Citation Nr: 22019913 Decision Date: 04/03/22 Archive Date: 04/03/22 DOCKET NO. 17-56 280 DATE: April 3, 2022 ORDER Entitlement to service connection for varicose veins of the left lower extremity is denied. FINDING OF FACT The most probative evidence indicates that the Veteran's varicose veins of the left lower extremity is not related to service CONCLUSION OF LAW The criteria for entitlement to service connection for varicose veins of the left lower extremity have not been met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2021). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1994 to June 1999. This matter comes before the Board of Veterans' Appeals (Board) from a May 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The case was last before the Board in December 2019 and has returned to the Board for further appellate review. 1. Entitlement to service connection for varicose veins of the left lower extremity The Veteran seeks service connection for left lower extremity varicose veins, which he asserts is related to service. Specifically, the Veteran asserts that he developed varicose veins in his left leg as a result of a fall during service. In an April 2021 correspondence, the Veteran's friend stated that he witnessed the Veteran fight through pain in both legs brought on by varicose veins. 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; 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). Upon review of the record, the Board finds the most probative evidence is against a finding that the Veteran's left lower extremity varicose veins is related to service. While service treatment records reveal various complaints of and treatment for right lower extremity varicose veins, they are silent for any complaints or treatment for left lower extremity varicose veins. The first medical evidence of left lower extremity varicose veins is an October 2011 private treatment record. Thereafter, a January 2012 private treatment record indicated that the Veteran's condition had not improved, and he subsequently underwent a procedure to treat his left leg varicose veins. In February 2020, a VA examiner opined that it is more likely than not the Veteran had an evaluation of the left leg during service and no varicose veins were present at the time of the evaluation. The examiner explained that the Veteran had several evaluations concerning his right leg varicose veins and it would be normal procedure to evaluate both lower extremities in an evaluation of varicose veins. Moreover, a typical vascular surgeon would certainly evaluate both lower extremities if there were abnormalities such as varicose veins in one leg and would have ordinarily made records of the left leg veins as well. The examiner further explained that there are no service treatment records pertaining to any varicose veins of the left leg. Additionally, if the Veteran had known he had varicose veins in service he would have complained about them at the time, like he did when his right leg symptoms arose. As such, the examiner concluded that it is highly unlikely that the Veteran's examining vascular surgeon would have seen left leg varicose veins and not made a diagnosis of such, even if they were asymptomatic at that time. The Board notes that the Veteran submitted two opinions from his private physicians dated February 2017 and April 2021. In February 2017, Dr. T.G., opined that due to the severity of the varicose veins in the Veteran's right leg, it is more likely than not there would have been varicose veins in the Veteran's left leg that should have been treated. In April 2021, Dr. C.W., opined that the Veteran's bilateral lower extremity varicose veins and venous insufficiency are due to the injury he suffered while in basic training. However, the Board finds the February 2020 VA opinion to be of greatest probative value, as it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Conversely, the 2017 private opinion does not appear to be based on review of evidence in the claims file and provided no rationale for the conclusion reached. Additionally, while Dr. C.W. indicated that his opinion was based in part on finding that the Veteran suffered blunt injury to both thighs during service, his finding is contrary to service treatment records revealing the Veteran only suffered injury to his right lower extremity. Accordingly, these opinions are afforded little, if any, weight. 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."). Although the Veteran is competent to report observable symptoms and believes that his left lower extremity varicose veins are related to service, he has not been shown to have the 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 or etiology). In this regard, the diagnosis and etiology of vein disorders are matters that require medical testing and expertise to determine. Thus, the Board finds the opinion of the VA examiner to be more probative than the Veteran's lay assertions. In sum, as the weight of the competent and probative evidence is against the claim, service connection for varicose veins of the left lower extremity is denied. In reaching the above conclusion, the Board has considered the applicability of the benefit of the doubt doctrine; however, as the competing evidence is not in approximate balance, the doctrine is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. James Springer Acting 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.