Citation Nr: 18143038 Decision Date: 10/18/18 Archive Date: 10/17/18 DOCKET NO. 14-34 705A DATE: October 18, 2018 ORDER Service connection for the cause of the Veteran's death is denied. FINDINGS OF FACT 1. The Veteran served on active duty from April 1969 to April 1971. 2. The Veteran served in the Republic of Vietnam and is presumed to have been exposed to herbicide agents in service. 3. The Veteran died in December 2001; the immediate cause of death was a metastatic colon cancer. 4. At the time of his death, the Veteran was not service connected for any disability. 5. The cause of the Veteran’s death was not etiologically related to service. CONCLUSION OF LAW The cause of the Veteran’s death was not incurred in or aggravated by active service, and cannot be presumed to have been incurred therein. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1310, 5103A, 5103(a) (2012); 38 C.F.R. §§ 3.102, 3.312 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION To establish service connection for the cause of a veteran’s death, the evidence must show that disability incurred in or aggravated by service either 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, a causal connection must be shown. 38 U.S.C. § 1310; 38 C.F.R. § 3.312. There are primary causes of death which by their very nature are so overwhelming that eventual death can be anticipated irrespective of coexisting conditions, but, even in such cases, there is for consideration whether there may be a reasonable basis for holding that a service-connected condition was of such severity as to have a material influence in accelerating death. 38 C.F.R. § 3.312(c)(4). In such a situation, however, it would not generally be reasonable to hold that a service-connected condition accelerated death unless such condition affected a vital organ and was of itself of a progressive or debilitating nature. In adjudicating a claim, the Board determines whether the weight of the evidence supports the claim or, whether the weight of the “positive” evidence in favor of the claim is in relative balance with the weight of the “negative” evidence against the claim. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. The basic facts are not in dispute. The Veteran died in December 2001. His immediate cause of death was listed metastatic colon cancer. There were no other significant conditions contributing to death. At the time of death, he was not service connected for any disability. The appellant asserts that exposure to herbicides in service caused the Veteran’s death. Initially, the service treatment records (STRs) do not show treatment or diagnosis related to colon cancer, or any symptomatology reasonably attributable thereto. At his April 1971 separation examination, no gastrointestinal complaints or findings were noted and examination of all systems was normal. Symptoms consistent with colon cancer were not shown until decades after his separation from active service and the appellant does not argue that the colon cancer began during service. Therefore, the colon cancer that caused his death is not directly related to service. The appellant’s primary contention is that the Veteran developed colon cancer as a result of in-service exposure to Agent Orange. His DD-214 confirms his service in the Republic of Vietnam. Accordingly, exposure to herbicide agents is presumed. Nonetheless, colon cancer is not a disability for which service connection is warranted on a presumptive basis due to herbicide exposure. 38 C.F.R. § 3.309(e). Therefore, service connection for colon cancer on the basis of presumed exposure to Agent Orange is denied. Notwithstanding the inapplicability of the Agent Orange presumptive service connection regulations, the Board has considered the claim on a direct exposure basis. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). As noted, there were no in-service complaints of, treatment for, or diagnosis related to colon cancer. However, the appellant has raised the argument that the Veteran’s colon cancer was a result of his in-service exposure to Agent Orange. In support of her claim, the appellant no medical evidence; only her lay statements describing her belief that the Veteran’s colon cancer was caused by herbicide exposure. She is competent to report her observations about the Veteran’s health and ultimate death because this requires only personal knowledge as it comes to her through her senses. Layno v. Brown, 6 Vet. App. 465, 469 (1994). However, she is not competent to offer an opinion as to the causes of his death due to the medical complexity of the matter involved. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Woehlaert v. Nicholson, 21 Vet. App. 456, 462. As such, her opinion alone is insufficient to establish a relationship between colon cancer and his death. As noted above, to establish service connection for the cause of a veteran’s death, the evidence must show that a disability incurred in or aggravated by service caused or contributed substantially or materially to cause the veteran’s death. In this case, other than the appellant’s lay statements, the evidence does not show that the Veteran’s colon cancer was incurred as a result of or aggravated by his in-service herbicide agent exposure. Therefore, the appeal is denied. Finally, the appellant has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not   required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Redman, Counsel