Citation Nr: 23046167 Decision Date: 08/21/23 Archive Date: 08/21/23 DOCKET NO. 18-28 432 DATE: August 21, 2023 ORDER Entitlement to service connection for tinnitus is granted. Entitlement to service connection for a skin disorder of the face is granted. Entitlement to service connection for a low back disorder is granted. Entitlement to service connection for a right shoulder disorder is denied. Entitlement to service connection for a left shoulder disorder is denied. Entitlement to service connection for bilateral hearing loss is denied. Entitlement to service connection for a dental disability is denied. Entitlement to service connection for a cardiovascular disorder, to include congestive heart failure, is denied. Entitlement to service connection for a respiratory disorder, to include as due to in-service exposure to asbestos, is denied. REMANDED Entitlement to service connection for diabetes mellitus, type II is remanded. Entitlement to service connection for a bilateral eye disorder, to include as secondary to diabetes mellitus, type II is remanded. Entitlement to service connection for a kidney disorder, to include as secondary to diabetes mellitus, type II is remanded. Entitlement to service connection for erectile dysfunction, to include as secondary to diabetes mellitus, type II is remanded. Entitlement to service connection for peripheral neuropathy of the right upper extremity, to include as secondary to diabetes mellitus, type II is remanded. Entitlement to service connection for peripheral neuropathy of the left upper extremity, to include as secondary to diabetes mellitus, type II is remanded. Entitlement to service connection for peripheral neuropathy of the right lower extremity, to include as secondary to diabetes mellitus, type II is remanded. Entitlement to service connection for peripheral neuropathy of the left lower extremity, to include as secondary to diabetes mellitus, type II is remanded. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran's favor, the Veteran's tinnitus was caused by or incurred during his active duty service. 2. Resolving reasonable doubt in the Veteran's favor, the Veteran's skin disorder was caused by or incurred during his active duty service. 3. Resolving reasonable doubt in the Veteran's favor, the Veteran's low back disorder was caused by or incurred during his active duty service. 4. The persuasive evidence of record is against finding that the Veteran's right shoulder disorder was incurred in or caused by active duty service. 5. The persuasive evidence of record is against finding that the Veteran's left shoulder disorder was incurred in or caused by active duty service. 6. The persuasive evidence of record is against finding that the Veteran has, or has had at any time during the appeal period, a right or left ear hearing loss disability for VA purposes. 7. The persuasive evidence is against finding of a dental disability for which compensation is payable. 8. The persuasive evidence of record is against finding that the Veteran's cardiovascular disorder, to include congestive heart failure, is due to or a result of active duty service, to include in-service exposure to asbestos. 9. The persuasive evidence of record is against finding that the Veteran has, or has had at any time during the appeal period, a current diagnosis of a respiratory disorder. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for entitlement to service connection for a skin disorder have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for entitlement to service connection for a low back disorder have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for entitlement to service connection for a right shoulder disorder have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 5. The criteria for entitlement to service connection for a left shoulder disorder have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 6. The criteria for entitlement to service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385. 7. The criteria for an entitlement to service connection for a dental condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.310, 4.150. 8. The criteria for entitlement to service connection for a cardiovascular disorder have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 9. The criteria for entitlement to service connection for a respiratory disorder have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from December 1979 to November 1987. This appeal stems from April 2017 and December 2018 Department of Veterans Affairs (VA) regional office (RO) rating decisions. In November 2021, the Veteran testified at a Board of Veterans' Appeals (Board) hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that hearing is associated with the claims file. In June 2023, the Veteran submitted a statement indicating that he desired a second Board hearing. In June 2023, the Board sent the Veteran a hearing clarification letter requesting confirmation that he wished to attend another Board hearing, and provided him with a 30 day time period in which to respond. However, the Veteran did not respond to the Board's June 2023 hearing clarification letter within the time period indicated in the letter; accordingly, the Board will proceed with adjudication of the Veteran's appeal. In May 2022, the Board remanded the Veteran's claims to the RO for additional development. The May 2022 Remand also included a claim for entitlement to service connection for an acquired psychiatric disorder. In a May 2023 rating decision, the RO granted service connection for an acquired psychiatric disorder. Accordingly, as service connection for this disability has been granted, a full grant of the benefit sought on appeal has been awarded pertaining to this issue, and it is no longer before the Board. Service Connection Service connection may be established for a disability resulting from diseases or injuries which are clearly present in service or for a disease diagnosed after discharge from service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). The vast majority of the Veteran's service treatment records are not associated with the claims file despite numerousattempts to obtain the records by the RO. The Veteran was notified of the unavailability of his service treatment records in a May 2023 letter. When a Veteran's service treatment records are unavailable through no fault of their own, the Board has a heightened obligation to explain its findings and conclusions and to carefully consider the benefit-of- the-doubt rule. See O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991); see also Washington v. Nicholson, 19 Vet. App. 362, 371 (2005). 1. Entitlement to service connection for tinnitus The Veteran contends that service connection is warranted for tinnitus. The Court of Appeals for Veterans Claims (Court) has held that lay evidence is competent and may be sufficient to establish a diagnosis of a condition when 1) a lay person is competent to identify the medical condition; 2) the lay person is reporting a contemporaneous medical diagnosis; or 3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Court has specifically held that tinnitus is capable of lay observation. See Charles v. Principi, 16 Vet. App. 370 (2002). Initially, the Board observes that the record contains a current diagnosis of tinnitus. See March 2023 VA examination. As noted above, the Veteran's service treatment records are unavailable. However, the Veteran has provided competent and credible lay statements regarding the onset of his tinnitus during active duty service. During his November 2021 hearing before the Board, the Veteran reported that he incurred hazardous noise exposure during basic training from munition explosions and at his permanent duty station during field exercises from tanks, and it was at this time that he began to experience ringing in his ears. He indicated that he spoke to a supervisor about the ringing in his ears, and that he experienced ringing in his ears throughout the entirety of his service. During his March 2023 VA examination, the Veteran reiterated that the onset of his tinnitus occurred "years ago." The Board finds the Veteran's lay statements with regard to his in-service tinnitus symptoms to be credible based on the consistent nature of his statements. In the absence of any contradictory evidence, the Board concludes that the evidence demonstrates in-service incurrence of tinnitus. Additionally, the persuasive evidence of record is at least in equipoise as to whether the Veteran's current tinnitus is related to his active duty service. In that regard, the Veteran provided competent and credible testimony explaining that he has experienced tinnitus continuously since his active duty service. He also explained that he has not experienced excessive noise exposure in his post-service employment as a computer specialist. Although the March 2023 VA examiner opined that it was less likely than not that the Veteran's tinnitus is related to his active duty service, the examiner did not address the Veteran's competent and credible lay statements regarding experiencing tinnitus during service and consistently since service. The rationale provided relied on the Veteran's military occupational specialty having a low probability of hazardous noise exposure and "no evidence of noise injury during military service." Because the March 2023 VA examiner did not consider the Veteran's competent and credible lay statements of in-service tinnitus symptoms which have continued since that time, the Board does not afford the opinion significant probative value. Having reviewed the evidence, the Veteran has explained that he first began experiencing tinnitus during service, and that it has continued since service discharge. The Veteran has not provided any inconsistent statements suggesting that the onset of his symptoms occurred at any time prior to or after his active duty service. The Board finds the Veteran to be a credible historian, and his statements regarding the onset of his tinnitus are given great probative weight. As such, the Veteran's statements are highly probative and, with consideration of the benefit of the doubt, the Board concludes that his tinnitus had its onset during active duty service. While there is a negative medical opinion in this case, the Veteran's credible statements as to his symptoms are found to be more probative and any reasonable doubt is resolved in the Veteran's favor. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Accordingly, service connection for tinnitus is granted. 2. Entitlement to service connection for a skin disorder of the face and entitlement to service connection for a low back disorder After thorough consideration of the evidence of record, the Board concludes that service connection for a skin disorder and a low back disorder is warranted. There is a current diagnosis of pseudofolliculitis barbae, as noted in a March 2023 VA examination. Additionally, there is current diagnoses of lumbosacral strain, intervertebral disc syndrome, and lumbar spondylosis, as shown in a March 2023 VA examination. Degmetich v. Brown, 104 F.3d 1328, 1333 (Fed. Cir. 1997) (holding that the existence of a current disability is the cornerstone of a claim for VA disability compensation). As noted above, the Veteran's service treatment records are unavailable. However, the Veteran has provided competent and credible lay statements regarding the onset of his skin disorder and low back disorder during active duty service. During his November 2021 Board hearing, the Veteran reported that his skin disorder started during basic training and that he was given shaving profiles during service. Additionally, dental records note that the Veteran had folliculitis in September 1981. The Veteran also noted that he began experiencing back pain during active duty service, and that he sought medical treatment for his symptoms and was put on a light duty profile. Similarly, during his March 2023 VA examination, the Veteran explained that he developed shave bumps due to shaving requirements during military service. In a March 2023 VA back examination, the Veteran reported that he began experiencing low back pain during service in 1980 after feeling a pop in his back while playing racquetball. He noted that he went to sick call for his symptoms and was given a physical profile. The Board acknowledges that the Veteran did not report a history of hives, skin rashes, arthritis, or rheumatism in questionnaires for dental treatment from September 1985 and May 1987. While the Veteran may not have marked the boxes indicating such a history, his failure to mark these boxes does not amount to a denial of symptoms. Ultimately, the Board finds the Veteran's lay statements and testimony with regard to his in-service skin and back symptoms to be credible in this instance. Accordingly, the Board concludes that the evidence demonstrates in-service incurrence of a skin disorder and in-service incurrence of a low back disorder. Last, the only medical evidence of record addressing the etiology of the Veteran's skin disorder and low back disorder relates it to his active duty service. In that regard, the March 2023 VA examiner opined that the Veteran's skin disorder is related to his active duty service. The rationale provided noted the Veteran's reports of the onset of shave bumps when required to shave for military standards during active duty service with a continuation of these symptoms since that time. The March 2023 VA examiner also concluded that the Veteran's low back disorder is related to his active duty service, and in particular, the in-service low back injury while playing racquetball. The Board finds the March 2023 VA opinions to be probative in this case, as they based upon a review of the pertinent evidence of record and adequately consider the Veteran's lay statements. The Board therefore concludes that, with the benefit of the doubt resolved in the Veteran's favor, a grant of service connection for a skin disorder and a low back disorder is warranted. See Gilbert, 1 Vet. App. at 55 ("[T]he 'benefit of the doubt' standard is similar to the rule deeply embedded in sandlot baseball folklore that 'the tie goes to the runner'.... [I]f... the play is close, i.e., 'there is an approximate balance of positive and negative evidence,' the veteran prevails by operation of [statute]."). 