BVA9504283 DOCKET NO. 92-55 186 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Seattle, Washington THE ISSUE Entitlement to service connection for residuals of mumps, hypertension, and heart disease. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Neil Reiter, Counsel INTRODUCTION The veteran served on active duty from September 1948 to June 1952. This matter came before the Board of Veterans' Appeals (the Board) from a rating decision of August 1991 by the Seattle, Washington, Regional Office denying service connection for the claimed disabilities. In June 1992, the Board remanded the case in order to attempt to obtain additional information. After such action was completed, the regional office affirmed its prior denial of the veteran's claims, and the case was returned to the Board for appellate consideration. In June 1994, the Board again remanded the case to the regional office to correct a mistake in a Department of Veterans Affairs (VA) examination. Another VA examination was requested, and it was performed in August 1994. Subsequently, the regional office again denied the veteran's claims, and the case was returned to the Board for appellate consideration. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends, in essence, that he was hospitalized in Germany in January 1952 for treatment of mumps, and that he was informed that he had a heart abnormality when he was hospitalized. He maintains that he was offered a medical discharge for this heart abnormality, but continued in service until the end of his enlistment. He contends that he is entitled to service connection for residuals of mumps, and for hypertension and a heart condition. He further contends that he should not be penalized because his records were accidentally destroyed. 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 veteran is not entitled to service connection for residuals of mumps, hypertension, or heart disease. FINDINGS OF FACT 1. All relevant evidence necessary for disposition of the veteran's appeal has been obtained by the regional office. 2. Hypertension and heart disease were not present in service. 3. Hypertension and heart disease were first manifested many years after discharge from service and are not shown to be etiologically related to any disability treated in service. 4. Mumps was acute and transitory in nature, without demonstrable residual disability shown at or after discharge from service. CONCLUSION OF LAW Mumps, hypertension, and heart disease were not incurred in or aggravated by service, and hypertension and heart disease may not be presumed to have been incurred in service. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107 (West 1991); 38 C.F.R. §§ 3.303, 3.307, 3.309 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran's claim is "well grounded" within the meaning of 38 U.S.C.A. § 5107(a). The Board is satisfied that all reasonable and logical efforts have been made to obtain all relevant facts. I. Background When the veteran applied for service connection for the claimed disabilities in January 1991, he reported that he was hospitalized in January 1952 in Germany for mumps, and that he was told at that time that he had a heart problem. He also reported that he had been treated by Dr. Shea for hypertension from 1970 to the present time. His wife reported in February 1991 that she had been married to the veteran for 37 years, and that he had always had problems with pain in his chest. Clinical notes from a private physician show that in early 1989, the veteran was treated for back pain and a possible fracture of the ribs on the left side, and that laboratory studies showed elevated cholesterol. An electrocardiogram in February 1978 was normal. The regional office attempted on different occasions to obtain service medical records from the service department, but the service department certified that no service medical records had been found, as records may have been destroyed in a fire. A special search for records showed notations on morning reports that the veteran had been hospitalized in January and February 1952, but the specific nature of the treatment was not indicated. Pursuant to the Board's remand in June 1992, a further search for information concerning this hospitalization was unsuccessful. Michael W. Shea, M.D., in August 1988, stated that he had treated the veteran since the early 1970's. It was indicated that the veteran's past medical history was significant only for a tonsillectomy. Dr. Shea reported that the veteran had always been overweight and that his blood pressure had always tended to be on the high side. In 1980, blood pressure was 140/90, and the veteran was placed on medication. He continued to receive medication for hypertension after 1980. In July 1992, Dr. Shea indicated that the veteran had been followed in his clinic through 1989, and he again reported that the veteran had been placed on medication for elevated blood pressure in 1980. It was further noted that the veteran was treated for a backache and a possible left rib fracture in 1989. On a VA examination in August 1992, the veteran stated that he was hospitalized for 16 days in 1952 for mumps and that he was told that he had a heart murmur while hospitalized. He indicated that he was well until the 1960's, when he began taking medication for hypertension. He reported that in the last 10 years he had had progressive problems with dyspnea on exertion as well as swelling in the ankles, but that he has had no