incomplete paralysis of the minor extremity. The Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran's claim for ratings in excess of 10 percent for a left wrist musculoskeletal disability and left ulnar nerve impairment. In denying such ratings, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Service connection laws and regulations VA law provides that, for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service, during a period of war, or other than a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation, except if the disability is a result of the veteran's own willful misconduct or abuse of alcohol or drugs. 38 U.S.C. §§ 1110, 1131. Entitlement to service connection on a direct basis requires (1) evidence of current nonservice-connected disability; (2) evidence of in-service incurrence or aggravation of disease or injury; and (3) evidence of a nexus between the in-service disease or injury and the current nonservice-connected disability. 38 C.F.R. § 3.303(a); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); Saunders v. Wilkie, 886 F.3d 1356 (2018). For specific enumerated diseases designated as "chronic," such as arthritis, there is a presumption that such chronic disease was incurred in or aggravated by service even though there is no evidence of such chronic disease during the period of service. In order for the presumption to attach, the disease must have become manifest to a degree of 10 percent or more within one year of separation from active duty. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307(a)(3), 3.309(a). Presumptive service connection for the specified chronic diseases may alternatively be established by way of continuity of symptomatology under 38 C.F.R. § 3.303(b). However, the United States Court of Appeals for the Federal Circuit (Federal Circuit) has held that the theory of continuity of symptomatology can be used only in cases involving those conditions explicitly recognized as chronic in 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Generally, lay evidence is competent with regard to identification of a disease with unique and readily identifiable features which are capable of lay observation. See Barr v. Shinseki, 21 Vet. App. 303, 308 (2007). A lay person may speak to etiology in some limited circumstances in which nexus is obvious merely through observation, such as sustaining a fall leading to a broken leg. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir 2007). Lay persons may also provide competent evidence regarding a contemporaneous medical diagnosis or a description of symptoms in service which supports a later diagnosis by a medical professional. However, a lay person is not competent to provide evidence as to more complex medical questions, i.e., those which are not capable of lay observation. Lay statements are not competent evidence regarding diagnosis or etiology in such cases. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007) (concerning rheumatic fever); Jandreau, at 1377, n. 4 ("sometimes the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer"); 38 C.F.R. § 3.159(a)(2). After the evidence has been assembled, it is the Board's responsibility to evaluate the entire record. 38 U.S.C. § 7104(a). When there is an approximate balance of evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3. A VA claimant need only demonstrate that there is an approximate balance of positive and negative evidence in order to prevail. Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the preponderance of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), Gilbert at 54. 3. Entitlement to service connection for low back pain The Veteran contends service connection is warranted for his low back condition. He contents he seems to reinjure his low back on a semi-frequent basis, which results in loss of stability and sharp pain. Service treatment records (STRs) include a March 1998 report of medical examination (enlistment examination). The lower extremities, spine, and other musculoskeletal systems were reported as normal. STRs do not contain complaints, treatment, or diagnosis for a low back condition. In a January 2003 report of medical assessment, the Veteran endorsed the statement that he did not seek medical care for minor back pain while on active duty. In October 2014 private treatment records, the Veteran reported low back pain to his chiropractor stating the condition started in high school and/or military service. He stated he seems to reinjure his low back on a semi-frequent basis and that the older he gets the more frequently his back hurts. A November 2017 VA examination report from Dr. T.J. noted review of the claims file and medical records, recounted the Veteran's complaints and history, and included a physical examination of the Veteran. The Veteran reported that the date of onset of symptoms is unknown. He reported flareups, functional loss, and/or functional impairment. There was no current diagnosis for a thoracolumbar spine condition. The examiner opined that the Veteran's low back condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale provided was that there was no current evidence of significant lumbar or thoracic pathology. VA treatment records from April 2018 include lumbar spine imaging. The findings indicate no acute osseous