BVA9505132 DOCKET NO. 90-43 688 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Cleveland, Ohio THE ISSUES 1. Entitlement to service connection for peptic ulcer disease. 2. Entitlement to service connection for a disorder manifested by jaundice. 3. Entitlement to service connection for a skin disorder, including jungle rot and jock itch. 4. Entitlement to service connection for an acquired psychiatric disorder, including post-traumatic stress disorder (PTSD). 5. Whether there was clear and unmistakable error in the rating decision of May 1954, which denied service connection for otitis externa. 6. Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for otitis externa. REPRESENTATION Appellant represented by: AMVETS ATTORNEY FOR THE BOARD L. B. Wirt, Associate Counsel INTRODUCTION The veteran served on active duty from January 1951 to January 1954. It is also indicated that he served in the Army National Guard from June 1950 to January 1951, when he was released in order to join the Marine Corps. A May 1954 rating decision of the Veterans Administration (now Department of Veterans Affairs) (VA) Cincinnati, Ohio, Regional Office (RO) denied the veteran entitlement to service connection for otitis externa. He did not appeal that decision within one year after notice of the denial was sent to him. This appeal arises from a May 1989 rating decision of the Cleveland, Ohio, RO, which denied the veteran entitlement to service connection for peptic ulcer disease; a disorder manifested by jaundice; a skin disorder, including jungle rot and jock itch; and an acquired psychiatric disorder, including post-traumatic stress disorder. This action also confirmed and continued the previous denial of service connection for otitis externa. The case was remanded by the Board of Veterans' Appeals (Board) in July 1991, with a request that the RO furnish the veteran with the relevant laws and regulations pertaining to finality (with regard to the otitis externa claim). The Board remanded the case again in January 1993, requesting that the RO attempt to locate additional medical records and adjudicate the issue of whether the May 1954 rating decision of the RO contained clear and unmistakable error. The veteran has also raised the issue of entitlement to an increased (compensable) evaluation for his service-connected malaria. This issue has not been developed, and is referred to the RO for appropriate action. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that peptic ulcer disease; a disorder manifested by jaundice; a skin disorder, including jungle rot and jock itch; and an acquired psychiatric disorder, including post-traumatic stress disorder, all had their onset in service or can be attributed to service. The veteran also contends, essentially, that the May 1954 RO rating decision, pertaining to service connection for otitis externa, was clearly and unmistakably erroneous. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against the grant of entitlement to service connection for peptic ulcer disease; a disorder manifested by jaundice; a skin disorder, including jungle rot and jock itch; and an acquired psychiatric disorder, including post-traumatic stress disorder. It is also the decision of the Board that the claim of clear and unmistakable error in the rating decision of May 1954 denying service connection for otitis externa is not well grounded. It is further the decision of the Board that new and material evidence has not been submitted to reopen a claim of entitlement to service connection for otitis externa. FINDINGS OF FACT 1. The evidence does not show that peptic ulcer disease had its onset in service or within one year of discharge from service. 2. The evidence does not show that the veteran currently has any disorder manifested by jaundice; he may have had a symptom of jaundice associated with his service-connected malaria, while he was in service. 3. The veteran was treated for a groin fungus and jock itch in service as well as for pediculosis pubis. 4. No skin pathology of the groin or pubic area was noted on the service discharge examination or on VA examination in April 1989. 5. The skin pathology involving the groin and pubic areas in service was acute and transitory and subsided without residual disability. 6. A skin disorder involving the feet including athletes foot, and "jungle rot" was not demonstrated during or subsequent to service. 7. An acquired psychiatric disorder was not demonstrated during service or on examination prior to discharge from service. 8. The veteran currently has a generalized anxiety disorder and does not carry a psychiatric diagnosis of PTSD. 9. The claim of clear and unmistakable error in the May 1954 rating decision denying service connection for otitis externa does not contain enough specificity to make the claim plausible or capable of substantiation. 10. Service connection for otitis externa was denied by a rating decision of May 1954. The veteran did not appeal that decision within one year after notice of that denial was sent to him. 11. Additional evidence submitted since the May 1954 rating decision is either irrelevant or non-probative with respect to whether the veteran has chronic otitis externa that developed during service. CONCLUSIONS OF LAW 1. Peptic ulcer disease was not incurred in or aggravated by wartime service, and nor may it be presumed to have been so incurred. 