Citation Nr: 0910646 Decision Date: 03/23/09 Archive Date: 04/01/09 DOCKET NO. 05-38 088 ) DATE ) ) ) On appeal from the Department of Veterans Affairs Regional Office in Los Angeles, California THE ISSUES 1. Entitlement to service connection for psoriasis. 2. Entitlement to service connection for a liver disorder. 3. Entitlement to service connection for hepatitis C. 4. Entitlement to service connection for a thyroid nodule. 5. Entitlement to service connection for residuals of asbestos exposure. 6. Entitlement to service connection for residuals of exposure to ionizing radiation. 7. Entitlement to service connection for residuals of herbicide exposure. 8. Entitlement to service connection for prostate cancer. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD F. Yankey, Associate Counsel INTRODUCTION The Veteran served on active duty from January 1971 to January 1973. This case comes before the Board of Veterans' Appeals (Board) on appeal of a July 2004 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in San Diego, California, and a March 2005 rating decision of the VA RO in Los Angeles, California. In January 2009, the Veteran failed to appear for a Travel Board hearing. He has not requested that the hearing be rescheduled. Therefore, his request for a hearing is considered withdrawn. See 38 C.F.R. § 20.702 (e) (2008). FINDINGS OF FACT 1. Psoriasis was not present in service and is not etiologically related to service. 2. A liver disorder was not present in service or until years thereafter, and the Veteran's current liver disorder is not etiologically related to service. 3. Hepatitis C was not present in service and is not etiologically related to service. 4. A thyroid nodule was not present in service and is not etiologically related to service. 5. Exposure to asbestos, in and of itself, is not a disability for VA compensation purposes. 6. The Veteran was not exposed to asbestos. 7. Exposure to ionizing radiation, in and of itself, is not a disability for VA compensation purposes. 8. The Veteran did not participate in a radiation-risk activity. 9. The Veteran is not a radiation-exposed Veteran. 10. Herbicide exposure, in and of itself, is not a disability for VA compensation purposes. 11. The Veteran was not exposed to herbicides. 12. Prostate cancer was not present in service and is not etiologically related to service. CONCLUSIONS OF LAW 1. Psoriasis was not incurred or aggravated during active duty, and its incurrence or aggravation during such service may not be presumed. 38 U.S.C.A. §§ 1101, 1110, 1112, (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2008). 2. A liver disorder was not incurred or aggravated during active duty, and its incurrence or aggravation during such service may not be presumed. 38 U.S.C.A. §§ 1101, 1110, 1112, (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2008). 3. Hepatitis C was not incurred or aggravated during active duty. 38 U.S.C.A. 1110 (West 2002); 38 C.F.R. § 3.303 (2008). 4. A thyroid nodule was not incurred or aggravated during active duty, and its incurrence or aggravation during such service may not be presumed. 38 U.S.C.A. §§ 1101, 1110, 1112, (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2008). 5. The criteria for service connection for residuals of asbestos exposure are not met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1131, 1137 (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2008). 6. The criteria for service connection for residuals of exposure to ionizing radiation are not met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1131, 1137 (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2008). 7. The criteria for service connection for residuals of herbicide exposure are not met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1131, 1137 (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2008). 8. Prostate cancer was not incurred or aggravated during active duty, and its incurrence or aggravation during such service may not be presumed. 38 U.S.C.A. §§ 1101, 1110, 1112, (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2008). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Legal Criteria Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. § 1110 (West 2002). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as opposed to merely isolated findings or a diagnosis including the word "chronic." When the fact of chronicity in service (or during any applicable presumptive period) is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b). Service connection may be granted for any disease initially diagnosed after service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without medical evidence of a current disability, medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and medical evidence of a nexus between the claimed in-service disease or injury and the present disease or injury. See Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff'd, 78 F.3d 604 (Fed. Cir. 1996) (table). Where a Veteran served for at least 90 days during a period of war and manifests cirrhosis of the liver to a degree of 10 percent within one year from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service. 