Citation Nr: 18158377 Decision Date: 12/14/18 Archive Date: 12/14/18 DOCKET NO. 15-23 686 DATE: December 14, 2018 ORDER Entitlement to service connection for ischemic heart disease is denied. FINDING OF FACT The Veteran’s ischemic heart disease did not have its onset in service, was not manifested to a compensable degree within one year of service discharge, and is not otherwise related to service. The Veteran is not presumed to have been exposed to herbicide agents during service. CONCLUSION OF LAW The criteria for service connection for ischemic heart disease are not met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a)-(b), (d), 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from March 1963 to February 1967. The Veteran testified at a videoconference Board hearing before the undersigned Veteran’s Law Judge in June 2018. A transcript of the hearing was prepared and associated with the claims file. 1. Entitlement to service connection for ischemic heart disease The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of service connection for ischemic heart disease on either a direct or presumptive basis. The reasons follow. The Veteran has been diagnosed with coronary artery disease (which is a form of ischemic heart disease), and thus there is evidence of a current disability. However, as to direct service incurrence, the Veteran’s claim fails on both the in-service disease or injury and the nexus to service. The service treatment records (STRs) show that the Veteran was found to have clinically normal evaluations of his heart in March 1965, April 1966, October 1966, and at his separation examination in February 1967. Although not directly related, at each of these evaluations, the Veteran denied a history of palpitation or pounding heart, high or low blood pressure, and pain or pressure in the chest. The Veteran’s repeated clinically normal evaluations of his heart in service is evidence that tends to show that the Veteran did not have ischemic heart disease in service. At the June 2018 Board hearing, the Veteran stated that the aircraft to which he was assigned was out of service for three months in 1965, and that seven of the 16 airplanes were also out of service. The Veteran stated he was also assigned to other duties for another three months. He stated he was otherwise on flight status for 28 months during service. The Veteran stated he flew into Vietnam on average of one to two times per month. The Veteran contends that he regularly was assigned to duties, which involved numerous regular assignments in Vietnam. The Veteran contends these assignments were throughout his service. However, the Veteran’s STRs show that the Veteran was medically evaluated at Travis AFB facilities October 10, 1963, June 2, 1964, June 10, 1964, March 16, 1965, September 2, 1965, December 14, 1965, March 22, 1966, April 4, 1966, October 5, 1966, and February 17, 1967. The Board notes that on March 16, 1965, the Veteran was assessed to not be medically qualified for flying until a December 14, 1965 STR found that the Veteran’s hiatal hernia did not preclude him from flying. Regardless, the STRs show that the Veteran only received a medical waiver effective April 1966. While these records do not account for the Veteran’s entire service, the evidence shows that on these dates, the Veteran was not in the Republic of Vietnam, but rather assigned to duties at Travis AFB, which is within the United States. Bolstering this analysis, the Veteran’s service records specifically show that he was assigned to duties at Travis AFB between March 1965 and February 1966. As noted in the June 2015 Statement of the Case, the Veteran contends that he flew numerous missions to Vietnam during the period between July 1965 and December 1965. However, as discussed above, the STRs show that the Veteran was assessed to not be medically qualified for flying until a December 14, 1965 STR found that the Veteran’s hiatal hernia did not preclude him from flying, and did not receive a medical waiver until April 1966. Additionally, the record shows that the Veteran was assigned to duties at Travis AFB, within the United States, from March 1965 to February 1966. Accordingly, the Board finds that the Veteran’s statements are outweighed by the objective documentation of record, which was documented contemporaneously with service. As to a nexus to service, the stated in his VA Form 21-526 that his ischemic heart disease began in either 1998 or 1999. In a July 2012 VA treatment record, it was noted that the Veteran was diagnosed with ischemic heart disease in 2000. In a November 1996 private medical record, the Veteran was found to be diagnosed with coronary artery disease and that he had experienced a myocardial infarction. Even if the earliest date is accepted, the Veteran would still have been diagnosed approximately 29 years following service discharge, which tends to establish that ischemic heart disease did not have its onset in service. Although the Veteran claims that his ischemic heart disease is related his service, it is well established that a layperson without medical training is not qualified to render medical opinions regarding the etiology of certain disorders and disabilities. 38 C.F.R. § 3.159(a)(1). In certain instances, lay testimony may be competent to establish medical etiology or nexus. However, heart disabilities require specialized training for determinations as to diagnosis and causation, and is therefore, not susceptible to lay opinions on etiology. The origin or cause of the Veteran’s ischemic heart disease is not a simple question that can be determined based on mere personal observation by a lay person, the Veteran’s lay assertion is not competent to establish a nexus. To the extent that the Veteran has stated that ischemic heart disease had its onset in service, his service treatment records do not support such a finding. The Board accords high probative value to the documentation the Veteran completed during his service, wherein he denied heart problems, as he completed these forms contemporaneously with service. As to presumptive service connection for a chronic disease, the Board finds that the Veteran did not incur an event, injury, or disease related to his current ischemic heart disease in service and that his ischemic heart disease disorder did not manifest during service or within one year of separation from service. Furthermore, the evidence of record does not demonstrate that the Veteran’s symptoms have been continuous since separation from service in February 1967. See 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). There were no complaints, diagnosis, or treatment for this disorder for approximately 29 years following service discharge. The absence of post-service complaints, findings, diagnosis, or treatment for approximately 29 years after service is one factor that tends to weigh against a finding of continuous symptoms since separation from service. The Board may weigh the absence of contemporaneous medical evidence as one factor in determining credibility of lay evidence. A prolonged period without medical complaint can be considered, along with other factors, as evidence of whether an injury or a disease was incurred in service which resulted in any chronic or persistent disability. As to presumptive service connection for herbicide agent exposure, the Board finds that the preponderance of the evidence does not support a finding that the Veteran had service in Vietnam, and is thus not presumed to have been exposed to herbicide agents. Although the Veteran has submitted numerous lay statements in support of his contention that he served in Vietnam, the Board finds that they are outweighed by objective documentation of the Veteran’s service dates and locations. For example, in an August 2012 VA Form 21-3101, VA found that there was no evidence in the Veteran’s claims file to support a finding that the Veteran served in Vietnam. Additionally, the Veteran’s military personnel records do not support that the Veteran served in Vietnam. For example, the Veteran’s records show that throughout his service, the Veteran was assigned to duty locations exclusively within the continental United States, including California, Texas, and Colorado. The records do not show that the Veteran was assigned to service in Vietnam. This is evidence against a finding that the Veteran served in Vietnam. The Veteran has submitted an article and letters from a historian in support of his contention. However, the Board finds that the submissions are speculative in nature, as they do not specifically indicate that the Veteran was assigned to flights that transited to Vietnam, and do not constitute either objective or definitive evidence that the Veteran served in Vietnam. Accordingly, the Board assigns these submissions no probative value. In sum, the Board concludes that the preponderance of the evidence of record is against the Veteran’s claim for service connection for ischemic heart disease. The benefit-of-the-doubt doctrine enunciated in 38 U.S.C. § 5107(b) is not applicable, as there is no approximate balance of evidence.   A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Husain, Associate Counsel