38 U.S.C.A. §§ 1101(3), 1110, 1112(a)(1), 1113(a) (West 1991); 38 C.F.R. §§ 3.307(a)(3), 3.309(a) (1994). 2. A chronic disability manifested by jaundice was not incurred in or aggravated by service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303(b) (1994). 3. A chronic skin condition, to include jungle rot and jock itch, was not incurred or aggravated by service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303(b) (1994). 4. An acquired psychiatric disorder including PTSD was not incurred in or aggravated by wartime service. 38 U.S.C.A. § 1110 (West 1991). 5. The claim of clear and unmistakable error in the rating decision of May 1954 denying entitlement to service connection for otitis externa is not well grounded. 38 U.S.C.A. § 5107(a) (West 1991). 6. The evidence received since the May 1954 rating decision denying entitlement to service connection for otitis externa is not new and material, and the veteran's claim is not reopened. 38 U.S.C.A. § 5108 (West 1991); 38 C.F.R. § 3.156 (a) (1994). 7. The rating decision of May 1954 denying entitlement to service connection for otitis externa is final. 38 U.S.C.A. § 7105(c) (West 1991); 38 C.F.R. § 3.105(a) (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Service Connection for Peptic Ulcer Disease The Board notes that the veteran's claim for service connection for peptic ulcer disease is well grounded within the meaning of 38 U.S.C.A. § 5107(a). The Board is also satisfied that all relevant facts have been properly developed and that no further assistance to the veteran is required to comply with the statutory duty to assist mandated by 38 U.S.C.A. § 5107(a) (West 1991). The veteran has appealed a denial of entitlement to service connection for peptic ulcer disease. Service connection may be established for disabilities resulting from injury or disease incurred in or aggravated by service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a). In addition, certain chronic diseases, including peptic ulcer disease will be presumed service connected, absent affirmative evidence to the contrary, if manifested to a degree of 10 percent within one year from the veteran's separation from service. 38 U.S.C.A. §§ 1101(3), 1112(a)(1), 1113(a); 38 C.F.R. §§ 3.307(a)(3), 3.309(a). The veteran's service medical records are negative for any evidence of peptic ulcer disease in service. The veteran contends that he developed the disorder between September and December 1954, within one year of his January 1954 discharge from service, while a student at "Georgia Tech." He asserts that he was treated in the infirmary at the school and put on a special diet. He also contends that he was a chronic ulcer patient for several years after that, and stated that he saw several different physicians. He stated that he was hospitalized at Centinella Valley Memorial Hospital in Inglewood, California, in 1959 or 1960, and eventually underwent a surgical procedure (apparently a vagotomy) for the problem in 1965 at Riverside Methodist Hospital in Columbus, Ohio. He stated that since the surgery he has not had a recurrence of his ulcer disease, but noted that he is prone to gas, having an upset stomach and loose bowel movements. The RO has attempted to obtain post-service medical evidence regarding the veteran's peptic ulcer disease, by sending letters to the Georgia Tech infirmary, Centinella Valley Memorial Hospital and Riverside Methodist Hospital. No response was received from Georgia Tech. Centinella Valley responded that their records date only to 1971, and Riverside Methodist replied that their records are retained only for 20 years. The veteran stated that he was unable to recall the names of any specific physicians who had treated him. The veteran underwent a VA examination in April 1989. His abdomen was reported as soft, his rectum was within normal limits and his perineal area was clear. There was no diagnosis of peptic ulcer disease or other related condition. We are aware that this examination was not specifically directed to ascertaining the presence peptic ulcer disease or postoperative residuals thereof. However, establishing the presence of such pathology in 1989 or at some time subsequent thereto, would not in any way establish its presence in service or within the first post service year. In light of the above, service connection for peptic ulcer disease cannot be granted. The veteran's service medical records do not reflect a diagnosis of peptic ulcer disease. There is also no medical evidence that the veteran was diagnosed as having peptic ulcer disease within one year from his discharge from service. 