Citation Nr: 0422742 Decision Date: 08/18/04 Archive Date: 08/24/04 DOCKET NO. 02-07 583 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Reno, Nevada THE ISSUES 1. Entitlement to service connection for a pulmonary disorder due to the use of tobacco products. 2. Entitlement to service connection for asbestosis. 3. Entitlement to service connection for other pulmonary disorders, including chronic obstructive pulmonary disease, asthma, bronchitis, and emphysema. 4. Entitlement to service connection for a constricted larynx. 5. Entitlement to compensation under 38 U.S.C.A. § 1151 (West 2002) for additional disability following a stress test at a VA medical facility in June 1983. REPRESENTATION Appellant represented by: The American Legion WITNESSES AT HEARINGS ON APPEAL Appellant and his wife ATTORNEY FOR THE BOARD N. T. Werner, Counsel INTRODUCTION The veteran served on active duty from July 1943 to April 1946. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2000 decision of the Reno, Nevada, Regional Office (RO) of the Department of Veterans Affairs (VA) which denied entitlement to service connection for a pulmonary disorder due to the use of tobacco products, entitlement to service connection for asbestosis, entitlement to service connection for other pulmonary disorders including chronic obstructive pulmonary disease, asthma, bronchitis, and emphysema as well as entitlement to service connection for a constricted larynx. In June 2002, the veteran testified at a personal hearing before a Decision Review Officer. In May 2003, the Board remanded the appeal to the RO to provide the veteran with a hearing before a Veterans Law Judge. Thereafter, the veteran perfected an appeal to an October 2002 RO decision that denied compensation under 38 U.S.C.A. § 1151 for additional disability due to a myocardial infarction following a stress test at a VA medical facility in June 1983. In January 2004, the veteran and his wife testified at a hearing before the undersigned sitting at the RO. The appeal is REMANDED, in part, to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify you if further action is required on your part. FINDING OF FACT The veteran filed his claim of entitlement to service connection for a pulmonary disorder due to the use of tobacco products in November 1999. CONCLUSION OF LAW The claim of entitlement to service connection for a pulmonary disorder due to the use of tobacco products is legally insufficient. 38 U.S.C.A. §§ 1103, 1110, 5103, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.300, 3.303, 3.307, 3.309, 3.312 (2003). REASONS AND BASES FOR FINDING AND CONCLUSION The Board notes that a review of the record on appeal shows that the veteran, in November 1999, filed his initial claim of entitlement to service connection for a pulmonary disorder. Thereafter, the veteran and/or his representative argued, in substance, that smoking that began while the veteran was in military service caused current pulmonary disorders. Accordingly, the claim was thereafter interpreted by the RO and the Board as including a claim for pulmonary disorders caused by the use of tobacco products. In this regard, the Board notes that on July 22, 1998, the Internal Revenue Service Restructuring and Reform Act was enacted. See Pub. L. No. 105-206, 112 Stat. 865 (1998). That law added 38 U.S.C.A. § 1103, which prohibits service connection for disability or death on the basis that it resulted from disease or injury attributable to the use of tobacco products during a veteran's active service. By its terms, 38 U.S.C.A. § 1103 is applicable to all claims filed after June 9, 1998. See also 38 C.F.R. § 3.300 (2003). In this case, the veteran filed his claim in November 1999. See November 1999 statement in support of claim. Accordingly, the claim entitlement to service connection for a pulmonary disorder due to the use of tobacco products is precluded as a matter of law and must be denied. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (where the law and not the evidence is dispositive, the Board should deny the claim on the ground of lack of legal merit). (Parenthetically, the Board notes that, while VAOPGCPREC 6- 2003 (October 28, 2003) provides an exception to the above bar to post June 9, 1998, claims based on tobacco use, this exception is not applicable to the veteran's appeal because neither the veteran nor his representative allege, nor does the record show, that the veteran's post-service use of tobacco products was caused by his only service connected disability - hypertrophied tonsils status post tonsillectomy.) As to the Veterans Claims Assistance Act of 2000, Pub. L. No. 106-475, 114 Stat. 2096 (2000), as reported above, the claim was denied because the veteran did not meet the statutory threshold for filing a claim of entitlement to service connection on the basis of tobacco use in service - a claim filed before June 9, 1998. 