Citation Nr: 1036785 Decision Date: 09/28/10 Archive Date: 10/05/10 DOCKET NO. 05-08 431 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Philadelphia, Pennsylvania THE ISSUE Entitlement to service connection for a stomach condition, claimed as secondary to herbicide, asbestos or ionizing-radiation exposure. WITNESS AT HEARING ON APPEAL Veteran ATTORNEY FOR THE BOARD C. Bruce, Associate Counsel INTRODUCTION The appellant is a Veteran who served on active duty from November 1961 to November 1965. This matter is before the Board of Veterans' Appeals (Board) on appeal from a February 2004 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania. The Veteran had a hearing before the Board in January 2007 and the transcript is of record and was reviewed. The Board notes that the above issue was remanded by the Board in May 2007 and April 2010 for further evidentiary development. As will be further explained below, this development having been achieved, the issue is now ready for appellate review. FINDINGS OF FACT 1. The Veteran is not shown to have been exposed to asbestos, herbicides, or ionizing radiation during service. 2. The competent evidence of record fails to demonstrate that any current stomach condition is related to the Veteran's active duty service, nor is any stomach condition the result of any incident occurring during his military service, including his claimed exposure to radiation, herbicides, or asbestos. CONCLUSION OF LAW A stomach condition was not incurred in or aggravated by active military service, nor may it be presumed to have been so incurred, to include as due to in-service exposure to radiation, herbicides, or asbestos. 38 U.S.C.A. §§ 1110, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.311 (2009). REASONS AND BASES FOR FINDINGS AND CONCLUSION VA's Duties to Notify and Assist Under the Veterans Claims Assistance Act (VCAA), when VA receives a complete or substantially complete application for benefits, it must notify the claimant of (1) the information and evidence not of record that is necessary to substantiate a claim, (2) which information and evidence VA will obtain, and (3) which information and evidence the claimant is expected to provide. 38 U.S.C.A. § 5103(a) (West 2002); 38 C.F.R. § 3.159 (2009); see also 73 Fed. Reg. 23,353-6 (April 30, 2008) (codified at 38 C.F.R. § 3.159 (May 30, 2008)). See Pelegrini v. Principi, 18 Vet. App. 112, 120-21 (2004) (Pelegrini II). After careful review of the claims file, the Board finds that the letters dated in September 2003 and May 2008 fully satisfied the duty to notify provisions. 38 U.S.C.A. § 5103(a) (West 2002); 38 C.F.R. § 3.159(b)(1) (2009); Quartuccio v. Principi, 16 Vet. App. 183, 187 (2002). In this regard, these letters advised the Veteran what information and evidence was needed to substantiate the claims decided herein. These letters also requested that the Veteran provide enough information for the RO to request records from any sources of information and evidence identified by the Veteran, as well as what information and evidence would be obtained by VA, namely, records like medical records, employment records, and records from other Federal agencies. On March 3, 2006, the Court issued a decision in Dingess v. Nicholson, 19 Vet. App. 473, 484 (2006), which held that the VCAA notice must include notice that a disability rating and an effective date for the award of benefits will be assigned if service connection is awarded. The May 2008 letter provided this notice to the Veteran. The Board observes that the September 2003 letter was sent to the Veteran prior to the February 2004 rating decision. The VCAA notice with respect to the elements addressed in this letter was therefore timely. See Pelegrini v. Principi, 18 Vet. App. 112 (2004). VCAA notice in accordance with Dingess, however, was sent after the initial adjudication of the Veteran's claim. Nevertheless, the Board finds this error nonprejudicial to the Veteran. See Mayfield v. Nicholson, 19 Vet. App. 103 (2005). In this regard, the notice provided in the May 2008 letter fully complied with the requirements of 38 U.S.C.A. § 5103(a) (2007), 38 C.F.R. § 3.159(b) (2009), and Dingess, supra, and after the notice was provided the case was readjudicated and a November 2009 supplemental statement of the case (SSOC) was provided to the Veteran. See Pelegrini II, supra; Mayfield v. Nicholson, 20 Vet. App. 537 (2006) (a (supplemental) statement of the case that complies with all applicable due process and notification requirements constitutes a readjudication decision). Therefore the Board concludes that the requirements of the notice provisions of the VCAA have been met, and there is no outstanding duty to inform the Veteran that any additional information or evidence is needed. In addition, the duty to assist the appellant has also been satisfied in this case. The RO has obtained the Veteran's service treatment records, as well as his identified VA and private medical treatment records. 