Citation Nr: 22018146 Decision Date: 03/28/22 Archive Date: 03/28/22 DOCKET NO. 19-34 836 DATE: March 28, 2022 ORDER Entitlement to service connection for a cardiovascular condition, to include high cholesterol, hypertension, and ischemic heart disease is denied. Entitlement to service connection for residuals of an appendix removal is denied. REMANDED Entitlement to service connection for arthritis/osteoarthritis is remanded. Entitlement to service connection for an eye condition is remanded. FINDINGS OF FACT 1. The Veteran has high cholesterol; however, high cholesterol is a laboratory finding not a disability. 2. The Veteran has current diagnoses of hypertension and ischemic heart disease, but neither were incurred in service. 3. The evidence is against a finding that the Veteran has a current disability related to his appendix. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a cardiovascular condition, to include high cholesterol, hypertension, and ischemic heart disease have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5103, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for entitlement to service connection for residuals of an appendix removal have not been met. 38 U.S.C. §§ 1101, 1131, 5103, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Navy from November 1972 to October 1979. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In October 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ); a transcript is of record. The issue of entitlement to service connection for presbyopia (claimed as poor vision) was denied by the RO in a May 2018 rating decision. Although the Veteran did not appeal that decision, as he already had a claim for an eye condition (claimed as poor vision due to cataracts) pending, the Board has recharacterized the issue to encompass any possible eye disorder. See Brokowski v. Shinseki, 23 Vet. App. 79, 85 (2009) (a claimant's identification of the benefit sought does not require any technical precision); Clemmons v. West, 206 F.3d 1401 (Fed. Cir. 2000) Moreover, the Veteran's claim for service connection for high cholesterol also has been recharacterized as reflected on the title page. See Brokowski, 23 Vet. App. at 84; Clemmons, 206 F.3d at 1401. 1. Entitlement to service connection for a cardiovascular condition, to include high cholesterol, hypertension, and ischemic heart disease. The Veteran seeks service connection for high cholesterol. For the reasons that follow, the Board finds that service connection is not warranted. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, to establish service connection, there must be competent, credible evidence of 1) a current disability, 2) in-service incurrence or aggravation of an injury or disease, and 3) a nexus, or link, between the current disability and the in-service disease or injury. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Where there is a chronic disease shown as such in service or within the presumptive period under 38 C.F.R. § 3.307, so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service-connected, unless clearly attributable to intercurrent causes. If there is no showing of a resulting chronic condition during service, then a showing of continuity of symptomatology after service is required to support a finding of chronicity. 38 C.F.R. § 3.303(b). Service connection may be established for chronic diseases, to include hypertension and ischemic heart disease, manifesting to a certain degree within a year after service. 38 U.S.C. §§ 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309(a). With regards to high cholesterol, private treatment records show that the Veteran has been found to have high cholesterol/hyperlipidemia. High cholesterol is also referred to as hypercholesterolemia or hyperlipidemia. However, hypercholesterolemia is simply defined as an "excess of cholesterol in the blood." Dorland's Illustrated Medical Dictionary 792 (28th ed. 1994) and hyperlipidemia is "a general term for elevated concentrations of any or all of the lipids in the plasma, including hypertriglyceridemia, hypercholesterolemia, etc." Id. at 795. Hyperlipidemia and elevated cholesterol are considered to be laboratory findings and therefore are not disabilities in and of themselves for which VA compensation benefits are payable. See 61 Fed. Reg. 20,440, 20,445 (May 7, 1996) (Diagnoses of hyperlipidemia, elevated triglycerides, and elevated cholesterol are actually laboratory results and are not, in and of themselves, disabilities). While private treatment records show diagnoses of hypertension and ischemic heart disease, which constitute disabilities for VA purposes, the Veteran's service treatment records (STRs) are silent for any complaints, treatment, or diagnoses related to these conditions. On his July 1979 Report of Medical Examination at separation, all body systems were noted as normal, and his blood pressure was 120/84 mmHg. See 38 C.F.R. § 4.104, Diagnostic Code 7101, Note 1 (defining hypertension). Moreover, the Veteran has not contended that his hypertension or ischemic heart disease is related to any specific injury, disease, or event in service. Nor does any competent evidence of record suggest such. Thus, without any evidence of an in-service incurrence, service connection on a direct basis cannot be granted. Further, as there is no evidence showing initial manifestations of hypertension or ischemic heart disease in service, or to any degree within one year of separation from service, the one-year presumption for this condition under 38 C.F.R. §§ 3.307 and 3.309 is not an avenue for service connection, nor are the provisions of 38 C.F.R. § 3.303(b) pertaining to chronicity or continuity of symptomatology. See 38 C.F.R. §§ 3.303(b), 3.307, 3.309. The evidence also does not reflect, nor does the Veteran contend, that a diagnosis of hypertension or ischemic heart disease was provided within a year of service discharge. Post-service medical records reflect that the Veteran was diagnosed with hypertension and ischemic heart disease in 2021. See February 2021 private treatment record. The Veteran has not been afforded a medical examination in connection with his claim, but in the absence of any competent, credible evidence of a possible association with service, VA is not required to further develop the claim by affording the Veteran a VA examination or by obtaining a medical opinion. He has not reported that his hypertension or ischemic heart disease had onset during service and there is no indication that these conditions may otherwise be related to service. Therefore, a VA examination or opinion is not necessary. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006); Waters v. Shinseki, 601 F.3d 1274, 1278-79 (Fed. Cir. 2010). Based on the foregoing, service connection for a cardiovascular condition, to include high cholesterol, hypertension, and ischemic heart disease is not warranted. In reaching this conclusion, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the persuasive of the evidence is against the Veteran's claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). 2. Entitlement to service connection for residuals of an appendix removal. The Veteran seeks service connection for residuals related to the removal of his appendix. For the reasons that follow, the Board finds that service connection is not warranted. The Veteran's STRs are silent for any complaints, treatment, or diagnoses related to the appendix. As noted above, all body systems were noted as normal on the Veteran's Report of Medical Examination at separation. See July 1979 Report of Medical Examination. Post-service private treatment records show that the Veteran experienced acute appendicitis and underwent an appendectomy in 2011, approximately six years prior to filing his claim for service connection. Private treatment records are otherwise silent for any complaints, treatment, or diagnoses related to the appendix during the course of this claim or immediately prior to the filing of the claim. The Veteran also has not contended, and there is no evidence to suggest, that he experiences any residuals as a result of his appendix removal. Accordingly, while the record shows that the Veteran had an appendectomy in 2011, his appendicitis resolved thereafter and there is no evidence of record that indicates the Veteran experiences any residuals or has been diagnosed with any other condition related to the appendix. Thus, in the absence of proof of a present disability, there can be no valid claim for service connection. Brammer, 3 Vet. App. 223 at 225. Alternatively, even when assuming that the Veteran experiences any claimed residuals, there is no indication of record that his appendix removal was in any way related to service or any event of service. The Veteran has not been afforded a medical examination in connection with his claim, but in the absence of any competent, credible evidence of a current disability and a possible association with service, VA is not required to further develop the claim by affording the Veteran a VA examination or by obtaining a medical opinion. Therefore, a VA examination or opinion is not necessary. See McLendon, 20 Vet. App. at 81. There is no doubt to be resolved; service connection for residuals an appendix removal is not warranted. REASONS FOR REMAND Entitlement to service connection for an eye condition and arthritis. The Veteran seeks service connection for an eye condition and arthritis. The Board finds that additional development is necessary prior to adjudication. The evidence of record shows that the Veteran has been diagnosed with presbyopia and gout. With regards to his eye condition, the Veteran contends that his symptoms began in service. Specifically, he reports that he experienced hazy, blurry sight as well as tearing in the eyes in service. See October 2021 hearing transcript. He also contends that his eye condition is related to exposure to fine dust from using tools, including a grinder, as a boatswain mate. Id. October 1978 STRs show that the Veteran's eyes watered slightly and that he was instructed to wash his eyes with drops after work. With regards to his arthritis, the Veteran contends that such is related to exposure to cold temperatures while serving aboard naval ships. The Veteran has not yet been afforded a VA examination for his eye condition and arthritis. In light of the foregoing, the Board finds that one should be provided on remand. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his eye condition. The examiner must review the claims file and a copy of this Remand. The examiner must opine whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's eye condition had its onset in, or is otherwise related to, active service, to include his complaints of eye symptoms in service and/or reported exposure to fine dust particles while working as a boatswain mate in service. A complete rationale must be provided for all opinions expressed. The rationale must consider and discuss the pertinent evidence of record, to include the Veteran's lay statements. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his arthritis/gout. The examiner must review the claims file and a copy of this Remand. The examiner must opine whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's arthritic condition had its onset in, or is otherwise related to, active service, to include exposure to cold weather in service. A complete rationale must be provided for all opinions expressed. The rationale must consider and discuss the pertinent evidence of record, to include the Veteran's lay statements. C. CRAWFORD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Mortimer, 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.