OSTEOARTHRITIS

Summary

The veteran, who served from August 1966 to August 1969, appeals the denial of service connection for arthritis of the right hand/fingers, a knee disability, and an eye disability. The Board found that while the veteran had current disabilities and an in-service injury to his left knee and right hand, the evidence persuasively weighed against a service connection. A VA examiner opined that the injuries were acute and would not be service connected, a conclusion the Board found credible. Buddy statements regarding post-service pain were given little weight due to lack of specific timing. For the eye disability, the veteran has cataracts, glaucoma, and decreased vision, but service treatment records showed no in-service issues, and the conditions were diagnosed years after service. The veteran's claim that straining his eyes during service caused these issues was unsupported. The Board also denied secondary service connection for the eye conditions to service-connected hearing loss and tinnitus, finding no nexus. The Board concluded that the evidence was persuasively against all claims, denying service connection for the right hand/fingers arthritis, knee disability, and eye disability.

Rationale

No nexus between current disability and in-service injury.; VA examiner opinion found credible.; Buddy statements lacked probative weight due to lack of timing.

Full Decision Text

Citation Nr: A22016161
Decision Date: 08/16/22	Archive Date: 08/16/22

DOCKET NO. 191218-219677
DATE: August 16, 2022

ORDER

Entitlement to service connection for arthritis of the right hand/fingers is denied. 

Entitlement to service connection for arthritis and/or a meniscal tear of the left knee (knee disability) is denied.

Entitlement to service connection for an eye disability is denied.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that arthritis of the right hand/fingers began during active service, or is otherwise related to an in-service injury or disease. 

2. The evidence of record persuasively weighs against finding that a knee disability began during active service, or is otherwise related to an in-service injury or disease. 

3. The Veteran's eye disabilities are not secondary to service-connected hearing loss and/or tinnitus, and are not otherwise related to an in-service injury or disease.

CONCLUSIONS OF LAW

1. The criteria for service connection for arthritis of the right hand/fingers are not met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for a knee disability are not met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for an eye disability due to service or hearing loss and/or tinnitus are not met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in active service from August 1966 to August 1969.  

A rating decision was issued under the legacy system in May 2018 and the appellant submitted a timely notice of disagreement (NOD). 

In October 2019, the agency of original jurisdiction (AOJ) issued a Statement of the Case (SOC). The appellant opted the claims into the modernized review system, also known as the Appeals Modernization Act (AMA), by submitting a timely VA Form 10182, Decision Review Request: Board Appeal (NOD) identifying the October 2019 SOC; therefore, this is the decision on appeal. 

In the December 2019 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the VA Form 10182.  38 C.F.R. § 20.303. Therefore, the May 2021 letter cannot be considered.

Arthritis of the right hand/fingers

Knee disability

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (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).

The Veteran meets the first two elements for arthritis of the right hand/fingers and his knee disability.  Moreover, he sustained an injury in service where he suffered acute injuries to both his left knee and right hand.  However, in neither instance are the disabilities service connected. 

As for the nexus, in the Veteran's exit examination he said he was in good health and did not have any injuries or maladies.  Moreover, the VA examiner from September 2019 stated that both injuries were acute in nature and that as a result the disabilities would not be service connected.  The Board finds that the examiner's opinion is credible based on his medical expertise.  There are no countervailing opinions in the record.

Of note, while there are various buddy statements indicating the Veteran had hand and knee pain for a considerable amount of time after service, the record does not indicate when the hand or knee pain began after service.  Thus, these statements provide little probative weight.

In rendering the decisions below, the Board acknowledges that the Veteran attributes his right hand/fingers arthritis and
 he said he was in good health and did not have any injuries or maladies.  Moreover, the VA examiner from September 2019 stated that both injuries were acute in nature and that as a result the disabilities would not be service connected.  The Board finds that the examiner's opinion is credible based on his medical expertise.  There are no countervailing opinions in the record.