38 U.S.C.A. § 1104; 38 C.F.R. § 3.300. Therefore, because the decision is mandated by a failure to meet a basic prerequisite, the Board may go forward with adjudication of the claim regardless of whether or not the record shows adequate notice and assistance as required by the Veterans Claims Assistance Act of 2000. See 38 U.S.C.A. §§ 5103, 5103A (West 2002); Mason v. Principi, 16 Vet. App. 129, 132 (2002). Further discussion of the VCAA is not required. ORDER Service connection for a pulmonary disorder due to the use of tobacco products is denied. REMAND As to entitlement to service connection for various pulmonary disorders due to asbestosis, and a constricted larynx, the veteran and his representative claim that they were caused by the veteran inhaling asbestos as well as other toxic chemicals while serving on Naval vessels as a gunners mate. Specifically, it is alleged the veteran was exposed to these chemicals through the asbestos gloves he wore to clean up hot shell casings, from breathing air below deck via air ducts that admitted particles, and by the work he did decommissioning two Naval ships. As to the § 1151 claim, the veteran and his representative contend that the appellant's June 1983 stress test was improperly conducted and caused a myocardial infarction. It is also requested that the veteran be afforded the benefit of the doubt. Initially, the Board notes that the Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096 (2000) requires that VA provide a medical examination or, obtain a medical opinion, when such an examination or opinion is necessary to make a decision on the claim. 38 U.S.C.A. § 5103A(d) (West 2002). Next, the Board notes that the record on appeal contains voluminous VA treatment records that show the veteran's complaints, diagnoses, and/or treatment for various pulmonary disorders diagnosed as, among other things, chronic obstructive pulmonary disease, asthma, bronchitis, and/or emphysema. Nonetheless, a remand is required because these records do not contain credible medical opinion evidence as to the following: an opinion as to whether the veteran has current x-ray evidence of asbestosis (see VA Adjudication Procedure Manual (M21-1), Part VI, par. 7.21(c) (a clinical diagnosis of asbestosis requires a history of exposure and radiographic evidence of parenchymal lung disease)); an opinion as to the origins or etiology of asbestosis taking into account both his in-service and post-service job history (id.); an opinion as to the origins or etiology of all other pulmonary disorders; an opinion as to whether the veteran has a chronic constricted larynx due to military service; and, because the claim was filed on or after October 1, 1997, an opinion as to whether the veteran had additional disability, including a myocardial infarction, following his June 1983 stress test caused by VA negligence or an unforeseen event (see Pub. L. No. 104-204, § 422(a), 110 Stat. 2926 (1996); See also VAOPGCPREC 40-97; 63 Fed. Reg. 31263 (1998)). As to the veteran's claim for a pulmonary disorder due to asbestos exposure, the Board notes that the M21-1 requires that the RO undertake the following development: (1) determine whether military records demonstrate evidence of asbestos exposure in service (see M21-1, Part III, par. 5.13(b); M21-1, Part VI, par. 7.21(d)(1)); (2) determine whether there was pre-service and/or post-service evidence of occupational or other asbestos exposure (Id.); and (3) determine if there was a relationship between asbestos exposure and the currently claimed disease, keeping in mind the latency and exposure information found at M21-1, Part III, par. 5.13(a) (see M21-1, Part VI, par. 7.21(d)(1)). As to all the issues on appeal, the Board notes that the VCAA requires VA to notify the claimant and his representative of any information, and any medical or lay evidence, not previously provided to the Secretary, that is necessary to substantiate the claim. See 38 U.S.C.A. § 5103 (West 2002); 38 C.F.R. § 3.159(b) (2003). Specifically, VA is to: (1) notify the claimant of the information and evidence not of record that is necessary to substantiate the claim; (2) notify him of the information and evidence that VA will seek to provide; (3) notify him of the information and evidence the claimant is expected to provide; and (4) tell the claimant to provide any evidence in his possession that pertains to the claim. 38 U.S.C.A. §§ 5100, 5103 (West 2002); 38 C.F.R. § 3.159 (2003). Therefore, while the RO made a good start in undertaking the necessary asbestos development and providing the veteran with the requisite VCAA notice in its April 2001, February 2002, February 2002, and May 2003 letters as well as the August 2002, October 2002, and January 2004 supplemental statements of the case, and the July 2003 statement of the case, on remand, they should continue to do so. Lastly, the Board notes that the VCAA requires VA to obtain and associate with the record all adequately identified records. See 38 U.S.C.A. § 5103A(b) (West 2002). In this regard, the veteran testified that he helped in the decommissioning of two Naval vessels (i.e., the USS Welles (DD628) and USS Boyle (DD600)) which work led to his