38 C.F.R. § 3.309(a) (1994) provides that a proper diagnosis of peptic ulcer is considered established if it represents a medically sound interpretation of sufficient clinical findings warranting such diagnosis and provides an adequate basis for a differential diagnosis from other conditions with like symptomatology; in short where the preponderance of evidence indicates a peptic ulcer. Whenever possible, laboratory findings should be used in corroboration of clinical data. In this case, the service medical records don't reveal treatment for any gastrointestinal pathology, much less gastrointestinal pathology which might represent peptic ulcer disease. The only evidence as to the existence of a peptic ulcer within one year from discharge is the veteran's own assertions. The Board is not bound to accept his uncorroborated statements. See Wood v. Derwinski, 1 Vet.App. 190, 192 (1991). II. Service Connection for a Disorder Manifested by Jaundice The Board notes that the veteran's claim for service connection for a disorder manifested by jaundice is well grounded within the meaning of 38 U.S.C.A. § 5107(a). The Board is also satisfied that all relevant facts have been properly developed and that no further assistance to the veteran is required to comply with the statutory duty to assist mandated by 38 U.S.C.A. § 5107(a). The veteran has appealed a denial of entitlement to service connection for a disorder manifested by jaundice. As noted previously, service connection may be established for disabilities resulting from injury or disease incurred in or aggravated by service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a). The veteran contends that he first contracted yellow jaundice in 1955 while a student at Georgia Tech. He stated that he was treated at that time in the school infirmary. He also stated that he had jaundice in the 1970s while in a hospital in Cincinnati, Ohio. He could not provide the name of the hospital. A request for records from the Georgia Tech infirmary did not elicit a response. The veteran's service medical records show that he was diagnosed as having malaria in June 1953. The record contains a notation that he also had "[q]uestionable icteric tint in [his] sclerae." No specific diagnosis pertaining to this symptom was made, other than malaria. Inasmuch as the veteran already has service connection for malaria, we construe this issue to involve service connection for a disorder manifested by jaundice, other than malaria. Clearly, if the veteran were to experience an attack of malaria currently, which involved jaundice, such could be a basis for a claim for an increased (compensable) rating for malaria. Along these lines, a disorder manifested by jaundice was not noted on his January 1954 separation examination. The veteran had a VA examination in April 1989. He was not found to be jaundiced at that time, and there were no findings of any condition relating to jaundice. As mentioned above, attempts by the RO to locate any post-service medical records were fruitless. Inasmuch as there is no medical evidence that the veteran has any disorder manifested by jaundice (other than malaria, for which service connection is in effect) service connection is denied. III. Service Connection for a Skin Condition, Including Jungle Rot and Jock Itch The Board notes that the veteran's claim for service connection for a skin condition is well grounded within the meaning of 38 U.S.C.A. § 5107(a). The Board is also satisfied that all relevant facts have been properly developed and that no further assistance to the veteran is required to comply with the statutory duty to assist mandated by 38 U.S.C.A. § 5107(a). The veteran has appealed a denial of service connection for a skin condition, to include jungle rot and jock itch. As noted, service connection may be established for disabilities resulting from injury or disease incurred in or aggravated by service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a). The veteran reported that he contracted an athlete's foot-type condition in service in Korea in approximately November 1951. He stated that he was given various salves and foot powders and instructed to wash his feet often. He stated that the condition would get better, then worse, until, he was told, the condition deteriorated to "jungle rot." He recalled being hospitalized for two weeks and soaking his feet in a purple solution. He contends that he still has athlete's foot regularly. The veteran also contends that he contracted jock itch around August 1952 in Korea. He stated that the prescription medication given to him in service did not work, so he saw a civilian physician while he was on leave. This physician apparently told the veteran he had an "[A]sian strain," and was able to clear up the condition. He contends that he gets jock itch on a regular basis. The examination for enlistment in the Army National Guard in June 1950 revealed no clinical documentation of a skin disorder. The examination at the time of enlistment in the Marine Corps in January 1951 revealed that the skin was normal. However, it was clinically noted at the time that the veteran had athlete's foot two years ago, but that the condition has not been present for the past year. The veteran's service medical records reflect that he was treated for a groin fungus and jock itch in October 1952. He was treated for a heat rash in November 1952. He was treated for pediculosis pubis in December 1953. His separation examination is negative for any residuals of these