Citation Nr: 0007773 Decision Date: 03/22/00 Archive Date: 03/28/00 DOCKET NO. 96-03 899 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Los Angeles, California THE ISSUE Entitlement to service connection for hemorrhoids. REPRESENTATION Appellant represented by: California Department of Veterans Affairs WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Michelle L. Nelsen, Associate Counsel INTRODUCTION The veteran had active duty from April 1972 to March 1976 and from August 1983 to August 1994. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 1995 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. The claims folder was subsequently transferred to the RO in Los Angeles, California. The case returns to the Board following a remand to the RO in June 1998. In a June 1999 rating decision, the RO favorably resolved the issue of service connection for a right ankle disorder, which was an issue previously on appeal. Accordingly, the matter is not currently before the Board. FINDING OF FACT There is no competent medical evidence of a nexus between the veteran's hemorrhoids and his period of active duty service. CONCLUSION OF LAW The veteran's claim of entitlement to service connection for hemorrhoids is not well grounded. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.102 (1999). REASONS AND BASES FOR FINDING AND CONCLUSION Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated in active military service. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. § 3.303(a) (1999). Direct service connection requires a finding that there is a current disability that has a definite relationship with an injury or disease or some other manifestation of the disability during service. Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992); Cuevas v. Principi, 3 Vet. App. 542, 548 (1992). A disorder may be service connected if the evidence of record reveals that the veteran currently has a disorder that was chronic in service or, if not chronic, that was seen in service with continuity of symptomatology demonstrated thereafter. 38 C.F.R. § 3.303(b); Savage v. Gober, 10 Vet. App. 488, 494-97 (1997). Evidence that relates the current disorder to service must be medical unless it relates to a disorder that may be competently demonstrated by lay observation. Savage, 10 Vet. App. at 495-97. 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." 38 C.F.R. § 3.303(b). Disorders diagnosed after discharge may still be service connected if all the evidence, including pertinent service records, establish that the disorder was incurred in-service. 38 U.S.C.A. § 1113(b); 38 C.F.R. § 3.303(d). However, a person claiming VA benefits must meet the initial burden of submitting evidence "sufficient to justify a belief in a fair and impartial individual that the claim is well grounded." 38 U.S.C.A. § 5107(a); Murphy v. Derwinski, 1 Vet. App. 78, 91 (1990); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). A claim that is well grounded is plausible, meritorious on its own, or capable of substantiation. Murphy, 1 Vet. App. at 81; Moreau v. Brown, 9 Vet. App. 389, 393 (1996). For purposes of determining whether a claim is well grounded, the Board presumes the truthfulness of the supporting evidence. Arms v. West, 12 Vet. App. 188, 193 (1999); Robinette v. Brown, 8 Vet. App. 69, 75 (1995); King v. Brown, 5 Vet. App. 19, 21 (1993). In order for a claim to be well grounded, there must be competent evidence of a current disability (a medical diagnosis); of incurrence or aggravation of a disease or injury in service (lay or medical evidence); and of a nexus between the in-service injury or disease and the current disability (medical evidence). Epps v. Gober, 126 F.3d 1464, 1468 (1997); Caluza v. Brown, 7 Vet. App. 498, 504 (1995). Where the determinative issue involves a medical diagnosis, there must be competent medical evidence to the effect that the claim is plausible; lay assertions of medical status do not constitute competent medical evidence. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993); Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992). VA cannot undertake to assist a veteran in developing facts pertinent to his claim until and unless the veteran submits a well grounded claim. Morton v. West, 12 Vet. App. 477, 486 (1999). In this case, VA medical evidence shows a diagnosis of hemorrhoids. Therefore, the first requirement of a well grounded claim is satisfied. In addition, the veteran asserts that he experienced rectal bleeding in service. For purposes of determining whether the claim is well grounded, the Board presumes the truthfulness of this assertion. Arms, 12 Vet. App. at 193; Robinette, 8 Vet. App. at 75; King, 5 Vet. App. at 21. However, a review of the service medical records is silent for complaints or treatment for rectal bleeding or hemorrhoids. During a November 1993 Medical Evaluation Board examination, it was specifically noted that hemorrhoids or rectal bleeding were not present. Furthermore, upon a review of the evidence, the Board finds that the claim is not well grounded because there is no competent medical evidence of a nexus between the current diagnosis and the veteran's period of active service. That is, there is no medical evidence that establishes a link between the disorder and service. Absent such evidence, the claim is not well grounded. Epps, 126 F.3d at 1468. During the July 1997 hearing, the veteran essentially testified that he experienced rectal bleeding in service and continued to have bleeding after his separation from service. He therefore believes that his hemorrhoids are related to service. The Board acknowledges that continuity of symptomatology may provide a basis for establishing service connection. However, the provisions of 38 C.F.R. § 3.303(b) do not relieve a veteran of the burden of providing a medical nexus in order to establish a well grounded claim. Rather, a veteran diagnosed with a chronic disorder must still provide a medical nexus between the current disorder and the putative continuous symptomatology. Voerth v. West, 13 Vet. App. 117, 120 (1999); McManaway v. West, 13 Vet. App. 60, 66 (1999). Moreover, there is no evidence of record that suggests that the veteran is trained in medicine. Therefore, he is competent to relate and describe symptoms, but he is not competent to offer an opinion on matters that require medical knowledge, such as a diagnosis or determination of etiology. Grottveit, 5 Vet. App. at 93; Espiritu, 2 Vet. App. at 494. Under these circumstances, the Board finds that the veteran has not submitted a well grounded claim for service connection for hemorrhoids. 38 U.S.C.A. § 5107(a); 38 C.F.R. § 3.102; Epps, 126 F.3d at 1468. Therefore, the duty to assist is not triggered and VA has no obligation to further develop the veteran's claim. Epps, 126 F.3d at 1469; Morton, 12 Vet. App. at 486; Grivois v. Brown, 5 Vet. App. 136, 140 (1994). If the veteran wishes to complete his application for service connection for hemorrhoids, he should produce medical evidence that establishes a link between the current diagnosis and his period of active duty service. 38 U.S.C.A. § 5103(a); Robinette, 8 Vet. App. at 77-80. ORDER Service connection for hemorrhoids is denied. RENÉE M. PELLETIER Member, Board of Veterans' Appeals