Citation Nr: 20021441 Decision Date: 03/25/20 Archive Date: 03/25/20 DOCKET NO. 19-34 985 DATE: March 25, 2020 ORDER Service connection for acute myeloid leukemia is denied. REMANDED Special monthly compensation (SMC) based on aid and attendance is remanded. Special monthly pension (SMP) based on the need for aid and attendance is remanded. FINDING OF FACT The Veteran has been diagnosed with acute myeloid leukemia but there is no evidence the condition was incurred in, aggravated by, or otherwise related to service. CONCLUSION OF LAW The criteria have not been met for service connection for acute myeloid leukemia. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1977 to November 1978 with a period of active duty for training (ACDUTRA) from October 1972 to March 1973. 1. Service connection for acute myeloid leukemia Legal Criteria Initially, the Board notes that it has reviewed all of the evidence in the record, with an emphasis on the evidence relevant to this appeal. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). The Board will summarize the relevant evidence as appropriate, and the Board’s analysis will focus specifically on what the evidence shows, or fails to show, as to the claim being decided. Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be established either by showing direct service incurrence or by using applicable presumptions, if available. Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994). Competent (that is, qualified) medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. Competent medical evidence may include statements contained in medical treatises, scientific articles, or research reports or analyses. 38 C.F.R. § 3.159(a)(1). Competent (that is, qualified) lay evidence means evidence not requiring that the person providing it have specialized education, training, or experience. Lay statements are qualified to establish that an event or circumstance occurred if the statements are provided by a person who has personal knowledge of and provides information about matters that can be observed and described by a lay person. 38 C.F.R. § 3.159(a)(2). This may include some medical matters, such as describing observable symptoms or reporting that a medical provider gave them a diagnosis in the past. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Lay evidence may be qualified to establish that an event or injury occurred during service, or that a chronic disability began during service. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). A claim will be granted if the evidence supports it or if the evidence for and against the claim is equally balanced (this is sometimes called “relative equipoise”). 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Factual Background The Veteran’s service treatment records (STRs) are silent for any diagnosis of, reports of, or treatment for leukemia. February 2018 treatment records include a diagnosis of acute myeloid leukemia and state the Veteran had been admitted to the hospital in January 2018 for treatment of acute myeloid leukemia. An October 2018 letter from the Veteran’s wife stated he had been diagnosed with acute myeloid leukemia in January 2018. Analysis As an initial matter, the Board finds that a VA examination addressing the question of the cause of the Veteran’s acute myeloid leukemia is not necessary. Absent any competent evidence suggesting a link between this disability and any aspect of his service, a medical nexus opinion for this question is not warranted, because even the low threshold standard for determining when an opinion is necessary is not met. See McLendon v. Nicholson, 20 Vet. App. 27 (2006); see also 38 C.F.R. § 3.159(c)(4). After review of the record, the Board finds that service connection is not warranted for acute myeloid leukemia. While the Veteran has a current diagnosis of acute myeloid leukemia, the evidence of record does not support a finding that this disability was caused by events in service. Direct service connection for acute myeloid leukemia is not warranted because a causal link (nexus) between the Veteran’s service and his current disability has not been shown. The record does not reflect, and the Veteran has not alleged, that his acute myeloid leukemia disability began in service or was caused by events in service. Furthermore, the Veteran’s treatment records indicate that his condition did not begin until well after service in 2018. He separated from service in 1978, 40 years prior. The Board finds that the preponderance of the evidence is against the claim of service connection for acute myeloid leukemia. Accordingly, the benefit of the doubt doctrine does not apply; the appeal in this matter must be denied. REASONS FOR REMAND 1. Special monthly compensation (SMC) based on aid and attendance is remanded. The Veteran timely filed a notice of disagreement with a January 2019 rating decision that denied SMC based on aid and attendance. The AOJ has not issued a statement of the case (SOC) in this matter. In such circumstances, the Board is required to remand for the issuance of an SOC. See Manlincon v. West, 12 Vet. App. 238, 240 (1999). These matters are not now before the Board and will only be on appeal to the Board if the Veteran timely files a substantive appeal after an SOC is issued. 2. Special monthly pension (SMP) based on the need for aid and attendance is remanded. The Veteran timely filed a notice of disagreement with a January 2019 rating decision that denied SMP based on the need for aid and attendance. The AOJ has not issued a statement of the case (SOC) in this matter. In such circumstances, the Board is required to remand for the issuance of an SOC. See Manlincon v. West, 12 Vet. App. 238, 240 (1999). These matters are not now before the Board and will only be on appeal to the Board if the Veteran timely files a substantive appeal after an SOC is issued. The matters are REMANDED for the following action: 1. The AOJ should review its determination on the claims for entitlement to special monthly compensation based on aid and attendance and entitlement to special monthly pension (SMP) based on the need for aid and attendance, and arrange for any further development indicated (including contemporaneous examinations, if indicated), and issue an appropriate SOC on this matter. [CONTINUED ON NEXT PAGE] If the Veteran perfects an appeal by submitting a timely VA Form 9, the issue should be returned to the Board for further appellate consideration. VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. D’Allaird, 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.