Citation Nr: 0000779 Decision Date: 01/11/00 Archive Date: 01/27/00 DOCKET NO. 97-15 748 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Phoenix, Arizona THE ISSUES 1. Entitlement to service connection for chronic sinusitis. 2. Entitlement to service connection for lung scars. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD K. K. Enferadi, Associate Counsel INTRODUCTION The veteran had active service from July 1988 to July 1992. This matter arises before the Board of Veterans' Appeals (Board) from a July 1996 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) that determined that the veteran's claims of entitlement to service connection for chronic sinusitis and lung scars were not well grounded. FINDINGS OF FACT 1. Medical evidence of a nexus between current sinusitis and the veteran's period of service has not been submitted. 2. Medical evidence of a nexus between the claimed scars of the lungs and the veteran's period of service has not been submitted. CONCLUSIONS OF LAW 1. The veteran's claim of entitlement to service connection for chronic sinusitis is not well grounded. 38 U.S.C.A. § 5107(a) (West 1991). 2. The veteran's claim of entitlement to service connection for scars of the lungs is not well grounded. 38 U.S.C.A. § 5107(a) (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS This veteran asserts that he is entitled to service connection for his chronic sinusitis and for lung scars. Specifically, the veteran contends that his disorders had their onset during the time in which he was exposed to volcanic ash from a volcanic eruption while serving in the Philippines in 1991. A veteran is entitled to service connection for disability resulting from disease or injury coincident with active service, or if preexisting such service, was aggravated therein. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. §§ 3.303, 3.306(a) (1999). Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (1999). If a chronic disease is shown in service, subsequent manifestations of the same chronic disease at any later date, however remote, may be service connected, unless clearly attributable to intercurrent causes. 38 C.F.R. § 3.303(b) (1999). However, continuity of symptoms is required where the condition in service is not, in fact, chronic or where diagnosis of chronicity may be legitimately questioned. 38 C.F.R. § 3.303(b) (1999). The United States Court of Appeals for Veterans Claims (known as the United States Court of Veterans Appeals prior to March 1, 1999, and hereinafter referred to as Court) requires that in order for a claim to be well grounded, there must be competent evidence of 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.) Caluza v. Brown, 7 Vet. App. 498 (1995); see also Epps v. Gober, 126 F.3d 1464 (Fed. Cir. 1997), aff'd sub nom. Epps v. Brown, 9 Vet. App. 341 (1996). The Court has further held that the second and third elements of a well grounded claim for service connection can also be satisfied under 38 C.F.R. § 3.303(b) (1998) by (a) evidence that a condition was "noted" during service or an applicable presumption period; (b) evidence showing post- service continuity of symptomatology; and (c) medical or, in certain circumstances, lay evidence of a nexus between the present disability and post-service symptomatology. See 38 C.F.R. § 3.303(b); Savage v. Gober, 10 Vet. App. 488, 495- 97 (1997). Overall, the veteran in this case has not submitted competent evidence so as to establish a well grounded claim. His failure to submit a well grounded claim necessarily means that he is not entitled to service connection for his claims of chronic sinusitis and scarring of the lungs. Specifically, the veteran has not provided competent evidence of a medical nexus between post-service disabilities and his period of active service. Id. The veteran's service medical records include a November 1987 report of medical examination in which there are no abnormal findings or notations. In a July 1988 clinical entry, the examiner noted that the veteran's entrance examination revealed no significant abnormalities. An August 1989 emergency care form reveals problems with a history of nosebleeds. In a December 1989 clinical entry, the veteran was treated for chills and a sore throat. In a sick call record dated in July 1990, the veteran was seen for heavy cough and chest pains. Noted is that the sinuses and lungs were basically clear. In December 1991, the veteran was noted to have a cough with brownish phlegm. It was noted that he had returned from Clark AFB in November 1991. It was noted that there was the potential that he had inhaled substantive volcanic ash was a possibility. In a January 1992 record, the veteran was diagnosed with sinusitis. Otherwise, the veteran's