Citation Nr: 20002231 Decision Date: 01/10/20 Archive Date: 01/09/20 DOCKET NO. 16-38 132 DATE: January 10, 2020 ORDER Entitlement to service connection for myasthenia gravis due to agent orange herbicide exposure is denied. FINDING OF FACT The Veteran’s myasthenia gravis was not shown in service or diagnosed within one year of service discharge and it is not associated with the Veteran’s presumed exposure to herbicide agents. CONCLUSION OF LAW The criteria for entitlement to service connection for myasthenia gravis due to herbicide agent exposure have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.309(e). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty for the United States Army from August 1968 to May 1970. 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 service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information lay and medical evidence of record in a case and when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (2012); 38 C.F.R. § 3.102 (2017); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, a preponderance of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). The Veteran was afforded a hearing before the undersigned in August 2019 and testified that his condition is due to exposure to agent orange herbicide during his active duty service in the Republic of Vietnam. The regulations provide that a number of diseases shall be service-connected if the Veteran was exposed to an herbicide agent during active service, even though there is no record of such disease during service and provided further that the requirements of 38 C.F.R. § 3.307 (d) are satisfied. 38 C.F.R. § 3.309(e). Unfortunately, myasthenia gravis is not one of the diseases that the VA presumes is related to agent orange exposure. 38 C.F.R. § 3.309(e). The Board concedes the Veteran’s exposure to herbicide agents. However, the Veteran is not competent to provide a nexus opinion in this case as it requires specialized medical education. Jandreau v. Nicholson, 492 F. 3d 1372. The Veteran submitted an excerpt of 38 C.F.R. § 3.309(a) to show that his myasthenia gravis is presumed by the VA to be service-connected. However, this section of the regulations specifically governs chronic diseases which must have become manifest to a compensable degree within one (1) year from the date of separation or within the applicable time limits under § 3.307. The Veteran separated from the United States Army in May 1970 and did not experience symptoms of the claimed disease until January 2015 when he was admitted into “Hospital Episcopal San Lucas” and later diagnosed. The Veteran’s myasthenia gravis was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established, and the disability is not otherwise etiologically related to an in-service injury or disease. Lastly, Veterans must be afforded the opportunity to show direct service connection, even if their disease did not qualify for presumptive service connection. Combee v. Brown, 34 F.3d 1039, 1045. The Veteran’s claim file does not contain evidence showing that the claimed disease was incurred in or aggravated by his service. He did not report complaints or symptoms for this disease during active duty service. Until January 2015, his outpatient records do not show any complaints of difficulty swallowing or controlling the reflux muscles in the throat. There is no evidence showing a link or nexus between this disease and the Veteran’s military service. Considering the pertinent evidence in light of the governing legal authority, the Board finds that the preponderance of the evidence is against the claim. The probative evidence does not show that the Veteran’s myasthenia gravis is related to his active military service. Given such, the evidence is not in equipoise. Therefore, the claim must be denied. M. Tenner Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Hamed, Law Clerk 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.