Citation Nr: 20003280 Decision Date: 01/14/20 Archive Date: 01/14/20 DOCKET NO. 18-14 039 DATE: January 14, 2020 ORDER Service connection for bilateral kidney disease is denied. FINDING OF FACT The preponderance of the evidence is against a finding that the Veteran’s bilateral kidney disease is related to his active service, to include his exposure to asbestos. CONCLUSION OF LAW The criteria for service connection for bilateral kidney disease have not been met. 38 U.S.C. §§ 1101, 1110, 5103, 5103a, 5107 (2012); 38 C.F.R. §§ 3.102, 3.103, 3.159, 3.303 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from June 1959 to June 1963. The claim was originally denied in a May 2017 rating decision and the Veteran timely appealed. He died in February 2019, during the pendency of the claim. The Appellant is his surviving spouse and has been substituted as the claimant. At a March 2019 hearing, the Appellant and her son testified before the undersigned Veterans Law Judge. A transcript of the proceeding has been associated with the claims file. This matter was previously before the Board in August 2019 at which time it was remanded for further evidentiary development. The Appellant has contended that the Veteran’s bilateral kidney disease was the result of asbestos exposure experienced during active service. Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303(a). This means that the facts establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Veteran served aboard the USS Bennington (CV-20) as an aircraft engine mechanic apprentice. The Appellant and her son described the Veteran’s duties as working on the flight deck and engine room, and moving cargo around amidst exhaust, fumes, chemicals, jet fuel, and asbestos. Evidence has been submitted which confirms the use of asbestos on the USS Bennington during the Veteran’s service period. The Veteran’s service treatment records do not contain any complaints, symptoms, treatment, or diagnosis of a kidney condition. Post-service, a March 2004 private treatment record diagnosing hypertension and chronic renal failure is the first medical evidence in the claims file of a kidney condition. The Veteran underwent a renal transplant evaluation in July 2006 where hypertension was again noted as a comorbid condition. He began hemodialysis on a three times weekly basis in July 2007. His treating clinician completed a Disability Benefits Questionnaire in December 2018 which diagnosed end-stage renal disease but did not discuss the etiology of the condition. He also noted that the Veteran had a current diagnosis of hypertension. The Appellant submitted a medical article which suggested a link between asbestos exposure and renal cancer. No medical opinion pertaining to the Veteran accompanied the material. At the hearing, the Appellant and her son described the onset of the Veteran’s post-service disabilities, noting that hypertension was the first physical condition that began after discharge, followed years later by kidney complications. They also suggested that asbestos exposure resulted in a “domino effect” of conditions, with his service-connected lung disability due to asbestos exposure causing other disabilities, including his bilateral kidney disease. A VA opinion was obtained in October 2019. The examiner stated that a review of the records indicated that the Veteran had a long-time history of hypertension. Private records continually mentioned hypertension and chronic kidney disease together. He stated that it was well-known in medical literature and in the medical community that hypertension was one of the two most important risk factors for the development of chronic kidney disease. Therefore, he reasoned, to attribute chronic kidney disease to some other condition such as asbestos exposure in the presence of hypertension would be speculation. Based on the evidence, he determined that it was less likely than not that the Veteran’s chronic kidney disease was related to asbestos exposure from service. The Board finds that service connection for bilateral kidney disease is not warranted. There is no evidence that the Veteran had any kidney condition during active service or for many years thereafter. By his family’s account, his hypertension preceded his kidney disease. All references to the Veteran’s kidney disease were made in conjunction with hypertension. The VA opinion noted that it was accepted medical knowledge that hypertension was one of the most important risk factors for chronic kidney disease and attributing the Veteran’s condition to asbestos exposure would be speculative. In contrast, there is no competent and credible evidence that the Veteran’s bilateral kidney disease is related to his in-service asbestos exposure. The Board acknowledges the Appellant’s contention that the Veteran’s service-connected lung disease which was due to asbestos exposure caused a domino effect, resulting in his kidney disease. However, none of the private medical records submitted support this contention. The Board recognizes that the Veteran’s family may believe that the claimed condition resulted from his military service, however, they have not been shown to have the requisite medical knowledge and expertise necessary to provide a competent opinion regarding etiology of complex medical conditions. Further, the medical article submitted by the Appellant referred to a connection between asbestos exposure and renal cancer, not bilateral kidney disease. The Court of Appeals for Veterans Claims has held that a medical article or treatise “can provide important support when combined with an opinion of a medical professional” if the medical article or treatise evidence discusses generic relationships with a degree of certainty such that, under the facts of a specific case, there is at least “plausible causality” based upon objective facts rather than on an unsubstantiated lay medical opinion. Mattern v. West, 12 Vet. App. 222, 228 (1999); see also Sacks v. West, 11 Vet. App. 314 (1998); Wallin v. West, 11 Vet. App. 509 (1998). Articles and treatises tend to be general in nature and to not relate to the specific facts in a given veteran’s claim. In the present case, the article submitted by the Appellant falls into this general category. Further, the article is not combined with an opinion of a medical professional and does not speak to the Veteran’s actual diagnosis. As such, it is not probative evidence. Based on the foregoing, the Board finds that the preponderance of the evidence is against a finding that the Veteran’s bilateral kidney disease is related to his active service, to include his exposure to asbestos. As the preponderance of the evidence is against the claim, the benefit of the doubt rule is not for application. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Rachel E. Jensen, 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.