conditions. His service medical records are negative for any indication that he had a fungal or infectious condition of the feet in service. The RO has attempted to obtain post-service medical records pertaining to the veteran. Unfortunately, he has been unable to recall the names of specific doctors who treated him. He provided the names of a few facilities at which he was treated after service, but their records are unavailable. At his April 1989 VA examination, the veteran's genitalia were within normal limits and his feet were clear. His skin was also described as normal. No jock itch or athlete's foot-type conditions were noted. The Board finds that service connection for a skin condition, to include jungle rot and jock itch, cannot be granted. Although the veteran's service medical records show that he had jock itch, a groin fungus and pediculosis pubis in service, these conditions were acute and transitory and subsided without residual disability. There was no reference to any of these conditions at his separation examination, and no reference anywhere in his service medical records that he had any fungal-type condition of his feet. He was also not shown to have any of these conditions at his April 1989 VA examination. Although the veteran claims that he still gets these conditions regularly, the Board is not bound to accept the veteran's uncorroborated statements in this regard. See Wood v. Derwinski, 1 Vet.App. 190, 192 (1991). There is no medical evidence reflecting any treatment for such since service, or showing that any current conditions can be attributed to his period of service. The veteran is not competent to offer an opinion as to medical causation. Espiritu v. Derwinski, 2 Vet.App. 492, 494 (1992). IV. Service Connection for an Acquired Psychiatric Disorder, Including Post-Traumatic Stress Disorder The Board notes that the veteran's claim for service connection for an acquired psychiatric condition is well grounded within the meaning of 38 U.S.C.A. § 5107(a). The Board is also satisfied that all relevant facts have been properly developed and that no further assistance to the veteran is required to comply with the statutory duty to assist mandated by 38 U.S.C.A. § 5107(a) (West 1991). The veteran has appealed a denial of entitlement to service connection for an acquired psychiatric disorder, to include post-traumatic stress disorder (PTSD). Service connection may be established for disabilities resulting from injury or disease incurred in or aggravated by service. 38 U.S.C.A. § 1110 (West 1991). Under 38 C.F.R. § 3.304(f) (1994), service connection for PTSD "requires medical evidence establishing a clear diagnosis of the condition, credible supporting evidence that the claimed in- service stressor actually occurred, and a link, established by medical evidence, between current symptomatology and the claimed in-service stressor." The regulation further provides that if the claimed stressor is related to combat, service department evidence that the veteran engaged in combat, will be accepted, in the absence of evidence to the contrary, as conclusive evidence of claimed in-service stressor. The veteran served in Korea from August 1951 to August 1952 and his service personnel records reveal that during this period be participated in operations against enemy forces in South and Central Korea. He contends that he is easily irritated and cannot seem to get along with people. He stated that he constantly finds fault with others, and that the actions and habits of others bother him. He stated that he tries to "put up a good front," but that underneath he is "super critical." He also reported having a hard time following orders and rules. He stated that he still thinks and has dreams about his military service, reliving what happened and thinking about what could have happened. He thinks about his friends and wonders what happened to them. He stated that "[i]t gets especially bad" if he runs into an old friend who starts talking about Korea. The veteran completed two combat questionnaires, in October 1988 and May 1989, which were apparently sent to him by the RO. He reported on these forms that his duty assignment in combat was as a field radio operator. He stated that in this role he used the field radio to call in artillery and naval gunfire as a forward observer attached to an infantry company. He also reported that he rarely or sometimes fired weapons (an M-1 rifle, carbine, and/or hand grenades) at the enemy. He rarely saw someone killed, and did not see any of his friends killed. He reported that he received sniper fire, as well as mortar attacks, but was never ambushed. He took cover and laid down to survive. He related one incident which occurred on hill 924 or 1024 while he was attached to the assault company of the "KMC." He stated that the hill was stripped of vegetation and there was a "steady stream" of wounded and many dead, as well as much small arms fire. He felt his combat experience was stressful, and although he stated that he did not have any prolonged memories of combat, he did report having some dreams or flashbacks three or four times a year. He reported feeling that he shut