Citation Nr: 22041348 Decision Date: 07/19/22 Archive Date: 07/19/22 DOCKET NO. 15-25 286 DATE: July 19, 2022 ORDER Entitlement to service connection for celiac disease is denied. Entitlement to service connection for an acquired psychiatric disorder, to include bipolar disorder, multiple personality disorder, schizoaffective disorder, and depressive disorder, is denied. FINDINGS OF FACT 1. The Veteran did not attend the scheduled VA examinations to determine the etiology of his celiac disease acquired psychiatric disorder and did not provide good cause for missing the examinations. 2. The Veteran's celiac disease is not shown to be causally or etiologically related to any disease, injury, or incident in service. 3. The Veteran's acquired psychiatric disorder is not shown to be causally or etiologically related to any disease, injury, or incident in service. CONCLUSIONS OF LAW 1. The criteria for service connection for celiac disease have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for an acquired psychiatric disorder have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the United States Army from August 1985 to September 1986. This matter is before the Board of Veterans' Appeals (the Board) on appeal from an October 2013 rating decision issued by a Department of Veteran Affairs (VA) Regional Office (RO). This case was previously before the Board in October 2018, at which time the issues currently on appeal were remanded for additional development. Specifically, the Board remanded the instant matters to obtain Social Security Administration (SSA) records and to complete appropriate authorization forms to allow VA to obtain treatment records from Health East Care System Minnesota, Hennepin County Minnesota Social Services, and Boulder County Colorado Social Services, as well as for scheduling of multiple VA examinations. SSA records were associated with the record in August 2019, which included medical records from Health East Care. Letters dated in April 2020 and January 2022 requested that the Veteran complete an Authorization to Disclose Information to VA (VA Form 21-4142) for various providers. However, as discussed in more detail below, the VA Form 21-4142 was not returned by the Veteran, and he did not attend his scheduled VA examinations. Therefore, the Board determines that there has been substantial compliance with its previous remand. Service Connection In order to establish service connection for a claimed disorder, the following must be shown: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). As explained in the October 2018 Board remand, the Board determined that remand for VA examinations was necessary in order to obtain medical opinions as to the etiology of his celiac disease and acquired psychiatric disorder. Following the October 2018 Board remand, the Agency of Original Jurisdiction (AOJ) attempted to schedule the Veteran for VA examinations and notice regarding the scheduled examinations was sent on multiple occasions in 2020, 2021 and 2022. An April 2022 document reflects that the Veteran did not report for VA examinations scheduled on April 5, 2022. The June 2022 supplemental statement of the case informed the Veteran that he failed to attend the VA examinations. No correspondence was received from the Veteran providing good cause for missing the examinations or requesting to reschedule. Under 38 C.F.R. § 3.655(a), when entitlement to a benefit cannot be established without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination or reexamination, action shall be taken in accordance with 38 C.F.R. § 3.655(b). 38 C.F.R. § 3.655(b) provides that when a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. In contrast, when the examination was scheduled in connection with, among other things, a claim for increase, "the claim shall be denied." A claim for service connection is an "original compensation claim" for purposes of 38 C.F.R. § 3.655(b). Turk v. Peake, 21 Vet. App. 565, 570 (2008). The examination documentation in the claims file reflects that the AOJ followed the regular process for scheduling an examination and notifying the Veteran of that examination and there is no indication that the notice was sent to an incorrect address, such as notification letters being returned as undeliverable. The Veteran has not indicated that his address has changed or that he had good cause for failure to report for the scheduled examination. The Board notes the duty to assist is not a one-way street; a claimant cannot stand idle and fail to cooperate. Wood v. Derwinski, 1 Vet. App. 190 (1991). Therefore, the Board finds that the Veteran failed to report for examinations scheduled in connection with his claims for service connection for an acquired psychiatric disorder. The next question to be addressed under 38 C.F.R. § 3.655(a) is whether entitlement to the benefits sought can be established without the scheduled examinations. As explained in more detail below, the Board has determined that it cannot. Additionally, in April 2020 and January 2022, the Veteran was sent requests to complete and return a VA Form 21-4142 identifying private treating providers and authorizing VA to request information from such providers. The Veteran did not return the VA Form 21-4142 identifying any private treating providers. There is no evidence in the record to suggest that the Veteran was unable to correspond with VA. "The duty to assist is not always a one-way street. If a [V]eteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence." Wood v. Derwinski, supra. Entitlement to service connection for celiac disease is denied. Entitlement to service connection for an acquired psychiatric disorder is denied. The Veteran generally