3. Entitlement to service connection for a right shoulder disorder and entitlement to service connection for a left shoulder disorder The Veteran seeks service connection for right and left shoulder disorders. The record establishes current diagnoses bilateral rotator cuff tendonitis and right rotator cuff tear, as shown in a March 2023 VA examination. Thus, current right and left shoulder disabilities are demonstrated. However, the record does not establish in-service incurrence of these disabilities. As noted above, the majority of the Veteran's service treatment records are not available. Nevertheless, the Veteran has not provided any lay statements or testimony indicating that he experienced symptoms of right and left shoulder disabilities during service. Although the Veteran noted problems passing physical training and difficulty with pushups and sit ups, he did not describe any symptoms of right or left shoulder disorders during service which are capable of lay observation. Accordingly, an in-service injury or event is not demonstrated. Additionally, the only medical evidence associated with the claims file shows that the Veteran's right and left shoulder disorders are not related to his active duty service. In a March 2023 VA opinion, the examiner opined that the Veteran's right and left shoulder disorders are not related to his active duty service. The examiner acknowledged the Veteran's reports of difficulty with pull-ups and push-ups during active duty service, but found no evidence in the lay statements of any acute injury to the shoulders during service. Further, the examiner noted the Veteran's report that his shoulder problems started in 2015 when he felt a tear in his right shoulder while putting on a seatbelt. The examiner explained that, in the absence of a history of chronic shoulder symptoms during service, it was less likely than not that the current shoulder disorders are related to the Veteran's active duty service. The Board finds the March 2023 VA opinion to be probative in this matter, as it is based upon a review of the pertinent evidence in the claims file, provides a thorough rationale, and addresses the Veteran's lay statements. Thus, a nexus between the current right and left shoulder disorders and the Veteran's active duty service is not shown. For the foregoing reasons, the Board finds that the claims of service connection for a right and left shoulder disorder must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the persuasive evidence of record is against the Veteran's claims, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 4. Entitlement to service connection for bilateral hearing loss The Veteran contends that he currently has bilateral hearing loss which is etiologically related to his active duty service. For the purpose of applying the laws administered by VA, impaired hearing will be considered a disability when the auditory threshold for any of the frequencies of 500, 1000, 2000, 3000 and 4000 Hertz (Hz) is 40 decibels or greater; the auditory thresholds for at least three of these frequencies are 26 decibels or greater; or speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. VA recognizes that the threshold for normal hearing is from 0 to 20 decibels, and higher threshold levels indicate some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155 (1993). After thorough consideration of the evidence of record, the Board concludes that service connection for bilateral hearing loss is not warranted, as the evidence of record does not establish that the Veteran has a bilateral hearing loss disability for VA purposes now or at any time during the appeal period. The Veteran filed his claim for entitlement to service connection for hearing loss in February 2017. In support of his claim, the Veteran submitted a December 2021 private audiogram. While the audiogram is uninterpreted, it is a straightforward graph, and the Board, as a finder of fact, can interpret the chart to determine the numeric values of the pure tone levels for adjudication purposes. Kelly v. Brown, 7 Vet. App. 471 (1995) (Court could not interpret the results of an audiogram because interpretation required a factual finding, which is not the role of the Court in the first instance, and indicated that the Board was empowered to make those factual findings in the first instance). The December 2021 private audiogram reveals puretone thresholds, in decibels, as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 20 20 20 25 20 LEFT 25 20 25 25 20 Although the private audiogram includes word recognition scores, it does not reflect that the controlled speech recognition testing was conducted using the Maryland CNC word list, as required by regulation for the audiometric testing to be considered. See 38 C.F.R. § 4.85(a). In March 2023, the Veteran underwent a VA audiological examination. At that time, puretone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 25 25 25 25 15 LEFT 30 25 20 30 20 Speech audiometry revealed speech recognition ability of 96 percent in both ears, using the Maryland CNC word list. The audiometric results of the December 2021 private audiogram and the March 2023 VA examination do not show that the Veteran has a right or left ear auditory threshold of 40 decibels or greater for any of the designated frequencies (500, 1000, 2000, 3000, 4000 Hertz), or he has at least three auditory thresholds of 26 decibels or greater for the designated frequencies, or that he has a speech recognition score using the Maryland CNC Test of less than 94 percent, and there is no other probative evidence in the claims file which