Citation Nr: 21042603 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 17-00 570 DATE: July 13, 2021 ORDER Entitlement to service connection for a left ankle disability is denied. Entitlement to service connection for a right ankle disability is denied. Entitlement to service connection for a left wrist disability is denied. Entitlement to service connection for a right wrist disability is denied. Entitlement to service connection for a right elbow disability is denied. Entitlement to service connection for a left elbow disability is denied. Entitlement to service connection for a neck disability is denied. Entitlement to service connection for a left knee disability is denied. Entitlement to service connection for a right knee disability is denied. Entitlement to service connection for a left foot disability is denied. Entitlement to service connection for a right foot disability is denied. FINDINGS OF FACT 1. The preponderance of the evidence shows that the Veteran was not diagnosed with left ankle, right ankle, left wrist, right wrist, and right elbow disabilities at any time during the pendency of the appeal. 2. The preponderance of the evidence shows that left elbow, neck, left knee, right knee, left foot, and right foot disabilities were not present in service or until many years thereafter, are not caused by an injury while serving with a Reserve Component, and they are not related to service or to an incident of service origin. CONCLUSION OF LAW The criteria for service connection left ankle, right ankle, left wrist, right wrist, right elbow, left elbow, neck, left knee, right knee, left foot, and right foot disabilities have not been met. 38 U.S.C. §§ 101, 106, 1101, 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.6, 3.102, 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty in the United States Army from May 2002 to March 2003 with service in Afghanistan. The Veteran also had earlier and subsequent periods of service with a Reserve Component. In May 2019 the Veteran testified at a video hearing before the undersigned and a transcript of that hearing has been associated with the claims file. In a September 2019 decision the undersigned, among other things, denied service connection for neck, bilateral elbow, bilateral wrist, bilateral knee, bilateral ankle, and bilateral foot disabilities. The Veteran appealed the September 2019 Board decision to the United States Court of Appeals for Veterans Claims (Court). In a subsequent August 2020 order, which incorporated the parties Joint Motion for Partial Remand (JMPR), the Court vacated and remanded the September 2019 Board decision to the extent that it denied service connection for neck, bilateral elbow, bilateral wrist, bilateral knee, bilateral ankle, and bilateral foot disabilities. In January 2021, the Board remanded the appeal. The Concerns Raised by the JMPR, Post-Remand Compliance, and Concerns Raised by the Representative Initially, the Board finds that the post-Remand development addressed the concern raised by the JMPR and complied with the Remand. See 38 U.S.C. § 5103; Barr v. Nicholson, 21 Vet. App. 303 (2007); Stegall v. West, 11 Vet. App. 268 (1998); D'Aries v. Peake, 22 Vet. App. 97 (2008) (holding that only substantial, and not strict compliance with the terms of a remand request, is required); Dyment v. West, 13 Vet. App. 141, 146-47 (holding that there was no Stegall violation when the examiner made the ultimate determination required by the Board's remand, because such determination more than substantially complied with the Board's remand order). The Board also finds that the record addresses the concerns raised by the Veteran's representative in the June 2021 Brief. The Board has reached this conclusion because in April 2021 the Veteran was afforded VA examinations to obtain diagnoses and etiology opinions as to his claims of service connection for left ankle, right ankle, left wrist, right wrist, right elbow, left elbow, neck, left knee, right knee, left foot, and right foot disabilities. Moreover, the April 2021 VA examiners thereafter opined as follows: the Veteran did not have left ankle, right ankle, left wrist, right wrist, and right elbow disabilities; even if the appellant had left ankle, right ankle, left wrist, right wrist, and right elbow disabilities they are not related to service; and his left elbow, neck, left knee, right knee, left foot, and right foot disabilities are not due to his military service. Additionally, the Board finds the April 2021 VA examiners opinions both competent and credible to adjudicate the Veteran's claims. The Board has reached this conclusion because notwithstanding the Veteran's representative's claims in its June 2021 Brief that they did not consider the appellant's competent and credible claims regarding in-service and post-service observable symptoms, the examinations contain specific references to these lay claims as well as the Board's remand instructions to consider these competent and credible assertions when providing the diagnoses and etiology opinions. See Guerrieri v. Brown, 4 Vet. App. 467, 473 (1993) ("the probative value of medical opinion evidence is based on the medical expert's personal examination of the patient, the physician's knowledge and skill in analyzing the data, and the medical conclusion the physician reaches.... As is true with any piece of evidence, the credibility and weight to be attached to these opinions [are] within the province of the [Board as] adjudicators..."). The Board also finds the April 2021 VA examiners opinions both competent and credible to adjudicate the Veteran's claims because the diagnoses and etiology opinions were provided after a review of the record on appeal and an examination of the Veteran, they took into account all theories of entitlement, they are supported by citation to the service treatment records and the post-service medical records, they took into account the lay claims regarding observable symptomatology, and the opinions are supported by medical reasoning as well as controlling medical literature. Id; Also see Wray v. Brown, 7 Vet. App. 488, 493 (1995) (holding that the adoption of an expert medical opinion may satisfy the Board's statutory requirement of an adequate statement of reasons and bases if the expert fairly considered the material evidence seemingly supporting the veteran's position); ElAmin v. Shinseki, 26 Vet. App. 136, 140-41 (2013) (holding that, when multiple theories of entitlement are at issue, the Board must ensure that the medical opinions of record directly address all theories reasonably raised by the record). The Board also finds that the post-Remand development complied with the Remand because while the appeal was in remand status all identified and available VA and private treatment records were obtained and associated with the record. See 38 U.S.C. § 5103; Stegall, supra. Therefore, the Board finds that further delay by remanding the appeal to provide the Veteran with new VA examination or to try to obtain additional medical records is not required. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (remands which would only result in unnecessarily imposing additional burdens on VA with no benefit flowing to the veteran are to be avoided). The Service Connection Claims The Veteran claims, in substance, that his current left ankle, right ankle, left wrist, right wrist, right elbow, left elbow, neck, left knee, right knee, left foot, and right foot disabilities started while on active duty and continued to the current time. Specifically, regarding his claimed bilateral ankle and foot disabilities, the Veteran testified that he did a lot of running with different gear and that he would be on his feet for extensive periods of time. He also claimed that he fractured his right foot during service. He indicated that he continued to experience problems with his ankles and feet after service and that he was eventually given pain medications and muscle relaxers to relieve the pain. However, he indicated that he had not sought any post-service treatment for his ankle or his foot pain. See Board hearing transcript, pp. 17-18, 20-22. Regarding his claimed bilateral wrist disabilities, the Veteran testified that he began experiencing wrist pain while working on lots of equipment and using many different types of hand tools (constantly twisting and turning) to repair the equipment. He testified that he continued to experience wrist pain since he separated from active duty service but that he had not sought any post-service treatment for his neck pain. See Board hearing transcript, pp. 16-17. As to the bilateral elbow disabilities, the Veteran testified that he had pain in his elbow joints and pain on stretching during his military service. He indicated that he did not seek treatment for his elbows during service but that he continued to experience "hurting" in his elbow joints. He testified that he was prescribed pain medications and muscle relaxers. The Veteran attributed his current pain to using power tools for extensive periods of time and working on different vehicles (in different positions and on different surfaces) while on active duty. See Board hearing transcript, pp. 18-19. Regarding his claimed neck disability, the Veteran testified that he began to experience neck pain while working on small engines and Humvees while on active duty. He indicated that he worked in all positions over engines, under engines, stretching in different positions and walking on different terrains (rocky, uneven surfaces). He testified that he had to work on vehicles wherever they broke down. He indicated that he never saw a doctor for his neck pain while in the military. He testified that he continued to experience neck pain since he separated from active duty service but that he had not sought any post-service treatment for his neck pain. See Board hearing transcript, pp. 19-20. As to the left and right knee disabilities, the Veteran contends that he began experiencing knee problems during his military service "in Afghanistan and Louisiana, working in the motor pool, working on military equipment and vehicles." See May 2019 Board hearing transcript, p. 9. He claims that he experienced joint pain and tenderness in service and that his symptoms have continued ever since he separated from military service. Id. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Additionally, service connection may be granted for disability resulting from disease or injury incurred or aggravated while performing active duty for training (ACDUTRA) or from injury incurred or aggravated while performing inactive duty training (INACDUTRA). 38 U.S.C. §§ 101(24), 106, 1131. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection if the disability is one that is listed in 38 C.F.R. § 3.309. 