asserts that he has celiac disease and an acquired psychiatric disorder that are related to his period of active service. Specific argument in support of this appeal has not been submitted. In his October 2012 VA Form 21-526b, the Veteran indicated that he was applying for VA benefits related to bipolar disorder, multiple personality disorder, and celiac disease. The application did not contain any additional detail with regard to his claimed bipolar disorder, multiple personality disorder, and celiac disease. The Veteran's service treatment records are unremarkable for any complaints of, treatment for, or diagnoses of celiac disease or an acquired psychiatric disorder during active service. Moreover, a review of the Veteran's post-service medical records shows that the Veteran first experienced a mental health condition in 1992. In this regard, in a December 2004 SSA Disability Report, the Veteran indicated that he first experienced mental health problems in 1992. With regard to his celiac disease, the first indication of celiac disease of record is a September 2004 private treatment note showing that the Veteran had a history of celiac disease. The Board notes that every veteran is presumed to have been in sound condition at entry into service except as to defects, infirmities, or disabilities noted at the time of such entry, or where clear and unmistakable evidence demonstrates that the injury or disease existed before entry and was not aggravated by such service. 38 U.S.C. § 1111. If a condition is noted on an entrance examination report, the presumption of soundness never attaches - the only benefits that can be awarded are for aggravation of such condition by application of 38 U.S.C. § 1153 and 38 C.F.R. § 3.306. Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004). Here, in the Veteran's November 1984 Report of Medical History, the Veteran indicated that he saw a psychiatrist approximately 6 times while in high school and stated that it was just to talk. The Board notes that the November 2014 enlistment examination clinical evaluation was absent any psychological disorder. As such, the Veteran is entitled to the presumption of soundness. Upon review of the evidence, the Board finds that entitlement to service connection for celiac disease and acquired psychiatric disorder is not warranted. In this regard, the Board has also considered the lay assertions of record, including the contentions of the Veteran in support of a medical nexus. The Veteran contends that he has celiac disease and an acquired psychiatric disorder that is due to his service. As a lay person, the Veteran is competent to report observable symptoms. See Washington v. Nicholson, 21 Vet. App. 191, 195 (2007) (holding that, "[a]s a layperson, an appellant is competent to provide information regarding visible, or otherwise observable symptoms of disability"); see also Barr v. Nicholson, 21 Vet. App. 303 (2007) (Lay testimony is competent to establish the presence of observable symptomatology); Layno v. Brown, 6 Vet. App. 465 (1994). Lay evidence may be competent on a variety of matters concerning the nature and cause of disability. Jandreau, 492 F.3d at 1377 n.4. However, while the Veteran is competent to report having experienced adverse reactions to gluten and wheat, as well as mental health symptoms, he is not competent to opine on the etiology of celiac disease or an acquired psychiatric disorder. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Opinions of that nature require medical expertise that is outside the realm of common knowledge of a layperson. Kahana v. Shinseki, 24 Vet. App. 428 (2011). Moreover, the Veteran has not been shown to possess the requisite medical training, expertise, or credentials needed to render a diagnosis or a competent opinion as to medical causation. Nothing in the record demonstrates that the Veteran received any special training or acquired any medical expertise in evaluating celiac disease and/or mental health conditions. See King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). As such, the Board assigns no probative weight to the Veteran's assertions that his celiac disease and acquired psychiatric disorder were incurred in or the result of his active military service. Therefore, the Veteran is not competent to provide etiology opinions in this case. Further, there is no competent evidence of record showing a nexus between the Veteran's current celiac disease and acquired psychiatric disorder and active service. (Continued on the next page) In this case, there is no competent evidence that the Veteran's celiac disease and acquired psychiatric disorder are related to service. To that end, and as explained above, the Veteran is not competent to relate his celiac disease or acquired psychiatric disorder with active service. Moreover, the AOJ made several attempts to obtain VA examinations and medical nexus opinions with regard to the claims; however, the Veteran has not attended such examinations or provided good cause for missing the examinations. Further, the Veteran did not return the VA Form 21-4142 authorizing release of any private treatment providers. Additionally, the first complaints and objective evidence of celiac disease and an acquired psychiatric disorder did not occur until more than a decade after service, and there is no competent evidence to link the Veteran's celiac disease and/or acquired psychiatric disorder with an incident of service. Accordingly, the evidence is persuasively against the claims, there is no doubt to be resolved. The claim is denied. Jessica Seay Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board O'Donnell, Christopher 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.