Citation Nr: 1102346 Decision Date: 01/20/11 Archive Date: 01/26/11 DOCKET NO. 05-21 273A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Columbia, South Carolina THE ISSUE Entitlement to service connection for a lung condition, to include asbestosis, chronic obstructive pulmonary disease (COPD), bronchospasm, dyspnea, and obstructive airway disease, including as secondary to in-service exposure to asbestos and ammonia. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESSES AT HEARING ON APPEAL Appellant and spouse ATTORNEY FOR THE BOARD E. Woodward Deutsch, Associate Counsel INTRODUCTION The Veteran had active military service from July 1955 to May 1966. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2004 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Columbia, South Carolina. In September 2006, the Veteran testified during a videoconference hearing before the undersigned Veterans Law Judge; a transcript of that hearing is of record. During the hearing, the Veteran submitted additional VA medical records along with a waiver of initial RO consideration of the evidence. Thereafter, in June 2009, the Veteran submitted further VA medical records and lay statements directly to the Board, and his representative subsequently waived the right to have that evidence reviewed by the RO. Accordingly, the Board accepts all of this recently submitted evidence for inclusion in the record. See 38 C.F.R. § 20.800 (2009). In remands dated in March 2007 and October 2008, the Board directed the RO, via the Appeals Management Center (AMC), to obtain additional VA and private treatment records and afford the Veteran a VA pulmonary examination. Thereafter, in February 2010, the Board requested a Veterans Health Administration (VHA) opinion with respect to the Veteran's claim. That additional development is now complete. As a final introductory matter, the Board recognizes that the issue on appeal was originally phrased as entitlement to service connection for asbestosis (claimed as a lung condition). However, in light of the clinical evidence of record showing diagnoses of COPD, bronchospasm, dyspnea, and obstructive airway disease, the Veteran's lay statements and hearing testimony asserting that he has asbestosis or a related lung condition due to in-service asbestos and ammonia exposure, and the recent determination in Brokowski v. Shinseki, 23 Vet. App. 79, 85-86 (2009), the Board has rephrased the issue on appeal as it appears on the title page of this decision. FINDING OF FACT There is no competent evidence of record that links any currently diagnosed lung condition to the Veteran's in-service asbestos exposure, claimed ammonia exposure, or any other aspect of his active service. CONCLUSION OF LAW Service connection for a lung disorder, to include as secondary to asbestos and/or ammonia exposure is not warranted. 38 U.S.C.A. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. § 3.303 (2009). REASONS AND BASES FOR FINDING AND CONCLUSION I. Veterans Claims Assistance Act of 2000 (VCAA) VA has complied with the duty-to-notify provisions of the Veterans Claims Assistance Act (VCAA). 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b)(1); Quartuccio v. Principi, 16 Vet. App. 183, 197 (2002). In particular, letters from the RO and AMC in March 2004 and May 2007 (1) informed the Veteran of the information and evidence not of record that was necessary to substantiate his claim; (2) informed him of the information and evidence that VA would obtain and assist him in obtaining; and (3) informed him of the information and evidence he was expected to provide. Pelegrini v. Principi, 18 Vet. App. 112 (2004) (Pelegrini II). In Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006), aff'd sub nom. Hartman v. Nicholson, 483 F.3d 1311 (2007), the Court held that the VCAA notice requirements of 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b) apply to all five elements of a service- connection claim: (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. The RO/AMC sent the Veteran a VCAA notice letter in May 2007, and has since gone back and readjudicated his claim in the April 2008 and May 2009 supplemental statements of the case (SSOCs), including considering any additional evidence received in response to that additional notice. This is important to point out because the Federal Circuit Court recently held that a statement of the case or supplemental SOC (SSOC) can constitute a "readjudication decision" that complies with all applicable due process and notification requirements if adequate VCAA notice is provided prior to the SOC or SSOC. See Mayfield v. Nicholson, 07-7130 (Fed. Cir. September 17, 2007) (Mayfield IV). As a matter of law, the provision of adequate VCAA notice prior to a readjudication "cures" any timing problem associated with inadequate notice or the lack of notice prior to an initial adjudication. See also Prickett v. Nicholson, 20 Vet. App. 370, 376 (2006). Consequently, even assuming that there is any deficiency in the notice to the Veteran, or the timing of the notice, it is harmless error. See Overton v. Nicholson, 20 Vet. App. 427, 435 (2006) (finding that the Board had erred by relying on various post-decisional documents for concluding that adequate 38 U.S.C.A. § 5103(a) notice had been provided to the appellant, but determining nonetheless that the evidence established the Veteran was afforded a meaningful opportunity to participate effectively in the adjudication of his claims, so found the error was harmless). Moreover, if there was any deficiency in the notice to the Veteran, the Board finds that the presumption of prejudice on VA's part has been rebutted. First, based on the communications sent to him over the course of this appeal and his responses, he clearly has actual knowledge of the evidence he is required to submit and needed to substantiate his claim. Secondly, based on his contentions he is reasonably expected to understand from the notices what was needed. See Sanders v. Nicholson, 487 F.3d 881 (2007). VA also fulfilled its duty to assist by obtaining all relevant evidence concerning the claim under 38 U.S.C.A. § 5103A and 38 C.F.R. § 3.159. All pertinent private and VA medical records identified by the Veteran and his representative have been obtained. Additionally, the Veteran and his representative have submitted lay statements and provided testimony at a Board hearing. They have not made VA aware of any additional evidence that needs to be obtained in order to fairly decide the Veteran's claim. The Board recognizes that, as part of its duty to assist, VA is obligated to provide a medical examination and/or seek a medical opinion when such examination or opinion is necessary to make a decision on the claim. VA considers an examination or opinion necessary to make a decision on the claim if the evidence of record (1) contains competent evidence that the claimant has a disability, or persistent recurring symptoms of disability; (2) indicates the disability or symptoms may be associated with his military service; and (3) contains insufficient medical evidence for VA to make a decision on the claim. See 38 U.S.C.A. § 5103A(d); 38 C.F.R. § 3.159(c)(4). See also McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this case, the Veteran was afforded a January 2009 VA pulmonary examination which yielded evidence pertinent to his claim for service connection for a lung disability. Additionally, the Board obtained a June 2010 Veterans Health Administration (VHA) opinion from a VA pulmonologist regarding whether any currently diagnosed lung disability was related to the Veteran's reported in-service exposure to asbestos and ammonia, or to any other aspect of his military service. The Board recognizes that the Veteran and his representative have asserted that the January 2009 VA examination was inadequate because it failed to explain "what information or medical reasons the [pulmonary function tests] PFTs showed patterns not typical of asbestos exposure" and did not address the Veteran's alternate contention that he acquired a lung condition through in-service ammonia exposure. Additionally, the Board is cognizant of the Veteran's representative's allegation that the January 2009 VA examiner did not have the requisite qualifications to render an opinion regarding the etiology of the Veteran's lung condition. As will be discussed in greater detail, below, however, the January 2009 VA examiner reported the PFT findings in full and explained how they reflected an obstructive pattern of breathing not typically associated with exposure to asbestos. Moreover, that examination was conducted by a licensed physician certified to perform VA examinations. The representative has not articulated, and the evidence of record does not otherwise show, any reason why that examiner should be considered unqualified. In any event, the Board has now obtained a VHA opinion from a pulmonary expert that specifically addresses the Veteran's contentions that he has lung disability that is related to in- service asbestos or ammonia exposure. That VHA examiner's opinion is supported by a detailed rationale and is reconciled with all medical and other pertinent information in the claims folder. As such, the Board finds that any deficiency associated with the prior January 2009 VA examination has been cured by the June 2010 VHA opinion and that VA is not required to afford the Veteran another VA etiological examination and opinion pursuant to 38 C.F.R. § 3.159(c)(4). In light of the foregoing, the Board finds that VA has done everything reasonably possible to notify and assist the Veteran and that no further action is necessary to meet the requirements of the VCAA. The Board will now turn to the merits of the Veteran's claim. II. Whether the Veteran is Entitled to Service Connection for a Lung Condition The Veteran, in written statements and testimony before the Board, contends that his currently diagnosed lung problems had their onset during his period of active service and that service connection is therefore warranted. Specifically, he asserts that he developed these problems as a result of exposure to asbestos while serving in the Navy as an engine repairman and firefighter. In the alternative, the Veteran alleges that he developed a lung condition through exposure to ammonia while working at an ice house in Morocco during his active service. Service connection is established where a particular injury or disease resulting in disability was incurred in the line of duty in active military service or, if preexisting such service, was aggravated during service. 