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159. As indicated in detail below, the RO has also completed all necessary development related to the Veteran's alleged in- service ionizing radiation exposure, herbicide exposure, and asbestos exposure. See 38 C.F.R. §§ 3.307, 3.309, 3.311 (2009). In May 2007 and April 2010, the Board remanded the case to the agency of original jurisdiction (AOJ) for additional development. A remand by the Board confers on the appellant, as a matter of law, the right to compliance with the remand orders. Stegall v. West, 11 Vet. App. 268 (1998). Specifically, in the May 2007 remand, the Board requested that the following information be obtained: treatment records, dating from June 2003 to the present, from the Philadelphia, Pennsylvania VA Medical Center (VAMC); the Veteran's Official Military Personnel File; verification through Joint Service Records Research Center (JSRRC) of the Veteran's Vietnam service and exposure to herbicides, specifically Agent Orange; November 1964 to January 1965 unit records for the 1611th Communication & Electronics Maintenance Squadron (CEMS); records from the Defense Finance Accounting Service regarding the Veteran's special pay status from November 1964 to November 1965; and finally verification of the Veteran's exposure to asbestos and radiation. The Board also requested that the Veteran be provided a VA examination for his claimed stomach condition to determine if any current stomach condition is related to the Veteran's in-service complaints and treatments for chronic constipation and stomach pains. Unfortunately, the examination for the Veteran's claimed stomach condition was never requested and as such the issue was remanded again in April 2010. In this regard, the Veteran was scheduled for an examination in May 2010, however the Veteran failed to report for the examination. As such, the Board finds that the requested development was achieved and the issue is now ready for appellate review. The Board recognizes a duty to provide a VA examination when the record lacks evidence to decide the Veteran's claim and there is evidence of (1) a current disability, (2) an in-service event, injury, or disease, and (3) some indication that the claimed disability may be associated with the established event, injury, or disease. 38 C.F.R. § 3.159(c)(4)(i) (2009); see also McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this regard, the Board notes that the Veteran was scheduled for an examination in conjunction with his claim for a stomach condition, however, the record indicates that the Veteran failed to report for the examination in May 2010, as such the Board will use the evidence currently of record in determining whether the Veteran is entitled to service connection. See 38 C.F.R. § 3.655. Under the circumstances of this case, "the record has been fully developed," and "it is difficult to discern what additional guidance VA could have provided to the Veteran regarding what further evidence he should submit to substantiate his claim." Conway v. Principi, 353 F.3d 1369 (Fed. Cir. 2004). Furthermore, as discussed above, the Board finds that there has been substantial compliance with its May 2007 and April 2010 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (a remand by the Board confers upon the claimant, as a matter of law, the right to compliance with the remand instructions, and imposes upon the VA a concomitant duty to ensure compliance with the terms of the remand). See also D'Aries v. Peake, 22 Vet. App. 97, 105 (2008); Dyment v. West, 13 Vet. App. 141, 146-47 (1999). Therefore, the Board is satisfied that VA has complied with the duty to assist requirements of the VCAA and the implementing regulations and the record is ready for appellate review. Analysis The Veteran in this case is seeking entitlement to service connection for a stomach disorder. He attributes this condition to in-service stomach issues and in-service exposure to ionizing radiation, herbicides, and asbestos. The Veteran claims that he was exposed to microwave radiation while performing his duties as a radio repairman. The Veteran further claims that he was exposed to herbicides and asbestos while working on aircraft that contained asbestos and herbicides. Specifically, the Veteran noted at his January 2007 hearing that the airplanes in which he repaired radios on were insulated with asbestos. He was exposed to herbicides that had leaked into the wiring and cables on the airplanes in which he repaired radios both in the United States and on claimed temporary duty in Vietnam. Additionally, the Veteran claims exposure to herbicides while on temporary duty in Vietnam. The Veteran