exposure to asbestos while disassembling the armament on these ships as well as exposure to other chemical that were sprayed on the ships to help seal them. Moreover, service personnel records show that the veteran served aboard the USS Welles from July 1944 to February 1946 and aboard the USS Boyle from February 1946 to March 1946. The veteran's service personnel records also note he was a gunners mate. Moreover, M21-1, Part VI, par. 7.21(b)(1) (October 3, 1997) (hereinafter M21- 1) includes in its non-exclusive list of occupations that have higher incidents of asbestos exposure shipyard work. Therefore, a remand is also required for VA to verify the nature of the veteran's shipboard duties and to verify if the veteran served on the ships at the time of their decommissioning. Similarly, while the veteran testified that chest x-rays in the 1950's in connection a life insurance examination from Prudential showed scarring, VA has not as yet provided the veteran help in obtaining these records. Likewise, while the veteran notified VA on a number of occasions that he received all of his medical care from VA, a review of the record on appeal fails to disclose any medical records from the years shortly after his April 1946 separation from military service - the medical evidence found in the claims file begins in the mid 1980's. The veteran also testified that he received ongoing treatment for his pulmonary disorders at either the Las Vegas or Hines VA medical centers which records have not as yet been associated with the claims file. Furthermore, while the veteran's post-service work history is crucial to his claim of entitlement to service connection for asbestosis (see M21-1, Part VI, par. 7.21(c)), the record does not contain documentation of his post-service work history or request for records from these employers. Therefore, on remand, the RO should obtain and associate with the record the above evidence. Therefore, these issues are REMANDED for the following action: 1. The RO must review the claim's file and ensure that all M21-1 development obligations and VCAA notice obligations have been satisfied in accordance with M21-1, Part VI, par. 7.21(a), (b), (c), (d)(1), and (d)(3) (October 3, 1997); M21-1, Part III, par. 5.13(b) (April 30, 1999); the decision in Quartuccio; 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A; 38 C.F.R. § 3.159; the Veterans Benefits Act of 2003; and any other applicable legal precedent. As to the M21-1 development, such development includes, but is not limited to, the following actions: (1) determining whether military records demonstrate evidence of asbestos exposure in service; (2) determining whether there was pre-service and/or post-service evidence of occupational or other asbestos exposure; and (3) determining if there is a relationship between asbestos exposure and the currently claimed disease, keeping in mind the latency and exposure information found at M21-1, Part III, par. 5.13(a). As to the VCAA notice, such notification includes, but is not limited to, notifying the veteran of the specific evidence needed to substantiate the claims of entitlement to service connection for asbestosis, other pulmonary disorders including chronic obstructive pulmonary disease, asthma, bronchitis, and emphysema as well as entitlement to service connection for a constricted larynx and § 1151 benefits. The letter must: (1) notify the claimant of the information and evidence not of record that is necessary to substantiate the claims; (2) notify him of the information and evidence that VA will seek to provide; (3) notify him of the information and evidence the claimant is expected to provide; and (4) request he provide all pertinent evidence in his possession that has yet to be submitted to VA. 2. The RO should contact the National Personnel Records Center and request a copy of the veteran's complete service personnel record, including a statement of the duties performed by someone with his occupational specialty. 3. The RO should contact the Navy and, after obtaining the dates of decommissioning for the USS Welles (DD628) and USS Boyle (DD600), obtain the deck logs for this time period in order to verify that the veteran served on these ships during this time. 4. The RO, after obtaining an authorization from the veteran, should contact Prudential and request a copy of the life insurance examination conducted in the 1950's, including a copy of the chest x-ray report. If any of the requested records are not available, or if the search for any such records otherwise yields negative results, that fact should clearly be documented in the claims file, and the veteran notified in writing. 5. The RO should contact the veteran and ask him to identify the name, address, and approximate (beginning and ending) dates of all employers he worked for since his separation from military service in April 1946 and the nature of his duties at each of those jobs. The veteran should also be asked in any of the above employers have any records that would be relevant to his current claims. Thereafter, after obtaining any necessary authorization(s), the RO should request all identified records. If any of the requested records are not available, or if the search for any such records otherwise yields negative results, that fact should clearly be documented in the claims file, and the veteran notified in writing. 