Citation Nr: 18146665 Decision Date: 10/31/18 Archive Date: 10/31/18 DOCKET NO. 16-46 444 DATE: October 31, 2018 ORDER Entitlement to service connection for prostate cancer, to include as secondary to exposure to contaminated water at Camp Lejeune is denied. FINDINGS OF FACT 1. The Veteran was stationed at Camp Lejeune for at least 30 days during his active service and is presumed to have been exposed to contaminants in the water supply therein. 2. Prostate cancer did not manifest in service, or within one year of separation, and is not related to service. CONCLUSION OF LAW Prostate cancer was not incurred in or aggravated by service and may not be presumed to have been incurred therein. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137 (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1966 to March 1968. This appeal to the Board of Veterans’ Appeals (Board) arose from a rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303 (a). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease incurred in service. 38 C.F.R. § 3.303 (d). Effective March 14, 2017, 38 C.F.R. §§ 3.307 and 3.309 were amended to establish presumptive service connection for Veterans, former reservists, and former National Guard members who served at the U.S. Marine Corps Base Camp Lejeune for no less than 30 days (either consecutive or nonconsecutive) during the period between August 1, 1953 and December 31, 1987, and who have been diagnosed with any of the following eight diseases: adult leukemia; aplastic anemia and other myelodysplastic syndromes; bladder cancer; kidney cancer; liver cancer; multiple myeloma; non-Hodgkin’s lymphoma; and Parkinson's disease. The amendments apply to claims received by VA on or after January 13, 2017, and claims pending before VA on that date. In addition, the amendments establish a presumption that these individuals were disabled during the relevant period of service, thus establishing active military service for benefit purposes. This amendment implements a decision by the Secretary of Veterans Affairs that service connection on a presumptive basis is warranted for claimants who served at Camp Lejeune and later develop the certain diseases listed above. 1. Entitlement to service connection for prostate cancer, to include as secondary to exposure to herbicide agents and contaminated water at Camp Lejeune is granted. The Veteran contends that service connection is warranted for prostate cancer. More specifically, the Veteran contends that presumptive service connection is warranted. The Board acknowledges that the Veteran’s personnel records indicate that he was stationed at Camp Lejeune for greater than 30 days in 1966; as a result, exposure to contaminated water is conceded. Notably, prostate cancer is not one of the diseases presumed to be related to exposure to contaminated water at Camp Lejeune. 38 C.F.R. § 3.309. The absence of a disease from the presumptive list does not, however, preclude a Veteran from otherwise proving that his disability resulted from exposure to contaminated water at Camp Lejeune. See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Accordingly, the Board will still consider whether entitlement to service connection can be granted on any other basis. The central issue in this case is whether the Veteran’s prostate cancer is related to that exposure. The Veteran’s service treatment records do not document any relevant symptoms, complaints, treatment or diagnosis of prostate cancer. Clinical evaluation at the Veteran’s separation examination revealed a normal genitourinary system, anus, rectum and prostate. Post-service treatment records indicate that prostate cancer was identified in May 2001, over three decades after separation. The Veteran was afforded a VA examination in August 2015. The subject matter expert concluded that it was less likely than not that the Veteran’s prostate cancer was related to his exposure to contaminated water at Camp Lejeune. In reaching this conclusion, the examiner cited the Veteran’s duration of service at Camp Lejeune, the exposure history, and his risk factors of prostate cancer. Specifically, the examiner explained that prostate cancer was very common among men in the Veteran’s age group, and that other risk factors including genetic factors and possible dietary factors are more likely the cause of the Veteran’s prostate cancer. The examiner cited extensive scientific and medical literature to support her opinion. Most notably, the examiner also noted the Veteran’s occupational risk factors, to include his exposure to solvents related to post-service employment at the time of his diagnosis. Specifically, the examiner noted that the Veteran was a tool and die maker. The probative value of a medical opinion primarily comes from its reasoning; threshold considerations are whether a person opining is suitably qualified and sufficiently informed. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). In this case, the Board accepts the August 2015 VA examiner’s opinion that the Veteran’s prostate cancer is less likely than not related to his exposure at Camp Lejeune as highly probative medical evidence on this point. The Board notes that the examiner rendered her opinion after thoroughly reviewing the claims file and relevant medical records. The examiner noted the Veteran’s pertinent history and provided a reasoned analysis of the case. See Hernandez-Toyens v. West, 11 Vet. App. 379, 383 (1998); Gabrielson v. Brown, 7 Vet. App. 36, 40 (1994) (the probative value of a physician’s opinion depends in part on the reasoning employed by the physician and whether or not (or the extent to which) he reviewed prior clinical records and other evidence). The Board has considered the Veteran’s lay assertions that his prostate cancer was caused by contaminated water supplies at Camp Lejeune during service. However, the Veteran is not shown to have specialized medical education, training, or experience necessary to provide a competent medical opinion as to etiology of his prostate cancer. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Further, these assertions are inconsistent with the VA examiner’s findings which were supported by medical and scientific literature, as well as the examiner’s subject matter medical expertise. Additionally, the examiner provided credible causal explanations for the cause of the Veteran’s prostate cancer, to include that of advanced age and post-service exposure to solvents. The Board accords great weight to the VA examiner’s opinion, as the examiner was informed by the Veteran’s service and post-service medical records and pertinent medical literature. Thus, the Board finds the medical evidence to be more probative than the Veteran’s assertions. As a result, the Board finds that the weight of the evidence shows that the Veteran’s prostate cancer is not related to his exposure to contaminated water at Camp Lejeune. Having considered the entirety of the evidence of record, there is no reliable evidence linking the Veteran’s prostate cancer to service and there is nothing in the record which suggests a history of prostate cancer dating back to service. The more probative evidence establishes that he did not have prostate cancer during service or within one year of separation. Furthermore, the evidence establishes that the remote onset or prostate cancer is unrelated to service, to include exposure to contaminated water. As such, the Board finds that the preponderance of the evidence is against the claim and it must be denied. DEBORAH W. SINGLETON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Tiffany N. Hanson, Associate Counsel