38 U.S.C.A. §§ 1101, 1112 (West 2002); 38 C.F.R. §§ 3.307, 3.309 (2008). 38 U.S.C.A. § 1116(a) (West 2002) provides presumptive service connection on the basis of herbicide exposure for specified diseases manifested to a degree of 10 percent within a specified period in a Veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975. It also provides presumptive service connection on the basis of herbicide exposure for each additional disease that the Secretary determines in regulations prescribed under this section warrants a presumption of service-connection by reason of having a positive association with exposure to an herbicide agent, and that becomes manifest within the period (if any) prescribed in such regulations in a Veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975. Whenever the Secretary determines, on the basis of sound medical and scientific evidence, that a positive association exists between (A) the exposure of humans to an herbicide agent, and (B) the occurrence of a disease in humans, the Secretary shall prescribe regulations providing that a presumption of service connection is warranted for that disease for the purposes of this section. 38 U.S.C.A. § 1116(b)(1). In making determinations for the purpose of this subsection, the Secretary shall take into account (A) reports received by the Secretary from the National Academy of Sciences under section 3 of the Agent Orange Act of 1991, and (B) all other sound medical and scientific information and analyses available to the Secretary. In evaluating any study for the purpose of making such determinations, the Secretary shall take into consideration whether the results are statistically significant, are capable of replication, and withstand peer review. 38 U.S.C.A. § 1116(b)(2). An association between the occurrence of a disease in humans and exposure to an herbicide agent shall be considered to be positive for the purposes of this section if the credible evidence for the association is equal to or outweighs the credible evidence against the association. 38 U.S.C.A. § 1116(b)(3). A "radiation-exposed Veteran" is defined as a Veteran who while serving on active duty or on active duty for training or inactive duty training, participated in a radiation-risk activity. "Radiation-risk activity" is defined to mean onsite participation in a test involving the atmospheric detonation of a nuclear device; the occupation of Hiroshima, Japan or Nagasaki, Japan by United States forces during the period beginning on August 6, 1945, and ending on July 1, 1946; or internment as a prisoner of war (or service on active duty in Japan immediately following such internment) during World War II which resulted in an opportunity for exposure to ionizing radiation comparable to that of the United States occupational forces in Hiroshima or Nagasaki during the period from August 6, 1945 through July 1, 1946. 38 C.F.R. § 3.309(d) (2008). Diseases subject to presumptive service connection based on participation in a "radiation-risk activity" are the following: (i) leukemia (other than chronic lymphocytic leukemia); (ii) cancer of the thyroid; (iii) cancer of the breast; (iv) cancer of the pharynx; (v) cancer of the esophagus; (vi) cancer of the stomach; (vii) cancer of the small intestine; (viii) cancer of the pancreas; (ix) multiple myeloma; (x) lymphomas (except Hodgkin's disease); (xi) cancer of the bile ducts; (xii) cancer of the gall bladder; (xiii) primary liver cancer (except if cirrhosis or hepatitis B is indicated); (xiv) cancer of the salivary gland; (xv) cancer of the urinary tract; (xvi) Bronchiolo-alveolar carcinoma; (xvii) Cancer of the bone; (xviii) Cancer of the brain; (xix) Cancer of the colon; (xx) Cancer of the lung; and (xxi) Cancer of the ovary. 38 C.F.R. § 3.309(d)(2) (2008). Other "radiogenic" diseases, such as any form of cancer listed under 38 C.F.R. § 3.311(b)(2), found five years or more after service in an ionizing radiation-exposed Veteran may also be service-connected if the VA Under Secretary for Benefits determines that they are related to ionizing radiation exposure while in service, or if they are otherwise linked medically to ionizing radiation exposure while in service. Other claimed diseases may be considered radiogenic if the claimant has cited or submitted competent scientific or medical evidence that supports that finding. 38 C.F.R. § 3.311(b)(4). When it has been determined that: (1) a Veteran has been exposed to ionizing radiation as a result of participation in the atmospheric testing of nuclear weapons; (2) the Veteran subsequently develops a specified radiogenic disease; and (3) the disease first becomes manifest 5 years or more after exposure, the claim will be referred to the Under Secretary for Benefits for further consideration in accordance with 38 C.F.R. § 3.311(c). When such a claim is forwarded for review, the Under Secretary for Benefits shall consider the claim with reference to 38 C.F.R. § 3.311(e) and may request an advisory medical opinion from the Under Secretary of Health. 38 C.F.R. §§ 3.311(b), (c)(1). The medical adviser must determine whether sound scientific and medical evidence supports a conclusion that it is "at least as likely as not" that the disease resulted from in-service radiation exposure or whether there is "no reasonable possibility" that the disease resulted from in- service radiation exposure. 38 C.F.R. § 3.311(c)(1). Notwithstanding the above, the United States Court of Appeals for the Federal Circuit (Federal Circuit) has held that when a Veteran is found not to be entitled to a regulatory presumption of service connection for a given disability the claim must nevertheless be reviewed to determine whether service connection can be established on a direct basis. See Combee v. Brown, 34 F.3d 1039, 1043-1044 (Fed.Cir.1994), reversing in part Combee v. Principi, 4 Vet. App. 78 (1993). Thus, the Board must not only determine whether the Veteran had a disability which is recognized by VA as being etiologically related to exposure to ionizing radiation, but must also determine whether his disability was otherwise the result of active service. In other words, the fact that the Veteran may not meet the requirements for service connection on a presumptive basis does not in and of itself preclude the establishment of service connection, as entitlement may alternatively be established on a direct basis. There is no specific statutory guidance with regard to asbestos-related claims, nor has the Secretary promulgated any regulations in regard to such claims. However, VA issued a circular on asbestos-related diseases -- DVB Circular 21- 88-8, Asbestos-Related Diseases (May 11, 1988) (DVB Circular) - that provided guidelines for considering compensation claims based on exposure to asbestos. The information and instructions from the DVB Circular were included in a VA Adjudication Procedure Manual, M21-1 (M21- 1), Part VI, 7.21. This manual is being revised, and the provisions concerning adjudication of claims for service connection for disabilities resulting from exposure to asbestos are now found at M21-1MR IV.ii.2.C.9. The Court has held that VA must analyze an appellant's claim to entitlement to service connection for asbestosis or asbestos-related disabilities under the administrative protocols under these guidelines. See Ennis v. Brown, 4 Vet. App, 523, 527 (1993); McGinty v. Brown, 4 Vet. App. 428, 432 (1993). VA Manual M-21-1, Part VI, para. 7.21 (October 3, 1997) provided that inhalation of asbestos fibers can produce fibrosis and tumor, most commonly interstitial pulmonary fibrosis (asbestosis). The guidelines provided that the latency period for asbestos-related diseases varies from 10- 45 years or more between first exposure and development of disease. M21-1, part VI, para. 7.21(b)(1) and (2). It is noted that an asbestos- related disease can develop from brief exposure to asbestos or as a bystander. Occupations involving asbestos exposure include mining and milling, shipyard and insulation work, demolition of old buildings, construction, manufacture and servicing of friction products such as clutch facings and brake linings, manufacture and installation of roofing and flooring materials, asbestos cement sheet and pipe products, etc. High exposure to asbestos and a high prevalence of disease have been noted in insulation and shipyard workers. The United States Court of Appeals for the Federal Circuit (Federal Circuit) concluded that M21-1, Part VI, § 7.68(b)(2) does not create a presumption of exposure to asbestos for any class of Veterans. Rather, M21-1 suggests that asbestos exposure is a fact to be determined from the evidence. See Dyment v. Principi, 287 F.3d 1377 (Fed. Cir. 2002). Medical- nexus evidence is required in claims for asbestos related disease related to alleged asbestos exposure in service. VA O.G.C. Prec. Op. No. 04-00. VA General Counsel opinions are binding on the Board. See 38 U.S.C.A. § 7104(c) (West 2002); 38 C.F.R. § 14.507 (2008). Analysis Psoriasis The Veteran contends that his currently demonstrated psoriasis is related to chemical exposure at the Hunter Liggett military base where he was stationed during active military service. See September 2004 notice of disagreement. He also claims that his military duties as an electrician resulted in his exposure to many environmental hazards, including asbestos, radiation exposed areas, and areas where Agent Orange was being sprayed. See November 2005 VA Form 9 and January 2009 Appellant's Brief. Psoriasis was not diagnosed until many years after service and there is no medical opinion that purports to relate it to service. In fact, VA outpatient treatment records show that the Veteran reported that the condition began approximately in 1985. Accordingly, service connection for psoriasis is not warranted on a direct basis. The Board also notes that the Veteran did not serve in Vietnam and there is no presumption of service connection for psoriasis based on exposure to herbicides. 38 U.S.C.A. § 1112(c); 38 C.F.R.