Citation Nr: 18153099 Decision Date: 11/27/18 Archive Date: 11/27/18 DOCKET NO. 12-14 774 DATE: November 27, 2018 ORDER Entitlement to service connection for a respiratory disability is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has a respiratory disability due to a disease or injury in service. CONCLUSION OF LAW The criteria for service connection for a respiratory disability are not met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1980 to July 1983. In September 2013, she testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the proceeding is in the record. Entitlement to service connection for a respiratory disability The Veteran contends that she was treated for bronchitis on multiple occasions while on active duty service, and she continued to have bouts of bronchitis over the years following her service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current diagnosis of chronic obstructive pulmonary disease (COPD), and evidence shows that the Veteran was treated for acute bronchitis both during and after her active duty service, the preponderance of the evidence weighs against finding that the Veteran’s respiratory conditions began during service or are otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). In 1981, during service, the Veteran was seen for an upper respiratory infection with subsequent entry of an alternate diagnosis of costochondritis versus pleurisy. Also in service, in June 1982, she was treated for paroxysmal nocturnal dyspnea and in October 1982 for chest tightness, coughing, and sinus congestion. Pulmonary function testing (PFT) at the time of her separation from service disclosed a forced vital capacity at one second of 107 percent of normal and a forced vital capacity of 126 percent of normal; but that notwithstanding, a notation was made in July 1983 of a history of bronchitis. A November 2009 VA treatment record noted the Veteran was diagnosed with a “cough with sinus congestion bronchitis.” A March 2012 VA emergency department note reflected the Veteran was seen for a cough and was assessed with bronchitis. A May 2013 VA treatment record noted the Veteran smoked one pack per day for 35 years. In October 2015, a VA examiner determined that the Veteran did not have a current respiratory disability, based upon a finding of a normal pulmonary function test, and therefore the issue of etiology was moot. However, the VA treatment records show a diagnosis of COPD in March 2013, as well as treatment for bronchitis in 2012. Following two Board remands to obtain adequate medical opinions concerning the etiology of any diagnosed respiratory condition, the Board sought an outside medical opinion (OMO) addressing the pertinent medical questions. In July 2018, a qualified VA physician concluded that the Veteran’s claimed respiratory condition of COPD and bronchitis were less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event or illness. In support of this conclusion, the VA physician noted that the Veteran’s records were reviewed. PFTs at separation were normal. The Veteran reported an episode of acute bronchitis in 1983. Post-service records documented a November 2009 episode in which the Veteran reported cough and wheezing. Her lungs were clear post viral, and the Veteran was noted to still be smoking. A January 2011 chest x-ray was clear. PFTs conducted in June 2015 showed that spirometry was within normal limits. There was no improvement following bronchodilator. Lung volumes were also noted to be within normal. The VA physician stated that there was no evidence of chronic bronchitis symptoms, which are the hallmark of COPD diagnosis at the time of active duty service or shortly thereafter. He concluded that the recent diagnosis of COPD was most likely related to the Veteran’s smoking history. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Significantly, there is no medical opinion supportive of the Veteran’s claim which contradicts the July 2018 VA examiner’s unfavorable opinion. The Veteran has submitted no competent medical evidence contrary to the medical opinions cited above. She has been accorded ample opportunity to furnish medical and other evidence in support of her claim, yet she has not done so. See 38 U.S.C. § 5107 (a). The only other evidence supporting the Veteran’s contention that her respiratory problems were the result of active duty service comes from her own lay statements. Lay persons are competent to provide opinions on some medical issues. Kahana v. Shinseki, 24 Vet. App. 428 (2011). However, the question of etiology here extends beyond an immediately observable cause-and-effect relationship and thus, falls outside the realm of common knowledge of a lay person. Jandreau v. Nicholson, 429 F.3d 1372 (Fed. Cir. 2007). Based on the totality of the record, the Board concludes that the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for a respiratory disability. As the preponderance of the evidence is against this claim, the benefit-of-the-doubt rule does not apply, and this claim is denied. See 38 U.S.C.A § 5107; 38 C.F.R. § 3.102. M. E. Larkin Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Jack S. Komperda, Counsel