was assigned to the 1611th Communication & Electronics Maintenance Squadron (CEMS). The Veteran was stationed at McGuire Air Force Base in Trenton, New Jersey, but claims to have been sent for approximately 25 missions to other Air Force bases in the U.S. and, on temporary duty assignments to Saigon, Vietnam, to work on repairing radios in airplanes. At his January 2007 hearing, the Veteran testified that he was sent on various temporary duty assignments in 1965 to various Air Force bases in the U.S and to Saigon, Vietnam, to repair radio equipment inside various airplanes. The Veteran stated that he was exposed to the asbestos in the insulation of the plane when he had to repair cables and wiring in order to make repairs on the radio equipment. See Hearing Transcript, p. 3. His exposure to herbicides occurred while working on cables and wires that ran the length of the floor of the plane that had become saturated with herbicides and Agent Orange leaked from barrels transported on the aircraft. See Hearing Transcript, p. 12. The Veteran was exposed to microwave radiation while working on the Wave guide, a Doppler search radar in the nose of the plane that, according to the Veteran, gave off microwave rays. See Hearing Transcript, p. 12. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. §§ 1110; 38 C.F.R. § 3.303. Service connection for certain chronic diseases will be presumed if they are manifest to a compensable degree within the year after active service. 38 U.S.C.A. §§ 1101, 1112, 1113 (West 2002); 38 C.F.R. §§ 3.307, 3.309. Service connection may also 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). In order to prevail on the issue of service connection there must be medical evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in- service occurrence or aggravation of a disease or injury; and medical evidence of a nexus between an in-service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999); see also Pond v. West, 12 Vet App. 341, 346 (1999). I. Herbicide Exposure There are statutory presumptions and VA regulations implementing them, that are intended to allow service connection for certain diseases when the evidence might otherwise not indicate service connection is warranted. See 38 C.F.R. § 3.303(d) (2008). In the case of a Veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the Vietnam era, namely from February 28, 1961, to May 7, 1975, VA regulations provide that he shall be presumed to have been exposed during such service to an herbicide agent, including Agent Orange, unless there is affirmative evidence to establish that the Veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307(a)(6)(iii) (2009). The following diseases shall be service connected if the Veteran was exposed to an herbicide agent during active service, even though there is no record of such disease during service, and provided further that the requirements of 38 C.F.R. § 3.307(d) (2009) are satisfied: chloracne or other acneform disease consistent with chloracne if manifest to a degree of 10 percent within one year of date of last exposure, type II diabetes mellitus, Hodgkin's disease, chronic lymphocytic leukemia, multiple myeloma, non-Hodgkin's lymphoma, acute and subacute peripheral neuropathy, porphyria cutanea tarda, prostate cancer, certain respiratory cancers, and soft tissue sarcoma. 38 C.F.R. § 3.309(e) (2009). General Counsel Opinion, VAOPGCPREC 27-97 (July 23, 1997), stated that claimants must demonstrate actual duty or visitation in the Republic of Vietnam to have qualifying service sufficient to raise the presumption of exposure to Agent Orange. Service in a deep water naval vessel in waters off the shore of the Republic of Vietnam does not constitute service in the Republic of Vietnam. See VAOPGCPREC 27-97 (O.C.G. Prec. 27-97). However, 'service in the Republic of Vietnam' includes service in the waters offshore and service in other locations if the conditions of service involved duty or visitation in the Republic of Vietnam. See 38 C.F.R. §§ 3.307(a)(6)(iii), 3.313(a). See also Haas v. Peake, 525 F.3d 1168 (Fed. Cir. 2008) (upheld VA's requirement that a claimant must have been present within the land borders of Vietnam at some point in the course of his or her military duty in order to be entitled to the presumption of herbicide exposure under 38 U.S.C. § 1116(a)(1) and 38 C.F.R. § 3.307(a)(6)(iii)). See also 38 C.F.R. § 3.313 (2008). The Board acknowledges that the Veteran does not claim that he was stationed in Vietnam, but rather that his trips to Vietnam were temporary duty assignments. The Veteran contends that he made an estimated 12 trips to Vietnam to work on aircraft in Saigon. However, the record does not indicate that the Veteran ever set foot in Vietnam according to the National Personnel Records Center (NPRC). Although it is noted that departure and arrival of individual unit members and aircraft flight paths are not included in unit histories, the U.S. Armed Services Center for Unit Records Research was unable to document or verify that the Veteran had missions to Vietnam. Finally, the Veteran's Official Military Personnel File (OMPF) does not indicate that the Veteran was assigned to duty in Vietnam. Indeed the file indicates that the Veteran was stationed at Lackland Air Force Base in Texas from November 1961 to December 1961; Keesler Air Force Base in Mississippi from December 1961 to February 1962; McGuire Air Force Base in New Jersey from October 1962 to November 1965; and finally Headquarters Air Reserve Records Center (CONAC) in Denver, Colorado. Additionally, the NPRC reported that there is no evidence that the Veteran was exposed to herbicides. The U.S. Armed Service Center for Unit Records Research was also unable to document or verify that Agent Orange damaged any aircraft. The Board notes that the Veteran provided payment statements from the Social Security Administration indicating that his salary increased temporarily for certain periods of time. The Veteran claims that these increases were based on temporary duty assignments to other Air Force bases in the U.S. to repair radio equipment inside airplanes. The Veteran noted at his hearing that these payments did not apply to his trips to Vietnam, but just to verify that he did have temporary duty assignments for which he was given extra pay for expenses. The RO requested the Veteran's Mater Military Pay Account (MMPA) records from the Defense Finance and Accounting Service-Denver Center Records Management Office (DFAS-RSAB/DE), however the records for the period of 1964 to 1965 were unable to be located. The Board acknowledges that the Veteran's pay did increase slightly for various periods, however, these pay statements do not indicate why the Veteran's pay increased and they are not sufficient to verify that the Veteran had temporary duty assignments to anywhere in the U.S. or in Vietnam as they merely note that the Veteran was in the Air Force at the time of payment. Additionally, VA's Secretary has determined that a presumption of service connection based on exposure to herbicides used in the Republic of Vietnam during the Vietnam era is not warranted for any condition for which the Secretary has not specifically determined a presumption of service connection is warranted. See 68 Fed. Reg. 27,630 (May 20, 2003). The Board notes that the Veteran's stomach condition is not included as presumptive disease for herbicide exposure. As such, the Board finds that the Veteran cannot be service connected for a stomach condition as due to herbicide exposure. II. Asbestos Exposure There is no specific statutory guidance with regard to asbestos- related claims, nor has the Secretary of VA promulgated any regulations in regard to such claims. VA has, however, issued a circular on asbestos-related diseases. DVB Circular 21-88-8, Asbestos-Related Diseases (May 11, 1988) provides guidelines for considering compensation claims based on exposure to asbestos. The DVB circular was subsumed verbatim as § 7.21 of Adjudication Procedure Manual, M21-1, Part VI. (This has now been reclassified in a revision to the Manual at M21- 1MR, Part IV, Subpart ii, Chapter 2, Section C.) See also VAOPGCPREC 4-00 (Apr. 13, 2000). The adjudication of a claim for service connection for a disability resulting from asbestos exposure should include a determination as to whether or not: (1) service records demonstrate the Veteran was exposed to asbestos during service; (2) development has been accomplished sufficient to determine whether or not the Veteran was exposed to asbestos either before or after service; and (3) a relationship exists between exposure to asbestos and the claimed disease in light of the latency and exposure factors. M21-1MR, Part IV, Subpart ii, Chapter 2, Section C, Subsection (h). In this regard, the M21-1 MR provides the following non- exclusive list of asbestos-related diseases/abnormalities: asbestosis, interstitial pulmonary fibrosis, tumors, effusions and fibrosis, pleural plaques, mesotheliomas of pleura and peritoneum, lung cancer, bronchial cancer, cancer of the larynx, cancer of the pharynx, cancer of the urogenital system (except the prostate), and cancers of the gastrointestinal tract. See M21-1 MR, part VI, Subpart ii, Chapter 2, Section C, 9 (b). The M21-1 MR also provides the following non-exclusive list of occupations that have higher incidents of asbestos exposure: mining, milling, work in shipyards, insulation work, demolition of old buildings, carpentry and construction, manufacture and servicing of friction products such as clutch facings and brake linings, and manufacture and installation of roofing and flooring materials, asbestos cement sheet and pipe products, and military equipment. See M21-1 MR, part VI, Subpart ii, Chapter 2, Section C, 9 (f). As noted above, the Veteran contends that he was exposed to asbestos that was in the insulation of the planes in which he repaired radios. The Board notes that the RO requested records indicating exposure to Asbestos. The Veteran's record does not indicate that he was exposed to asbestos, nor does his military occupational specialty indicate that he had an occupation that had a higher incidence of asbestos exposure. In Dyment v. West, 13 Vet. App. 141, 145 (1999), the United States Court of Appeals for Veterans Claims (Court) found that provisions in former paragraph 7.68 (predecessor to paragraph 7.21) of VBA Manual M21- 1, Part VI, did not create a presumption of exposure to asbestos. Medical-nexus evidence is required in claims for asbestos- related disease related to alleged asbestos exposure in service. See VAOGCPPREC 04-00. The diseases typically associated with asbestos exposure affect the lungs and digestive tract. With regard to whether the Veteran suffers from any lung disorder, as is typical with asbestos exposure, the Veteran stated at his January 2007 hearing that he does not have any lung disorder. The Board notes that the non- exclusive list of asbestos-related diseases/abnormalities includes cancer of the gastrointestinal tract, however, the only stomach related condition that the Veteran is diagnosed with is gastroesophageal reflux disease (GERD). Additionally, the Board notes that there is no indication in the medical records that the Veteran's stomach condition is related to asbestos exposure. As such the Board finds that the Veteran is not entitled to service connection for a stomach condition as due to asbestos exposure. III. Ionizing and Microwave Radiation Exposure Service connection for a disability claimed to be attributable to exposure to ionizing radiation, during service can be demonstrated by various methods. See Davis v. Brown, 10 Vet. App. 209, 211 (1997); Rucker v. Brown, 10 Vet. App. 67, 71 (1997). First, there are specific diseases which may be presumptively service-connected if manifest in a radiation-exposed Veteran. A 'radiation-exposed Veteran' is defined by 38 C.F.R. § 3.309(d)(3) 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; 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; or the Veteran's presence at certain specified additional locations. See 38 C.F.R. § 3.309(d)(3). In applying this statutory presumption, there is no requirement for documenting the level of radiation exposure. The presumptively service-connected diseases specific to radiation- exposed Veterans are the following: leukemia (other than chronic lymphocytic leukemia), cancer of the thyroid, cancer of the breast, cancer of the pharynx, cancer of the esophagus, cancer of the stomach, cancer of the small intestine, cancer of the pancreas, multiple myeloma, lymphomas (except Hodgkin's disease), cancer of the bile ducts, cancer of the gall bladder, primary liver cancer (except if cirrhosis or hepatitis B is indicated), cancer of the salivary gland, cancer of the urinary tract, bronchiolo-alveolar carcinoma, cancer of the bone, cancer of the brain, cancer of the colon, cancer of the lung, and cancer of the ovary. 38 C.F.R. § 3.309(d)(2). After reviewing the evidence of record, the Board finds that the Veteran is not shown to be a 'radiation-exposed Veteran' as that term is defined in 38 C.F.R. § 3.309(d)(3). Moreover, a stomach condition is not listed as a condition warranting presumptive service connection for radiation-exposed Veterans. 38 C.F.R. § 3.309(d)(2). As such, service connection for a stomach condition, is not warranted under this presumption. The second avenue of recovery is found under 38 C.F.R. § 3.311(b)(2). This provision provides that certain listed 'radiogenic' diseases found 5 years or more after service in an ionizing-radiation-exposed Veteran may be service connected if the VA Undersecretary 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. Pursuant to 38 C.F.R. § 3.311(b)(2), radiogenic diseases include the following: all forms of leukemia except chronic lymphatic (lymphocytic) leukemia, thyroid cancer, breast cancer, lung cancer, bone cancer, liver cancer, skin cancer, esophageal cancer, stomach cancer, colon cancer, pancreatic cancer, kidney cancer, urinary bladder cancer, salivary gland cancer, multiple myeloma, posterior subcapsular cataracts, non-malignant thyroid nodular disease, ovarian cancer, parathyroid adenoma, tumors of the brain and central nervous system, cancer of the rectum, lymphomas other than Hodgkin's disease, prostate cancer, and any other cancer. 