BVA9507771 DOCKET NO. 92-22 309 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Paul, Minnesota THE ISSUE Entitlement to service connection for chronic bronchitis. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD Michele M. Florack, Associate Counsel INTRODUCTION The veteran served on active duty from May 1946 to October 1947. In a statement dated in March 1995, the veteran's representative raised a claim for service connection for a lung condition, due to smoking. This issue has not been adjudicated by the regional office and is not currently part of the veteran's appeal. Since it is not inextricably intertwined with the issue currently on appeal, it is referred to the regional office for appropriate action. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he incurred chronic bronchitis in service. He claims that since bronchitis was shown in service and after service, service connection is warranted for the disorder. DECISION OF THE BOARD The Board of Veterans' Appeals (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 claim for service connection for chronic bronchitis. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the instant appeal has been obtained by the Regional Office (RO). 2. Acute bronchitis shown in service was an acute and transitory disorder, resolving without residual impairment. 3. No complaints, treatment, or findings of chronic bronchitis are shown at separation from service or for many years after service; chronic bronchitis is not shown to be related to active service. CONCLUSION OF LAW Chronic bronchitis was not incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131, 5107(a) (West 1991); 38 C.F.R. § 3.303 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Board initially finds that the veteran's claim is "well grounded" or plausible within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). Therefore, the Department of Veterans Affairs (VA) has a duty to assist the veteran in the development of facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991). In that regard, the Board notes that this case was the subject of a Board Remand in August 1994 for further development. In an effort to help the veteran establish service connection for chronic bronchitis, all relevant postservice treatment records were sought. Treatment records from private and VA sources for the period 1987 to 1994 were received. The Board finds that the VA has now met the statutory duty to assist and the case is ready for appellate review. To establish entitlement to service connection generally requires that the facts, as shown by the evidence, show that a particular injury or disease resulting in chronic disability was incurred in service, or, if preexisting service, was aggravated therein. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. § 3.303 (1994). For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "chronic." Continuity of symptomatology is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b) (1994). The service medical records show that the veteran complained of persistent nasal discharge, coughing, and shortness of breath on exercising in November 1946. The veteran reported a history of pneumonia at age 6, and asthma and hay fever all his life. The provisional diagnosis was acute bronchitis. X-rays were conducted, and an ear, nose and throat consultation showed a subsiding upper respiratory infection. The final diagnoses were nasopharyngitis, acute, catarrhal and severe, and bronchitis, acute, organism undetermined. The veteran was reported improved and returned to duty. No other findings of bronchial complaints are shown in service. The separation examination dated in September 1947 is negative for any findings of bronchitis. Since the disorder found in service was acute bronchitis, identified as such by diagnosis and by the fact that no other findings were shown, what the veteran needs to show is continuity of symptomatology from the time of the episode in service until the present time. The veteran initiated his claim for service connection for chronic bronchitis informally in April 1968. He reported that he had had a problem with bronchitis since an episode of bronchitis in service. He later submitted a letter from D. W. Francis, M.D., dated February 1975, in which the physician indicated that the veteran had been his patient from 1936 to 1945. Dr. Francis reported that the veteran had made a complete recovery from pneumonia prior to service, and that the veteran had no bronchitis prior to 1947 when he was in service. It is obvious that Dr. Francis could only report about the period for which he treated the veteran, which was apparently prior to service. It is not even clear from the letter that Dr. Francis was offering a current diagnosis of chronic bronchitis, but giving a second-hand history of the veteran's acute episode in service. However, even if Dr. Francis' letter were to be construed as a current diagnosis of chronic bronchitis, it is still too remote from service, over 25 years, to establish continuity of symptomatology. In fact, the first clear medical evidence of chronic bronchitis is a March 1987 pulmonary study conducted by Rice County District One Hospital, at which time the veteran reported that he had had chronic bronchitis since service. Outpatient treatment records from that facility for the period from March 1987 to July 1992 show treatment of chronic bronchitis. Outpatient treatment records for the period from April 1987 to September 1993 from the Faribault Clinic include treatment of chronic obstructive lung disease, hypertension, and alcohol dependence. VA outpatient treatment records for September 1993 to November 1994 show the treatment of chronic bronchitis or chronic obstructive pulmonary disease. In all of these clinical treatment records, there is no medical evidence to establish that chronic bronchitis was shown any sooner than 40 years subsequent to service. In August 1992, the veteran submitted five lay statements in support of his claim. The five statements were from friends or associates who reported that they noticed the veteran's coughing and breathing problem in the preceding 2-5 years. None of the friends or associates claimed to know the veteran for more than 25 years (or since 1967), which is still 20 years after service. These persons are qualified to report the symptoms they observed, but the statements are not competent evidence that the veteran had chronic bronchitis during that time. Even if the lay opinions were not so remote from service, their lay opinions as to when the veteran had bronchitis would not be competent evidence, as they lack the necessary expertise to present expert opinions in the matter of a medical diagnosis. Espiritu v. Derwinski, 2 Vet.App. 492 (1992); Grottveit v. Brown, 5 Vet.App. 91 (1993). Similarly, the veteran's own statements may be competent evidence that he has had trouble with his respiratory system since separation from service, but they are not competent evidence that he had chronic bronchitis from the time of separation from service until the first clinical documentation many years after separation from service, especially since the evidence shows that he currently has additional lung pathology. Furthermore, a general statement by the veteran that he had had trouble with bronchitis since service, made more than 20 years after service, and the general history of chronic bronchitis since service recorded in 1987, approximately 40 years after separation from service, are not specific enough to establish a frequency of occurrences or "continuity" for the entire time period in question upon which to conclude that the episode of bronchitis in service was the beginning of chronic bronchitis. In conclusion, competent evidence has not been submitted to show chronic bronchitis from service until the first clinical documentation of chronic bronchitis many years after separation from service, in order to establish the continuity of the disorder that is required for a grant of service connection. In that the evidence of record does not demonstrate a chronic disease or injury in service or a continuity of symptomatology post-service necessary to support a grant of service connection, it is the determination of the Board that the preponderance of the evidence is against the claim for service connection for chronic bronchitis. ORDER Service connection for chronic bronchitis is denied. WILLIAM J. REDDY 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.