Citation Nr: 0813738 Decision Date: 04/25/08 Archive Date: 05/01/08 DOCKET NO. 05-38 636 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Columbia, South Carolina THE ISSUE Entitlement to service connection for chronic disability residual to military immunizations, including Anthrax. ATTORNEY FOR THE BOARD J. Johnston, Counsel INTRODUCTION The veteran had active military duty from February to May 1987, and from May to July 1990. There was no overseas or combat service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2005 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Columbia, South Carolina. The veteran had requested and was scheduled and notified for the conduct of a Travel Board hearing. At his request, this hearing was rescheduled to March 2008. The veteran did not appear for this hearing, and there is no motion for a new hearing. The case is now ready for appellate review. FINDINGS OF FACT 1. All relevant evidence necessary for a fair and equitable disposition of the issue on appeal has been requested or obtained. 2. The service medical records reveal that the veteran received ordinary immunizations (not including Anthrax), there is no evidence that the veteran had any adverse reaction to any immunization, and the veteran's hospitalization in June 1990 was for treatment of an acute episode of pneumonia which appears to have resolved without identifiable residual. 3. There is a complete absence of any competent clinical evidence or opinion which in any way shows or suggests that the veteran has any chronic disability attributable to immunizations he received during service. CONCLUSION OF LAW Chronic disability attributable to immunizations during service was not incurred or aggravated in active military duty. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1137, 5102, 5103, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.303, 3.309, 3.307 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSION Law and Regulation: VCAA and regulations implementing this liberalizing legislation are applicable to the veteran's claim. VCAA requires VA to notify claimants of the evidence necessary to substantiate their claims, and to make reasonable efforts to assist claimants in obtaining such evidence. The veteran was provided formal VCCA notice with respect to this claim in November 2004, prior to the issuance of the adverse rating decision now on appeal from April 2005. This notice informed him of the evidence necessary to substantiate his claim, the evidence he was responsible to submit, the evidence VA would collect on his behalf, and advised he submit any relevant evidence in his possession. The service medical records were collected for review although, records of his initial period of service from February to May 1987 could not be located, despite several attempts. The veteran specifically has claimed chronic disability from military immunizations which occurred during his second period of service in 1990, and all of these records have been located and included in the claims folder. The veteran was notified on multiple occasions of the RO's attempts to obtain records identified by him as relevant to his claim. At no time during the pendency of this appeal, despite being notified of the evidence necessary to substantiate his claim, has the veteran ever submitted any clinical evidence which in any way demonstrates any chronic disability attributable to military immunizations, or to any other cause. All known available evidence has been collected for review and VCAA is satisfied. 38 U.S.C.A. §§ 5102, 5103, 5103A, 5107; Quartuccio v. Principi, 16 Vet. App. 183 (2002). Service connection may be established for disease or injury incurred or aggravated in line of active military duty. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303. Service connection may also be granted for certain specified diseases which are shown to have become manifest to a compensable degree within one year from the date of service separation. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify a disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings. Continuity of symptomatology is required where the condition noted during service is not shown to be chronic, or when a diagnosis of chronicity may be legitimately questioned. When chronicity in service is not supported, a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b). Analysis: The veteran filed his initial claim for VA disability compensation in October 2004, over 14 years after he was separated from military service in 1990. He reported being hospitalized during service in 1990, with diarrhea, red and watering eyes, gray tinted skin, fever, thick yellow mucus, chills, body aches, chest pain, joint pain, dizziness, nausea, blurred vision, fatigue, weakness, nervousness, anxiety, sweating, "etc." He attributed these symptoms to a severe adverse reaction to immunization vaccines, which included Anthrax. The veteran has subsequently submitted numerous written statements alleging essentially the same fact pattern, but principally attributing all symptoms to a bad batch of Anthrax vaccine. He claims to have chronically manifested these symptoms at all times since this incident in service. The service medical records include the veteran's original International Certificate of Vaccination which documents a series of routine and ordinary vaccinations provided from 16- 18 May 1990. None of these vaccinations was for Anthrax. There is no indication that the veteran had any immediate adverse reaction to any vaccination provided in May 1990. Nearly two weeks later on 30 May 1990, the veteran was seen with complaints of cold symptoms for five days, the assessment was a cold, and he was provided Actifed, Tylenol and cough syrup. On 3 June, the veteran presented for treatment with increased symptoms of a hacking cough, chills, sweats and yellow sputum and the assessment was pneumonia. The veteran was admitted for treatment with five days' bed rest and treatment including antibiotics, inhalers, and nebulizers. Chest X-rays were performed and the assessment was probable infiltrates lingulae. The discharge summary from the Martin Army Hospital at Fort Benning included diagnoses of lingual pneumonia, bronchospasm, a mucocele or retention cyst of one sinus, rule out nasal polyp, and nebulizer therapy. The veteran was discharged, and given a physical profile for light duty for one week. On 15 June, the veteran was seen and noted to have a continued mild rhonchi. He was to continue taking prescribed medication and was cleared for return to duty. There is no indication in the service medical records that the veteran thereafter sought or required treatment for this acute episode of pneumonia at any time throughout the remainder of his short period of service which ended on 26 July 1990. There is, following service separation, a complete absence of any competent clinical evidence or opinion which shows or suggests that the veteran has or manifests the panoply of chronic symptoms of which he has complained in this claim. The Board notes that in his initial formal claim filed in October 2004, the veteran listed no medical treatment of any kind following his hospitalization during service in June 1990. The Board notes that widely publicized events of Anthrax discovered by the US Postal Service and other public officials and Government offices did not occur until 2001. Moreover, the military-wide Anthrax vaccine immunization program was initiated in 1997, with actual inoculations not occurring until 1998. The Board finds that a clear preponderance of the evidence on file is against the veteran's claim that he has any form of chronic disability attributable to any incident, injury, disease, or immunization during service, manifested by the panoply of symptoms which he has routinely described in writing. The veteran is shown to have received routine immunizations during service in May 1990, but there is a complete absence of any objective medical evidence which shows or suggests that he had any adverse reactions or incurred any chronic disability from any of these immunizations. There is no evidence that he was immunized for Anthrax during military service. The veteran is shown to have had an acute episode of pneumonia commencing some time after these immunizations were performed during service for which he was hospitalized and treated. There are significant records available from this hospitalization and they contain no mention of any form of adverse reaction to military immunizations, but consistently note infiltrates in the lungs with the ordinary signs and symptoms of an acute episode of pneumonia. This was treated and resolved prior to the veteran's separation from service without any identifiable residual following the veteran's release from the hospital at any time for the remainder of his military service through July 1990, and at any time thereafter. Although the veteran is certainly competent to provide a subjective description of symptoms that he believes that he experiences, he certainly lacks the requisite medical expertise to provide any form of competent clinical opinion that these symptoms are attributable to military immunizations which took place well over 14 years before he filed his claim for VA compensation in 2004. See Espiritu v. Derwinski, 2 Vet. App. 492, 494-495 (1992). The Board considered referring this issue for VA examination with a review of the claims folder and a request for opinions consistent with VCAA at 38 U.S.C.A. § 5103A(d). However, in the complete absence of any competent medical or other objective evidence which shows or suggests that the veteran has a form of chronic disease consistent with those alleged in his written statements, or any other form of chronic residuals attributable to incidents of service, including immunizations, there is simply no duty to order and obtain such examination. There is, in fact, a complete absence of any competent medical evidence of any chronic disability of any kind on file. ORDER Entitlement to service connection for chronic disability attributable to military immunizations is denied. ____________________________________________ F. JUDGE FLOWERS Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs