Citation Nr: 0006937 Decision Date: 03/15/00 Archive Date: 03/23/00 DOCKET NO. 95-02 790 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Providence, Rhode Island THE ISSUE Entitlement to service connection for a disease of the respiratory system, including histoplasmosis, residuals of pneumonia, and chronic obstructive pulmonary disease (COPD). WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD Richard V. Chamberlain, Counsel INTRODUCTION The veteran had active service from July 1964 to June 1967. He also had service after June 1967 in the Army National Guard. This appeal comes to the Board of Veterans' Appeals (Board) from a July 1995 RO rating decision that denied service connection for a disease of the respiratory system, including COPD, residuals of pneumonia, and histoplasmosis. FINDING OF FACT The veteran has not submitted competent evidence showing the presence of histoplasmosis in service or linking his current COPD to an incident of service, including acute pneumonia treated in service. CONCLUSION OF LAW The claim for service connection for a disease of the respiratory system, including histoplasmosis, residuals of pneumonia, and COPD is not well grounded. 38 U.S.C.A. § 5107(a) (West 1991). REASONS AND BASES FOR FINDING AND CONCLUSION The threshold question to be answered in this case is whether the veteran has presented evidence of a well-grounded claim; that is, evidence which shows that his claim for service connection for a disease of the respiratory system, including histoplasmosis, residuals of pneumonia, and COPD is plausible, meritorious on its own, or capable of substantiation. 38 U.S.C.A. § 5107(a) (West 1991); Murphy v. Derwinski, 1 Vet. App. 78 (1990). If he has not presented such a claim, his appeal must, as a matter of law, be denied, and there is no duty on the VA to assist him further in the development of the claim. Murphy at 81. "The United States Court of Appeals for Veterans Claims (known as the United States Court of Veterans Appeals prior to March 1, 1999) (hereinafter, "the Court")" has also stated that a claim must be accompanied by supporting evidence; an allegation is not enough. Tirpak v. Derwinski, 2 Vet. App. 609 (1992). In a claim of service connection, this generally means that evidence must be presented which in some fashion links a current disability to a period of military service, or as secondary to a disability which has already been service- connected. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. §§ 3.303, 3.310 (1999); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). "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 testimony), ...; and of a nexus between the inservice injury or disease and the current disability (medical evidence)." Caluza v. Brown, 7 Vet. App. 498 (1995). A review of the record shows that service connection has not been granted for any of the veteran's disabilities. Hence, service connection for the condition being considered in this appeal based on a causal relationship to a service-connected disability is not for consideration. 38 C.F.R. § 3.310(a). In the case of any veteran who engaged in combat with the enemy in active service with a military, naval or air organization of the United States during a period of war, campaign or expedition, the VA Secretary shall accept as sufficient proof of service-connection of any disease or injury alleged to have been incurred in or aggravated by such service satisfactory lay or other evidence of service incurrence or aggravation of such injury or disease, if consistent with the circumstances, condition or hardship of such service, notwithstanding the fact that there is no official record of such incurrence or aggravation in such service, and, to that end, shall resolve every reasonable doubt in favor of the veteran. Service-connection of such injury or disease may be rebutted by clear and convincing evidence to the contrary. The reason for granting or denying service-connection in each case shall be recorded in full 38 U.S.C.A. § 1154(b) (West 1991). In this case, the evidence does not reveal that the veteran engaged in combat while in service. Therefore, the provisions of 38 U.S.C.A. § 1154(b) are not for consideration. In July 1964, he was seen for a cough and cold. His chest was clear to percussion and auscultation. It was noted that he had a routine upper respiratory infection and that he was ordered to bed rest. Service medical records show that the veteran was seen for respiratory problems in April 1967. On April 14, he was seen for a sore throat of 2 days. He had mildly swollen glands and small pus pockets. He was treated with penicillin, an upper respiratory infection pack, and recommended for light duty. On April 15, he still had a throat infection and he was started on medication. On April 20, he complained of headache with a constant cough. His throat looked normal, and his lungs were clear. He was treated with medication and a cold pack, and ordered to quarters. In July 1964, he was seen for a cough and cold. His chest was clear to percussion and auscultation. It was noted that he had a routine upper respiratory infection and that he was ordered to bed rest. A physical profiled notes that the veteran was medically qualified for duty in May 1967. It was noted that he was convalescing from pneumonia and that he should restrict strenuous physical activities. The report of the veteran's medical examination for separation from service in May 1967 notes the veteran had pneumonia in April 1967 and that this condition had cleared by X-ray in May 1967. Chest X-ray was reportedly negative and a disease of the respiratory system was not found at the time of this medical examination. The post-service medical records show that the veteran underwent a service department medical examination in September 1975 for induction in the Army National Guard. A report of chest X-ray notes the presence of numerous tiny calcifications scattered throughout the lungs, otherwise, the lung fields were clear. The findings were noted to be of long standing and not clinically remarkable. A disease of the respiratory system was not found at the time of this examination. A private medical report of chest X-rays in July 1992 shows diffuse, small, and dense nodules scattered throughout the lung that were probably calcified and due to old granulomatous disease. There was no evidence of acute cardiopulmonary disease. A report of the veteran's VA medical examination in June 1995 reveals a diagnosis of COPD. Chest X-rays demonstrated multiple small pulmonary calcifications. The examiner who conducted the June 1995 medical examination noted that the X- rays revealed calcified nodules consistent with history of histoplasmosis involving the respiratory tract. There was also evidence and findings consistent with COPD. The post-service medical records also include VA pulmonary function studies of the veteran's lungs in 1995 and 1996 that show possible restrictive defect. The post-service medical records do not show the presence of a chronic disease of the respiratory system until many years after service, and these records do not link the veteran's current COPD to an incident of service, including the veteran's pneumonia treated in service. The post service medical records include X-rays findings consistent with history of histoplasmosis, but do not demonstrate the presence of this disease at any time after service. Assuming for the sake of argument, that the veteran's statements are sufficient to demonstrate the presence of histoplasmosis in service, there is no medical evidence linking the COPD to histoplasmosis, and the evidence does not show that the veteran currently has histoplasmosis. The only chronic respiratory disease currently demonstrated by the medical evidence is COPD. A claim for service connection of a disability is not well grounded where there is no medical evidence of the claimed condition or of evidence linking a current disability to an incident of service. Caluza, 7 Vet. App. 498. Statements and testimony from the veteran are to the effect that he was treated for histoplasmosis at the Walter Reed Army hospital while in service, but attempts by the RO to obtain reports of this treatment were unsuccessful. In December 1996, the Walter Reed Army Hospital and the National Personnel Records Center notified the RO that they had no records of the veteran's treatment while in service. The veteran's lay statements are not sufficient to demonstrate the presence of a disability or to support a claim for service connection based on medical causation. Espiritu v. Derwinski, 2 Vet. App. 492 (1992). In this case, there is no competent (medical) evidence showing the presence of histoplasmosis in service and there is no competent (medical) evidence linking the veteran's current COPD to an incident of service, including the acute pneumonia treated while he was in service. Hence, the claim for service connection for a disease of the respiratory system, including histoplasmosis, residuals of pneumonia, and COPD, is not plausible, and it is denied as not well grounded. ORDER The claim for service connection for a disease of the respiratory system, including histoplasmosis, residuals of pneumonia, and COPD, is denied as not well grounded. J. E. Day Member, Board of Veterans' Appeals