38 C.F.R. § 3.303(b); see also Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). In addition, service connection may also be granted on the basis of a post-service initial diagnosis of a disease, where the physician relates the current condition to the period of service. 38 C.F.R. § 3.303(d). In addition, service connection may also be granted on the basis of a post-service initial diagnosis of a disease, where the physician relates the current condition to the period of service. 38 C.F.R. § 3.303(d). Other specifically enumerated disorders, including arthritis, will be presumed to have been incurred in service if they manifested to a compensable degree within the first year following separation from active duty. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. However, presumptive periods do not apply to ACDUTRA or INACDUTRA. See Biggins v. Derwinski, 1 Vet. App. 474, 477-78 (1991). Active military, naval, or air service includes any period of ACDUTRA during which the individual concerned was disabled or died from a disease or injury incurred in or aggravated in line of duty, or any period of INACDUTRA during which the individual concerned was disabled or died from injury incurred in or aggravated in line of duty. 38 U.S.C. §§ 101(21) and (24); 38 C.F.R. §§ 3.6(a) and (d). ACDUTRA is, inter alia, full-time duty performed by member of the National Guard of any State. 38 C.F.R. § 3.6(c)(3). In this regard, in order to establish service connection for the claimed disorders, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999). The requirement of a current disability is "satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim." See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). In evaluating the evidence, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. Owens v. Brown, 7 Vet. App. 429, 433 (1995). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Initially, as to all the issues on appeal, the Board finds that the Veteran is competent to report on the events he experienced while on active duty and the manifestations of his disabilities, such as (for example) pain, swelling, and lost motion in all the joints in question. See Davidson, supra. Next, as to the Veteran's claim that he has all of the claimed disorders due to, among other things, working on lots of equipment and using many different types of hand tools (constantly twisting and turning) to repair the equipment, the Board notes that his DD 214 lists his occupational specialty as construction equipment repair. i. left ankle, right ankle, left wrist, right wrist, and right elbow disabilities As to the claims of service connection for left ankle, right ankle, left wrist, right wrist, and right elbow disabilities, the Board notes that service and Reserve Component treatment records, including the November 1999 Annual Medical Certificate, November 2001 Annual Medical Certificate, January 2002 Annual Medical Certificate, May 2002 Pre-Deployment Examination, January 2003 Post-Deployment Health Assessment, February 2003 Post-Deployment Health Assessment, March 2003 Report of Medical Assessment, September 2003 Reserve Component examination, February 2004 Annual Medical Certificate, and April 2004 Reserve Component examination, are negative for injuries, complaints, histories, diagnoses, or treatment for any of these disabilities. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991) (VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions). Likewise, and more importantly, the post-service record including the April 2021 VA examinations are negative for diagnoses of left ankle, right ankle, left wrist, right wrist, and right elbow disabilities despite some treatment records documenting his reports of pain. In fact, at the April 2021 VA examinations which were held for the express purpose of obtaining diagnoses the examiners, after a detailed examinations which specifically considered the Veteran's lay claims of observable in-service and post-service symptomatology, opined that he did not have left ankle, right ankle, left wrist, right wrist, and right elbow disabilities. Moreover, the Board finds the opinions provided by the above April 2021 VA examiners to be both competent and credible to adjudicate the Veteran's claims as well as the most probative evidence of record because they were provided after a review of the record on appeal and an examination of the appellant by medical professionals and took into account all theories of entitlement, they are supported by citation to the service treatment records and the post-service medical records, they took into account the competent and credible lay claims regarding observable symptomatology, and the opinions are supported by medical reasoning and controlling medical literature. See Guerrieri, supra; Wray, supra; ElAmin, supra. The Board also notes that these medical opinions are not directly contradicted by any other medical evidence of record. See Colvin, supra. Further, the Board nots that the Veteran's representative claimed in its June 2021 Brief that the Veteran had current left ankle, right ankle, left wrist, right wrist, and right elbow disabilities when taking into account the Court's holding in Saunders, supra. The Veteran's representative argues, in substance, that the appellant's telling the April 2021 VA examiners that the claimed disabilities, including