6. The RO should contact the veteran and ask him to identify the name, address, and approximate (beginning and ending) dates of all VA and non-VA health care providers that treated him for pulmonary disorders and/or a constricted larynx for the time period from his April 1946 separation from military service to the mid 1980's and residuals of a the stress test since June 1983. The RO should inform the veteran that VA will make efforts to obtain relevant evidence, such as VA and non-VA medical records, employment records, or records from government agencies, if he identifies the custodians thereof. Obtain all records identified by the veteran that have not already been associated with the claims file, including all yet to be obtained contemporaneous treatment records of his from the Las Vegas and Hines VA medical centers. The aid of the veteran in securing all identified records, to include providing necessary authorization(s), should be enlisted, as needed. If any of the requested records are not available, or if the search for any such records otherwise yields negative results, that fact should clearly be documented in the claims file, and the veteran notified in writing. 7. After associating with the record all evidence obtained in connection with the above development (to the extent possible), the RO should make arrangements with the appropriate VA medical facility for the veteran to be afforded a pulmonary examination. The claims file should be made available to the examiner. All necessary testing, including chest x-rays and a pulmonary function test, should be conducted as needed. Based on a review of the claims folder and the examination of the veteran, the examiner should provide answers to the following questions: a. Asbestosis: i. Is there current x-ray evidence of asbestosis? See M21-1, Part VI, par. 7.21(c) (a clinical diagnosis of asbestosis requires a history of exposure and radiographic evidence of parenchymal lung disease. ii. If so, is it as least as likely as not that currently diagnosed asbestosis was incurred during military service? b. Other Pulmonary Disorders: i. Is there current evidence of chronic obstructive pulmonary disease, asthma, bronchitis, and/or emphysema? ii. If so, is it as least as likely as not that any of the currently diagnosed pulmonary disorders were incurred in or aggravated by military service? Note 1: In answering the above questions, the examiner should comment on the veteran's in-service and post-service work histories, the two normal in-service chest x-rays, the post-service x-rays, and the December 2003 opinion provided by Dr. Michael D. Schlachter. 8. After associating with the record all evidence obtained in connection with the above development (to the extent possible), the RO should make arrangements with the appropriate VA medical facility for the veteran to be afforded an ears, nose, and throat examination. The claims file should be made available to the examiner. All necessary testing should be conducted. Based on a review of the claims folder and the examination of the veteran, the examiner should provide answers to the following question: a. Constricted Larynx: i. Is there current evidence of a chronic constricted larynx? ii. If so, is it as least as likely as not that it was incurred in or aggravated by military service? 9. After associating with the record all evidence obtained in connection with the above development (to the extent possible), the RO should make arrangements with the appropriate VA medical facility for the veteran's claims file to be reviewed by a cardiologist. Based on a review of the claims folder, the examiner should provide answers to the following questions: i. Did the veteran have a myocardial infarction following the June 1983 stress test? ii. Did the veteran have any other additional disability as a result of the June 1983 stress test? iii. If so, was the myocardial infarction or other additional disability caused by VA negligence or an unforeseen event? 10. After the development requested above has been completed, the RO should review the examination report and opinion to ensure that they are in complete compliance with the directives of this REMAND. If they are deficient in any manner, the RO must implement corrective procedures at once. 11. Thereafter, following any other appropriate development, the RO should readjudicate the appealed issues. If any of the benefits sought on appeal remain denied, he and his representative should be provided a supplemental statement of the case which includes a summary of all evidence submitted in connection with the claims, applicable laws and regulations, and the reasons for the decision. They should then be afforded an applicable time to respond. The veteran has the right to submit additional evidence and argument on the matter or matters the Board has remanded to the regional office. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment by the RO. The law requires that all claims that are remanded by the Board or by the Court for additional development or other appropriate action must be handled in an expeditious manner. See The Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 302, 108 Stat. 4645, 4658 (1994), 38 U.S.C.A. § 5101 (West 2002) (Historical and Statutory Notes). In addition, VBA's Adjudication Procedure Manual, M21-1, Part IV, directs the ROs to provide expeditious handling of all cases that have been remanded by the Board and the Court. See M21-1, Part IV, paras. 8.43 and 38.02. ______________________________________________ LAWRENCE M. SULLIVAN Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs YOUR RIGHTS TO APPEAL OUR DECISION The attached decision by the Board of Veterans' Appeals (BVA or Board) is the final decision for all issues addressed in the "Order" section of the decision. The Board may also choose to remand an issue or issues to the local VA office for additional development. If the Board did this in your case, then a "Remand" section follows the "Order." However, you cannot appeal an issue remanded to the local VA office because a remand is not a final decision. The advice below on how to appeal a claim applies only to issues that were allowed, denied, or dismissed in the "Order." If you are satisfied with the outcome of your appeal, you do not need to do anything. We will return your file to your local VA office to implement the BVA's decision. However, if you are not satisfied with the Board's decision on any or all of the issues allowed, denied, or dismissed, you have the following options, which are listed in no particular order of importance: ? Appeal to the United States Court of Appeals for Veterans Claims (Court) ? File with the Board a motion for reconsideration of this decision ? File with the Board a motion to vacate this decision ? File with the Board a motion for revision of this decision based on clear and unmistakable error. Although it would not affect this BVA decision, you may choose to also: ? Reopen your claim at the local VA office by submitting new and material evidence. There is no time limit for filing a motion for reconsideration, a motion to vacate, or a motion for revision based on clear and unmistakable error with the Board, or a claim to reopen at the local VA office. None of these things is mutually exclusive - you can do all five things at the same time if you wish. However, if you file a Notice of Appeal with the Court and a motion with the Board at the same time, this may delay your case because of jurisdictional conflicts. If you file a Notice of Appeal with the Court before you file a motion with the BVA, the BVA will not be able to consider your motion without the Court's permission. How long do I have to start my appeal to the Court? You have 120 days from the date this decision was mailed to you (as shown on the first page of this decision) to file a Notice of Appeal with the United States Court of Appeals for Veterans Claims. If you also want to file a motion for reconsideration or a motion to vacate, you will still have time to appeal to the Court. As long as you file your motion(s) with the Board within 120 days of the date this decision was mailed to you, you will then have another 120 days from the date the BVA decides the motion for reconsideration or the motion to vacate to appeal to the Court. You should know that even if you have a representative, as discussed below, it is your responsibility to make sure that your appeal to Court is filed on time. How do I appeal to the United States Court of Appeals for Veterans Claims? Send your Notice of Appeal to the Court at: Clerk, U.S. Court of Appeals for Veterans Claims 625 Indiana Avenue, NW, Suite 900 Washington, DC 20004-2950 You can get information about the Notice of Appeal, the procedure for filing a Notice of Appeal, the filing fee (or a motion to waive the filing fee if payment would cause financial hardship), and other matters covered by the Court's rules directly from the Court. You can also get this information from the Court's web site on the Internet at www.vetapp.uscourts.gov, and you can download forms directly from that website. The Court's facsimile number is (202) 501-5848. To ensure full protection of your right of appeal to the Court, you must file your Notice of Appeal with the Court, not with the Board, or any other VA office. How do I file a motion for reconsideration? You can file a motion asking the BVA to reconsider any part of this decision by writing a letter to the BVA stating why you believe that the BVA committed an obvious error of fact or law in this decision, or stating that new and material military service records have been discovered that apply to your appeal. If the BVA has decided more than one issue, be sure to tell us which issue(s) you want