service medical records are silent for any pertinent findings, notations, or complaints. In general, the record does not support the presence of chronic disability in service. Post-service records include an August 1992 VA examination in which the examiner noted the veteran's reported past medical history of exposure to volcanic ash that resulted in a productive cough. On examination, the veteran's sinuses and respiratory system were noted as clear. During a September 1992 VA examination, the veteran was diagnosed with bronchitis. A December 1992 VA outpatient record discloses the veteran's past medical history of exposure to ash and a chronic cough. In a VA x-ray study conducted in September 1993, the radiologist noted clear lungs. VA outpatient records dated in August 1994 reveal complaints of cough and sore throat related to an apparent bacterial or viral infection. In private outpatient records for treatment that extended from November 1994 to March 1995, the patient was seen for upper respiratory problems, including complaints of sinusitis. A private medical record dated in September 1995 primarily relates to treatment for other disorders. In November 1995, a VA outpatient record reflects complaints of ongoing sinus problems in addition to other upper respiratory infections. Again, the veteran reported his exposure to volcanic ash while in the Philippines. Also noted on that record is that the veteran had an eight-month history of smoking while in the service. By way of history, the examiner diagnosed sinusitis. Further, in VA outpatient records dated from February to April 1996, the veteran complained of upper congestion and recurrent symptoms of sinusitis. A diagnosis noted in an April entry is possible limited sinusitis. X-ray studies conducted in 1996 and 1997 reveal clear lungs, no pertinent abnormalities, and some mucosal thickening and septate sinuses. In spite of the veteran's contentions that he was exposed to volcanic ash when there was an explosion during his tour in the Philippines and that such exposure caused him to endure respiratory problems, including sinusitis and scarring of the lungs, the veteran has not presented evidence of skills, training, or qualifications otherwise so as to render his opinions medically competent. See Espiritu v. Derwinski, 2 Vet. App. 492 (1992). Given the absence of a medical opinion to substantiate that the veteran's current sinusitis or any scars of the lungs relates to his period of service, and in particular, to the incident in service, the veteran thereby fails to establish a well grounded claim. Caluza at 506. Moreover, while the articles and treatises submitted by the veteran in support of his claims, serve the purpose to document the course of the volcanic event in the Philippines, they do not impart competent medical opinions or evidence otherwise to establish a medical nexus between the veteran's chronic post-service sinusitis and lung scars and the veteran's period of active service. Evidence that requires medical knowledge must be provided by someone qualified as an expert by knowledge, skill, experience, training, or education. Espiritu at 492. Thus, in this regard as well, the veteran has failed to establish a well grounded claim. Id. Essentially, other than contentions made by the veteran, there is no evidence of record to support that the veteran's disorders relate to his period of service. Significantly, there is no competent evidence of record that any post- service sinusitis relates to the veteran's exposure to volcanic ash in the Philippines. Additionally, there is no indication of record whatsoever of any scarring of the lungs or any lung disorder neither coincident with service nor currently. Moreover, although the examiners reported the veteran's sinusitis and respiratory infections by way of history of exposure to volcanic ash as noted in several clinical records above, such allegations must be supported by credible and competent evidence. Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992). When a medical opinion depends upon the veteran's rendition of his own medical history, the Board is not bound to accept the medical conclusions as they have no greater probative value than the facts alleged by the veteran. Swann v. Brown, 5 Vet. App. 229, 233 (1993). Thus, such recitations do not provide an avenue to establish that the veteran's post- service disabilities are causally related to volcanic exposure during service. Therefore, in light of the above, the evidence of record preponderates against the veteran's service connection claims. ORDER Entitlement to service connection for chronic sinusitis is denied. Entitlement to service connection for lung scars is denied. V. L. Jordan Member, Board of Veterans' Appeals