suggests that the Veteran has hearing loss of such severity to constitute a disability for VA purposes under the pertinent regulations. Thus, the evidence does not demonstrate a right or left ear hearing loss "disability" for VA purposes under the provisions of 38 C.F.R. § 3.385 at any point during the appeal period. The Veteran has not challenged the accuracy of the March 2023 examination, nor has he submitted additional evidence in support of his claim showing that his right or left ear hearing loss meets the threshold requirements set out by 38 C.F.R. § 3.385. While the Veteran is competent to report what comes to him through his senses, including diminished hearing capacity, he is not competent to assess that such hearing loss meets the criteria for hearing loss disability as set forth in 38 C.F.R. § 3.385. See Layno v. Brown, 6 Vet. App. 465 (1994). Rather, such may only be established by audiometric testing. The evidence in this case simply does not support a finding that he currently has a right ear hearing loss disability for VA purposes. The Board may not grant the Veteran service connection, even at a noncompensable level, when the standard for a disability has not been met. Congress has specifically limited entitlement to service connection to instances where disease or injury has resulted in a disability. See 38 U.S.C. §§ 1110, 1131. The evidence reflects that the Veteran does not have a right or left ear hearing loss disability for VA purposes. In the absence of proof of current disability at any point during the appeal period, the claim of service connection may not be granted. See Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). There has been no finding of a current VA disability proximate to or during the pendency of the Veteran's claim. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). Thus, service connection for bilateral hearing loss is not warranted. 5. Entitlement to service connection for a dental disability The Veteran contends that service connection is warranted for a dental disability. Dental disabilities that may be awarded compensable disability ratings include chronic osteomyelitis or osteoradionecrosis of the maxilla or mandible, loss of the mandible, nonunion or malunion of the mandible, loss of the maxilla, nonunion or malunion of the maxilla, limited temporomandibular motion, loss of the ramus, loss of the condyloid or coronoid processes, loss of the hard palate, and loss of teeth due to the loss of substance of the body of the maxilla or mandible without loss of continuity. 38 C.F.R. § 4.150, Diagnostic Codes 9900-9916. Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease are not compensable disabilities, but may be service connected solely for the purpose of establishing eligibility for outpatient dental treatment. 38 C.F.R. §§ 3.381, 17.161. Compensation is only available for loss of teeth, where the lost masticatory surface cannot be restored by suitable prosthesis, if such is due to loss of substance of body of maxilla or mandible, but only if such bone loss is due to trauma or osteomyelitis, and not to the loss of the alveolar process as a result of periodontal disease, as such loss is not considered disabling. See 38 C.F.R. § 4.150, Diagnostic Code 9913. To establish entitlement to service connection for loss of a tooth, the Veteran must have sustained a combat wound or other in-service trauma. 38 U.S.C. § 1712; 38 C.F.R. § 3.381(b). The term "service trauma" does not include the intended effects of therapy or restorative dental care and treatment provided during a veteran's active service. In that regard, dental treatment of the teeth during service, even extractions, do not constitute dental trauma. See generally 38 C.F.R. § 3.306(b)(1); VAOGCPREC 5-97. The Federal Circuit defined "service trauma" as "an injury or wound produced by an external force during the service member's performance of military duties." Nielson v. Shinseki, 607 F.3d 802, 808 (Fed. Cir. 2010). This definition may encompass unintended results of treatment due to medical malpractice; however, it excludes the intended result of proper medical treatment. Id. The Veteran contends that service connection is warranted for his loss of teeth as a result of in-service dental treatment and orthognathic surgery. The Veteran's service dental records show that he underwent bilateral intraoral sagittal osteotomy of the mandible in February 1982. Dental records from that time reflect that the Veteran noted that his lower jaw stuck out and he requested correction. The Veteran indicated that he became aware of the problem in the summer of 1981 during routine examination. The Veteran underwent a VA examination in February 2023. The Veteran reported that a group of his teeth were removed during service, and that his current symptoms included tooth aches, inability to chew, and uncomfortable appearance. The examiner indicated that the Veteran had anatomical loss or bony injury leading to loss of the teeth, but clarified that there