reconsidered. Send your letter to: Director, Management and Administration (014) Board of Veterans' Appeals 810 Vermont Avenue, NW Washington, DC 20420 VA FORM JUN 2003 (RS) 4597 Page 1 CONTINUED Remember, the Board places no time limit on filing a motion for reconsideration, and you can do this at any time. However, if you also plan to appeal this decision to the Court, you must file your motion within 120 days from the date of this decision. How do I file a motion to vacate? You can file a motion asking the BVA to vacate any part of this decision by writing a letter to the BVA stating why you believe you were denied due process of law during your appeal. For example, you were denied your right to representation through action or inaction by VA personnel, you were not provided a Statement of the Case or Supplemental Statement of the Case, or you did not get a personal hearing that you requested. You can also file a motion to vacate any part of this decision on the basis that the Board allowed benefits based on false or fraudulent evidence. Send this motion to the address above for the Director, Management and Administration, at the Board. Remember, the Board places no time limit on filing a motion to vacate, and you can do this at any time. However, if you also plan to appeal this decision to the Court, you must file your motion within 120 days from the date of this decision. How do I file a motion to revise the Board's decision on the basis of clear and unmistakable error? You can file a motion asking that the Board revise this decision if you believe that the decision is based on "clear and unmistakable error" (CUE). Send this motion to the address above for the Director, Management and Administration, at the Board. You should be careful when preparing such a motion because it must meet specific requirements, and the Board will not review a final decision on this basis more than once. You should carefully review the Board's Rules of Practice on CUE, 38 C.F.R. 20.1400 -- 20.1411, and seek help from a qualified representative before filing such a motion. See discussion on representation below. Remember, the Board places no time limit on filing a CUE review motion, and you can do this at any time. How do I reopen my claim? You can ask your local VA office to reopen your claim by simply sending them a statement indicating that you want to reopen your claim. However, to be successful in reopening your claim, you must submit new and material evidence to that office. See 38 C.F.R. 3.156(a). Can someone represent me in my appeal? Yes. You can always represent yourself in any claim before VA, including the BVA, but you can also appoint someone to represent you. An accredited representative of a recognized service organization may represent you free of charge. VA approves these organizations to help veterans, service members, and dependents prepare their claims and present them to VA. An accredited representative works for the service organization and knows how to prepare and present claims. You can find a listing of these organizations on the Internet at: www.va.gov/vso. You can also choose to be represented by a private attorney or by an "agent." (An agent is a person who is not a lawyer, but is specially accredited by VA.) If you want someone to represent you before the Court, rather than before VA, then you can get information on how to do so by writing directly to the Court. Upon request, the Court will provide you with a state-by-state listing of persons admitted to practice before the Court who have indicated their availability to represent appellants. This information is also provided on the Court's website at www.vetapp.uscourts.gov. Do I have to pay an attorney or agent to represent me? Except for a claim involving a home or small business VA loan under Chapter 37 of title 38, United States Code, attorneys or agents cannot charge you a fee or accept payment for services they provide before the date BVA makes a final decision on your appeal. If you hire an attorney or accredited agent within 1 year of a final BVA decision, then the attorney or agent is allowed to charge you a fee for representing you before VA in most situations. An attorney can also charge you for representing you before the Court. VA cannot pay fees of attorneys or agents. Fee for VA home and small business loan cases: An attorney or agent may charge you a reasonable fee for services involving a VA home loan or small business loan. For more information, read section 5904, title 38, United States Code. In all cases, a copy of any fee agreement between you and an attorney or accredited agent must be sent to: Office of the Senior Deputy Vice Chairman (012) Board of Veterans' Appeals 810 Vermont Avenue, NW Washington, DC 20420 The Board may decide, on its own, to review a fee agreement for reasonableness, or you or your attorney or agent can file a motion asking the Board to do so. Send such a motion to the address above for the Office of the Senior Deputy Vice Chairman at the Board. VA FORM JUN 2003 (RS) 4597 Page 2