Citation Nr: A25035900 Decision Date: 04/18/25 Archive Date: 04/18/25 DOCKET NO. 241008-481378 DATE: April 18, 2025 ORDER Entitlement to service connection for an abnormal heart is denied. FINDING OF FACT The evidence of record persuasively weighs against finding that the Veteran has had a heart disability at any time during or approximate to the pendency of the claim. CONCLUSION OF LAW The criteria for service connection for an abnormal heart have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1997 to May 2000 and January 2003 to January 2005, with other Reserve service. This matter comes before the Board of Veterans' Appeal (Board) on appeal from a November 2023 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In July 2023, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a July 2022 decision. In November 2023, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior July 2022 decision. In the October 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the July 2022 AOJ decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 1. Entitlement to service connection for an abnormal heart. The Veteran is seeking service connection for an abnormal heart, which he claims is due to service. See 2/18/19 VA Form 21-526EZ. To establish direct service connection, there must be competent evidence of (1) a current disability; (2) an 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. 38 C.F.R. § 3.303; Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection is also warranted for a disability which is proximately due to or the result of a service-connected disease or?injury. 38?C.F.R. § 3.310(a). Such secondary service connection?is warranted for any increase in severity of a nonservice-connected disability that is proximately due to or the result of a service-connected disability.?38 C.F.R. § 3.310(b). Pertinent to a claim for service connection, such a determination requires a finding of current disability that is related to an injury or disease in service. Brammer v. Derwinski,?3?Vet. App.?223, 225?(1992). In?McClain?v. Nicholson, the Court held that the requirement of the existence of a current disability is satisfied when a veteran has a disability at the time he or she files a claim for service connection or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim. 21?Vet. App.?319, 321?(2007). The claimant is entitled to the benefit of the doubt when there is an "approximate" (meaning nearly equal) balance of positive and negative evidence regarding any material determination. See Lynch v. McDonough, 999 F.3d 1391 (2021); Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001); 38 U.S.C. § 5107; 38 C.F.R. § 3.102.?However, when the evidence persuasively weighs against service connection, the claim will be denied. Turning to the evidence of record, service treatment records and post-service clinical records do not show any complaints, symptoms, or treatment related to the Veteran's claimed heart disability. In a May 2003 pre-deployment health assessment he denied cardiac issues. In August 2019, the Veteran submitted genetic testing results from March 2011 showing that he was positive for a genetic mutation related to his heart. See 8/19/19 Medical Treatment Record - Government Facility at 32-34. However, no diagnosis of a specific heart condition was noted. In April 2022, the Veteran underwent a VA examination for his claimed heart disability. He reported that his sister was diagnosed with long qt syndrome and that he underwent genetic testing and tested positive for the same gene as his sister, which predisposes one to such syndrome. See 4/19/22 VA Examination at 8. The VA examiner examined the Veteran and conducted ECG testing, which yielded normal results. He found no diagnosis of any heart disability and explained that although the Veteran may have had a genetic propensity towards a possible heart condition, he had no past or present symptoms or findings to suggest a cardiac abnormality. There was also no clinical indication for any further cardiac diagnostic testing based on the same. The Veteran did not submit any relevant lay statements regarding his claimed heart disability. He also did not submit any relevant lay statements from other individuals in connection with his heart claim. Thus, there is no evidence to suggest a history of continuous relevant symptoms dating back to service such as to suggest a chronic disability and no evidence demonstrating an impairment in earning capacity. In sum, the competent evidence of record does not reflect a diagnosis of a heart disability or a history of potentially relevant symptoms. Therefore, the evidence persuasively weighs against finding a current disability here. In reaching this conclusion, the Board has considered the Veteran's position in his October 2024 VA Form 10182 that his positive genetic testing results for the particular gene shows he has a current heart disability because such satisfies the criteria under the General Rating Formula for Disease of the Heart in 38 C.F.R. § 4.104. However, such rating criteria is based on METs, which are based on testing of the heart, and symptoms related to heart failure. Positive genetic testing is not a criterion in the rating formula. Furthermore, the Veteran could be positive for a gene that predisposes him to a disability but does not necessarily mean he has the disability itself, as explained by the April 2022 VA examiner. In this case, while he may have a gene that could predispose him to a heart condition, he does not have a heart diagnosis, or symptoms related to such. The Veteran also indicates that he had Long QT syndrome and experiences manifestations of this disorder. Again, however, there is no documented treatment for any heart disorder anywhere in the clinical record, and the Veteran has not specifically identified symptoms that he believes are associated with such disorder. Thus, the Board rejects the assertion that an addendum opinion is needed. Indeed, there is no evidence, include lay statements, as to relevant symptoms upon which an examiner could render an opinion on. Further, while the Veteran believes that he has a heart disability and that it is related to service, he has not provided any specific details in support of his assertions and, in any event, as a lay person he is not competent to render diagnoses or address questions of etiology, which are medically complex.?See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Moreover, while he is competent to report observable symptoms, in this case he has not done so. The Veteran has also raised the contention that he has obesity as a result of his service-connected left knee disability and that such obesity has led to a heart disorder. However, this theory of entitlement is dependent on a showing of current disability, and here the evidence persuasively weighs against this element of the claim. The Board emphasizes that Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability. See?38 U.S.C. § 1110; see also?McClain,?21 Vet. App. at 321. Accordingly, where, as here, competent medical evidence indicates that the Veteran does not have the disability for which service connection is sought, there can be no valid claim for service connection for the disability. See Gilpin v. West,?155 F.3d 1353?(Fed. Cir. 1998); Brammer,?3?Vet. App.?223, 225?(1992). Thus, the remaining elements for service connection do not need to be addressed. (Continued on the next page) ? Based on the foregoing, service connection for an abnormal heart is denied. The evidence is not in approximate balance, or nearly equal, so the benefit of the doubt doctrine is not applicable. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch, 21 F.4th at 776. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Sproviero 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.