Citation Nr: 18143458 Decision Date: 10/19/18 Archive Date: 10/19/18 DOCKET NO. 14-27 840A DATE: October 19, 2018 ORDER Entitlement to service connection for the cause of the Veteran’s death is denied. Entitlement to a special monthly pension (SMP) for a surviving spouse, based on the need for regular aid and attendance or by reason of being housebound, is denied. FINDINGS OF FACT 1. The probative evidence of record shows that the Veteran’s cause of death was unrelated to his military service. 2. The preponderance of the evidence is against finding that the appellant was in need of regular aid and attendance or was housebound during the period on appeal. CONCLUSIONS OF LAW 1. The criteria for service connection for the cause of the Veteran’s death have not been met. 38 U.S.C. §§ 1110, 1310, 5107(b); 38 C.F.R. §§ 3.303, 3.312. 2. The criteria for special monthly pension for a surviving spouse based on the need for aid and attendance or by reason of being housebound have not been met. 38 U.S.C. §§ 1502, 1503, 1541; 38 C.F.R. §§ 3.3. 3.23, 3.50, 3.351, 3.352. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from June 1953 to April 1955. The Veteran died in May 2011. The appellant is the Veteran’s surviving spouse. Cause of Death 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; 38 C.F.R. § 3.312(a). 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. 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). The Board finds that the weight of 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 renal failure and chronic renal disease. Significant contributing factors were severe dementia, bladder cancer, and prostate cancer. A review, however, of his service treatment records are negative for any symptoms, treatment, diagnosis, or complaints of any of the disabilities leading to his death. Particularly of note, the Veteran did not have any service-connected disabilities. Moreover, the record shows that the Veteran never filed a claim for service connection for the above-listed causes of death and contributing factors. Finally, there is no medical evidence linking the Veteran’s causes of death and contributing factors to service. The appellant is not competent 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. SMP Pension benefits are available to surviving spouses of veterans with qualifying service who meet specific income and net worth requirements. See 38 C.F.R. § 3.3(b). VA law provides that a pension is payable to surviving spouses of veterans of a period of war. Basic entitlement exists if the veteran served in the active military, naval, or air service for 90 days or more during a period of war, or who at the time of death was receiving compensation for a service-connected disability, subject to certain net worth and annual income requirements. See 38 U.S.C. § 1541; 38 C.F.R. § 3.3. Improved pension rates are provided for surviving spouses in need of aid and attendance or is permanently housebound. See 38 U.S.C. § 1541(d)-(e); 38 C.F.R. § 3.23(a)(6). These improved pension rates for a surviving spouse are similarly limited to specific monetary awards and offset by the income of the surviving spouse. See 38 U.S.C. § 1541; 38 C.F.R. § 3.23. Need for aid and attendance means helplessness or being so nearly helpless as to require the regular aid and attendance of another person. See 38 U.S.C. § 1502(b); 38 C.F.R. § 3.351(b). The surviving spouse will be considered in need of regular aid and attendance if he or she is blind or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to five degrees or less; is a patient in a nursing home because of mental or physical incapacity; or establishes a factual need for aid and attendance under the criteria set forth in 38 C.F.R. § 3.352(a). See 38 U.S.C. § 1502(b); 38 C.F.R. § 3.351(c). Increased pension shall be as prescribed if, in addition to having a single permanent disability rated 100 percent disabling under the Schedule for Rating Disabilities there is additional disability or disabilities independently ratable at 60 percent or more, separate and distinct from the permanent disability rated as 100 percent disabling and involving different anatomical segments or bodily systems, or is “permanently housebound” by reason of disability or disabilities. Permanently housebound means the individual is substantially confined to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical area, and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime. 38 C.F.R. § 3.351(d). As a preliminary matter, the Board notes that the appellant is already in receipt of pension. Accordingly, the remaining issue to be determined is whether the appellant meets the requirements for an improved pension based on her need of aid and attendance of another person. Having reviewed the record, the Board finds that entitlement to SMP for a surviving spouse has not been established based on aid and attendance or by reason of being housebound. Other than general assertions that she is disabled, the appellant has not submitted any evidence showing that she is in need of regular aid and attendance due to being blind or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to five degrees or less. Additionally, she has not shown that she is a patient in a nursing home because of mental or physical incapacity. Moreover, she has not established a factual need for aid and attendance under the criteria set forth in 38 C.F.R. § 3.352(a). Further, the evidence does not show that the appellant is permanently housebound by reason of disability or disabilities. For these reasons, the Board must deny the claim for entitlement to SMP based on the need for aid and attendance or by reason of being housebound. 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. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Vang, Associate Counsel