was not loss of teeth due to loss of substance of the body of the maxilla or mandible without loss of continuity. The examiner noted that there was loss of teeth due to trauma or disease, which the examiner described as "[t]rauma / decay." The examiner reported that the Veteran was missing four upper teeth (teeth numbered 1, 12, 13, and 14) and five lower teeth (teeth numbered 18, 19, 29, 30, and 31). The examiner indicated that the Veteran's masticatory surfaces could be restored by suitable prosthesis such as implants and dentures. The diagnoses were loss of teeth and orthognathic (jaw) surgery, and the examiner remarked that the Veteran had problems with his jaw and teeth since his in-service jaw surgery with tooth removal. In an accompanying opinion, the examiner opined that the Veteran's current dental condition is related to his active duty service, as he has had problems with his jaw and teeth since the in-service orthognathic surgery. The examiner further noted that the in-service surgery was performed because the Veteran had "a prognathic mandible" and that there was no mention that it was elective or traumatic. The examiner also reported that the Veteran had several teeth worked on during service, including removal of teeth, and that during that process his jaw was fractured and orthognathic surgery was completed. Since that time, he has had problems with his jaw and teeth. After having carefully reviewed the evidence of record, the Board finds that the persuasive evidence of record is against finding that service connection for loss of teeth for compensation purposes is warranted. The evidence of record does not show that the Veteran experienced dental trauma during service. As noted above, the service treatment records document extensive dental treatment as the Veteran underwent jaw surgery. However, the Veteran has never claimed that he experienced any sort of trauma. In this case, the evidence of record is unremarkable for any compensable dental condition ("Class I" eligibility). See 38 C.F.R. § 17.161(a). That is, there is no diagnosis of record for loss of whole or part of the mandible, nonunion or malunion of the mandible, loss of whole or part of the ramus, loss of whole or part of the maxilla, nonunion or malunion of the maxilla, loss of the condyloid or coronoid process, or loss of any part of the hard palate, for which service-connected compensation could be granted. See 38 C.F.R. § 4.150, Diagnostic Codes 9900-9916. In that regard, the record shows that the Veteran underwent correction for a prognathic mandible during service, but there is no evidence of a current disability affecting the mandible. Significantly, the evidence does not show that the Veteran's current loss of teeth is related to the loss of substance of the body of the maxilla or mandible during service through trauma or disease, such as osteomyelitis. Although the February 2023 VA examiner opined that the Veteran's current jaw and teeth symptoms stem from his in-service treatment, service connection for loss of teeth and problems with the jaw in the absence of loss of substance of the maxilla or mandible during service due to trauma or disease do not constitute a dental disability for which compensation may be awarded. As noted above, the VA examiner reported that there was no evidence of loss of teeth due to loss of substance of the body of the maxilla or mandible. While the examiner noted that there was loss of teeth due to "[t]rauma/ decay," decay . . . and the only "trauma" identified by the examiner in the VA opinion was the orthognathic surgery and tooth extractions. There is no evidence of trauma documented in the dental records and the Veteran has not alleged any in-service trauma to his teeth or jaw. As discussed above, "service trauma" does not include restorative dental care and treatment provided during a veteran's active service, and extractions do not constitute dental trauma. See 38 C.F.R. § 3.306(b)(1); VAOGCPREC 5-97. In conclusion, there is no evidence that the Veteran has a dental or oral disability that is recognized as a "disability" for purposes of compensation under 38 C.F.R. § 4.150. As the persuasive evidence of record weighs against the claim, the benefit-of-the-doubt doctrine does not apply. See 38 U.S.C. § 5107(b). 