specifically his wrist disability, caused problems at work, shows they caused functional impairment that affects earning capacity as envisioned by Saunders. The Board finds that notwithstanding the Veteran's representative's claims in its June 2021 Brief ,the facts of this appeal are distinguishable from those in Saunders, supra. The Board has reached this conclusion because whether a disability causes functional impairment that affects earning capacity is a complex medical question and the Veteran does not have the required medical training to provide this opinion. See Owens, supra; Also see Davidson, supra. The Board has also reached this conclusion because the findings by the April 2021 VA examiners shows that none of the claimed disabilities result in functional impairment that affects earning capacity as envisioned by Saunders. Id. The Board's finds the representative's argument fundamentally flawed: A person telling an examiner that an alleged joint issue causes problems at work does not "create" a disability. More factors must be involved or there would be no basis for an examination to confirm the existence of the disability at issue. In this regard, the fact that the Veteran has filed several claims regarding alleged disabilities related to service and even the existence of the problem can not be confirmed (let alone a finding that these problems are related to service) undermines the Veteran's credibility with the Board. A review of the record indicates that the Veteran is not an accurate historian of his alleged problems due to service. Lastly, while the Veteran and his wife are competent to report on the symptoms they observe, the Board finds that they are not competent to diagnose left ankle, right ankle, left wrist, right wrist, and right elbow disabilities because diagnosing them requires special medical training and therefore they cannot provide the missing diagnoses because they do not have the required training. See Davidson, supra. Accordingly, the Board finds that the most probative evidence of record shows that the Veteran did not have a diagnosis of a left ankle, right ankle, left wrist, right wrist, and right elbow disabilities at any time during the pendency of the appeal despite the reports of pain seen in the record and the Veteran's claims regarding them interfering with work . See Owens, supra. Therefore, the Board finds that the claims of service connection left ankle, right ankle, left wrist, right wrist, and right elbow disabilities are denied. 38 U.S.C. §§ 101, 106, 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. ii. left elbow, neck, left knee, right knee, left foot, and right foot disabilities As to the claims of service connection for left elbow, neck, left knee, right knee, left foot, and right foot disabilities, the record shows the Veteran being diagnosed with left elbow olecranon bursitis, neck arthritis and spondylolisthesis, left knee and right knee arthritis, and left and right foot hallux valgus. See, e.g., VA examinations dated in April 2021. However, service and Reserve Component treatment records, including the November 1999 Annual Medical Certificate, November 2001 Annual Medical Certificate, January 2002 Annual Medical Certificate, May 2002 Pre-Deployment Examination, January 2003 Post-Deployment Health Assessment, February 2003 Post-Deployment Health Assessment, March 2003 Report of Medical Assessment, September 2003 Reserve Component examination, February 2004 Annual Medical Certificate, and April 2004 Reserve Component examination, are negative for injuries, complaints, history, diagnoses, or treatment for left elbow, neck, left knee, right knee, left foot, and right foot disabilities. See Colvin, supra. In fact, in the November 1999, November 2001, January 2002, and February 2004 Annual Medical Certificates the Veteran specifically denied having any medical problems. Likewise, the May 2002 Pre-Deployment Examination, January 2003 Post-Deployment Health Assessment, and February 2003 Post-Deployment Health Assessment are negative for any problems related to the issues on appeal. Moreover, in the March 2003 Report of Medical Assessment the Veteran reported that he had not had any illness or injury since his last assessment. Furthermore, the Board notes that at the September 2003 and April 2004 Reserve Component examinations the Veteran specifically denied have problems with painful shoulder, elbow, or wrist; foot trouble; impaired arms, legs, hand, feet; and swollen or painful joints. Lastly, the Board notes that the September 2003 and April 2004 Reserve Component examiners opined that the Veteran's upper and lower extremities, feet, spine, and other musculoskeletal systems were normal. At this point, it is important for the Veteran to understand that he himself, at this point, provides highly probative factual evidence against these claims. The Board cannot ignore the fact that the Veteran himself either failed to report having a problem with any of the claimed disorders while on active duty and serving with a Reserve Component, on other occasions specifically denied having a problem with any of the claimed disorders while on active duty and serving with a Reserve Component, and at the two Reserve Component examinations shortly after his active duty it was specifically opined that his upper and lower extremities, feet, spine. and other musculoskeletal systems were normal. The Board finds that the best evidence in this case does not support a finding that the Veteran injured his left elbow, neck, left knee, right knee, left foot, and right foot during service. The Veteran's recollection of events from over a decade ago, based on his prior statements, is found to be in error. In any event, even if the Board were to assume, notwithstanding the Veteran's own prior statements, that he did, in fact, injure his left elbow, neck, left knee, right knee, left foot, and right foot during active duty over a decade ago or while serving with a Reserve Component, the Board also finds, as the September 2003 and April 2004 Reserve Component examinations must have found, that the most probative evidence of record shows that any problem the Veteran may have had was, at best, transient in nature and resolved by the time he was examined in 2003 and 2004. See Owens, supra. This finding is supported by the Veteran's own prior statements, as noted above. Accordingly, the Board finds that the most probative evidence of record shows that the Veteran did not have left elbow, neck, left knee, right knee, left foot, and right foot disabilities while on active duty or left elbow, neck, left knee, right knee, left foot, and right foot disabilities due to an injury while serving with a Reserve Component. 38 U.S.C. §§ 101, 106, 1110; 38 C.F.R. § 3.303(a); Colvin, supra. In this regard, the Board must note that in the November 1999, November 2001, January 2002, and February 2004 Annual Medical Certificates, May 2002 Pre-Deployment Examination, January 2003 Post-Deployment Health Assessment, February 2003 Post-Deployment Health Assessment, March 2003 Report of Medical Assessment, and September 2003 and April 2004 Reserve Component examinations even the Veteran did not think he had left elbow, neck, left knee, right knee, left foot, and right foot disabilities while on active duty and when examined shortly after he separated from service when serving with a Reserve Component. As to service connection for left elbow, neck, left knee, right knee, left foot, and right foot disabilities based on the presumptions found at 38 C.F.R. § 3.309(a), the record does not show that arthritis in any of these joints manifest in the first year following his separation from a qualify period of active duty service. In this regard, while the Veteran's representative in its June 2021 Brief claims that x-ray evidence of bilateral knee arthritis in February 2016 meets the criteria for this presumption, the Board notes that these x-rays were taken 13 years after his 2003 separation from active duty and these presumptive periods do not apply to periods of ACDUTRA or INACDUTRA. See Biggins, supra. Therefore, notwithstanding the Veteran's representative's claims to the contrary, the Board finds that the presumptions found at 38 C.F.R. § 3.309(a) do not help the Veteran establish service connection for any of the claimed disabilities including the left and right knee disabilities. See 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. § 3.307. Next, the Board will consider whether the Veteran is entitled to service connection for left elbow, neck, left knee, right knee, left foot, and right foot disabilities due to continuity of symptomatology under 38 U.S.C. § 1110; 38 C.F.R. § 3.303(b). In this regard, and as noted above, in the November 1999, November 2001, January 2002, and February 2004 Annual Medical Certificates the Veteran specifically denied having any medical problems. Likewise, the May 2002 Pre-Deployment Examination, January 2003 Post-Deployment Health Assessment, and February 2003 Post-Deployment Health Assessment are negative for any problems related to the issues on appeal. Similarly, in the March 2003 Report of Medical Assessment the appellant reported that he had not had any illness or injury since last assessment. Moreover, at the September 2003 and April 2004 Reserve Component examinations the Veteran specifically denied have problems with painful shoulder, elbow, or wrist; foot trouble; impaired arms, legs, hand, feet; and swollen or painful joints. In addition, the Board notes that the September 2003 and April 2004 Reserve Component examiners opined that the Veteran's upper and lower extremities, feet, spine, and other musculoskeletal systems were normal. See Colvin, supra. Likewise, and more important than the above, the post-service record is negative for complaints, diagnoses, or treatment for the left elbow, neck, left knee, right knee, left foot, and right foot disabilities until, at the earliest, 2014 (see, e.g., Dr. Randall Brown treatment record dated in December 2014 (bilateral knee pain); VA treatment records dated in January 2016 (knee pain); February 2016 (cervical spine segment dysfunction; x-ray evidence of bilateral knee degenerative joint disease); March 2020 (x-ray evidence of degenerative joint disease); April 2021 (x-ray evidence of bilateral hallux valgus); April 2021 (x-ray evidence of left elbow olecranon bursitis); Dr. Randal Crabtree treatment records dated in October 2017 (neck pain) and November 2017 (diagnosing cervical spine degenerative disc disease)); at least a decade after his 2003 separation from active duty. See Colvin, supra. In this regard, the Board finds of particular significance the fact that, not only do none of the active duty or Reserve Component records cited to above