Citation Nr: 0309503 Decision Date: 05/21/03 Archive Date: 05/27/03 DOCKET NO. 02-13 907 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUE Entitlement to service connection for primary myelofibrosis. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD A. P. Simpson, Counsel INTRODUCTION The veteran served on active duty from June 1961 to February 1979. He had prior service in the Navy reserve. This case comes before the Board of Veterans' Appeals (the Board) on appeal from a March 2002 rating decision of the Montgomery, Alabama, Department of Veterans Affairs (VA) Regional Office (RO). The RO denied service connection for primary myelofibrosis. In December 2002, the veteran testified at a personal hearing before the undersigned acting Veterans Law Judge. A transcript of that hearing has been associated with the claims file. In March 2003, the case was advanced on the Board's docket under authority provided in 38 U.S.C.A. § 7107 and 38 C.F.R. § 20.900(c). FINDING OF FACT There is competent evidence attributing the diagnosis of primary myelofibrosis to the veteran's service. CONCLUSION OF LAW Primary myelofibrosis was incurred in service. 38 U.S.C.A. §§ 1110, 1131, 5103, 5103A, 5107 (West 2002); 38 C.F.R. § 3.303 (2002). REASONS AND BASES FOR FINDING AND CONCLUSION Although the Veterans Claims Assistance Act of 2000, Pub. L. No. 106-475, 114 Stat. 2096, is applicable to the veteran's claim, the Board finds that it is unnecessary to address its applicability in this case in view of the disposition reached herein. The veteran's service records show that his occupational specialty was that of an aircraft engine mechanic during his military career. In 2000, the veteran was diagnosed with primary myelofibrosis. The veteran asserts that he developed this disease due to Agent Orange exposure while in Vietnam. In an April 2002 letter from a private physician, he stated that the veteran had been diagnosed with primary myelofibrosis, which was a rare blood disease. He noted that very little research had been done regarding this disease and that the specific cause was unknown. The private physician noted that the veteran had been exposed to toxic herbicides while in Vietnam and that primary myelofibrosis was "very similar" to the diseases that are recognized as being caused by herbicide exposure. In December 2002, the veteran testified at a hearing before the undersigned. There, he stated that he was exposed to herbicides while in Vietnam and that he felt reasonable doubt should be resolved in his favor and that service connection for primary myelofibrosis should be granted. He noted that a physician had indicated that primary myelofibrosis was similar to diseases that already had a connection with herbicide exposure. In April 2003, the Board sought a Veterans Health Administration medical opinion, which opinion was received in May 2003. In that opinion, the examiner, an expert in hematology/oncology, indicated he had reviewed the veteran's claims file and reported the relevant facts. He stated that it was unlikely that the veteran's primary myelofibrosis was related to Agent Orange. However, the examiner stated the following, in part: On the other hand, the best-known association, often recognized as causality, is between exposure to benzene and primary myelofibrosis as well as other myeloproliferative disorders. The appellant was possibly exposed to benzene and other organic solvents while working in airplanes and helicopters. This connection between service and his primary myelofibrosis [is] more likely than unlikely. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. § 1110 (West 2002). Service connection may be granted for any disease diagnosed after service when all the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2002). In order for a claimant to prevail in a claim for service connection, there must be (1) competent evidence of a current disability (a medical diagnosis); (2) incurrence or aggravation of a disease or injury in service (lay or medical evidence); and (3) a nexus between the in-service disease or injury and the current disability (medical evidence). Caluza v. Brown, 7 Vet. App. 498, 506 (1995). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Board has carefully reviewed the evidence of record and finds that the evidence supports the grant of service connection for primary myelofibrosis. The evidence of record shows that there is competent evidence of a current disability, here, primary myelofibrosis. The veteran's service records show that he was an aircraft engine mechanic, which would indicate a likelihood that the veteran was exposed to benzene while in service. Finally, there is competent evidence from a hematology/oncology expert, who stated that there was a likely connection between the veteran's diagnosis of primary myelofibrosis and exposure to benzene in service. The Board notes that there is no competent evidence to refute the expert's opinion, which provides a plausible theory to relate the veteran's disability to his military service. The Board finds that the circumstances of the veteran's service and his principal occupational duties were such that it is not resorting to speculation to conclude that he likely had exposure to such solvents on a regular basis. Thus, the veteran has fulfilled the requirements for a grant of service connection for primary myelofibrosis. See Caluza, supra. ORDER Service connection for primary myelofibrosis is granted. ____________________________________________ Mark J. Swiatek Acting Veterans Law Judge, Board of Veterans' Appeals IMPORTANT NOTICE: We have attached a VA Form 4597 that tells you what steps you can take if you disagree with our decision. We are in the process of updating the form to reflect changes in the law effective on December 27, 2001. See the Veterans Education and Benefits Expansion Act of 2001, Pub. L. No. 107-103, 115 Stat. 976 (2001). In the meanwhile, please note these important corrections to the advice in the form: ? These changes apply to the section entitled "Appeal to the United States Court of Appeals for Veterans Claims." (1) A "Notice of Disagreement filed on or after November 18, 1988" is no longer required to appeal to the Court. (2) You are no longer required to file a copy of your Notice of Appeal with VA's General Counsel. ? In the section entitled "Representation before VA," filing a "Notice of Disagreement with respect to the claim on or after November 18, 1988" is no longer a condition for an attorney-at-law or a VA accredited agent to charge you a fee for representing you.