Citation Nr: 18160009 Decision Date: 12/20/18 Archive Date: 12/20/18 DOCKET NO. 17 58-819 DATE: December 20, 2018 ORDER Entitlement to service connection for the cause of the Veteran’s death is denied. FINDING OF FACT 1. The Veteran died on July [redacted], 2015, with the cause of death being multi-organ system failure, sepsis, and c-difficile colitis due to metastatic malignancy of unknown primary. 2. At the time of the Veteran’s death, service connection was in effect for tinnitus. 3. None of the disabilities causing or contributing to the Veteran’s death (multi organ system failure, sepsis and c-difficile colitis due to metastatic malignancy of unknown primary), were present in service, or within a year following discharge from service and they are not shown to be related to service. CONCLUSION OF LAW A service connected disability did not cause death or contribute substantially or materially to death. 38 U.S.C. §§ 1131, 1310, 5103, 5103A, 5107 (2012); 38 C.F.R. § 3.312 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1970 to May 1973. This matter is before the Board of Veterans Appeals (Board) on appeal from a May 2016, rating decision of the Philadelphia, Pennsylvania, Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for the cause of the Veteran’s death VA death benefits are payable to the surviving spouse of a veteran if the veteran died from a service-connected disability. 38 U.S.C. § 1310; 38 C.F.R. §§ 3.5, 3.312. To establish service connection for the cause of a veteran’s death, the evidence must show that a disability incurred in or aggravated by active service was the principal or contributory cause of death. 38 C.F.R. § 3.312. To be considered a principal cause of death, a service-connected disability must have been singly or jointly with some other condition the immediate or underlying cause of death or have been etiologically related to the cause of death. For a service-connected disability to be a contributing cause, it must have substantially or materially contributed to a veteran’s death; it is not sufficient to show that it casually shared in producing death, but rather there must be a causal connection. A contributory cause of death is inherently one not related to the principal cause. 38 U.S.C. § 1310; 38 C.F.R. § 3.312(b), (c). In April 2016 the appellant submitted a claim for service connection for cause of death. The appellant provided no argument as to why she believes service connection should be granted. The Veteran’s STRs do not indicate any treatment for or complaints of multi organ system failure, sepsis, c-difficile colitis, or a metastatic malignancy. There is no evidence in the Veteran’s STRs that he suffered from any of the conditions which are listed as the Veteran’s cause of death. Again, the Certificate of Death showed the immediate cause of death was multi organ system failure, sepsis, and c-difficile colitis, with the underlying cause being metastatic malignancy of unknown primary. Although the appellant believes the Veteran’s cause of death was proximately due to service, she is not competent to provide a nexus opinion in this case. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body/interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). She is not competent to relate the Veteran’s cause of death to service. The evidence of record does not show that tinnitus contributed substantially or materially to cause the Veteran’s death. 38 U.S.C. § 1310 (2012); 38 C.F.R. § 3.312(c)(1) (2017). Although the Board is sympathetic to the contentions of the appellant, there is no probative evidence of record indicating the Veteran’s death was service related. The appellant has submitted no evidence or further indication as to why she believes the Veteran’s cause of death was service related. The service treatment records are negative for metastatic malignancy, and the Veteran was only service connected for tinnitus. (Continued on the next page)   As the preponderance of the competent evidence fails to show that the Veteran’s service-connected disabilities played any part in his death, service connection for the cause of the Veteran’s death is denied. 38 U.S.C. § 5107(b) (2012). H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Skiouris, Associate Counsel