abnormality in the lumbar spine, and L5 spondylolysis with grade 1 anterolisthesis of L5 on S1. Private treatment records from December 2017 to February 2018, and January 2019 to February 2020 confirm ongoing chiropractic treatment for his low back condition. The Veteran testified at the February 2020 Board hearing that while in service, he did have a "stiff back" several times which made standing hard and painful. He added that he was able to "shake that off or work around it" since he was on casual status for his left wrist condition and Wolff-Parkinson-White Syndrome during much of that time. Since then, the Veteran asserted he reinjures it more frequently. A February 2021 VA medical opinion from Dr. R.L. noted review of the VA e-folder and medical records, and opined that the low back condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale provided was that medical records did not reveal continuous ongoing medical treatment or aggravation of acute or chronic low back condition during time of discharge from active military service to present day. The low back condition started several years after discharge from military service. As such, it is less likely than not that the low back condition is related to the Veteran's time in service. In a February 2021 addendum opinion, Dr. R.L. was to consider the Veteran's lay statements from the February 2020 hearing. The examiner's opinion nor rationale changed. He opined the veteran's back condition was less likely than not incurred during service "as noted by the Veteran's competent lay statements and back complaints shortly after discharge from service." The Board has reviewed all of the lay and medical evidence of record in conjunction with the applicable laws and regulations and finds that the criteria for entitlement to service connection for low back condition are not met. The Board acknowledges that the Veteran currently has a low back condition, to include spondylolysis. Thus, the first element of service connection has been established. See Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013); 38 C.F.R. § 3.303(a). However, the earliest record of his spondylolysis was a diagnosis in 2018, five years after service. Because the evidence does not show spondylosis as a chronic condition wile in service or becoming manifest to a degree of 10 percent or more within one year of separation from active duty, presumptive service connection for a chronic condition is not applicable. See 38 C.F.R. §§ 3.307(a)(3), 3.309(a). The Board acknowledges that the Veteran contends he had a stiff back several times while in service. In the January 2003 report of medical assessment, the Veteran endorsed the statement that he did not seek medical care for minor back pain while in service. The reason for not seeking medical care was explained during the February 2020 Board hearing. The Veteran testified that he was able to work around his stiff back in service since he was on "casual status" for his left wrist condition and Wolff-Parkinson-White Syndrome. Affording the Veteran the benefit of the doubt, the Board finds his testimony regarding back stiffness while in service credible. Thus, the second element of service connection has been established. See Romanowsky, 26 Vet. App. at 293; 38 C.F.R. § 3.303(a). Turning to the third element, however, the Board finds the evidence of record insufficient to award service connection. In reaching this conclusion, the Board finds that the most probative evidence of record to be the objective medical opinions from the VA examiners. The opinions were rendered after examination of the Veteran and/or review of the record. Specifically, the February 2021 VA examiner opined that the low back condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. This opinion was supported by the rationale that the medical records did not reveal continuous ongoing medical treatment or aggravation of acute or chronic low back condition during time of discharge from active military service to present day. Since the current low back condition started several years after discharge, the examiner opined it is less likely than not that the low back condition is related to the Veteran's time in service. The Board finds this medical opinion to be competent, credible, and highly probative on the issue of etiology. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (the probative value of a medical opinion comes from whether it is factually accurate, fully articulated, and has sound reasoning for the conclusion, not from the mere fact that the claims file was reviewed). Likewise, the Board finds the February 2021 addendum opinion to be probative on the issue of etiology. The examiner's opinion did not change when instructed to address the Veteran's lay statements from the February 2020 hearing. The examiner once again opined that the Veteran's back condition was less likely than not incurred during service "as noted by the Veteran's competent lay statements and back complaints shortly after discharge from service." This opinion, taken along with the November 2017 VA examiners opinion and the February 2021 VA examiners opinion, all find that the current back condition is less likely than not related to service. While the Veteran may believe that his current condition is related to service, he is