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. § 3.303(a) (2009). Generally, in order to prevail on the issue of service connection on the merits, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in- service occurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in service disease or injury and the present disease or injury. See Hickson v. West, 12 Vet. App. 247, 253 (1999). In addition, service connection may be presumed for certain chronic diseases that are manifested to a compensable degree within one year after separation from service. 38 U.S.C.A. §§ 1101, 1112, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a). However, neither asbestosis, COPD, nor any of the other lung conditions with which the Veteran has been diagnosed are diseases subject to presumptive service connection. In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C.A. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 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 has issued a circular on asbestos-related diseases, which provides guidelines for considering compensation claims based on exposure to asbestos. DVB Circular 21-88-8, Asbestos-Related Diseases (May 11, 1988). The information and instructions from the DVB Circular have been included in the VA Adjudication Procedure Manual, M21-1 (M21-1), Part VI, § 7.21. In December 2005, M21-1, Part VI was rescinded and replaced with a new VA Adjudication Procedure Manual, M21-1MR. The U.S. Court of Appeals for Veterans Claims (Court) has held that VA must analyze an appellant's claim for service connection for asbestosis or asbestos-related disabilities under the administrative protocols under these guidelines. See Ennis v. Brown, 4 Vet. App. 523 (1993); McGinty v. Brown, 4 Vet. App. 428 (1993). The applicable section of M21-1MR is Part IV, Subpart ii, Chapter 1, Section H, topic 29. It lists some of the major occupations involving exposure to asbestos, including 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, manufacture and installation of roofing and flooring materials, asbestos cement and pipe products, and military equipment. High exposure to respirable asbestos and a high prevalence of disease have been noted in insulation and shipyard workers. Here, the Veteran's service personnel records reflect that he served on the USS Limpkin, USS Grand Canyon, USS Fiske, USS Kankakee and the USS Fulton. His DD Form 214 lists his military occupational specialties as engine man and fireman, each of which entails a high probability of asbestos exposure. Accordingly, in light of the aforementioned guidelines provided in the VA Adjudication Procedure Manual, M21-1MR, and resolving all reasonable doubt in the Veteran's favor, the Board finds that he likely was exposed to asbestos in service. See M21-1, VBA Adjudication Procedure Manual M21-1 Manual Rewrite (M21-1 MR), Part IV, Subpart ii, Ch. 2, Section C, Topic 9 and Section H, Topic 29 (Dec. 13, 2005); 38 C.F.R. § 4.3. The Board's inquiry does not end here, however, as it must now consider whether a nexus exists between the Veteran's in-service asbestos exposure and any current lung condition, including asbestosis, COPD, bronchospasm, dyspnea, and obstructive airway disease. See Hickson, supra. The Veteran's service treatment records reflect that in January 1961, he was treated for complaints of coughing, congestion, and heart palpitations. However, on clinical examination, his chest was found to be clear and he was returned to active duty. In February 1962, he sought treatment for chest pains, but physical examination and chest X-rays did not yield any diagnosis of a chest or lung disorder. In May 1963, the Veteran was afforded medical care as a result of exposure to a case of active tuberculosis. However, several chest X-rays taken at this time were negative. His service treatment records are otherwise silent as to any complaints, diagnoses, or treatment of asbestosis or related lung problems. On examination prior to his separation from service in May 1966, the Veteran did not report, nor did the clinical findings reveal, any abnormalities pertaining to the lungs. Accordingly, the Board finds that a chronic lung disorder in service is not established in this case. See 38 C.F.R. § 3.303(b). As chronicity in service has not been established, a showing of continuity of symptoms after discharge is required to support the Veteran's claim for service connection for a lung condition. Id. The first post-service clinical evidence pertaining to the Veteran's claim consists of a July 2000 VA general examination in which he denied any shortness of breath or chest pains. Nor did he report any other respiratory problems. Clinical evaluation was negative for COPD and no other pulmonary disorders were diagnosed. Chest X-rays taken in February 2003 