Citation Nr: 18132321
Decision Date: 09/06/18	Archive Date: 09/06/18

DOCKET NO. 12-27 419
DATE:	September 6, 2018
ORDER
Entitlement to service connection for chronic fatigue syndrome is denied.
Entitlement to service connection for sleep apnea is denied.
Entitlement to service connection for idiopathic thrombocytopenic purpura is denied.
FINDINGS OF FACT
1. The evidence of record does not indicate a current diagnosis of chronic fatigue syndrome.
2. The evidence of record does not indicate that the Veteran had complaints of or sought treatment for sleep apnea during service.
3. The evidence of record does not indicate that the Veteran had complaints of or sought treatment for idiopathic thrombocytopenic purpura during service.
CONCLUSIONS OF LAW
1. The criteria for service connection for chronic fatigue syndrome have not been met.  38 U.S.C. § 1110; 38 C.F.R. § 3.303.
2. The criteria for service connection for sleep apnea have not been met.  38 U.S.C. § 1110; 38 C.F.R. § 3.303.
3. The criteria for service connection for idiopathic thrombocytopenic purpura have not been met.  38 U.S.C. § 1110; 38 C.F.R. § 3.303.
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
The Veteran served active duty in the United States Air Force from February 2001 to June 2001, from October 2001 to August 2003, and from February 2004 to March 2006. 
In a December 2012 VA Form 9, the Veteran requested a Board hearing.  In a January 2017 VA 646, the Veteran, through his representative, requested that an informal hearing be held in lieu of the requested formal hearing.  An informal hearing was held in December 2017.  Therefore, the Board will proceed accordingly.
Service Connection
Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a).  Service connection may be established for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that disease was incurred in service.  38 C.F.R. § 3.303(d).
Generally, to prevail on a claim of service connection on the merits, there must be competent evidence of (1) current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence or other competent evidence of a nexus between the claimed in-service disease or injury and the present disease or injury.  See Hickson v. West, 12 Vet. App. 247 (1999); Jandreau v. Nicholson, 492 F.3d at 1372.
1. Service connection for chronic fatigue syndrome.
The Veteran contends that he has chronic fatigue syndrome due to his period of service.
The Board finds that the Veteran does not have a diagnosis, such that service connection would be warranted.
In February 2018, the Veteran was afforded a VA examination.  The examiner determined that the Veteran does not have a diagnosis of chronic fatigue syndrome.  The examiner explained that the Veteran does not meet the criteria for chronic fatigue syndrome.  The examiner further noted that the Veteran has multiple reasons for fatigue, including untreated PTSD, poor sleep, TBI, hypogonadism, sleep apnea, and sedentary lifestyle. 
After review of the record, the Board finds that the evidence weighs against a grant of service connection for the claimed chronic fatigue syndrome.  The medical evidence of record indicates that the Veteran does not have a diagnosis of chronic fatigue syndrome.  The first element of service connection, a current diagnosis, has not been met.  Therefore, service connection is not warranted, and no further analysis is warranted.
The Board recognizes the Veteran’s contention that his claimed chronic fatigue syndrome resulted from his period of service.  Although lay persons are competent to provide opinions on some medical issues, the specific issue of determining the diagnosis and etiology of the Veteran’s claimed chronic fatigue syndrome falls outside the realm of common knowledge of a lay person.  See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011).  In this regard, while the Veteran can competently report observed symptoms of fatigue, any opinion regarding whether he has chronic fatigue syndrome or that it was related to his period of service requires medical expertise that the Veteran has not demonstrated.  See Jandreau v. Nicholson, 492 F. 3d 1372, 1376 (2007).  As such, the Board assigns no probative weight to the Veteran’s assertions that his claimed chronic fatigue syndrome was due to his service.
Finally, in reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, as the evidence weighs against a finding of service connection, this doctrine is not applicable.
2. Service connection for sleep apnea.
The Veteran also asserts that his sleep apnea is due to his period of service.
The Board finds that the record does not establish an in-service incurrence, and therefore, service connection for sleep apnea is not warranted.
A December 2017 VA medical record indicates that the Veteran has a diagnosis of a sleep disorder.  Therefore, the first element of service connection has been met.
The Veteran’s service treatment records do not indicate a diagnosis of, complaint of, or treatment for sleep apnea or sleep impairment during service.  As the second element of service connection has not been met, service connection is not warranted.
The Board recognizes the Veteran’s contention that his sleep apnea resulted from his period of service.  Although lay persons are competent to provide opinions on some medical issues, the specific issue of determining the etiology of the Veteran’s sleep apnea falls outside the realm of common knowledge of a lay person.  See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011).  In this regard, while the Veteran can competently report observed symptoms, any opinion regarding whether his sleep apnea was related to his period of service requires medical expertise that the Veteran has not demonstrated.  See Jandreau v. Nicholson, 492 F. 3d 1372, 1376 (2007).  As such, the Board assigns no probative weight to the Veteran’s assertions that his sleep apnea was due to his service.
For the foregoing reasons, the Board finds that the preponderance of the evidence is against a grant of service connection for sleep apnea.  In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine.
3. Service connection for idiopathic thrombocytopenic purpura.
The Veteran further asserts that his idiopathic thrombocytopenic purpura is due to his period of service.
The Board finds that the evidence of record is insufficient to establish an in-service incurrence, such that service connection for idiopathic thrombocytopenic purpura would be warranted.
Turning to the record of evidence, a December 2010 private medical record establishes a diagnosis of thrombocytopenic purpura.  Therefore, the first element of service connection has been met.
In a December 2012 lay statement, the Veteran asserted that, while in Uzbekistan, he was at K2, which was a former chemical storage site.  The Veteran further asserted that he believed that exposure caused significant health problems, to include a blood disorder that causes excessive bleeding.  He went on to state that he must constantly monitor his body for bruises due to his thrombocytopenic purpura. 
The Veteran’s service treatment records do not indicate a diagnosis of, complaint of, or treatment for symptoms of thrombocytopenic purpura during service.  As the second element of service connection has not been met, service connection on a direct causation theory is not warranted.
The Board recognizes the Veteran’s contention that his thrombocytopenic purpura resulted from his period of service.  Although lay persons are competent to provide opinions on some medical issues, the specific issue of determining the etiology of the Veteran’s thrombocytopenic purpura falls outside the realm of common knowledge of a lay person.  See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011).  In this regard, while the Veteran can competently report observed symptoms, any opinion regarding whether his thrombocytopenic purpura was related to his period of service requires medical expertise that the Veteran has not demonstrated.  See Jandreau v. Nicholson, 492 F. 3d 1372, 1376 (2007).  As such, the Board assigns no probative weight to the Veteran’s assertions that his thrombocytopenic purpura was due to his service.
For the foregoing reasons, the Board finds that the preponderance of the evidence is against a grant of service connection for thrombocytopenic purpura.  In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine.
 
JENNIFER HWA
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	C. Ford, Associate Counsel 

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