not competent to provide that opinion. See Jandreau, 492 F.3d at 1376-77. As the only competent and credible medical opinions of record, uncontradicted by any of the other competent and credible evidence, the Board affords the VA examiner's opinions considerable probative value on appeal. Thus, the Board finds that the third element of service connection has not been established. See Romanowsky, 26 Vet. App. at 293; 38 C.F.R. § 3.303(a). Because the evidence of record does not support the Veteran's claim for entitlement to service connection for a low back condition, the Veteran's appeal is denied. The Board is unable to find an approximate balance of the positive and negative evidence submitted to warrant for the Veteran a favorable decision. See 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 53; 38 C.F.R. §§ 3.102, 3.303(a). 4. Entitlement to service connection for Wolff-Parkinson-White Syndrome The Veteran contends service connection is warranted for his heart condition, to include Wolff-Parkinson-White (WPW) Syndrome. The Veteran was treated for WPW Syndrome in October 1999 while in service, and believes that his heart condition has continued since separation from service. The question for the Board is whether the Veteran has a current disability that was incurred in or as a result of active duty service. Turning to the evidence of record, STRs from October 1999 indicate the Veteran was diagnosed with WPW Syndrome. He underwent an elective ablation in October 1999. In May 2000 he underwent a follow-up with a cardiologist. It was determined there were "no recurrence of cardiac symptoms." Private treatment records from January 2009 included an examination. His cardiovascular findings included a normal rate, regular rhythm, and normal heart sounds. Private treatment records from October 2009 included an examination. His cardiovascular findings included a normal rate, regular rhythm, normal heart sounds, and intact distal pulses. The findings were negative for chest pain and palpitations. A December 2009 sleep study with an electrocardiogram revealed tachybrady episodes in association with disordered breathing events. The electromyogram and electroencephalogram were within normal limits. Private treatment records from April 2010 included an examination. His cardiovascular findings included a normal heart rate, regular rhythm, normal heart sounds, and intact distal pulses. Chest x-rays were normal. A January 2021 VA examination report noted review of the VA e-folder and medical records, recounted the Veteran's complaints and history, and included a physical examination of the Veteran. Regarding the Veteran's heart, he had a heart rate of 85; regular rhythm; point of maximal impact not palpable; normal heart sounds; no jugular-venous distension; clear auscultation of lungs; normal peripheral pulses; and no peripheral edema. Testing was performed. His EKG was normal; chest x-ray normal; and echocardiogram was normal. No functional impact was reported. The examiner stated that there is no evidence that the Veteran currently has WPW Syndrome or suffers any symptoms of it. It was further noted, ablation is known to permanently correct the abnormal heart rhythm that is caused by extra electrical pathways of WPW Syndrome. The Veteran had the elective ablation performed in October 1999. Therefore the Veteran should not have palpitations that are related to WPW Syndrome. A March 2021 VA addendum opinion was obtained. The same examiner stated that WPW Syndrome was diagnosed during service, but the Veteran had an ablation to resolve the condition. The most up to date EKG does not show any abnormality. Further, there is no imaging evidence to support tachycardia (palpitations) currently. The Board has reviewed all of the lay and medical evidence of record in conjunction with the applicable laws and regulations and finds that the criteria for entitlement to service connection for WPW Syndrome are not met. Here, there is no persuasive competent or credible lay or medical evidence of a current disability. The Veteran has provided no medical evidence of a current condition in the form of diagnoses or treatment records. Numerous treatment records from May 2000 to March 2021 have been associated with the record. These records reveal normal cardiovascular examinations. Specifically, the January 2021 VA examination explicitly stated that there is no evidence that the Veteran currently has WPW Syndrome or suffers any symptoms of it. As such, the most probative evidence of record reflects that the Veteran lacks a current diagnosis of WPW Syndrome during the relevant appeal period. Where the evidence does not support a finding of current disability upon which to predicate a grant of service connection, there can be no valid claim for that benefit. See Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). As such, the Board finds that there is no evidence of a current disability and service connection must therefore be denied. The evidence in this case is not so evenly balanced so as to allow application of the benefit-of-the-doubt rule as required by law and VA regulation. Gilbert, 1 Vet. App. at 49; 38 C.F.R. § 3.102. J. GALLAGHER Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A.M. Edwards, 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.