out the rest of the world, and noted that he has been told he has no feelings or emotions regarding the deaths of family members or friends. He described his combat experience as "something that happened," and stated that he may talk of Korea when drunk but hardly ever when sober. He noted that he was much calmer before his combat experience. The veteran's DD Form 214 confirms that he was a radio telephone operator, with Marine Ground Control Intercept Squadron Nine. This record also shows that he received a National Defense Service Medal, Korean Service Medal with three stars and a United Nations Service Medal. His service medical records are negative for any treatment for or diagnosis of a psychiatric disorder. The veteran underwent a VA psychiatric examination in April 1989. It was initially reported by the physician that he served in Korea, was a combat veteran and had malaria while in service. He reported that he generally feels uneasy, cannot sit still, becomes argumentative, and has periods of sweatiness, irritability and feeling flushed. He stated that he had had anxiety problems since 1957. He reported having difficulty falling and remaining asleep. He denied any unusual nightmares, but reported having dreams of being on an unknown military base. He also reported having bad memories of war when he was looking for bodies for identification, which he stated affected him emotionally but did not have any current unusual effect on him. He reported that he likes being alone, and has trouble developing relationships and trusting others. He denied any destructive thoughts or any suicidal or homicidal ideations. A mental status examination revealed that he appeared anxious, tense, fidgety and restless. His face was flushed and his eyes were glassy and intense. He maintained fair eye contact. His speech was productive with episodic increases of tone and volume, as well as being coherent, logical and relevant. The veteran stated that his emotions tend to fluctuate and that he frequently becomes intense and hostile. He described himself as an unhappy person and a "failure," and admitted to feeling hopeless and worthless. He reportedly had a poor self-esteem due to his inability to obtain gainful employment. His mood was considered somewhat low, and his affect was anxious and tense. There was no evidence of any delusions, hallucinations, phobias, compulsions or obsessions. His sensorium was clear, and he was alert and oriented to time, place and person. He was considered to be of average intelligence, and had good comprehension ability, but his attention span seemed to fluctuate as he became distracted. He was considered to have fair to good insight. The diagnoses were generalized anxiety disorder and substance abuse disorder (alcohol), intermittent. Based on the above, the Board finds that service connection for PTSD cannot be granted. Although the veteran appears to have had combat exposure, there is no medical evidence establishing a diagnosis of PTSD, and no evidence linking his claimed in-service stressors to his current psychiatric condition. Under 38 C.F.R. § 3.304(f) (1994), such evidence is required in order to establish entitlement to service connection for PTSD. There is also no indication in the veteran's service medical records of any treatment for or diagnosis of a psychiatric condition. His current neurosis, a generalized anxiety disorder, was initially shown to be manifest 35 years after service, in 1989. As such, service connection may not be granted for a psychiatric disorder. V. Clear and Unmistakable Error in the May 1954 Rating Decision The veteran has alleged that the rating decision of May 1954, denying him entitlement to service connection for otitis externa, was clearly and unmistakably erroneous. Under 38 C.F.R. § 3.105(a), previous final determinations will be accepted as correct in the absence of clear and unmistakable error. The initial question, however, is whether the veteran has submitted a well-grounded claim as required by 38 U.S.C.A. § 5107(a), which provides in part that "a person who submits a claim for benefits . . . shall have the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded." The Court of Veteran's Appeals (Court) has stated that clear and unmistakable errors are those which are "undebatable, so that it can be said that reasonable minds could only conclude that the original decision was fatally flawed at the time it was made." Russell v. Principi, 3 Vet.App. 310, 313-14 (1992). The Court further stated that clear and unmistakable error means that "[e]ither the correct facts, as they were known at the time, were not before the adjudicator or the statutory or regulatory provisions extant at the time were incorrectly applied. The claimant, in short, must assert more than a disagreement as to how the facts were weighed or evaluated." Id. at 313. Thus, in order to establish a valid claim of clear and unmistakable error, there must be some degree of specificity as to what the alleged error is, and persuasive reasons must be given as to why the result would have been manifestly different but for the alleged error. Fugo v. Brown, 6 Vet.App. 40, 44 (1993). If the alleged