Of note, while there are various buddy statements indicating the Veteran had hand and knee pain for a considerable amount of time after service, the record does not indicate when the hand or knee pain began after service.  Thus, these statements provide little probative weight.

In rendering the decisions below, the Board acknowledges that the Veteran attributes his right hand/fingers arthritis and his knee disability to his in service injuries.  However, the Veteran does not have the requisite medical knowledge, training, or experience to be able to render a competent medical opinion regarding the cause of such medically complex disabilities.

Considering the pertinent evidence in light of the governing legal authority, the Board finds that the evidence is persuasively against the claim.  In reaching this decision the Board considered the doctrine of reasonable doubt, however, the doctrine is not for application and the claim must be denied.

Eye disability 

Once again, service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (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).

The Veteran has or had cataracts, glaucoma, and decreased vision in both eyes. However, the Veteran does not have an in-service incurrence or aggravation of a disease or injury.  The Veteran attributes his problems to straining while driving during his active service. Other than his assertion linking the two, there is no evidence that straining caused any eye problems.  Service treatment records do not indicate that the Veteran had eye problems while in service. Records indicate the Veteran was diagnosed with glaucoma in January 2017 and cataracts in February 2018.  In February 2018, his poor vision in his left eye was attributed to cataracts and poor vision in his right eye was attributed to glaucoma. This gap in time and lack of treatment to show any chronic disability is persuasive evidence against the claim.  The claim for service connection fails on a direct basis because the third element to be service connected is not established.

In addition to finding a Veteran disabled on a direct basis as described above, a disability can also be secondarily service connected. In order to establish service connection on a secondary basis, there must be (1) a current non-service-connected disability, (2) a service-connected disability, and (3) evidence showing that the current non-service-connected disability is either proximately due to or the result of, or aggravated (increased in severity) beyond its natural progress by the service-connected disability. 38 C.F.R. § 3.310.

In the Veteran's March 2018 claim for benefits, he stated that his eye problems were secondary to his hearing problems. As already mentioned, the Veteran has various eye disabilities.  His hearing loss and tinnitus are service connected. That being said there is no evidence showing the Veteran's eye disabilities are due to or aggravated by his hearing loss.  The Veteran does not put forth a theory by which the two are connected. The claim is denied because there is no nexus between the Veteran's hearing disabilities and eye disabilities.

VA is obliged to provide an examination or obtain a medical opinion in a claim for service connection when the record contains competent evidence that the claimant has a current disability or persistent or recurrent symptoms of disability, the record indicates that the disability or symptoms of disability may be associated with active service, and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C. § 5103A (d); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The threshold for finding a link between current disability and service is low. Locklear v. Nicholson, 20 Vet. App. 410 (2006). That low threshold is not met.  Evidence does not support finding a VA examination is needed. The Veteran's poor vision comes from glaucoma and cataracts. Other than unsupported statements by the Veteran, there is no indication that these disabilities are related to straining his eyes while in service.   Thus,
 may be associated with active service, and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C. § 5103A (d); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The threshold for finding a link between current disability and service is low. Locklear v. Nicholson, 20 Vet. App. 410 (2006). That low threshold is not met.  Evidence does not support finding a VA examination is needed. The Veteran's poor vision comes from glaucoma and cataracts. Other than unsupported statements by the Veteran, there is no indication that these disabilities are related to straining his eyes while in service.   Thus, referral is not necessary.

In rendering the decisions below, the Board acknowledges that the Veteran attributes his eye problems to straining to see while in service and his hearing loss.  However, the Veteran does not have the requisite medical knowledge, training, or experience to be able to render a competent medical opinion regarding the cause of such medically complex disabilities.

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Considering the pertinent evidence in light of the governing legal authority, the Board finds that the evidence is persuasively against the claim.  In reaching this decision the Board considered the doctrine of reasonable doubt, however, the doctrine is not for application and the claim must be denied. 

 

SONJA S. AN

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	P. Chalker, 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.