Citation Nr: 18154895 Decision Date: 12/04/18 Archive Date: 11/30/18 DOCKET NO. 14-19 935 DATE: December 4, 2018 ORDER Service connection for gallbladder cancer is denied. FINDING OF FACT It is less likely than not (less than 50 percent probability) that the Veteran’s gallbladder cancer either began during or was otherwise caused by his military service, to include as a result of exposure to asbestos and/or lead paint. CONCLUSION OF LAW The criteria for service connection for gallbladder cancer have not been met. 38 U.S.C.§§ 1110, 5107; 38 C.F.R.§§ 3.102, 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from October 1967 to August 1969. Service Connection The Veteran is seeking service connection for his gallbladder cancer, which he believes, may have been caused by his exposure to asbestos and lead paint during service. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C.§ 1110; 38 C.F.R.§ 3.303. Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service (nexus). Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be established with certain chronic diseases based upon a legal presumption by showing that the disease manifested itself to a degree of 10 percent disabling or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309(a). Here, the records show that the earliest treatment record for gallbladder cancer is dated in 2009, almost 40 years after he separated from his service, therefore, service connection based on the presumption for chronic disease is not warranted. Even when presumptive service connection is not available, the Board must also consider whether service connection is warranted on a direct basis. The Veteran testified at the Board hearing in May 2017 that he had exposure to asbestos and lead paint for over 18 months while he served on a battleship when it was undergoing major repairs in dry dock. The Veteran’s service personnel records show that he served on USS Barry between1968 and 1969 and his military specialty was carpenter. As the records are consistent with the circumstances of the hazard exposure described by the Veteran, exposure to asbestos and lead paint is conceded. However, exposure to hazardous material alone is not considered to be a disability, rather, it must be shown that the hazard exposure caused gallbladder cancer. In December 2017, the Board remanded the matter to afford the Veteran a VA examination and to obtain a medical opinion from the examiner as to whether it is at least as likely as not (50 percent or greater) that the Veteran’s gallbladder cancer is etiologically related to his service, to include exposure to asbestos and lead paint, and asked the examiner to provide an underlying rationale for the opinion. In February 2018, the Veteran was afforded a VA examination, at which the examiner examined the Veteran in person and reviewed the entire case file. The examiner noted diagnosis of gallbladder neoplasm and opined that it was less likely than not (less than 50 percent probability) that the Veteran’s gallbladder cancer incurred during or caused by his military service. The examiner explained that there was no medical association of bladder cancer to asbestos and/or lead paint currently acknowledged by the VA. The examiner reported that there was no new medical evidence brought forward to the examination which could indicate a nexus associating bladder cancer with military service. Based on the evidence at hand, the examiner concluded that a nexus was not established between the Veteran’s in-service exposures and his development of gallbladder cancer decades later. The examiner’s opinion has not been challenged or contradicted by other medical opinion, and it is rendered after a comprehensive in person examination of the Veteran and grounded in the evidence of record. As such, the opinion is afforded great probative value. Moreover, this evidence makes it less likely than not that the Veteran had gallbladder cancer either began during or was otherwise caused by his military service, to include as a result of exposure to asbestos and lead paint. While the Veteran believes that his gallbladder cancer was caused by his exposure to asbestos and lead paint during service, such a determination is a medically complex question, and the Veteran lacks the medical training or expertise to render such an opinion. See Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Nevertheless, a medical opinion was obtained to directly and specifically consider the Veteran’s contentions, but ultimately the medical professional found that the evidence did not medically support the Veteran’s contentions. In sum, the evidence is insufficient to establish service connection for Veteran’s gallbladder cancer on either a presumptive or a direct basis. Service connection is denied. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Q. Wang, Associate Counsel