and September 2003 were also negative for any lung abnormalities. Private treatment records from Palmetto Health, dated in April 2005, show that the Veteran was found to have a history of bronchospasm and dyspnea (shortness of breath) and was diagnosed with COPD. Subsequent VA medical records indicate that the Veteran has continued to receive periodic treatment for lung and respiratory problems. Specifically, those records contain clinical findings of "diffuse moderate wheezing bilaterally" and a "sub centimeter pleural based nodule in the left mid-lung field," shown on X-ray. The Veteran's chest X-rays, however, reveal no evidence of interstitial changes, pulmonary fissures, or pleural plaques. In addition to the above clinical findings, the record contains PFT results, which reflect borderline airway obstruction with no improvement after inhaled bronchodilators. Significantly, however, no private or VA medical provider has opined that the Veteran's currently diagnosed lung problems were caused by asbestos exposure in the Navy or are otherwise related to his period of active service. Moreover, his VA medical treatment records show that he has a long history of tobacco use, thereby suggesting that his COPD, bronchospasm, dyspnea, and related pulmonary symptoms have been caused or aggravated by risk factors, such as smoking, which are not related to service. Pursuant to the Board's remand, the Veteran was afforded a January 2009 VA pulmonary examination to address the etiology of his current lung problems. At that examination, the Veteran reported a history of in-service asbestos exposure as well as a nonservice-related history of pulmonary risk factors manifested by smoking one pack of cigarettes per day for more than 50 years. He also acknowledged that he did not develop any symptoms of lung disease until the 1980s. Since that time, the Veteran maintained, his lung problems had progressively worsened to the point where he was unable to walk more than 10-15 feet without experiencing shortness of breath. He stated that he used an inhaler three to four times daily, which had "some moderate effect" in alleviating his symptoms. Nevertheless, the Veteran emphasized that he was unable to engage in strenuous activities or perform many of the activities of daily living due to his lung problems. On physical examination, the Veteran was noted to walk fairly slowly. He appeared in "no acute distress" and did not seem "particularly short of breath." During a period of rest, his oxygen saturation level was measured as 96 percent on room air. His heart rate was assessed as 71 beats per minute. Additionally, the Veteran was found to manifest some end- inspiratory wheezing in the lung bases, bilaterally, as well as some upper pulmonary rhonchi, with lung sounds that were "clear but distant in the upper areas." The VA examination also included a cardiac echocardiogram, which revealed an estimated ejection fraction of 64 percent, accompanied by mild aortic and mitral valve regurgitation. On PFTs administered prior to his use of bronchodilators, the Veteran exhibited a forced expiratory volume in one second (FEV-1) of 2.26, or 29 percent of predicted value, a Forced Vital Capacity (FVC) of 3.13, or 79 percent of predicted value, a FEV-1/FVC ratio of 72 percent. Following the use of bronchodilators, his FEV-1/FVC ratio was assessed as 69 percent. The VA examiner noted that these PFT results demonstrated borderline airway obstruction that underwent no significant improvement through the use of bronchodilators. Based upon the results of the examination and a review of the claims folder, the VA examiner diagnosed the Veteran with mild to moderate obstructive airway disease, but opined that his lung condition was less likely than not related to his in-service asbestos exposure. As a rationale for that opinion, the VA examiner noted that the PFT findings were consistent with an obstructive airway pattern that was not typical of asbestos exposure. Additionally, that VA examiner observed that the Veteran "had a long 50-year history of smoking one pack per day" and that it was "much more likely that his current pulmonary condition [was] related to his long smoking history than [to] asbestos exposure." In February 2010, the Board requested a Veterans Health Administration (VHA) opinion from a VA pulmonologist regarding whether any currently diagnosed lung disability had been caused or aggravated by the Veteran's reported in-service asbestos exposure. The Board also requested that the VHA opinion address whether any current lung disability was related to the Veteran's reports of ammonia exposure while stationed in Morocco, or any other aspect of his military service. In a June 2010 opinion, a VA pulmonologist, after reviewing the Veteran's claims folder and relevant medical literature, determined that the Veteran had only minimal pulmonary impairment, which was unrelated to his reported in-service asbestos and ammonia exposure. As a rationale for that opinion, the VHA examiner observed that, since July 2000, the Veteran had undergone multiple pulmonary evaluations, including PFTs that showed his forced vital capacity (FVC) and forced expiratory in one second (FEV-1) to be no worse than 79 percent and 73.7 percent of predicted value, respectively. The VHA examiner observed that those PFT results and the other clinical evidence of record revealed only minimal airway obstruction, which was attributable to the Veteran's long history of cigarette smoking. In this regard, the VHA examiner noted that, despite his smoking history, the Veteran's overall lung function was better preserved than most men of his age. Additionally, the VHA examiner opined that the Veteran did not exhibit any symptoms of asbestos- or ammonia-related lung disease, specifically interstitial changes, pleural plaques and thickening, and pulmonary fissures and scars. An evaluation of the probative value of medical opinion evidence is based on the medical expert's personal examination of the patient, the examiner's knowledge and skill in analyzing the data, and the medical conclusion reached. The credibility and weight to be attached to such opinions are within the province of the Board as adjudicators. Guerrieri v. Brown, 4 Vet. App. 467, 470-471 (1993). The probative value of a medical opinion is generally based on the scope of the examination or review, as well as the relative merits of the expert's qualifications and analytical findings, and the probative weight of a medical opinion may be reduced if the examiner fails to explain the basis for an opinion. See Sklar v. Brown, 5 Vet. App. 140, 146 (1993). The Board finds the opinions set forth by the January 2009 VA examiner and the June 2010 VHA examiner, which collectively indicate that the Veteran does not have a current lung disability related to his reported in-service asbestos and ammonia exposure, to be both probative and persuasive. The January 2009 VA examiner's opinion was based on that examiner's thorough and detailed examination of Veteran and the claims folder and supported by a rationale. See Prejean v. West, 13 Vet. App. 444, 448 (2000) (factors for assessing the probative value of a medical opinion include the physician's access to the claims folder and the Veteran's history, and the thoroughness and detail of the opinion). Similarly, the June 2010 VHA examiner based his opinion on a thorough and detailed examination of claims folder and supported that opinion with a detailed rationale that expressly considered and reconciled the findings of the prior January 2009 VA examination and the other pertinent evidence of record. Id. Additionally, the Board considers it significant that the VHA examiner's opinion constitutes the most recent medical evidence of record and was undertaken directly to address the issue on appeal. The Board acknowledges the argument advanced by the Veteran's representative that the January 2009 VA examiner's opinion is inadequate because it "fail[s] to provide what information or medical reasons the PFTs showed patterns not typical of asbestos exposure." As noted in that representative's August 2009 post- remand brief, VA medical opinions must include specific reasons or bases for all conclusions reached in order to be considered probative. See Connolly v. Derwinski, 1 Vet. App. 566, 569 (1991) (holding that Board erred in relying on "generally accepted medical principles," which it failed to explicitly name and discuss); see also Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990) (Board decisions must include the 'reasons or bases' for medical conclusions, even those opined by the VA physician; a mere statement of an opinion, without more, is insufficient); Colvin v. Derwinski, 1 Vet. App. 171, 174-75 (1991). Nevertheless, the Board finds that the VA examiner's January 2009 opinion contains a lengthy discussion of the PFT results and explains how those results, showing borderline airway obstruction with no significant improvement after bronchodilators, are inconsistent with an obstruction pattern due to asbestos exposure and more likely a manifestation of smoking-related lung problems. In so doing, the VA examiner's opinion provides a sufficient rationale, comprised of specific reasons and bases, for why the Veteran's currently diagnosed lung condition is less likely than not related to his in-service asbestos exposure. The Board is also cognizant of the contention raised by the Veteran's representative that "it is not clear what qualifications" the January 2009 VA examiner had to opine on the etiology of the Veteran's lung condition. However, there has been no evidence submitted by the Veteran's representative, or otherwise provided in the record, indicating that the January 2009 examiner, a medical doctor certified to perform VA examinations, was unqualified to render an opinion in this case. Even assuming, without deciding, that the January 2009 VA examination was deficient for all of the reasons noted above, the Board finds that those deficiencies were cured by the subsequent opinion rendered by the VHA examiner. That opinion included a lengthy rationale, with specific reasons and bases for the VHA examiner's findings. Moreover, that VHA examiner was a physician who was part of VA's pulmonary