§ 3.309(e). Furthermore, the Veteran's service did not involve "radiation-risk" activity as defined in 38 C.F.R. § 3.309(d)(3)(ii), and the Veteran may not be deemed a "radiation-exposed Veteran" as defined by 38 C.F.R. § 3.309(d)(3)(i). Furthermore, psoriasis is not listed among the diseases subject to presumptive service connection for a "radiation-exposed Veteran" under 38 C.F.R. § 3.309(d)(2), nor is it listed as a radiogenic disease under 38 C.F.R. § 3.311(b)(2). There is no (competent) evidence that psoriasis may be considered radiogenic in nature. Consequently, the presumptive provisions of 38 C.F.R. § 3.309(d)(2) and special development procedures of 38 C.F.R. § 3.311 do not apply. There is also no evidence to support the Veteran's contentions that he was exposed to chemicals or asbestos during active duty. In essence, the evidence of a nexus between the Veteran's psoriasis and his military service is limited to the Veteran's own statements. This is not competent evidence of the claimed nexus since laypersons, such as the Veteran, are not qualified to render an opinion concerning medical causation. See Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992). For the reasons and basis stated above, the Board finds that service connection for psoriasis is not warranted on a direct or presumptive basis. Liver Disorder The Veteran contends that his currently demonstrated enlarged liver is due to exposure to ionizing radiation during active military service. Specifically, he claims that test areas at the Fort Hunter Liggett military base, where he was stationed during active service, and where radiation was used, were very close to the living, eating and working areas. He also claims that there were test vehicles, airplanes and helicopters running daily. See November 2005 VA Form 9. Service treatment records are negative for any complaints, treatment or diagnosis for a liver disorder. The post- service medical evidence of record is limited to VA outpatient treatment records from the VA Medical Center in Loma Linda, California dated from October 2000 to August 2005, and outpatient treatment records from the Victorville Community Based Outpatient Clinic (CBOC) dated from January 2003 to January 2005. These records show that the Veteran was diagnosed with an enlarged liver several years after his discharge from active service. However, none of these records relate the Veteran's current liver disorder to his active military service. The Board also notes that as discussed above, the Veteran's service did not involve "radiation-risk" activity as defined in 38 C.F.R. § 3.309(d)(3)(ii), and the Veteran may not be deemed a "radiation-exposed Veteran" as defined by 38 C.F.R. § 3.309(d)(3)(i). Furthermore, an enlarged liver is not listed among the diseases subject to presumptive service connection for a "radiation-exposed Veteran" under 38 C.F.R. § 3.309(d)(2), nor is it listed as a radiogenic disease under 38 C.F.R. § 3.311(b)(2). There is no (competent) evidence that an enlarged liver may be considered radiogenic in nature. Consequently, the presumptive provisions of 38 C.F.R. § 3.309(d)(2) and special development procedures of 38 C.F.R. § 3.311 do not apply. In essence, the evidence of a nexus between the Veteran's enlarged liver and his military service is limited to the Veteran's own statements. This is not competent evidence of the claimed nexus since as noted above, laypersons, such as the Veteran, are not qualified to render an opinion concerning medical causation. See Espiritu v. Derwinski. For the reasons and basis stated above, the Board finds that service connection for a liver disorder is not warranted on a direct or presumptive basis. Hepatitis C The Veteran contends that he developed hepatitis C during his service when he was inoculated through the use of airgun injectors. He claims that during the inoculations in shot lines, he remembers seeing blood and men fainting, and that he does not recall anyone wiping arms or the gun after they were used. See November 2005 VA Form 9. The Veteran's service medical records do not reflect any complaint, history, or diagnosis of hepatitis C. VA outpatient treatment records dated from October 2000 to August 2005 show that the Veteran has been diagnosed with hepatitis C. A note dated in June 2002 indicates that the Veteran reported a history of abnormal liver tests since 1992 while he was drinking alcohol. The Veteran also denied any history of blood transfusions and reported intravenous drug abuse and intranasal cocaine use in the 1970's. According to the Veteran, he stopped drinking in 1995, a follow-up liver test in 1996 remained high, and he was diagnosed with hepatitis C in 1997. The VA outpatient treatment records do not relate the Veteran's hepatitis to his military service. Furthermore, with regard to vaccine injections by air gun as a risk factor for hepatitis C, VA does not consider such inoculations by air gun as a risk factor for hepatitis C. Veterans Benefits Administration (VBA), Director Bulletin, 211B (98-110) (Nov. 30, 1998); VBA, Fast letter 04-13 (June 29, 2004). The only evidence of a nexus between the Veteran's current diagnosis of hepatitis C and his active military service is the Veteran's own statements. This is not competent evidence of the alleged nexus since the Veteran does not have the medical expertise to render an opinion concerning medical causation. See Espiritu. Accordingly, the Board must conclude that the preponderance of the evidence is against