error is not set forth with appropriate specificity, the claim of clear and unmistakable error is not well grounded. Newman v. Brown, 5 Vet.App. 99, 102 (1993). In this case, the veteran, in his March 1992 statement (submitted on a VA Form 1-9), stated simply that he felt his case was "not properly handled" in 1954. It is not clear from his statement to which issue he is referring, but the May 1954 rating decision concerned only service connection for otitis externa (which was denied) and service connection for malaria (which was granted). These were the only claims made on his original application for compensation, which was received at the RO in February 1954. His representative has argued, essentially, that the May 1954 rating decision was erroneous because the RO did not order a VA examination to determine any residuals the veteran had from service, but rather relied on the evidence of record (consisting of service medical records, including his discharge examination which was negative for any ear condition). The Board finds that the veteran has not alleged clear and unmistakable error with sufficient specificity to meet the requirements set forth in Russell, 3 Vet.App. at 313, and Fugo, 6 Vet.App. at 44. The arguments of the veteran and his representative merely question the judgment of the RO in 1954, and do not assert that there were facts not before the adjudicator or that the laws or regulations were improperly applied. The veteran has therefore not submitted a valid claim of clear and unmistakable error with respect to the May 1954 rating decision, and the claim is thus dismissed as not well grounded, pursuant to Newman v. Brown, 5 Vet.App. at 102. The Board notes that the January 1993 remand, which directed the RO to adjudicate the issue of whether the May 1954 rating decision contained clear and unmistakable error, was issued prior to the Court's decisions in Fugo and Newman. Although we now dispose of this issue on a different basis than that utilized by the RO, the veteran has not been prejudiced because the RO gave the issue more consideration than it actually merited. Therefore, the Board's treatment of the issue of whether the May 1954 rating decision was clearly and unmistakably erroneous is not in conflict with Bernard v. Brown, 4 Vet.App. 384 (1993). VI. New and Material Evidence Regarding the Claim for Service Connection for Otitis Externa The Board notes that the veteran's claim as to whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for otitis externa is well grounded within the meaning of 38 U.S.C.A. § 5107(a). The Board is also satisfied that all relevant facts have been properly developed and that no further assistance to the veteran is required to comply with the statutory duty to assist mandated by 38 U.S.C.A. § 5107(a). Service connection may be established for disabilities resulting from injury or disease incurred in or aggravated by service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(b). In order to show the existence of a chronic disease in service, a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity is required. 38 C.F.R. § 3.303(b) (1993). When chronicity is not shown in service, then continuity of symptomatology after discharge is required to support the claim. Id. A claim for entitlement to service connection for otitis externa was originally denied by the Cincinnati RO in May 1954. The veteran did not appeal that decision, and it became final. 38 U.S.C.A. § 7105(c). A claim may be reopened after it has been disallowed if new and material evidence is presented. 38 U.S.C.A. § 5108. When considering a request to reopen a claim, the Board must first determine whether the evidence is new and material. Manio v. Derwinski, 1 Vet.App. 140, 145 (1991). If the Board so determines, the claim is reopened and the Board must then evaluate the merits of the veteran's claim in light of all the evidence, both new and old. Id. The United States Court of Veterans Appeals (Court) defined what is meant by "new and material" in Colvin v. Derwinski, 1 Vet.App. 171 (1991). "New evidence is not that which is merely cumulative of other evidence on the record. Material evidence is relevant and probative of the issue at hand." Id. at 174 (citations omitted); see also 38 C.F.R. § 3.156(a). The Court noted, though, that not all new evidence, even if it is relevant and probative, is sufficient to reopen a case, in that some evidence is of too limited a weight to justify a reopening. Id. The Court embraced the "bright line" rule adopted by other federal courts, which is that "to justify a reopening on the basis of new and material evidence, there must be a reasonable possibility that the new evidence, when viewed in the context of all the evidence, both new and old, would change the outcome." Id. (citations omitted). In addition, for the limited purpose of determining whether the case should be reopened, the evidence should be presumed to be credible. Justus v. Principi, 3 Vet.App. 510, 513 (1992). The evidence of record at the time of the May 1954 rating decision consisted of the veteran's service medical records. These records show that the veteran had otitis externa in his right