6. Entitlement to service connection for a cardiovascular disorder, to include congestive heart failure The Board concludes that, while the Veteran had diagnoses of congestive heart failure, cardiomyopathy, and paroxysmal atrial fibrillation, the persuasive evidence is against finding that the Veteran's cardiovascular disorder began during active service, or was otherwise related to an in-service injury or disease, to include in-service exposure to asbestos. There is no evidence of an in-service injury or disease. As noted above, the majority of the Veteran's service treatment records are unavailable. However, the Veteran has not reported experiencing any symptoms of a cardiovascular disorder during service. While the Veteran noted having difficulty with physical exercises during service, he specifically denied experiencing heart problems during service. The first evidence of a diagnosis of cardiovascular disorder shown in the record is dated in 2021, 34 years after service discharge. Thus, the record does not show that the Veteran's cardiovascular disorder had its onset during his active duty service. Also, there is no competent medical or lay evidence to suggest that the Veteran's cardiovascular disorder is otherwise etiologically related to his active duty service. Last, to the extent that the Veteran alleges that his cardiovascular disorder is the result of exposure to asbestos during service, there is no probative evidence supporting that claim. The Veteran's DD-214 reflects that his military occupational specialty was administrative specialist, which is not a military occupational specialty which has been determined to involve exposure to asbestos. Additionally, the Veteran's lay testimony alleging exposure to asbestos from visiting a supply room which with asbestos on a regular basis is not competent or sufficient to establish actual exposure to asbestos. Identification of asbestos is not within the general knowledge of a layperson, and the statements of the Veteran did not identify any training or qualifications that he possessed that would have enabled him to identify asbestos in a supply room. Accordingly, the Board does not find the Veteran's lay testimony alleging exposure to asbestos during service to be competent evidence of in-service exposure to asbestos. Thus, the Board finds that the persuasive evidence of record is against finding of service connection for a cardiovascular disorder. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the persuasive evidence is against the claim, that doctrine is not applicable. 38 C.F.R. § 3.102, Gilbert, 1 Vet. App. at 54-56. 7. Entitlement to service connection for a respiratory disorder, to include as due to in-service exposure to asbestos After thorough review of the evidence of record, the Board concludes that the Veteran does not have a current diagnosis of a respiratory disorder, and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). The medical evidence of record is silent for any findings of a respiratory disability. The Board acknowledges that the Veteran has identified additional private treatment records which have not been obtained. However, despite numerous requests, the Veteran has not provided the necessary authorizations to allow VA to request those records on his behalf. As the U.S. Court of Appeals for Veterans Claims has held, "[t]he duty to assist in the development and adjudication of a claim is not a one-way street." Wamhoff v. Brown, 8 Vet. App. 517, 522 (1996). "If a [claimant] 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, 1 Vet. App. 190, 193 (1991); see also Olson v. Principi, 3 Vet. App. 480, 483 (1992). Additionally, the Veteran has specifically denied having a diagnosed respiratory disability. During his November 2021 hearing before the Board, the Veteran noted that he experienced shortness of breath, but that it was associated with his diagnosed congestive heart failure. The Veteran has not identified any other symptoms which he attributes to a respiratory disorder. In the absence of any clinical evidence supportive of a diagnosis of a respiratory disorder and any lay evidence identifying symptoms of a respiratory disorder, the persuasive evidence of record does not establish that the Veteran has a current respiratory disability. The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. §§ 1110, 1131; see Degmetich v. Brown, 104 F.3d 1328, 1332 (Fed. Cir. 1997) (holding that interpretation of section 1110 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). In the absence of proof of a present disability, there can be no valid claim. Brammer, 3 Vet. App. at 225. As the evidence of record persuasively shows that the Veteran does not have a diagnosed respiratory disability, the benefit-of-the-doubt doctrine is not for application, and the claim must be denied. 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. 49. REASONS FOR REMAND Entitlement to service connection for diabetes mellitus, type II; entitlement to service connection for a bilateral eye disorder, to include as secondary to diabetes mellitus, type II; entitlement to service connection for a kidney disorder, to include as secondary to diabetes mellitus, type II; entitlement to service connection for erectile dysfunction, to include as secondary to diabetes mellitus, type II; entitlement to service connection for peripheral neuropathy of the right upper extremity, to include as secondary to diabetes mellitus, type II; entitlement to service connection for peripheral neuropathy of the left upper extremity, to include as secondary to diabetes mellitus, type II; entitlement to service connection for peripheral neuropathy of the right lower extremity, to include as secondary to diabetes