Citation Nr: 18154454 Decision Date: 11/30/18 Archive Date: 11/29/18 DOCKET NO. 16-23 366 DATE: November 30, 2018 ORDER Entitlement to service connection for the Veteran’s cause of death is denied. FINDINGS OF FACT 1. The Veteran died in August 2014. His death certificate listed the cause of death as post-obstructive pneumonia and metastatic carcinoma. 2. The probative evidence of record shows that the Veteran’s cause of death was unrelated to his military service. CONCLUSION OF LAW The criteria for service connection for the Veteran’s cause of death have not been met. 38 U.S.C. §§ 1310, 5107; 38 C.F.R. §§ 3.102, 3.312. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty in the Air Force from June 1964 to May 1968. The Veteran passed away in August 2014. The Appellant is his surviving spouse. Service connection for the cause of the Veteran’s death To establish service connection for the cause of a veteran’s death, the evidence must show that a disability incurred in or aggravated by service either caused or contributed substantially or materially to the cause of death. 38 U.S.C. § 1310; 38 C.F.R. § 3.312. For a service-connected disability to be the cause of death, it must singly or with some other condition be the immediate or underlying cause, or be etiologically related. For a service-connected disability to constitute a contributory cause, it must be shown that the service-connected disability 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 causally shared in producing death, but rather it must be shown that there was a causal connection. 38 C.F.R. § 3.312; Lathan v. Brown, 7 Vet. App. 359 (1995); see also Gabrielson v. Brown, 7 Vet. App. 36, 39 (1994). Medical evidence is required to establish a causal connection between service or a disability of service origin and the Veteran’s death. See Van Slack v. Brown, 5 Vet. App. 499, 502 (1993). The Appellant contends that the Veteran’s death was related to his service-connected disabilities because his cancer was located in the area of his cervical disc disease. The Appellant has also asserted that the Veteran’s neuropathy of the bilateral upper extremities contributed to his death and that the pain from his service-connected conditions accelerated his death. After a full review of the record, including the medical evidence, as well as statements by the Appellant, the Board finds that service connection for the cause of the Veteran’s death must be denied. The Veteran died in August 2014 and his death certificate listed the cause of death as post-obstructive pneumonia and metastatic carcinoma. At the time of the Veteran’s death, he was service-connected for the following: cervical disc disease, neuropathy of the bilateral upper extremities, tinnitus, foreign body in the right thumb, and left varicocele. The evidence does not show that any of his service-connected disabilities were the primary or contributory cause of death. The Veteran’s service treatment records are negative for any symptoms, treatment, diagnosis or complaints of any of the conditions leading to his death. To the extent the Appellant’s assertions are advanced to establish a medical relationship between the Veteran’s death and his active military service or his service-connected disabilities, the Appellant lacks the requisite expertise to render an opinion as to whether the Veteran’s service-connected disabilities contributed substantially or materially to his death. These are complex medical questions that require a level of expertise not demonstrated by the Appellant. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). As such, the Board assigns no probative weight to the Appellant’s assertions that the cause of the Veteran’s death is related to his military service. The Appellant submitted a December 2014 letter from the Veteran’s primary care physician, Dr. R.M. According to Dr. R.M., it was unknown whether the Veteran’s cancer was related to his previous prostate cancer, bladder cancer, chronic spinal problems, or exposure to other carcinogens. In April 2016, a VA examiner opined that there was no legitimate medical relationship between the Veteran’s service-connected conditions and his death. The examiner explained that according to Harrison’s Principles of Internal Medicine, cervical disc disease, neuropathy of the bilateral upper extremities, tinnitus, right thumb foreign body, and left varicocele simply have no basis for medical relation to the listed causes of death, including metastatic adenocarcinoma. She further stated that it was less likely than not that the Veteran’s service-connected conditions and treatments, either individually or in combination, materially or substantially contributed to his death, combined to cause death, or aided or lent assistance to the production of death. Additionally, she opined that it was less likely than not that Veteran’s service-connected conditions resulted in debilitating effects and general impairment of health to an extent that would render the Veteran less capable of resisting the effects of other disease or injury primarily causing death. It was further noted that the Veteran’s service treatment records did not reveal any additional diagnosis or treatment which would have at least as likely as not contributed to his death. The evidence does not show that any of the Veteran’s service-connected disabilities were the primary or contributory cause of death. Further, there is no medical evidence linking post-obstructive pneumonia and metastatic carcinoma to the Veteran’s active duty service. 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 is not for application. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Freeman, Associate Counsel