the Veteran's claim. Residuals of Asbestos Exposure The Veteran claims that during active duty at Fort Hunter Liggett, he did electrical work in buildings where he was probably exposed to asbestos since the buildings were generally old and had insulation in them. See September 2004 notice of disagreement. The Board notes that exposure to asbestos in and of itself, is not considered a disability for VA compensation purposes. There must be evidence of a disability resulting from the exposure in order for a claim for service connection to be granted. The Veteran does not claim and the evidence of record does not show that he suffers from a disability associated with asbestos exposure such as asbestosis or any other pulmonary disorder. Furthermore, there is no competent evidence of record to show that the Veteran was exposed to asbestos during active military service. Accordingly, the Board concludes that service connection for asbestos exposure is not warranted, and the claim is denied. Residuals of Exposure to Ionizing Radiation The Veteran contends that his claimed exposure to ionizing radiation is related to chemical exposure at Fort Hunter Liggett. The Board notes that exposure to ionizing radiation in and of itself, is not considered a disability for VA compensation purposes. There must be evidence of a disability resulting from the exposure in order for a claim for service connection to be granted. As noted above, the Veteran's service did not involve "radiation-risk" activity as defined in 38 C.F.R. § 3.309(d)(3)(ii), and the Veteran may not be deemed a "radiation-exposed Veteran" as defined by 38 C.F.R. § 3.309(d)(3)(i). Furthermore, the Veteran has been diagnosed with a disability listed among the diseases subject to presumptive service connection for a "radiation-exposed Veteran" under 38 C.F.R. § 3.309(d)(2), or a disability listed as a radiogenic disease under 38 C.F.R. § 3.311(b)(2). Accordingly, the Board concludes that service connection for exposure to ionizing radiation is not warranted, and the claim is denied. Residuals of Herbicide Exposure As discussed above, the Veteran contends that he was exposed to herbicides while stationed at Fort Hunter Liggett during active military duty. The Board notes that exposure to herbicides in and of itself, is not considered a disability for VA compensation purposes. There must be evidence of a disability resulting from the exposure in order for a claim for service connection to be granted. As discussed above, the Veteran did not serve in Vietnam, and therefore, his exposure to herbicides is not presumed. Furthermore, there is no competent evidence of record to show that the Veteran was exposed to herbicides during active duty in California. There is also no evidence of the Veteran being diagnosed with a disability associated with herbicide exposure. Accordingly, the Board concludes that service connection for herbicide exposure is not warranted, and the claim is denied. Thyroid Nodule The Veteran contends that his currently demonstrated thyroid nodule developed as a result of his claimed exposure to ionizing radiation during military service at the Fort Hunter Liggett military base in California where he served as an electrician in an experimentation battalion. He claims further that the base is listed on the military bases clean up list for herbicides, pesticides and "acid pitts", and that the base is now closed. He also claims that there were radiation signs everywhere on the base. See September 2004 notice of disagreement. He also claims, as noted above, that test areas on the base were very close to the living, eating and working areas, and that there were test vehicles, airplanes and helicopters running daily. In addition, the Veteran claims that he knows that there was real environmental exposure on the base because of the signs that were posted, which referred to nuclear, radiation hazard, pesticides spraying, mine fields and blast areas. See November 2005 VA Form 9. Service treatment records are negative for any complaints, treatment or diagnosis for a thyroid nodule or any disorder related to the Veteran's thyroid gland. The post-service medical evidence of record is limited to VA outpatient treatment records from the VA Medical Center in Loma Linda, California dated from October 2000 to August 2005, and outpatient treatment records from the Victorville Community Based Outpatient Clinic (CBOC) dated from January 2003 to January 2005. These records show that in 2003, the Veteran was noted to have a left thyroid nodule. However, none of these records relate the Veteran's thyroid nodule to his active military service. Furthermore, the Veteran has never been given a definitive diagnosis of thyroid cancer. In fact, he himself admits that he has had biopsies which determined that his thyroid nodule was not cancerous. See September 2004 notice of disagreement. The Board also notes that as discussed above, the Veteran's service did not involve "radiation-risk" activity as defined in 38 C.F.R. § 3.309(d)(3)(ii), and the Veteran may not be deemed a "radiation-exposed Veteran" as defined by 38 C.F.R. § 3.309(d)(3)(i). Furthermore, although thyroid cancer is