arrhythmias or other cardiovascular symptomatology. He reported no other sequelae. Blood pressure readings were within normal range, aside from one which was 138/90. Examination of the lungs showed scattered rhonchi and wheezes with forced expiration. There was a systolic murmur. A chest X-ray resulted in the opinion of a prominent pulmonary interstitium and an electrocardiogram was interpreted as normal. The examiner indicated that the findings were suggestive of marginal cardiac output, secondary to hypertensive and possibly valvular disease. On another VA examination in June 1993, the veteran's records and history were reviewed. An echocardiogram was suggested to assess whether the heart murmur was related to valvular heart disease, which might be secondary to a prior "varicella" infection. The echocardiogram, which was conducted that same month, was interpreted as showing a small pericardial effusion. It was indicated that there was no evidence of a post "varicella" cardiomyopathy or mitral regurgitation. The Board remanded the case in June 1994 to clarify the terminology used in the previous examinations, because the examiners referred to "varicella" in the veteran's history, rather than to the claimed mumps. The previous VA examiner again examined the veteran in August 1994, and he stated that the previous examinations were in fact performed for post-mumps symptoms, although the name "varicella" had been used. He reported that he was not aware of post-mumps cardiac syndromes or conditions which would explain the veteran's symptomatology. He again reviewed the veteran's history, noting that hypertension was not found until the mid-1960's. The veteran stated that he had a heart murmur after his hospitalization for mumps. The examiner stated that it was conceivable that the murmur had been present and not previously noted, or that it was unmasked in the acute febrile episode, although there "is not likely a direct causal link between the mumps infection itself and any cardiac dysfunction." II. Analysis In this case, unfortunately, service medical records are unavailable and may have been destroyed. The only service medical records available are morning reports which provide information that the veteran was hospitalized in January and February 1952. The nature of his illness or treatment was not provided. Thus, service medical records can neither confirm nor deny whether the veteran incurred or aggravated the claimed disabilities in service. Further, available records fail to support the veteran's contention that he could have received a medical discharge from service. The Board has reviewed the veteran's statements relating to the incurrence of the claimed disabilities in the context of the clinical and medical data of record, realizing that service medical records are unavailable. In this regard, the veteran has stated that he was treated for mumps in January and February 1952. If he had such an illness, as claimed, he has not introduced any medical evidence to show that there were residuals of mumps after such treatment, upon discharge from service, or after discharge from service. The veteran's private physician and VA examinations have not provided any history or findings suggestive that there were symptoms or residuals of mumps after the veteran's discharge from service. The veteran's physician has indicated that the veteran was treated for hypertension beginning in the 1970's, approximately 20 years after discharge from service, and this physician has not linked the hypertension to the episode of mumps which occurred in service. The physician has also failed to link any heart disease to the veteran's service or to the episode of mumps in service. The VA examinations conducted in 1992, 1993, and 1994 also failed to provide any etiological link between the veteran's hypertension, heart murmur, or other heart disease and the veteran's service or treatment for mumps. Specifically, the VA examiner in 1994 expressed the opinion that there were no post- mumps cardiac syndromes or conditions which would explain the veteran's present symptomatology, and that "there is not likely a direct causal link between the mumps infection itself and any cardiac dysfunction." Accordingly, the evidence establishes that the mumps reportedly treated in service was acute and transitory in nature, without demonstrable residual disability shown after treatment, at the time of discharge from service, or since discharge from service. 38 C.F.R. § 3.303. The present evidence, further, does not establish that hypertension or heart disease was incurred during the veteran's period of service, or that such disabilities can be presumed to have been incurred in service. Finally, it has not been shown that the claimed disabilities are related to any illness treated in service. The veteran's conentions to the contrary, in the absence of supporting evidence, are of negligible probative value given his lack of medical knowledge or expertise. Espiritu v. Derwinski, 2 Vet.App. 492 (1992). As a result, entitlement to service connection for mumps, hypertension, and organic heart disease is not warranted. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309. Doubt has not arisen in this case as to any material issue which would permit an allowance of the veteran's claims. 38 U.S.C.A. § 5107. ORDER Entitlement to service connection for mumps, hypertension, and heart disease is denied. WAYNE M. BRAEUER 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.