BVA9500441 DOCKET NO. 93-10 373 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Sioux Falls, South Dakota THE ISSUE Entitlement to service connection for cirrhosis of the liver. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD K. E. Harrison, Associate Counsel INTRODUCTION The veteran had active military service from August 1965 to August 1969. This matter originally came before the Board of Veterans' Appeals (Board) on appeal from a rating decision of October 1992, by the Sioux Falls, South Dakota, Regional Office (RO) of the Department of Veterans Affairs (VA). CONTENTIONS OF APPELLANT ON APPEAL The veteran claims that his cirrhosis of the liver began in service. He notes that laboratory reports just prior to military discharge show abnormalities which, he feels, were early indications of cirrhosis. 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 has not met his initial burden of submitting evidence sufficient to justify a belief by an impartial individual that he has presented a claim of service connection for cirrhosis of the liver. FINDING OF FACT No competent evidence has been submitted to show that the veteran's cirrhosis of the liver is the result of disease or injury in service. CONCLUSION OF LAW The veteran has not presented a well-grounded claim of service connection for cirrhosis of the liver. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 5107(a), 7104 (West 1991); 38 C.F.R. §§ 3.307, 3.309 (1993) REASONS AND BASES FOR FINDING AND CONCLUSION Background. A careful review of the evidence of record shows that the veteran was initially treated for chronic persistent hepatitis of unclear etiology in 1981. The veteran was diagnosed with Stage IV primary biliary cirrhosis of the liver in 1987. A September 1992 VA examination confirmed the diagnosis of primary biliary cirrhosis. The examiner stated that he examined records from the late 1960's and found no evidence of abnormal liver function prior to 1981. The veteran's representative claimed that the VA examination was inadequate in that the report did not indicate whether the laboratory reports prior to military discharge were indicative of the beginning of liver problems. The claims file was forwarded to a VA Medical Center for medical review and expression of opinion as to whether the laboratory reports just prior to discharge showed abnormalities which were early manifestations of cirrhosis. The opinion stated that the data suggested to be indicative of early liver disease was actually a documented urinary tract infection with albumin, "RBC's," "WBC's" and a few casts in the urine over a three-day period with urine "C & S positive" for enterococci. The doctor added that less than two weeks later (8-6-89) only an occasional "WBC" was noted in the urine and the condition cleared without evidence of sequela. The doctor stated that these results represented a transient infection in another body system and was unrelated to liver disease of any type, past or present. Analysis The law provides that service connection may be granted for disability which was incurred in or aggravated by active military service. 38 U.S.C.A. §§ 1110 (wartime), 1131 (peacetime) (West 1991). Where a veteran served continuously for ninety days or more during a period of war or during peacetime after December 31, 1946, and develops cirrhosis of the liver to a degree of 10 percent or more within one year from date of termination of such service, this disease will be presumed to have been incurred in service even though there is no evidence of the disease during the period of service. 38 C.F.R. § 3.309 (1993). However, the preliminary requirement for establishing entitlement to any VA benefit is that the applicant submit a claim which is well grounded. 38 U.S.C.A. § 5107(a) (West 1991). The Court of Veteran Appeals (the Court) has defined a well-grounded claim as "a plausible claim, one which is meritorious on its own or capable of substantiation." Murphy v. Derwinski, 1 Vet.App. 78, 81 (1990). The Board finds that the veteran's claim for service connection for cirrhosis of the liver is not well grounded. There was no liver disease shown in service or within one year after service. The first signs of liver disease were found in 1981. The veteran contends that his service medical records contain laboratory findings which could be early indications of cirrhosis. He supports this contention by citing a medical treatise which he claims states that it can take anywhere from 2 to 10 years or more for liver cirrhosis to actually develop. However, to be well grounded, a claim must be accompanied by evidence that suggests more than a purely speculative basis for granting entitlement. Dixon v. Derwinski, 3 Vet.App. 261 (1992); Tirpak v. Derwinski, 2 Vet.App. 609 (1992). Furthermore, the veteran's lay assertions concerning questions of medical causation cannot constitute evidence to render a claim well grounded under § 5107(a). Tirpak, Id., at 610; Grottveit v. Brown, 5 Vet.App. 91 (1993). The veteran has submitted no cognizable evidence to support his assertions concerning the cause of his liver cirrhosis. In fact, the recently obtained medical opinion by VA indicated that the manifestations in service were reflective of an acute and transitory urinary tract infection and not related to liver disease of any type. Tirpak, Id., at 610; Grottveit v. Brown, 5 Vet.App. 91 (1993). In the absence of a well-grounded claim, the Board does not have jurisdiction to enter a decision with respect to the merits of the issue raised. Boeck v. Brown, 6 Vet.App. 14 (1994) ORDER As a well-grounded claim of service connection for cirrhosis of the liver has not been presented, the appeal is dismissed. STEPHEN L. WILKINS 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.