mellitus, type II; and entitlement to service connection for peripheral neuropathy of the left lower extremity, to include as secondary to diabetes mellitus, type II The Veteran contends that service connection is warranted for diabetes mellitus, type II, is warranted based upon in-service exposure to Agent Orange, and that service connection for an eye disorder, kidney disorder, erectile dysfunction, and peripheral neuropathy of the upper and lower extremities is warranted on a secondary basis due to diabetes mellitus. During his November 2021 hearing before the Board, the Veteran testified that he believed he was exposed to herbicide agents during basic training while stationed at Fort Jackson, South Carolina. The RO has not made any attempts to verify the Veteran's reported in-service exposure to herbicide agents. Thus, the Board finds additional development is necessary regarding the Veteran's claimed exposure to Agent Orange. On remand the RO should contact the Compensation Service, the Military Records Research Center (MRRC) (the successor to the U.S. Army and Joint Services Records Research Center (JSRRC)), and any other appropriate source to attempt to verify the claimed herbicide agent exposure during the reported period. If there is still insufficient information to verify exposure to herbicide agents, the RO should issue a Formal Finding outlining the steps taken to assist the Veteran, and notify the Veteran and his representative of VA's inability to verify the reported in-service herbicide agent exposure. Following the requested development, if the Veteran's exposure to Agent Orange has been confirmed, the RO should provide the Veteran with VA examinations to determine the existence and etiology of his claimed disorders. In this regard, the Board notes that the medical evidence of record reflects diagnoses of diabetes mellitus, type II, and erectile dysfunction with a history of eye surgery; however, the Veteran has not undergone VA examinations to determine the existence and etiology of the eye disorder, kidney disorder, erectile dysfunction, and peripheral neuropathy of the upper and lower extremities. As such, if exposure to herbicide agents is confirmed, the RO should obtain VA examinations for these conditions. The matters are REMANDED for the following action: 1. The RO must contact the MRRC and any other appropriate research agency for verification of the Veteran's reported in-service exposure to herbicide agents, including Agent Orange, during his basic training at Fort Jackson, South Carolina. All requests to the MRRC or any other research agency must be made in accordance with applicable procedures. Any response from the MRRC or applicable agency should be associated with the record. Make as many requests as are necessary to verify the Veteran's claims of exposure to herbicide agents and end these efforts only if it is concluded that the records sought do not exist or that further efforts to obtain those records would be futile. 2. If herbicide exposure is confirmed, schedule the Veteran for VA examinations to determine the existence and etiology of his eye disorder, kidney disorder, erectile dysfunction, and peripheral neuropathy of the upper and lower extremities. The Veteran's claims file, all electronic records, and a copy of this remand must be reviewed by the examiner, and the examiner must state that this evidence was reviewed in the examination report. All pertinent symptomatology and findings must be reported in detail. All indicated tests and studies must be accomplished. Based upon a complete review of the evidence of record, the examiner is asked to respond to the following questions: (a.) Does the Veteran have a diagnosis of an eye disorder, kidney disorder, erectile dysfunction, and/or peripheral neuropathy of the bilateral upper and/or lower extremities now or at any time during the appeal period? (b.) If so, are any of these diagnosed disorders at least as likely as not related to the Veteran's active duty service? (c.) Is it at least as likely as not that any of the diagnosed disorders was caused or aggravated by diabetes mellitus, type II? Aggravation is defined as any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease. The examiner is advised that a finding that a disorder was aggravated beyond the normal progression due to a service-connected disability does not require evidence of permanent worsening and may encompass any additional impairment in earning capacity resulting from an already service-connected condition. A complete rationale for all opinions must be provided. The examiner must consider and discuss all pertinent evidence in the claims file, to include the service treatment records and the Veteran's lay statements regarding in-service and post-service symptomatology. Also, the examiner is advised that the Veteran is competent to report observable symptomatology. C. CRAWFORD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Katz, 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.