listed both among the diseases subject to presumptive service connection for a "radiation-exposed Veteran" under 38 C.F.R. § 3.309(d)(2), and as a radiogenic disease under 38 C.F.R. § 3.311(b)(2); a thyroid nodule, which is not necessarily cancerous, is not. There is also no competent evidence that a noncancerous thyroid nodule may be considered radiogenic in nature. Consequently, the presumptive provisions of 38 C.F.R. § 3.309(d)(2) and special development procedures of 38 C.F.R. § 3.311 do not apply. The Board notes that in a November 2004 VA clinic visit note, B.B. noted the Veteran's reports that he was exposed to many chemicals during service and that he suspects he was exposed to radiation as well. B.B. also noted that "[w]ith concurrent prostate cancer at age 52 and likely thyroid cancer there is likely a relation to chemical exposure and likely service connected." The Board finds that inasmuch as B.B. is opining that the Veteran's thyroid nodule is related to chemical exposure in service, this opinion lacks probative value because it is based on the Veteran's reported oral history, which is not corroborated by the service medical records, and B.B. did not indicate that he had reviewed the Veteran's medical records before rendering his opinion. The Board also finds that a VA examination is not warranted in response to this claim because the medical evidence currently of record is sufficient to reach a decision. The VCAA and the pertinent implementing regulation provide, generally, that an examination or opinion is necessary if the evidence of record contains competent evidence that the claimant has a current disability, or persistent or recurrent symptoms of disability, establishes that he suffered an injury or disease in service, and indicates that the claimed disability or symptoms may be associated with the established injury or disease in service, or with another service- connected disability, but does not contain sufficient medical evidence for the Secretary to make a decision on the claim. See 38 C.F.R. § 3.159(c)(4); see also Charles v. Principi, 16 Vet. App. 370 (2002). Although the Veteran has a current diagnosis of a left thyroid nodule, and the noted VA Medical Center examiner indicates that the claimed disability may be associated with chemical exposure in service, the record does not contain competent evidence of an in-service injury or disease or evidence of an association between his current diagnosed disability and an injury or disease in service. Furthermore, as discussed above, the record is also negative for any evidence of exposure to chemicals or radiation in service. While an examination could identify a current diagnosis for the Veteran's condition (something already shown in the evidence of record), it could no more than speculate as to a possible link between the condition and service, since there is absolutely no evidence of incurrence of injury during active duty service or exposure to noted elements that could result in such a condition. Without evidence of in-service injury or exposure to harmful elements, a new examination to obtain an opinion linking a current diagnosis to an undefined event/injury in service would be no more than speculation. The only other evidence of a nexus between the Veteran's thyroid nodule and his military service is limited to the Veteran's own statements. This is not competent evidence of the claimed nexus since as noted above, laypersons, such as the Veteran, are not qualified to render an opinion concerning medical causation. See Espiritu v. Derwinski. Accordingly, the Board must conclude that the preponderance of the evidence is against the Veteran's claim. Prostate Cancer The Veteran contends that his currently demonstrated prostate cancer developed as a result of exposure to herbicides, chemicals and contaminated ground water during his active duty at the Fort Hunter Liggett military base in California. See April 2005 notice of disagreement. Prostate cancer was not diagnosed until many years after service and there is no medical opinion that purports to relate it to service. Accordingly, service connection for prostate cancer is not warranted on a direct basis. The Secretary has determined that a positive association exists between the exposure of humans to an herbicide agent and the occurrence of prostate cancer in humans. Therefore, a presumption of service connection is warranted for that disease for the purposes of this section. 38 U.S.C.A. § 1116. However, the Board notes that the Veteran did not serve in Vietnam and therefore, his exposure to herbicides is not presumed. See id. Furthermore, there is no competent evidence of record showing that he was exposed to herbicides during active duty in California or any other place he may have been stationed. There is also no evidence that the Veteran was exposed to chemicals or contaminated ground water during active duty, and the Board notes that exposure to contaminated ground water or unspecified chemicals is not shown to be related to the development of prostate cancer. In essence, the only other evidence of a nexus between the Veteran's prostate cancer and his military service is limited to the Veteran's own statements. This is not competent evidence of the claimed nexus since as noted above, laypersons, such as the Veteran, are not qualified to render an opinion concerning medical causation. See Espiritu v. Derwinski. Accordingly, the Board must conclude that the preponderance of the evidence is against the Veteran's claim. Duties to Notify and to Assist Claimants VA's duties to notify and assist claimants in substantiating a claim for VA benefits are found at 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2008); 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a) (2008). Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant and his or her representative, if any, of any information, and any medical or lay evidence, that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a) (West 2002 & Supp. 2008); 38 C.F.R. § 3.159(b) (2008); Quartuccio v. Principi, 16 Vet. App. 183 (2002). Proper notice must inform the claimant of any information and evidence not of record (1) that is necessary to substantiate the claim; (2) that VA will seek to provide; and (3) that the claimant is expected to provide. Notice should be provided to a claimant before the initial unfavorable agency of original jurisdiction (AOJ) decision on a claim. Pelegrini v. Principi, 18 Vet. App. 112 (2004); see also Mayfield v. Nicholson, 19 Vet. App. 103 (2005). The notice requirements of 38 U.S.C. § 5103(a) and 38 C.F.R. § 3.159(b) apply to all five elements of a "service connection" claim, defined to include: (1) Veteran status; (2) existence of a disability; (3) a connection between the Veteran's service and the disability; (4) degree of disability; and (5) effective date of the disability. See Dingess v. Nicholson, 19 Vet. App. 473 (2006). The record reflects that in April 2004 and December 2004, the Veteran was provided with the notice required by section 5103(a). The Board notes that, even though the letters requested a response within 60 days, they also expressly notified the Veteran that he had one year to submit the requested information and/or evidence, in compliance with 38 U.S.C.A. § 5103(b) (evidence must be received by the Secretary within one year from the date notice is sent). The Board also notes that although the Veteran has not been provided notice of the type of evidence necessary to establish a disability rating or an effective date for his service connection claims, the Board finds that there is no prejudice to the Veteran in proceeding with the issuance of a final decision. See Bernard v. Brown, 4 Vet. App. 384, 394 (1993). The Board has determined that service connection for psoriasis, a liver disorder, hepatitis C, a thyroid nodule, residuals of asbestos exposure, residuals of exposure to ionizing radiation, residuals of exposure to herbicides, and prostate cancer is not warranted. Consequently, no disability rating or effective date will be assigned, so the failure to provide notice with respect to those elements of the claims was no more than harmless error. Finally, the Board notes that the Veteran's service treatment records and all other pertinent available records have been obtained in this case. Neither the Veteran nor his representative has identified any outstanding evidence, to include medical records, which could be obtained to substantiate the denied claims. The Board is also unaware of any such outstanding evidence. The Board has considered the decision in Charles v. Principi, 16 Vet. App. 370, 374-75 (2002). However, the outcome of these claims hinges on what occurred, or more precisely what did not occur, during service. In the absence of evidence of an in-service disease or injury, or evidence of exposure to chemicals, asbestos, herbicides or ionizing radiation, referral of this case to obtain an examination and/or an opinion as to the etiology of the Veteran's claimed disabilities would in essence place the examining physician in the role of a fact finder. This is the Board's responsibility. The holding in Charles was clearly predicated on the existence of evidence of both in-service incurrence and of a current diagnosis. Simply stated, referral of this case for an examination or obtainment of a medical opinion under the circumstances here presented would be a useless act. The duty to assist is not invoked, even under Charles, where "no reasonable possibility exists that such assistance would aid in substantiating the claim." See also 38 U.S.C.A. § 5103A(a)(2). In sum, the Board is satisfied that any procedural errors in the development and consideration of the claims by the originating agency were not prejudicial to the Veteran. ORDER Service connection for psoriasis is denied. Service connection for a liver disorder is denied. Service connection for hepatitis C is denied. Service connection for a thyroid nodule is denied. Service connection for residuals of asbestos exposure is denied. Service connection for residuals of exposure to ionizing radiation is denied. Service connection for herbicide exposure is denied. Service connection for prostate cancer is denied. ____________________________________________ MARY GALLAGHER Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs