Citation Nr: 18143181 Decision Date: 10/18/18 Archive Date: 10/18/18 DOCKET NO. 16-32 796 DATE: October 18, 2018 ORDER Entitlement to service connection for tonsillar cancer is denied. FINDING OF FACT Tonsillar cancer was not demonstrated inservice, it was not compensably disabling within a year of the claimant’s separation from active duty, and there is no competent evidence showing that it is related to active duty service. CONCLUSION OF LAW Tonsillar cancer was not incurred or aggravated inservice, and it may not be presumed to have been so incurred. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1969 to May 1971. The Board of Veterans’ Appeals (Board) acknowledges the Veteran was not provided a Department of Veterans Affairs (VA) examination or medical opinion in response to his claim for service connection for tonsillar cancer. VA must provide a VA examination when there is evidence of (1) a current disability, (2) an in-service event, injury, or disease, (3) some indication that the claimed disability may be associated with the established event, injury, or disease, and (4) insufficient competent evidence of record for VA to make a decision. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); see also 38 U.S.C. § 5103A(d), 38 C.F.R. § 3.159(c)(4)(i). The threshold for finding that the evidence of record indicates that the claimed disability or symptoms may be related to service is a low. McLendon, 20 Vet. App. at 83. In this case, there is no competent evidence that tonsillar cancer was manifested in service, or that the disorder was compensably disabling within a year of his separation from active duty. In addition, while the Veteran is presumed to have been exposed to Agent Orange in light of his service with the crew of the USS Walke on the Mekong River in September 1969, there is no competent evidence suggesting a link between tonsillar cancer and his active duty service to include due to inservice herbicide exposure. It is well to note that cancer of the tonsils is not considered by VA to be a respiratory cancer. 38 C.F.R. § 3.309(e). Therefore, VA is not obliged to provide an examination or obtain an opinion in response to the claim. Based on the foregoing, the Board finds that all relevant facts have been properly and sufficiently developed in this appeal, and no further development is required to comply with the duty to assist the Veteran in developing the facts pertinent to the matters decided below. Neither the Veteran nor his attorney has raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (“the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). The Veteran asserts that his tonsillar cancer is due to herbicide agent exposure. Specifically, he asserts that he was exposed to Agent Orange while serving aboard the USS Walke (DD-723) during his Vietnam service. See May 2013 Statement. Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). If a veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases, shall be service connected if the requirements of 38 C.F.R. § 3.307(a)(6)(iv) are met. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6)(iv), 3.309(e). These diseases must become manifest to a degree of 10 percent or more at any time after service. 38 C.F.R. § 3.307(a)(6)(ii). While the Veteran is presumed to have been exposed to herbicides while on active duty, the list of diseases presumed under the law to have been incurred due to inservice herbicide exposure does not include tonsillar cancer. The record does reflect a current diagnosis for tonsillar cancer. See April 2015 Treatment Report. Service treatment records are, however, absent for any complaints or treatment for tonsil cancer. Further, there is no clinical evidence showing that tonsillar cancer was compensably disabling within a year of the claimant’s separation from active duty. Finally, there is no medical evidence to support that the Veteran’s tonsillar cancer is related to military service. While a veteran is competent to describe symptoms that he is able to perceive through the use of his senses and to give evidence about what he has experienced, Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007), the appellant is not shown to possess any medical expertise to provide an opinion addressing the etiology of his tonsillar cancer. Thus, his opinion as to the etiology of his tonsillar cancer is not competent medical evidence. Moreover, whether any symptoms the Veteran experienced in service or following service are in any way related to his current disability requires medical expertise to determine. See Clyburn v. West, 12 Vet. App. 296, 301 (1999) (“Although the veteran is competent to testify to the pain he has experienced since (service), he is not competent to testify to the fact that what he experienced in service and since service is the same condition he is currently diagnosed with.”). In summary, the preponderance of the most probative evidence is against a finding that the Veteran has tonsillar cancer that was caused or aggravated by service. Thus, the claim for service connection is denied. In reaching this decision the Board considered the doctrine of reasonable doubt, however, as the preponderance of the evidence is against the appellant’s claim, the doctrine is not for application. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). DEREK R. BROWN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Gonzalez, Associate Counsel