Source: https://va-claim.com/2018/12/26/service-connection-for-a-left-elbow-disability-denied-entitlement-to-a-total-rating-based-on-unemployability-due-to-service-connected-disability-tdiu-remanded-citation-nr-18123976/
Timestamp: 2019-04-18 22:53:07+00:00

Document:
Service connection for a left elbow disability is denied.
The issue of entitlement to a total rating based on unemployability due to service-connected disability (TDIU) is remanded.
The Veteran does not have a left elbow disability.
The criteria for service connection for a left elbow disability have not been met.  38 U.S.C. §§ 1110, 1111, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a) (2017).
The Veteran contends that he has a left elbow disability that is related to service.  Specifically, he has indicated that while at Ft. Leonard Wood for basic training, he was involved in a motor vehicle accident in which his elbows were injured.  In August 2013, he stated that his unit was in a truck that was involved in an accident, and that he sustained a broken arm and back injury.
Review of the service treatment records is negative for any diagnosis, complaint, or abnormal finding referable to the Veteran’s left elbow.  Treatment records subsequent to service are also negative for such findings.
On VA examination in March 2015, the Veteran reported having been involved in a motor vehicle accident at Ft. Leonard Wood, sustaining a right arm fracture, as well as right shoulder and low back injuries.  The examiner noted that the left shoulder, elbow, and wrist were within normal limits, without objective evidence supporting a left arm condition.  On physical examination, the left elbow lacked 5 degrees of flexion; however, the examiner indicated that the left arm had normal range of motion.  The examiner also indicated that the range of motion did not contribute to a functional loss, and that there was no pain noted on examination.  The Veteran did not report flare-ups with respect to his left elbow.
Upon review of the record, the Board concludes that the Veteran does not have a left elbow disability and has not had one at any time during the pendency of the claim.  38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d).
In the absence of proof of a current disability, there can be no valid claim for service connection.  Brammer v. Derwinski, 3 Vet. App. 223 (1992); see also Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998) (service connection may not be granted unless a current disability exists).
The Board acknowledges the Veteran’s contention regarding the existence of a left elbow disability; however, there is no competent evidence diagnosing such a disability, to include any functional limitation of the left elbow due to pain.  See Saunders v. Wilkie, 2018 U.S. App. LEXIS 8467 (Fed. Cir. Apr. 3, 2018).
To the extent that the Veteran asserts that he has a left elbow disability, the Board observes that he may attest to factual matters of which he has first-hand knowledge, such as subjective complaints, and that his assertions in that regard are entitled to some probative weight.  See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005).  He is competent to report incidents and symptoms; he is not, however, competent to render an opinion as to whether there is a left elbow disability, because he does not have the requisite medical knowledge or training, and because such matters are beyond the ability of a lay person to observe.
To qualify for compensation under 38 U.S.C. §§ 1110, the Veteran must prove existence of a disability, and one that has resulted from a disease or injury that occurred in the line of duty.  As there is no competent evidence of a left elbow disability, the preponderance of the evidence is against the claim and there is no doubt to be resolved.  Gilbert v. Derwinski, 1 Vet. App. 49 (1990).
The Veteran’s claim for TDIU was denied in August 2013.  Since then, service connection was granted for a stab wound scar in July 2014, a right elbow disability in May 2015, for posttraumatic stress disorder (PTSD) in December 2015, and hypertension and erectile dysfunction in November 2017.
In a January 2016 statement, the Veteran specified that he no longer worked due to his service-connected disabilities, including his PTSD.  He pointed out that the impact of his PTSD had not been previously considered.  He also indicated that he had been seen for many months by a VA provider, who had found that his PTSD symptoms caused major impairment.
As service connection has been granted for various disabilities since the denial of a TDIU, and because the Veteran maintains that his treating VA provider has found major impairment due to his psychiatric symptoms, the Board concludes that updated VA treatment records should be obtained, and that the Veteran should be afforded an examination(s) to determine the impact of his service-connected disabilities on his ability to perform work activities.
1. Obtain any outstanding records of VA treatment.
2. Schedule the Veteran for appropriate VA examination(s) to address the impact of his service-connected disabilities on his ability to perform the physical and mental acts required for employment.
The examiner(s) must elicit from the Veteran his complete history regarding his level of education, any special training, and previous work experience.
All appropriate tests and studies should be accomplished (with all results made available to the examiner prior to the completion of his or her report), and all clinical findings should be reported in detail.
The examiner(s) should discuss the Veteran’s functional limitations due solely to his service-connected disabilities (PTSD, right elbow impingement syndrome, tinnitus, posterior trunk scar, hypertension, and erectile dysfunction), jointly, as they may relate to his ability to function in a work setting and to perform work tasks.  Neither non-service-connected disabilities nor the Veteran’s age may be taken into consideration in this assessment.

References: v. 
 v. 
 v. 
 § 3
 v. 
 v. 
 v. 
 v. 
 v.