Citation Nr: 21040886 Decision Date: 07/07/21 Archive Date: 07/07/21 DOCKET NO. 17-29 966 DATE: July 7, 2021 ORDER Entitlement to service connection for Parkinson's disease is denied. FINDING OF FACT Parkinson's disease was not shown in service or for many years thereafter, and the most probative evidence of record is against finding that the Veteran's diagnosed Parkinson's disease is related to service. CONCLUSION OF LAW The criteria for establishing service connection for Parkinson's disease have not been met. 38 U.S.C. §§ 1110, 1112, 1117, 1118, 1131, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.317. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1983 to October 1992. This matter comes before the Board of Veterans' Appeals (Board) from a January 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In July 2020, the Veteran testified at a hearing before a Veterans Law Judge (VLJ), and a transcript of that hearing is of record. In an April 2021 correspondence, the Veteran was advised that the VLJ who conducted the hearing was no longer with the Board and he was afforded the opportunity to have a hearing before another VLJ. In an April 2021 letter, The Veteran indicated that he did not want another hearing. 1. Entitlement to service connection for Parkinson's disease Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Generally, to prove service connection there must be: (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). Moreover, where a veteran served continuously for 90 days or more during active service, and organic diseases of the nervous system becomes manifest to a degree of 10 percent within one year from date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. Additionally, under legislation specific to Persian Gulf War veterans, service connection may be established for a qualifying chronic disability resulting from an undiagnosed illness that became manifest during active service in the Southwest Asia theater of operations during the Persian Gulf War or to a degree of 10 percent or more no later than December 31, 2021. 38 U.S.C. § 1117; 38 C.F.R. § 3.317(a)(1). The term "qualifying chronic disability" means a chronic disability resulting from any of the following (or any combination of any of the following): (A) an undiagnosed illness; (B) a medically unexplained chronic multi-symptom illness that is defined by a cluster of signs or symptoms, such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome; or (C) any diagnosed illness that the Secretary determines in regulations prescribed under subsection (d) warrants presumptive service-connection. 38 U.S.C. § 1117(a)(2); 38 C.F.R. § 3.317(a)(2)(i). Such chronic disability must not be attributed to any known clinical diagnosis by history, physical examination, or laboratory tests. 38 C.F.R. § 3.317(a)(1). The Veteran seeks service connection for Parkinson's disease, which he asserts is related to his exposure to various chemicals while working as an aircraft maintenance technician during service in the Persian Gulf. Alternatively, the Veteran asserts that his claimed disability is an undiagnosed illness or a medically unexplained chronic multi-symptom illness attributable to his service in the Persian Gulf. The Veteran does not contend, and the evidence does not reflect, that his claimed disability arose during service or within one year after discharge from service. See 38 C.F.R. §§ 3.303, 3.307, 3.309(a). As an initial matter, the Veteran's DD Form 214 confirms his service in the Southwest Asia theatre of operations during the Persian Gulf War. Therefore, he qualifies for consideration for presumptive service connection for disabilities resulting from an undiagnosed illness or medically unexplained chronic multi-symptom illness. Upon review of the record, the Board finds that service connection is not warranted on a presumptive basis under legislation specific to Persian Gulf War veterans under 38 C.F.R. § 3.317 as an undiagnosed illness because the Veteran's symptoms have been attributed to a known clinical diagnosis of Parkinson's disease. Additionally, the Board finds that service connection is not warranted on a direct basis. The Veteran underwent a VA examination in October 2020, during which the examiner indicated that the Veteran had a diagnosis of Parkinson's disease. The Veteran reported exposure to environmental hazards and chemicals during service and that his father was also diagnosed with Parkinson's disease. The examiner noted the private medical opinion; however, citing medical literature, the examiner explained that the evidence is inconclusive for other putative risk factors, which include exposure to hydrocarbon solvents, particularly trichloroethylene; however, there is increasing evidence that genetic factors play a role in the pathogenesis of Parkinson's disease, particularly when the age at symptom onset is younger than fifty years. The examiner further explained that there is a clear diagnosis and etiology for Parkinson's disease and Parkinson's disease does not constitute a medically unexplained chronic multi-symptom illness or a manifestation of an undiagnosed illness related to the Veteran's Persian Gulf service. As such, the examiner opined that the Veteran's Parkinson's disease was less likely than not incurred in or caused by the Veteran's active service, including exposure to environmental hazards or chemicals during service in the Persian Gulf. The Board affords this opinion great probative weight as it was rendered following review of the claims file and cited to medical treatise information as the basis for the opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 04 (2008) (holding that it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value to a medical opinion). The Board acknowledges an August 2020 letter from the Veteran's private physician, in which he opined that the Veteran's Parkinson's disease is more likely than not a result of toxic exposures experienced during service. However, the physician's statement is conclusory and did not provide an adequate rationale for the opinion. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A] medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). Accordingly, the Board affords the August 2020 private opinion little, if any, probative weight. To the extent that the Veteran believes that his current disability is related to service, as a lay person, the Veteran has not shown that he has specialized training sufficient to render such an opinion. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). In this regard, the diagnosis and etiology of neurological conditions are matters that require medical training and expertise to determine. Thus, the opinion of the Veteran regarding the etiology of his currently diagnosed Parkinson's disease is not competent medical evidence. In sum, the preponderance of the competent and probative evidence is against the claim, and service connection is denied. In reaching the above conclusion, the Board considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the claim, the doctrine is not for application. See Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1990). K. A. BANFIELD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Lance, 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.