ever document history, complaints, diagnoses, or treatment for any the claimed disorders but in many of them the Veteran specifically denied having the problems and subsequent physical examinations did not diagnose any of the claimed disorders. See Owens, supra. Once again, it is important for the Veteran to understand that notwithstanding any current claims that he has had left elbow, neck, left knee, right knee, left foot, and right foot disabilities in, and since, his active duty service in 2003, he himself in the above active duty and Reserve Component records provides highly probative evidence against his claims because not only did these records not list or diagnose any of the claimed disabilities but the appellant himself did not think he had them at the time of these records were generated. See Owens, supra. We cannot ignore the Veteran's own prior statements. While the Board is certain that the Veteran believes that his left elbow, neck, left knee, right knee, left foot, and right foot disabilities started while on active duty almost 20 years ago in 2003 and continued to the current time, the Board nonetheless finds such claims incredulous given the November 1999, November 2001, January 2002, and February 2004 Annual Medical Certificates in which the Veteran specifically denied having any medical problems; the May 2002 Pre-Deployment Examination, January 2003 Post-Deployment Health Assessment, and February 2003 Post-Deployment Health Assessment being negative for any problems related to the issues on appeal; the March 2003 Report of Medical Assessment in which the appellant reported that he had not had any illness or injury since last assessment; and the September 2003 and April 2004 Reserve Component examinations at which he specifically denied have problems with painful shoulder, elbow, or wrist; foot trouble; impaired arms, legs, hand, feet, and swollen or painful joints and the examiners opined that his upper and lower extremities, feet, spine and, other musculoskeletal systems were normal, and the first problems with any of his disabilities not appearing in the record until 2014 (see Dr. Randall Brown treatment record dated in December 2014); over 10 years after his 2003 separation from active duty. Id. The Veteran's statements and recollections of events from so many years ago are simply not accurate based on the evidence, including the Veteran's own prior statements (as noted above). At this point, the Board finds that the service medical records, Reserve Component examinations, and the post-active duty medical records provide the most probative evidence of record and it is against finding continuity of symptomatology. See Owens, supra. Therefore, the Board finds that the most probative evidence of record shows that the Veteran did not have a continued problem with left elbow, neck, left knee, right knee, left foot, and right foot disabilities in and since his separation from active duty in 2003, almost 20 years ago, despite the claims to the contrary. See 38 U.S.C. § 101, 106, 1110; 38 C.F.R. § 3.303(b). Furthermore, the Board finds that the most probative evidence of record shows that the Veteran's post-service left elbow, neck, left knee, right knee, left foot, and right foot disabilities are not due to his military service. See 38 U.S.C. §§ 101, 106, 1110; 38 C.F.R. § 3.303(d); also see Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992) (establishing service connection requires finding a relationship between a current disability and events in service or an injury or disease incurred therein). In this regard, and as noted above, the April 2021 VA examiners opined that his left elbow, neck, left knee, right knee, left foot, and right foot disabilities are not due to his military service. Moreover, the Board finds these opinions the most probative evidence of record because the etiology opinions were provided after a review of the record on appeal and an examination of the Veteran, they took into account all theories of entitlement, they took into account the lay claims regarding observable symptomatology, they are supported by citation to the service treatment records and the post-service medical records, and the opinions are supported by medical reasoning as well as controlling medical literature. See Owens, supra; Guerrieri, supra; Wray, supra. The Board also finds that the Veteran and his wife are not competent to provide the missing nexus opinions because they do not have the required medical expertise to provide an answer to this complex medical question (i.e., what caused the current left elbow, neck, left knee, right knee, left foot, and right foot disabilities disabilities). See Davidson, supra. Accordingly, the Board finds that the preponderance of the evidence is also against the Veteran's claims of service connection for left elbow, neck, left knee, right knee, left foot, and right foot disabilities. 38 U.S.C. §§ 101, 106, 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. Conclusion In reaching the above conclusions, the Board considered the doctrine of reasonable doubt. 38 U.S.C. § 5107(b). However, as the preponderance of the evidence is against the claims, the Board finds that the doctrine is not for application. See also, e.g., Ortiz, supra; Gilbert, supra. John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N.T. Werner, 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.