38 C.F.R. § 3.311(b)(2). A disease is also considered a radiogenic disease where competent scientific or medical evidence that the claimed condition is a radiogenic disease is received. See 38 C.F.R. § 3.311(b)(4). In this regard, the Veteran suffers from a stomach condition. Specifically, the treatment records indicate that the Veteran is diagnosed with GERD. As such, the Board finds that the Veteran's stomach condition is not a radiogenic disease. Therefore, as neither a stomach condition nor GERD is shown to be a radiogenic disease as defined in 38 C.F.R. § 3.311(b)(2), and given that there is no competent evidence of record suggesting that either of these conditions is a radiogenic disease, service connection as due to in-service exposure to ionizing radiation, must be denied. See 38 C.F.R. § 3.311(b)(4). The Veteran stated at his January 2007 hearing, his exposure to radiation occurred while working on radio equipment and wiring including some equipment that would put him in contact with Wave guide Doppler radar equipment, all of which emitted microwave radiation. The Court of Appeals for Veterans Claims has taken judicial notice that such radio equipment emits microwave-type non-ionizing radiation. Rucker v. Brown, 10 Vet. App. 67, 69, 71-2 (1997) (citing The Microwave Problem, Scientific American, September 1986; Effects upon Health of Occupational Exposure to Microwave Radiation (RADAR), American Journal of Epidemiology, Vol. 112, 1980; and Biological Effects of Radiofrequency Radiation, United States Environmental Protection Agency, September 1984. The evidence supports that the Veteran was a technician who worked on radio equipment while on active duty service. Indeed, according to his DD-214, the Veteran's military occupational specialty (MOS) was listed as radio repairman. Such equipment does not emit ionizing radiation, but rather, as even the Veteran asserts, microwave radiation. As such, the Board finds that the provisions associated with 38 C.F.R. § 3.311 requiring further development with the presence of a radiogenic disease are not applicable in this instance as the Veteran was not exposed to ionizing radiation. While the Board finds that the Veteran was not exposed to ionizing radiation, it is conceded that he was exposed to microwave radiation and as such, the Board must determine whether the Veteran is entitled to service connection as a result of exposure to microwave radiation. The Board notes initially that there is no presumption for microwave radiation exposure. The Veteran has provided no evidence that his claimed disability is the result of microwave radiation. Additionally, there is no competent medical evidence of record that the Veteran's stomach condition is etiologically related to microwave radiation exposure. As such, the Board finds that the Veteran is not entitled to service connection for a stomach condition as a result of microwave radiation exposure. Finally, the Board notes the Veteran's statements that he suffers from a stomach condition that is related to his active duty service due to in-service exposure to microwave radiation, ionized radiation, herbicides, and and/or asbestos, and while the Veteran as a lay person is competent to provide evidence regarding any symptomatology, he is not competent to provide evidence regarding diagnosis, including the severity of a disease or disorder, or etiology. Espiritu v. Derwinski, 2 Vet. App. 492 (1992). Lay statements may be competent to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C.A. § 1153(a); 38 C.F.R. §§ 3.303(a), 3.159(a); see Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (addressing lay evidence as potentially competent to support presence of disability even where not corroborated by contemporaneous medical evidence). See also Robinson v. Shinseki, 312 Fed. Appx. 336 (Fed. Cir. 2009) (non-precedential) (confirming that, 'in some cases, lay evidence will be competent and credible evidence of etiology'). However, the possibility of a causal relationship between a disability and exposure to microwave radiation, ionized radiation, herbicides, and asbestos requires specialized training for a determination as to causation, and is therefore not susceptible of lay opinions on etiology. Only a medical professional can provide evidence regarding etiology of a disease or disorder. Thus, the Veteran's statements are afforded no probative value with respect to the medical question of whether his claim is related to any exposure to microwave radiation, ionized radiation, herbicides or asbestos that the Veteran might have suffered while in service. Under these circumstances, the Board concludes that the Veteran was not exposed to microwave radiation, ionizing radiation, herbicides or asbestos during service. Thus, service connection for the claims on appeal, due to microwave radiation, ionizing radiation, herbicides, and/or asbestos exposure, is not warranted. As such, the Board will limit its analysis to a direct service connection as required by Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). IV. Direct Service Connection As noted above, in order to prevail on the issue of service connection there must be medical evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in- service occurrence or aggravation of a disease or injury; and medical evidence of a nexus between an in-service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999); see also Pond v. West, 12 Vet App. 341, 346 (1999). The Board notes that the Veteran is currently diagnosed with GERD as evidenced by various VA treatment records dating from March 2003 to February 2009. As such the Board finds that the Veteran does have a current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999); see also Pond v. West, 12 Vet App. 341, 346 (1999). The Board observes that the most recent treatment reports indicate that the Veteran's GERD is asymptomatic, due to treatment with medication. The record does not indicate that the Veteran is currently suffering from any other stomach related disabilities other than the occasional problems with diarrhea, a side effect from treatment of other disabilities. The Board acknowledges that the Veteran suffered from several stomach issues while in service. The Veteran's October 1961 entrance examination report, as well as the accompanying report of medical history, lists the Veteran's gastrointestinal system as normal and notes no complaints regarding stomach problems. The Veteran's service treatment records reveal that the Veteran complained multiple times of both constipation and diarrhea while on active duty. The service treatment records indicate, however, that both the constipation and diarrhea were associated with the Veteran's hemorrhoids. Finally the Board notes that the Veteran's June 1965 separation examination and report of medical history do not note any gastrointestinal problems. The Board acknowledges that the separation examination notes that the Veteran suffers from constipation, but that it is associated with internal hemorrhoids and cryptitis. As such, the Board finds that the Veteran was not diagnosed with a chronic stomach condition while in service. Finally the Board notes that there is no medical evidence that relates any current stomach condition to his military service. As noted, the only current stomach related condition from which the Veteran suffers is GERD. There is no indication in the Veteran's service treatment records that he suffered from GERD while on active duty. Additionally, in making this determination, the Board points out that the first evidence of the Veteran having been diagnosed with GERD appears in 2003, over thirty-five years after his discharge from the service. This gap in the evidentiary record preponderates strongly against this claim on the basis of continuity of symptomatology. See Mense v. Derwinski, 1 Vet. App. 354 (1991). The Board may consider in its assessment of a service connection claim the passage of a lengthy period of time wherein the Veteran has not complained of the maladies at issue. See Maxson v. West, 12 Vet. App. 453, 459 (1999), aff'd sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). Finally the Board notes the Veteran's statements that he suffers from a stomach condition and while the Veteran as a lay person is competent to provide evidence regarding injury and symptomatology, he is not competent to provide evidence regarding diagnosis, including the severity of a disease or disorder, or etiology. Espiritu v. Derwinski, 2 Vet. App. 492 (1992). Lay statements may be competent to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C.A. § 1153(a); 38 C.F.R. §§ 3.303(a), 3.159(a); see Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However only a medical professional can provide evidence of a diagnosis or etiology of a disease or disorder. Thus, the Veteran's statements are afforded no probative value with respect to the medical question of whether he has a stomach condition that is related to his active duty service. With consideration of all of the above, while the Veteran does have a current disability, there is no evidence that the Veteran suffered from that condition while on active duty and in the absence of competent medical evidence that the Veteran has a stomach condition that is related to his military service, the preponderance of the evidence is against the Veteran's claim for service connection for a stomach condition. As such, the benefit-of-the-doubt rule does not apply, and the claim must be denied. 38 U.S.C.A. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). ORDER Entitlement to service connection for a stomach condition, claimed as secondary to herbicide, asbestos or ionizing- radiation exposure is denied. ____________________________________________ MICHELLE L. KANE Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs