Citation Nr: 19166178 Decision Date: 08/27/19 Archive Date: 08/27/19 DOCKET NO. 15-33 737 DATE: August 27, 2019 ORDER Service connection for cause of death is denied. FINDING OF FACT The weight of the evidence does not show that the Veteran’s service at least as likely as not resulted in any disabilities that have primarily caused, or otherwise either substantially or materially contributed to, aided in or assisted in his death. CONCLUSION OF LAW The criteria for the award of service connection for cause of death have not been met. 38 U.S.C. § 1310; 38 C.F.R. § 3.312. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran honorably served on active duty in the United States Navy aboard USS Taluga from August 1960 to August 1964 and died in September 2011. His death certificate lists the immediate cause of death as respiratory failure due to severe malnutrition, dysphagia, and squamous cell carcinoma of the head, and the other significant contributing conditions are listed as ulcerative colitis and sclerosing cholangitis. None of these disabilities have been claimed to be service connected during the Veteran’s life. In August 2014, the Veteran’s surviving spouse (Appellant) filed her claim seeking service connection for the cause of the Veteran’s death, suggesting that the disabilities causing his death may have resulted from exposure to unregulated environmental hazards during his service aboard USS Taluga. Service connection for cause of death may be granted, but only when the evidence shows that either the principal or a contributory cause of death at least as likely as not etiologically relates to a service event resulting in a disability underlying death. See 38 C.F.R. § 3.312. Such a determination is medically complex, particularly in this case given a multitude of the Veteran’s disabilities during his life and an attenuation of the disabilities resulting in his death from his services by many years. For this reason, the Board remanded the claim to obtain a medical opinion addressing the etiology of the cause of the Veteran’s death. In April 2019, a VA examiner carefully reviewed entire claims file, to include all medical and lay evidence or record. The examiner was also apprised of the appellant’s arguments. Upon considering the comprehensive data, the examiner opined that the evidence does not warrant a finding that it is at least as likely as not that any exposures during the Veteran’s service either directly or proximately caused his death. As such, the evidence of record does not show that any of the Veteran’s disabilities that primarily caused or otherwise substantially or materially contributed to, aided in, or assisted in his death are etiologically related to his service, to include the claimed exposure to any of the environmental hazards during service. The Board acknowledges the Appellant’s belief to the contrary. The Appellant statements submitted in support of her claim assert the rarity of the Veteran’s liver disease with the onset latency and multiple medical opinions that the Veteran’s exposure to toxins in service well may have resulted in his disabilities. For example, in a statement received in November 2017, the Appellant’s states that the Veteran’s doctors suggested more than once that the origin of the illness may have been caused during his Navy days of Vietnam War and remained dormant for many years. However, no such opinions have ever been presented. In a statement received in November 2016, the Appellant asserts that it was suggested that the Veteran’s early exposure to chemicals on board ship while in the Navy, such as lead paint, which he chipped and repainted, or toxic cleansing of oil tanks, which he participated in, or other chemical substances, which could have contributed, indeed, began the process of destruction of his liver in years to come. Although these statements have suggested that the Veteran’s service may have resulted in disabilities substantially or materially contributing to his death, they were carefully reviewed and rebutted by the VA medical examiner. Moreover, a mere suggestion of an association is insufficient to satisfy the requisite evidentiary standard of “at least as likely as not,” meaning a probability of fifty percent or greater. Unfortunately, none of the medical opinions that the Appellant references in her statements are of record or corroborated by the medical evidence of record. In her substantive appeal (VA Form 9 received in September 2015), the Appellant further contends that the evidence does not exclude service as a possible cause and thus the Veteran’s death may have been caused by his service. As discussed, “may” is not the legal standard. Rather, the ultimate question before the Board in this appeal is whether evidence shows such a possibility with the requisite degree of probability of fifty percent or greater. The VA examiner answered this question in the negative, noting that the Veteran’s alleged in-service exposure to hazardous chemicals (lead paint, oil, oil cleaning chemicals) less likely than not contributed substantially or materially to his death, due to finding no probative evidence to render the opposite conclusion. This negative opinion is uncontradicted by any competent evidence of record. The Appellant without specialized knowledge, training, or experience, generally is said not to possess the requisite expertise to render etiological opinions concerning medically complex etiology of disabilities with an onset many years after service. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The Appellant does not dispute this. Rather, her December 2014 statement indicates that the Veteran’s disability is “a devastating disease, for which cause we do not know.” Her November 2016 statement reflects the Appellant’s opinion that the Veteran’s “illness was not definitive in relation to cause.” The November 2016 statement further reflects the Appellant’s concession that there might be some intervening causes beyond service because the Veteran “became a machinist by trade and the chemicals used in the 70’s – 80’s may have contributed” to his disabilities leading to his death. Upon considering the Appellant’s contention that the Veteran’s disabilities resulting in his death may be etiologically related to his service against the VA examiner’s opinion that the Veteran’s disabilities having caused, or contributed substantially or materially to his death, are not at least as likely as not etiologically related to his service, the Board accords the VA opinion a greater probative weight. As such, the preponderance of the evidence weights against the Appellant’s claim. In reaching this conclusion, the Board has considered the regulatory provisions for a presumptive exposure to certain environmental hazards, such as herbicide agents, and presumptions of service connection for certain chronic diseases, but ultimately finds that none of the provisions apply in this case. 38 C.F.R. §§ 3.307, 3.309. The Board is sympathetic to the Appellant and her difficult circumstances imposed by the Veteran’s disabilities, to include his three liver transplants and renal failure, progressively debilitating over a period of fifteen years and resulting in emotional and financial hardships. Regretfully, the Board does not have any authority to grant sought benefits on an equitable basis and is bound by the existing laws passed by Congress. 38 U.S.C. §§ 503, 7104; Harvey v. Brown, 6 Vet. App. 416, 425 (1994). Under the existing law, unless the favorable evidence of record meets the requisite evidentiary threshold of at least fifty-percent probability, the claim must be denied. Accordingly, service connection for the Veteran’s cause of death is denied. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Bardin, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.