Citation Nr: 18151856 Decision Date: 11/20/18 Archive Date: 11/20/18 DOCKET NO. 16-34 469 DATE: November 20, 2018 ORDER Service connection for breathing difficulties due to exposure to hazardous materials to include asbestos and radiation is denied. Service connection for obstructive sleep apnea is denied. REMANDED Service connection for eczema (claimed as a rash), to include as a result of exposure to hazardous materials to include asbestos and fiberglass is remanded. FINDINGS OF FACT 1. The weight of the evidence of record is against finding that the Veteran has a current breathing disability, or has had one at any time during the appeal period. 2. The weight of the evidence is against finding that the Veteran’s obstructive sleep apnea either began during or was otherwise caused by his military service, to include as a result of any exposures therein. CONCLUSIONS OF LAW 1. The criteria for service connection for a breathing disability are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for service connection for obstructive sleep apnea have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1965 to October 1969. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110. The Veteran asserts that he has breathing difficulties, obstructive sleep apnea (OSA), and a head and arm skin rash as a result of his military service. In an August 2012 written correspondence, the Veteran asserted that during his active service, from May to June 1965, his job was as a mess cook, where he was tasked with removing asbestos out of the chow hall galley, which was done daily Monday through Friday for approximately five hours. Additionally, from July 1965 until discharge, the Veteran reported working in the rubber and plastic shop exposing him to fiberglass, solvents, rubber compounds, acetone, and MEK. The Veteran further asserted radiation exposure during service and a possible link between his current disabilities and his military service. 1. Service connection for breathing difficulties due to exposure to hazardous materials to include asbestos and radiation. The Veteran does not have a current diagnosis of a breathing disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 5107(b); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). Service treatment records are silent for complaints or treatment for breathing related complaints. The Veteran’s entrance and separation examinations have no of breathing related complaints. A private treatment record from June 2010 indicate that the Veteran experienced diminished bilateral air flow, asymmetry and non-patent (obstructed) nostrils. His lungs were clear to auscultation and he had symmetrical breathing movements. The Veteran was assessed with allergic rhinitis, but no specific respiratory disease. Private treatment records after June 2010 into 2011 show no indication of nasal problems, diminished air flow, or other breathing problems. While the Veteran believes he has a current breathing disability, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education and knowledge of the body’s functioning. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). In this case, the Veteran experienced an acute incident of diminished air flow diagnosed as allergic rhinitis. The record contains no indication that the Veteran chronically experiences symptoms of diminished airflow or obstructed nostrils or has experienced such symptoms since service. Notably, the Veteran has not asserted that he has experienced breathing problems in service or since his separation from service, rather he asserts exposure to asbestos and other hazardous materials. While the Veteran may have been exposed to hazardous materials during his active service, such exposure is not something that can be service connected. Rather, it must be shown that the in-service exposures (many of which have been conceded such as asbestos exposure) actually caused the development of a respiratory disorder. Here, no specific respiratory disorder has been diagnosed, and to the extent the Veteran is referring to allergic rhinitis as “difficulty breathing” there is no suggestion that such a condition, either began during or was otherwise caused by his military service, to include as a result of any exposure therein. As such, service connection is not warranted. 2. Service connection for obstructive sleep apnea (OSA). While the Veteran has a current diagnosis of OSA, the preponderance of the evidence weighs against finding that his OSA began during service or was otherwise caused by an in-service injury, event, or disease. Service treatment records are silent for complaints or treatment for snoring or other sleep related complaints. The Veteran’s entrance and separation examinations have no notation for OSA or other sleep related complaints. A June 2010 private treatment record indicates that the Veteran reported symptoms of snoring and feeling tired and fatigued during the day. He was noted to experience worsening snoring as his weight increased. At that time the Veteran experienced a fifteen-pound weight gain. The Veteran’s past sleep study was noted as normal and a new sleep study was ordered. The Veteran was assessed with probable OSA secondary to weight gain. A July 2011 private treatment record indicates that the Veteran was diagnosed moderate obstructive sleep apnea syndrome and started on CPAP treatment. Additional treatment options, to include ENT surgery, dental appliance, and weight loss were discussed. While the Veteran is competent to report having experienced symptoms of snoring and daytime fatigue at the time of diagnosis, he has not alleged that such symptoms existed during active service, or have been persistent since his separation from service. Further, the Veteran is not competent to provide an opinion about the etiology of his OSA diagnosis. The issue is medically complex, as it requires knowledge of the internal workings the body and the interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Private treatment records show the Veteran was not diagnosed with OSA until July 2010, approximately three decades after his separation from service. During his post service treatment encounters the Veteran made no mention of continuing symptoms since service. Further, the medical evidence suggests that the Veteran’s weight was the causal factor in his OSA, rather than his military service. Notably, the Veteran’s sleep study prior to 20110 was noted as normal. Further, medical providers have also noted a relationship between the Veteran’s increased OSA symptomatology and his increased weight. The record contains no objective suggestion that the Veteran’s OSA either began during or was otherwise caused by his military service. While the Veteran may have been exposed to asbestos, such exposure is not presumptive of sleep apnea and cannot establish a basis for service connection. Consequently, the Board gives more probative weight to the objective medical evidence. As such, service connection for OSA is not warranted. REASONS FOR REMAND As stated above, the Veteran asserts that he has a skin rash as a result of multiple exposures to hazardous materials during active service. Service records indicate that the Veteran experienced dry flaky hands in September 1968. The Veteran also has several diagnoses related to his skin. In August 2003, he was assessed with dyshidrotic eczema. In November 2004, the Veteran was thought to have pseudolymphoma or atypical lymphoproliferative. In October 2005, he was diagnosed with follicular eczema. While the evidence of record indicates that Veteran experienced an in-service incurrence of skin problems and current skin rash problems, no VA examiner has addressed the etiology of the Veteran’s current skin condition. Further, the Veteran’s military specialty was FN-000 (fireman) and he was noted to work in rubber and plastics manufacturing and repair for four months in August 1965. Additionally, service records indicate that the Veteran was exposed to .013 gamma and x-ray radiation from November 1967 to December 1967. VA has conceded his exposure to asbestos. Accordingly, more information is needed before the Board can make a fully informed decision. The matters are REMANDED for the following action: Schedule the Veteran for an examination to determine the etiology of any current skin conditions, to include dyshidrotic eczema, pseudolymphoma, atypical lymphoproliferative, and follicular eczema. The examiner should opine whether it is at least as likely as not (50 percent or greater) that any current skin condition either began during or was otherwise caused by the Veteran’s military service, to include whether any current skin condition represents a continuation of the Veteran’s in-service diagnosis of dry flaky hands, or whether any skin condition should be considered to be the result of exposure to hazardous materials to include asbestos, fiberglass, solvents, rubber compounds, acetone, and MEK. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. I. Sims, Associate Counsel