service, making him clearly qualified to opine on the etiology of the Veteran's lung condition. Furthermore, that VHA examiner expressly addressed the Veteran's contentions that his current lung problems were caused by either asbestos or ammonia exposure in service. In so doing, that VHA examiner supplemented the January 2009 VA examiner's findings, which only addressed the theory of in- service asbestos exposure. While expanding upon the prior VA examiner's findings, however, the June 2010 VHA opinion did not contradict those findings. Nor did that VHA opinion conflict with any of the other pertinent evidence of record. Accordingly, the Board finds that the June 2010 VHA examiner's opinion effectively resolved any underlying defect in the January 2009 VA examination and that an additional VA examination is not warranted. 38 C.F.R. § 3.159(c)(4). Based upon a careful review of the record, the Board finds that the evidence is against a finding of a nexus between military service and the Veteran's current lung problems. See Degmetich v. Brown, 104 F.3d 1328 (Fed. Cir. 1997); Rabideau v. Derwinski, 2 Vet. App. 141 (1992). As noted above, the January 2009 VA examiner and June 2010 VHA examiner collectively concluded that none of the Veteran's current lung problems are related to any in-service asbestos or ammonia exposure, and the Board affords that those opinions carry great probative weight. Accordingly, the Board finds that service connection for a lung condition, to include as secondary to in-service asbestos and/or ammonia exposure, is not warranted. Nor is service connection warranted on a direct basis. As discussed above, the Veteran was not diagnosed with any lung disability in service. No complaints or clinical findings of lung problems were made at the time of his discharge. The first post-service evidence of treatment for breathing problems and a diagnosis of COPD is dated in April 2005, nearly 39 years after his separation from service. Moreover, while the Veteran informed the January 2009 VA examiner that he first developed symptoms of lung disease in the 1980s, the onset of those symptoms, by the Veteran's own account, is still many years after he left service. In view of the lengthy period without complaints, diagnoses, or treatment related to asbestosis or any other lung condition, there is no evidence of a continuity of symptomatology, and this weighs heavily against the claim. See Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). In addition, the Board notes that the link between lung problems and smoking is well known. The Veteran's long history of smoking is documented in the claims folder and was noted by both the January 2009 and June 2010 VA examiners as a likely causal or aggravating factor in the development of his current lung condition. This provides further evidence against his claim. The Board is sympathetic to the Veteran's contentions that his current lung problems are related to his active service, including to in-service exposure to asbestos and/or ammonia. Lay evidence is one type of evidence that the Board must consider when a Veteran's claim seeks disability benefits. See 38 C.F.R. § 3.307(b) (2009). The Veteran is certainly competent, as a lay person, to state that he was exposed to asbestos and ammonia in service. See McGinty v. Brown, 4 Vet. App. 428, 432 (1993). He is also competent to report symptoms of which he has personal knowledge, in this case shortness of breath and related respiratory problems, and the Board finds his account credible. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). However, the Board finds that the Veteran is not competent to offer a medical opinion as to the cause or etiology of his current lung problems, as there is no evidence of record that he has specialized medical knowledge in dealing with pulmonary disabilities. See Routen v. Brown, 10 Vet. App. 183, 186 (1997) (layperson is generally not capable of opinion on matter requiring medical knowledge); Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992). Accordingly, the Board finds that the Veteran's lay statements and testimony as to medical causation and etiology, in the absence of any corroborating medical opinion evidence, lack sufficient probative value to establish a nexus between his current lung problems and his time in service. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) (whether lay evidence is competent and sufficient in a particular case is a fact issue to be addressed by the Board). In sum, the Board finds that the preponderance of the evidence weighs against a finding that any current lung condition is due to in-service asbestos and/or ammonia exposure, or is otherwise related to the Veteran's period of active service. As the preponderance of the evidence is against the claim for service connection, the benefit of the doubt rule is not for application, and the claim must be denied. See 38 U.S.C.A. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). ORDER Service connection for a lung condition is denied. ____________________________________________ K. OSBORNE Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs