Citation Nr: 18141634 Decision Date: 10/11/18 Archive Date: 10/11/18 DOCKET NO. 14-24 212A DATE: October 11, 2018 ORDER Service connection for the cause of the Veteran’s death is denied. FINDINGS OF FACT 1. The Veteran died in November 2003. The Veteran’s death certificate lists the immediate cause of death as cardiomyopathy. 2. At the time of his death, the Veteran was in receipt of a 50 percent disability rating for anxiety due to service connected brain trauma (anxiety). 3. The competent evidence of record does not establish that the Veteran’s service connected anxiety caused or materially contributed to his cardiomyopathy. 4. The Veteran’s cardiomyopathy developed many years after his separation from service and is not related to service or to any incident therein. CONCLUSION OF LAW A disability incurred in or aggravated by service did not cause or contribute substantially and materially to the cause of the Veteran’s death. 38 U.S.C. § 1110, 1310, 5103, 5103A, 5107(b); 38 C.F.R. § 3.102, 3.301, 3.303, 3.312. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from October 1946 to September 1949. He died in November 2003. The appellant is his surviving spouse. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania. Service Connection for Cause of Death Service connection may be established for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110. Service connection may also be granted for any disease initially diagnosed after discharge, when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). To establish service connection for the cause of the Veteran’s death, the evidence must show that a disability incurred in or aggravated by service caused or contributed substantially or materially to cause death. For a service-connected disability to be the cause of death it must singly, or with some other condition, be the immediate or underlying cause, or be etiologically related. For a service-connected disability to constitute a contributory cause, it is not sufficient to show that it casually shared in producing death; but, rather, it must be shown that there was a causal connection. 38 C.F.R. § 3.312. In this case, the Veteran died in November 2003. The appellant contends that the Veteran’s service connected anxiety aggravated his cardiomyopathy, and was therefore, a contributing factor in causing his death. The Veteran’s death certificate indicates that his immediate cause of death was cardiomyopathy. No other conditions causing or contributing to his death were noted. The Veteran’s enlistment examination is unavailable. However, his separation examination indicates that his heart was within normal limits. The separation examination also notes that he suffered injuries to the head, legs, and knees. In March 1952, the Veteran’s anxiety was rated at 10 percent disabling. The most recent rating decision regarding the Veteran’s anxiety was in May 2002; that decision determined that a 50 percent rating continued to be warranted for the anxiety, but no higher. The medical evidence of record indicates that the Veteran was diagnosed with cardiomyopathy in March 2002. However, the record is devoid of any medical evidence establishing a connection between the anxiety and his diagnosed cardiomyopathy, or between his cardiomyopathy and service. In December 2012, and March 2013, the RO sent letters to the appellant requesting medical evidence documenting that the Veteran’s death had any relationship to military service. No medical evidence was submitted. Therefore, the claims file lacks competent evidence linking the Veteran’s cardiomyopathy to his active military service. The only evidence that has been received regarding a connection between the Veteran’s anxiety and his cardiomyopathy is the appellant’s lay assertions. In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Layno v. Brown, 6 Vet. App. 465, 469 (1994). Lay testimony is competent when it regards the readily observable features or symptoms of injury or illness. See Layno, 6 Vet. App. at 469; 38 C.F.R. § 3.159(a)(2). Although lay persons are competent to provide opinions on some medical issues, See Kahana v. Shinseki, 24 Vet. App. 428 (2011), an opinion as to the connection between the Veteran’s cause of death and his service connected anxiety falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The Board is mindful of the appellant’s sincere belief that the Veteran’s cause of death is the result of anxiety caused by his service. However, she has not been shown to have the training or expertise to render such a medically complex opinion. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau, 492 F. 3d 1372, 1376-77 (Fed. Cir. 2007). A medical doctor signed the Veteran’s death certificate, and found that the cause of death was cardiomyopathy. The doctor did not indicate that any other conditions caused or contributed to the Veteran’s death. Moreover, no additional opinions have been received opining that anxiety contributed to the Veteran’s death. [CONTINUED ON NEXT PAGE] The standard of proof to be applied in decisions on claims for Veterans’ benefits is set forth at 38 U.S.C. § 5107. A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence. 38 C.F.R. § 3.102. Because there is no evidence that the Veteran’s cardiomyopathy was caused or contributed to by his active military service, service connection for cause of death is denied. As the weight of the evidence is against the claim, the “benefit of the doubt” rule is not for application. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Temple, Associate Counsel