Citation Nr: 18150511 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 15-13 132 DATE: November 15, 2018 ORDER Entitlement to service connection for cause of death is denied. FINDINGS OF FACT 1. The Veteran died in January 2014; the cause of death was a gunshot wound to the head. 2. At the time of his death, the Veteran was service connected for bilateral hearing loss and tinnitus. CONCLUSION OF LAW The criteria for service connection for the cause of the Veteran’s death have not been met. 38 U.S.C. § 1310; 38 C.F.R. § 3.312. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran had active service in the Navy from August 1950 to June 1954. He died in January 2014. The appellant is the Veteran’s widow. In connection with this appeal, the appellant and the Veteran’s son testified at a hearing before the undersigned Veterans Law Judge in February 2018. A transcript of that hearing is of record. Service Connection for Cause of Death The appellant asserts that the cause of the Veteran’s death as listed on his death certificate, a gunshot wound to the head, was a self-inflicted due to auditory hallucinations he was experiencing from his service-connected bilateral hearing loss and tinnitus. To establish service connection for the cause of a Veteran’s death, the evidence must show that a disability incurred in or aggravated by active service either caused or contributed substantially or materially to cause death. 38 U.S.C. § 1310. A service-connected disorder is one that was incurred in or aggravated by active service; one for which there exists a refutable presumption of service incurrence, such as refractory non-Hodgkin’s lymphoma, if manifested to the required degree within a prescribed period from the Veteran’s separation from active duty; or one that is proximately due to or the result of, or aggravated by, a service-connected disability. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131; 38 C.F.R. §§ 3.307, 3.309, 3.310(a). A service-connected disability will be considered as the principal (primary) cause of death when such disability, singly or jointly with some other disorder, was the immediate or underlying cause of death or was etiologically related thereto. 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 that there was a causal connection. 38 C.F.R. § 3.312. Here, it is undisputed that the Veteran’s death was caused by a gunshot wound to the head. However, service connection for the cause of the Veteran’s death requires more than just a showing that he died from a gunshot wound to the head. Rather, it must be shown that the gunshot wound to the head was either directly or presumptively linked to his time in active service. Unfortunately, the evidence of record fails to establish that the Veteran’s gunshot wound to the head was otherwise caused by his active service. The Veteran died in January 2014. His death certificate lists the cause of his death as a gunshot wound to the head. At the time of his death, the Veteran was service connected for bilateral hearing loss and tinnitus. At the February 2018 Board hearing, the appellant and her son both testified that the Veteran experienced auditory hallucinations and that progressively worsened. They both testified that he eventually committed suicide. They both testified that the Veteran’s auditory hallucinations were due to his service connected bilateral hearing loss and tinnitus. In September 2017, a VA geriatric psychiatrist reviewed the Veteran’s claims folder. The geriatric psychiatrist reported that the Veteran experienced depressive symptoms in the context of various health problems including coronary artery disease, chronic obstructive pulmonary disease, severe bilateral hearing loss, and tinnitus. The geriatric psychiatrist reported that the Veteran’s suicide was secondary to his depressed mood. The geriatric psychiatrist reported that medical literature did not indicate suicidal behavior due to auditory hallucination from hearing loss, which resulted in music hallucinations. The geriatric psychiatrist reported that depressed mood in the elderly was multifactorial and associated with vascular risk factors, physical disability, and social stresses. The geriatric psychiatrist opined it was unlikely that the Veteran’s depressed mood and suicide were the result of hearing loss or tinnitus. The geriatric psychiatrist opined that the Veteran’s auditory hallucinations were likely secondary to severe depressive symptoms. The geriatric psychiatrist opined that the Veteran’s hearing loss and tinnitus did not cause or trigger his suicide. The appellant submitted multiple medical articles including: Hearing Loss as a Risk Factor for Dementia; Relationship of Hearing Impairment to Dementia and Cognitive Dysfunction in Older Adults; The Correlation of the Tinnitus Handicap Inventory with Depression and Anxiety in Veterans with Tinnitus; and articles on delirium and dementia. The Court has held that a medical article or treatise “can provide important support when combined with an opinion of a medical professional” if it discusses generic relationships with a degree of certainty such that, under the facts of a specific case, there is at least “plausible causality” based upon objective facts rather than on an unsubstantiated lay medical opinion. Mattern v. West, 12 Vet. App. 222, 228 (1999). However, the medical article submitted by the appellant was not accompanied by the opinion of any medical expert. The Board obtained an expert medical opinion to address this contention, but as discussed above the psychiatrist found it was less likely than not that the Veteran’s service connected disabilities caused his suicide. After weighing all the evidence, the Board finds great probative value in the VA geriatric psychiatrist’s opinion. This negative opinion is sufficient to satisfy the statutory requirements of producing an adequate statement of reasons and bases where the expert has fairly considered material evidence which appears to support the appellant’s position. Wray v. Brown, 7 Vet. App. 488, at 492-93 (1995). The appellant has not submitted any medical evidence directly supporting her assertion that the Veteran’s suicide was due to his bilateral hearing loss and tinnitus. Therefore, after weighing all the evidence, the Board finds great probative value in the VA geriatric psychiatrist’s opinion. Consideration has been given to the assertions of appellant that the Veteran’s death was due to his bilateral hearing loss and tinnitus. She is clearly competent to report the Veteran’s symptoms of bilateral hearing loss and tinnitus. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). However, while the appellant may describe symptoms of bilateral hearing loss and tinnitus, she lacks the medical training or qualification either to diagnose the Veteran with auditory hallucinations that resulted in his suicide or to determine its etiology. Id. The Board would like to express that it is extremely sympathetic toward the appellant’s claim and is deeply appreciative of the Veteran’s naval service. Unfortunately, the Board is ultimately bound by the law passed by Congress, and this decision is dictated by the relevant statutes and regulations. The Board is without authority to grant benefits simply because it might perceive the result to be equitable. See 38 U.S.C. §§503, 7104; Harvey v. Brown, 6 Vet. App. 416, 425 (1994). Accordingly, the claim for service connection for the cause of the Veteran’s death is denied. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Berryman, Counsel