ear in May 1953, and in both ears in June 1953. While hospitalized for malaria in August and September 1953, it was noted that he also had bilateral otitis externa (described as infection of the external auditory meatus, diffuse, organism undetermined). He was also noted to have otitis externa in his left ear in December 1953, which had cleared up by December 15. At his service discharge examination, dated in January 1954, his ears were found to be normal. No diagnosis of otitis externa was noted. Evidence added to the file since the May 1954 rating decision consists of an application for compensation or pension submitted by the veteran in October 1988, with attachments; a PTSD questionnaire, submitted by the veteran in May 1989; VA examination report, dated in April 1989; the veteran's substantive appeal, received in June 1990, with attached statement; a statement from the veteran, submitted on VA Form 1-9, received in March 1992; a statement from the veteran, received in September 1993; a response from Riverside Methodist Hospital, dated in November 1993; and a response from Centinella Valley Memorial Hospital, received in March 1994. The veteran's October 1988 application for compensation or pension mentions that he had fungal infections of the ear numerous times in service. No mention of any treatment or recurrence of such a condition was noted. Attached to this application is a statement indicating treatment for malaria, jaundice and stomach ulcers during and since service, but the statement is negative for any information about an ear condition. A PTSD questionnaire is also attached, but this is irrelevant to the ear claim. None of these documents constitutes new and material evidence, because the only information provided about an ear condition relates that he had the condition in service. This fact is shown in his service medical records, which were considered by the RO in the May 1954 rating decision. Therefore, these documents cannot support a reopening of the claim. The May 1989 PTSD questionnaire is new but obviously irrelevant to his ear claim, and thus is not material. It cannot support a reopening of the claim. The report from the veteran's April 1989 VA examination indicates that his ear canals were normal, but that he had a fungus disease of the ear drums. This report, while new, is not material in that it does not show a nexus between the fungus disease diagnosed and the otitis externa the veteran had in service 36 years previously. Thus, the report is not probative of the issue at hand because it does not tend to show that the veteran has had recurrent otitis externa since service. It cannot support a reopening of the claim. The veteran's substantive appeal was received at the RO in June 1990. He also attached a lengthy handwritten statement detailing his various claims. The portion of this statement which deals with otitis externa is new, in that it was not previously considered. The statement is not material, though, because it does not provide evidence that the veteran has had recurrent otitis externa since service. To the contrary, the veteran stated that he has not had an ear infection since service. He instead claims that he now has a hearing loss from exposure to loud noises in service. Thus, this statement cannot support a reopening of the claim because it is not probative of the issue at hand. The veteran's March 1992 statement is also new but not material. It was not previously considered, but it does not refer to the veteran's otitis externa claim at all. The veteran's September 1993 statement is likewise new but not material. It concerns primarily his skin disorder in the groin area and malaria conditions, and does not mention his otitis externa claim. Therefore, these documents are not relevant or probative of the issue at hand, and are not sufficient to reopen the claim. The RO received a response to a request for treatment records from Riverside Methodist Hospital in Columbus, Ohio, in November 1993. The hospital indicated that their records are only maintained for 20 years, and that the records requested (from 1965-66) were thus no longer available. A response to a similar request was received from Centinella Valley Memorial Hospital in Inglewood, California, in March 1994. That facility noted that their records dated only to 1971, and that the requested records from 1959 were therefore not available. Both of these responses are new, but they are obviously not material because they are not probative of the issue at hand. They are therefore insufficient to justify a reopening of the claim. ORDER Entitlement to service connection for peptic ulcer disease, a disorder manifested by jaundice, a skin condition (including jungle rot and jock itch), and an acquired psychiatric condition (including PTSD) is denied. The claim for service connection otitis externa based on clear and unmistakable error in the May 1954 rating decision is dismissed. New and material evidence not having been submitted to reopen a claim of entitlement to service connection for otitis externa, the benefit being sought on appeal is denied. BRUCE E. HYMAN Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.