Citation Nr: 18142547 Decision Date: 10/16/18 Archive Date: 10/16/18 DOCKET NO. 15-44 335 DATE: October 16, 2018 ORDER Entitlement to service connection for the Veteran’s cause of death is denied. FINDING OF FACT The probative evidence of record shows that the Veteran’s cause of death was unrelated to his military service. CONCLUSION OF LAW The criteria for service connection for the cause of the Veteran’s death have not been met. 38 U.S.C. §§ 1110, 1131, 1310, 5107(b); 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.312. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty from June 1955 to December 1958 and February 1966 to June 1966. The Veteran died in December 2013. The appellant is the Veteran’s wife. Entitlement to the Veteran’s cause of death The appellant believes that the Veteran’s death is related to his service-connected disabilities. She claims that the Veteran developed depression because of his service-connected bilateral knee disorders and gout, which caused him mobility issues. See appellant’s statement dated March 2015. As a result, the Veteran consumed alcohol as a mechanism to deal with his depression, which, in turn, manifested in his liver and kidney diseases. Id. In order to establish service connection for the cause of the Veteran’s death, the evidence of record must show that a disability incurred in or aggravated by service either caused or contributed substantially or materially to death. 38 U.S.C. § 1310 (2012); 38 C.F.R. § 3.312(a) (2017). This determination will be made by exercising sound judgment, without recourse to speculation, after a careful analysis of all the facts and circumstances surrounding the death, including, particularly, autopsy reports. Id. A service-connected disability will be considered the principal cause of death when the disability singly or jointly with some other condition was the immediate or underlying cause of death or was etiologically related thereto. 38 C.F.R. § 3.312(b). A contributory cause of death is inherently one not related to the principal cause. In determining whether the service-connected disability contributed to death, it must be shown that it contributed substantially or materially, that it combined to cause death, or that it aided or lent assistance to the production of death. It is not sufficient to show that it casually shared in producing death, but rather it must be shown there was a causal connection. 38 C.F.R. § 3.312(c). See, e.g, Schoonover v. Derwinski, 3 Vet. App. 166, 168-69 (1992); see also Mattern v. West, 12 Vet. App. 222, 227-28 (1999). In addition, VA regulations further provide that: [s]ervice-connected diseases or injuries involving active processes affecting vital organs should receive careful consideration as a contributory cause of death, the primary cause being unrelated, from the viewpoint of whether there were resulting debilitating effects and general impairment of health to an extent that would render the person materially less capable of resisting the effects of other disease or injury primarily causing death. 38 C.F.R. § 3.312(c)(3). Unfortunately, the probative evidence of record precludes granting this claim. In reaching this decision, the Board observes that the Veteran’s death certificate reflects that the immediate cause of death was due to hepatic encephalopathy and alcoholic cirrhosis. Other conditions contributing to death included acute hepato renal syndrome/renal/adrenal failure. A review, however, of his service treatment records are negative for any symptoms, treatment, diagnosis of complaints of any of the disabilities leading to his death. As noted above, the Veteran was service-connected for gout, instability of the right knee, anterior cruciate ligament laxity of the left knee, bilateral arthritis of both knees, and pilonidal cyst scar. He was also awarded a total disability rating due to individual unemployability, effective January 13, 2005. The evidence does not show that any of his service-connected disabilities was the primary or contributory cause of death. Moreover, the record shows that the Veteran never filed a claim for service connection for any psychiatric disorder, including depression, or for renal or adrenal disorder. Rather, the medical evidence of record reflects that on several occasions the Veteran continued to consume alcohol despite medical advice to the contrary. See private medical treatment records from Eastern Carolina Internal Medicine P.A. dated from December 1997; see also VA medical treatment records dated March 2007, June 2012 and March 2013. Further, there is no medical evidence linking hepatic encephalopathy and alcoholic cirrhosis with acute hepato renal syndrome/renal/adrenal failure to the Veteran’s active duty. For these reasons, the Board must deny the claim for service connection for the cause of the Veteran’s death. The preponderance of the evidence is against the claim, and under these circumstances, the benefit-of-the-doubt doctrine does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Sangster, Counsel