Citation Nr: 20053167 Decision Date: 08/11/20 Archive Date: 08/11/20 DOCKET NO. 17-58 147 DATE: August 11, 2020 ORDER Entitlement to service connection for cause of death is granted. FINDING OF FACT 1. The Veteran served along the perimeter of Ubon Royal Thai Airforce Base and is presumed to have been exposed to herbicides. 2. The Veteran died in November 2015. The certificate of death lists the underlying cause of death as coronary artery disease. CONCLUSION OF LAW The criteria for entitlement to service connection for the cause of the Veteran's death have been met. 38 U.S.C. §§ 1110, 1116, 1154, 1310, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307(a), 3.309(e), 3.312. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1953 to January 1979. He subsequently passed away in November 2015. The appellant is his surviving spouse. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a January 2017 rating decision by the Regional Office (RO) of the Department of Veterans Affairs (VA). Entitlement to service connection for cause of death. The Appellant asserts that the Veteran was exposed to herbicide agents while serving in Thailand, and that his exposure is causally related to his cause of death. The Veteran died in November 2015. The death certificate lists his cause of death as cardiopulmonary arrest due to coronary artery disease (CAD). (3/16/2016, Death Certificate, p. 1). His surviving spouse filed a claim of service connection for the cause of his death in March 2016. (3/14/2016, VA 21-534, p. 1) In order to establish service connection for the cause of the Veteran's death, the evidence of record must show that a disability incurred in or aggravated by service either caused or contributed substantially or materially to death. 38 U.S.C. § 1310; 38 C.F.R. § 3.312(a). The service-connected disability will be considered as the principal (primary) cause of death when such disability, singly or jointly with some other condition, was the immediate or underlying cause of death or was etiologically related thereto. 38 C.F.R. § 3.312(b). A contributory cause of death is inherently one not related to the principal cause. In determining whether the service-connected disability contributed to death, it must be shown that it contributed substantially or materially; that it combined to cause death; that it aided or lent assistance to the production of death. It is not sufficient to show that it casually shared in producing death, but rather it must be shown that there was a causal connection. 38 C.F.R. § 3.312(c). Service-connected diseases or injuries involving active processes affecting vital organs should receive careful consideration as a contributory cause of death, the primary cause being unrelated, from the viewpoint of whether there were resulting debilitating effects and general impairment of health to an extent that would render the person materially less capable of resisting the effects of other disease or injury primarily causing death. Where the service-connected condition affects vital organs as distinguished from muscular or skeletal functions and is evaluated as 100 percent disabling, debilitation may be assumed. 38 C.F.R. § 3.312(c). In determining whether the disability that resulted in the death of the Veteran was the result of active service, the laws and regulations pertaining to basic service connection apply. 38 U.S.C. § 1310. Service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Consistent with this framework, service connection is warranted for a disease first 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). Certain diseases associated with exposure to herbicide agents will be presumed to have been incurred in service even though there is no evidence of that disease during the period of service at issue, including CAD. These diseases must manifest to a degree of 10 percent or more at any time after service for the presumption to apply. 38 U.S.C. § 1116(a); 38 C.F.R. §§ 3.307(a)(6), 3.309(e). The Board concludes that the Veteran has a current disability that is causally related to exposure to herbicide agents while serving in Thailand. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). In this regard, the Veteran served in Thailand at Ubon Royal Thai Air Force Base (RTAFB) from July 1969 to April 1970. (5/20/2016, Military Personnel Record, p. 6). His military records do not indicate that he served in Vietnam, and therefore exposure to herbicide agents cannot be presumed in accordance with 38 C.F.R. § 3.307(a)(6)(iii). However, exposure can be shown on a facts-found basis. Based on a 1973 Department of Defense report titled “CHECO Southeast Asia Report: Base Defense in Thailand 1968-1972,” the Board acknowledges that herbicides were used along the perimeters of RTAFBs, to include Ubon. As the use of herbicides in Thailand was limited to the perimeters of the RTAFBs, the Board must determine if the Veteran served along the perimeter of the base. The Veteran’s military personnel records confirm, as already noted, that he was stationed at Ubon RTAFB. These records also indicate that he was stationed at “Ubon Airfield.” The Appellant asserts that references to “Ubon Airfield” in the Veteran’s military personnel records refer to a specific location, the Ubon flight line, within Ubon RTAFB as opposed to the base as a whole. It is not clear to the Board whether this is actually what the Veteran’s military personnel records are meant to reflect, but given that his performance report indicates that he “planned, coordinated and implemented the annual Base Wire Communications Program,” and the need for wired communication equipment throughout the entirety of a military base, the Board finds that the evidence is in relative equipoise as to whether the Veteran worked at the Ubon flight line. As such, the Board will apply the benefit of the doubt doctrine and find that the Veteran was stationed at the Ubon flight line. As to the issue of exposure to herbicide agents while stationed at the Ubon flight line, the Appellant has submitted the U.S. Department of the Army Field Manual for “Tactical Employment of Herbicides,” which advises a 500-meter buffer distance when dispersing herbicide agents using ground-based systems. (6/2/2020, Medical Treatment Record, p. 20). The Board notes that the flight line is within 500-meters of the perimeter of Ubon RTAFB. Based on the competent and probative evidence of record, the Board finds that the Veteran served within 500-meters of the perimeter of Ubon RTAFB, an area which would be affected by the ground-based employment of herbicide agents. Further, based on the CHECO Report, the Board finds that the Veteran served in Thailand during a period where herbicide agents were employed. Therefore, the Board concludes that the Veteran was exposed to herbicide agents while stationed in Thailand. Finally, as CAD is presumptively related to herbicide agent exposure, the Board finds that CAD incurred during the Veteran’s service in Thailand. With respect to the requirement that the disability manifests to a degree of 10 percent disabling or more as set forth under 38 C.F.R. § 3.307(a)(6)(ii), the Board finds that the evidence is at least in equipoise on this point. See 38 C.F.R. § 4.104 Diagnostic Code 7005. In this regard, the Veteran’s private medical records indicate that he was prescribed anticoagulants prior to his death. (3/14/2016, Medical Treatment Record, p. 13). In sum, resolving all doubt in favor of the Veteran, the weight of the evidence establishes that he was exposed to herbicide agents while serving in Thailand and that his underlying cause of death was CAD, a disease presumptively related to exposure to herbicide agents. Accordingly, service connection for his cause of death is warranted. Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Glenn, 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.