Citation Nr: 0001088 Decision Date: 01/13/00 Archive Date: 01/27/00 DOCKET NO. 95-40 313A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in San Juan, Puerto Rico THE ISSUES 1. Entitlement to service connection for a skin disorder, diagnosed as atopic eczema and intertrigo. 2. Entitlement to service connection for chest pain. ATTORNEY FOR THE BOARD L. M. Barnard, Counsel INTRODUCTION The veteran served on active duty from October 1984 to November 1991. This appeal arose from a January 1995 rating decision of the San Juan, Puerto Rico, Department of Veterans Affairs (VA), Regional Office (RO), which denied entitlement to the requested benefits. This decision was confirmed and continued by a rating action issued in October 1998. FINDING OF FACT The veteran has not submitted competent medical evidence that he currently suffers from atopic eczema and intertrigo, and chest pain, that can be related to his period of service. CONCLUSION OF LAW The claims of entitlement to service connection for atopic eczema and intertrigo, and for chest pain, are not well grounded. 38 U.S.C.A. § 5107(a) (West 1991). REASONS AND BASES FOR FINDING AND CONCLUSION The issues before the Board of Veterans' Appeals (Board) are whether the veteran is entitled to service connection for atopic eczema and intertrigo, and for chest pain. A veteran who submits a claim for benefits to the VA shall have the burden of offering sufficient evidence to justify a belief by a fair and impartial individual that the claim is well grounded. See 38 U.S.C.A. § 5107(a) (West 1991). In the absence of evidence of a well grounded claim, there is no duty to assist the veteran in developing the facts pertinent to his claim, and the claim must fail. Epps v. Gober, 126 F.3d 1464, 1467-68 (Fed. Cir. 1997). The veteran must demonstrate three elements to establish that a claim is well grounded. First, the veteran must present medical evidence of a current disability. Second, the veteran must produce medical or, in some instances, lay evidence of an in-service incurrence or aggravation of a disease or injury. Finally, the veteran must offer medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Epps, 126 F.3d at 1468-69. A veteran may also establish a well grounded claim for service connection under the chronicity provision of 38 C.F.R. § 3.303(b) (1999), which is applicable where evidence, regardless of its date, shows that a veteran had a chronic condition in service or during an applicable presumption period, and that the same condition currently exists. Such evidence must be medical unless the condition at issue is a type as to which, under the case law, lay observation is considered competent to demonstrate its existence. If the chronicity provision is not applicable, a claim still may be well grounded pursuant to the same regulation if the evidence shows that the condition was observed during service or any applicable presumption period and continuity of symptomatology was demonstrated thereafter, and includes competent evidence relating the current condition to that symptomatology. Savage v. Gober, 10 Vet. App. 488, 495-98 (1997). FACTS Skin disorder The veteran's service medical records indicated that his skin was normal at the time that he entered active duty in October 1984. On October 9, 1987, he was seen with complaints of a rash. There was no edema, drainage or signs of infection. The assessment was razor burn, rule out pseudofolliculitis barbae. His skin was noted to be normal during examinations conducted in September 1988 and November 1989. It was also normal at the time of the separation examination performed in November 1991. The veteran was examined by VA in January 1998. A skin diseases examination noted his complaints of a skin rash since 1994 or 1995. He described it as pruritic and indicated that it would come and go. The objective examination noted eczematous patches with scaliness and follicular accentuation in the elbows. There was also hyperpigmentation in the groin and the scrotum. The diagnoses were atopic eczema and intertrigo. Chest pain The veteran's service medical records showed that his chest was within normal limits at the time of the entrance examination performed in October 1984, an extension examination of September 1988 and an examination of November 1989. On August 29, 1991, he reported a one week history of left-sided, anterior chest wall aching pain that was worse with palpation and deep inspiration. He knew of nothing that tended to improve the pain. He denied fever and chills, although he noted that he had an occasional cough with yellow sputum. There was no known trauma. The objective examination noted that his chest was tender to palpation along number 4, 5, and 6 anterior ribs. The assessment was costochondritis. A chest x-ray performed in October 1991 noted that his heart was normal. A separation examination conducted in November 1991 was within normal limits. VA examined the veteran in January 1998. He did complain of some occasional shortness of breath. However, the examination of the chest was normal and his heart displayed a regular rate and rhythm. ANALYSIS The objective evidence of record indicates that the veteran has been diagnosed as currently suffering from atopic eczema and intertrigo. There was one notation in service of razor burn; however, no skin condition was ever diagnosed in service. Significantly, there is no objective competent medical evidence establishing a link between the veteran's currently diagnosed skin disorders and his service. In regard to the claim for service connection for a condition manifested by chest pain, it is noted that the veteran did have one complaint of chest wall pain in service, which was diagnosed as costochondritis. However, there is no objective competent medical evidence of the existence of a current disability manifested by chest pain. The only evidence of record suggesting the existence of current disabilities related to his service is the veteran's assertions. However, the veteran, as a layperson, does not have the medical expertise needed to render diagnoses or opinions as to medical causation. Espiritu v. Derwinski, 2 Vet. App. 492, 494-5 (1992). Therefore, it is concluded that the veteran has failed to present evidence of well grounded claims for service connection for atopic eczema and intertrigo, and for chest pain. ORDER Service connection for atopic eczema and intertrigo, and for chest pain, is denied. M. S. SIEGEL Acting Member, Board of Veterans' Appeals