Citation Nr: 21000348 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 14-32 306A DATE: January 5, 2021 ORDER Entitlement to service connection for glaucoma is denied. Entitlement to service connection for lipoma is denied. Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is denied. FINDINGS OF FACT 1. Glaucoma was not incurred in service and is not related to service, including in-service herbicide exposure. 2. Lipoma was not incurred in service and is not related to service, including in-service herbicide exposure. 3. COPD was not incurred in service and is not related to service, including in-service herbicide exposure. CONCLUSIONS OF LAW 1. The criteria for service connection for glaucoma have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 2. The criteria for service connection for lipoma have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 3. The criteria for service connection for COPD have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from November 1962 to November 1966. Service Connection Service connection may be established for disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be granted for any disease initially diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Service incurrence for certain diseases will be presumed on the basis of an association with certain herbicide agents (e.g., Agent Orange). 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6), 3.309(e). The Veteran is presumed exposed to herbicides. 38 U.S.C. § 1116; 38 C.F.R. § 3.307. 1. Glaucoma Service treatment records reveal no findings or histories of glaucoma, and service examination records, including the November 1966 separation examination, reveal normal clinical findings. The April 1965 examination record reports a negative history of eye trouble. The November 1966 separation examination record reports a history of eye trouble, but the record clarifies that the history was regarding hyperopia since 1962, for which the Veteran used glasses. A February 2018 VA examination record reveals diagnosis of glaucoma. The examiner determined that it was less than likely that the glaucoma was incurred in or caused by service. The examiner added that the he was not aware of glaucoma being specifically associated with exposure to agent orange type agents. A July 2020 VA medical opinion from the February 2018 VA examiner reveals the determination that it was less than likely that the glaucoma was etiologically related to herbicide exposure, explaining that the physician was not aware of glaucoma being specifically linked to herbicide exposure. After review of the record, the Board finds service connection is not warranted for glaucoma. The service medical records do not suggest the existence of glaucoma, and the Veteran has not alleged symptoms attributed to glaucoma during and since service. Furthermore, the probative evidence does not suggest that the glaucoma is related to service. The record does not include any medical findings linking the glaucoma to service. The appellant has contended that the glaucoma is due to herbicide exposure. However, the appellant has not submitted medical evidence in support of that contention, glaucoma is not presumptively linked to herbicide exposure and the VA examiner determined that the glaucoma is not related to service, including herbicide exposure. The examiner noted that medical literature does not identify herbicide exposure as a cause of glaucoma. Accordingly, the claim must be denied. In reaching this decision, the Board has considered the doctrine of reasonable doubt but has determined that it is not applicable because the preponderance of the evidence is against the claim. 2. Lipoma Service treatment records reveal no findings or histories of lipoma, and April 1965 and November 1966 examination records reveal normal clinical findings. A June 2013 treatment record reveals finding of lipoma on the neck and history of past surgical removal of lipoma. A February 2018 VA examination record reveals a diagnosis of lipoma, first removed in 1985. The examiner noted that an August 2013 magnetic resonance imaging (MRI) report showed a lipoma of the neck. The examiner stated that the lipoma was less likely than not incurred in or related to service, explaining that there was no evidence of a lipoma in service and the first mention was the reported removal in 1985. A December 2019 VA medical opinion reveals the determination that there was no relationship between lipoma, a fatty subcutaneous growth, and exposure to herbicides. The physician noted that the Institute of Medicine report on Agent Orange found no association between exposure to Agent Orange and lipomas and that the only association found between Agent Orange and skin disease was for chloracne. After review of the record, the Board finds service connection is not warranted for lipoma. The service medical records do not suggest the existence of lipoma, and the Veteran has not alleged symptoms attributed to lipoma during and since service. Furthermore, the probative evidence does not suggest that the lipoma is related to service. The record does not include any medical findings linking the lipoma to service. The appellant has contended that the lipoma is due to herbicide exposure. However, the appellant has not submitted medical evidence in support of that contention, lipoma is not presumptively linked to herbicide exposure and the VA examiner determined that the lipoma is not related to service, including herbicide exposure. The examiner noted that medical literature does not identify herbicide exposure as a cause of lipoma. Accordingly, the claim must be denied. In reaching this decision, the Board has considered the doctrine of reasonable doubt but has determined that it is not applicable because the preponderance of the evidence is against the claim. 3. COPD An October 1963 treatment record does reveal findings of questionable echocardiogram abnormality and right lower lobe coin lesion, but no disease was found after inpatient observation. A December 1964 treatment record reveals the Veteran’s three-month history of chest pain and exertional dyspnea. The record notes that the Veteran was seen for suspicion of a coin lesion in October 1963 and that follow-up chest X-ray showed no abnormality, including no coin lesion. The diagnosis was no evidence of pulmonary disease at this time. An April 1965 examination record reveals normal clinical findings for the lungs and chest, negative chest X-ray imaging, and negative histories of shortness of breath, chronic cough, or pain or pressure in chest. A March 2004 treatment record reveals diagnosis of COPD exacerbation. A May 2009 private treatment record reveals diagnosis of advanced COPD and a history of smoking. A June 2012 private treatment record reveals the history of smoking until 2003, when he was diagnosed with COPD. A February 2018 VA examination record reveals a diagnosis of COPD. The examiner reported that COPD was diagnosed in June 2004. The examiner determined that the COPD was less likely than not incurred in or caused by service, explaining that the service records showed careful evaluation of cardiopulmonary status without evidence of pulmonary disease, that the November 1966 examination was normal, and that the first diagnosis dated 35 years after service. A March 2018 addendum opinion reveals the determination that the COPD was not related to service, including in-service exposure to materials used as an illustrator. The examiner reported that there was no published medical data that identified any respiratory toxicity of materials used as an illustrator and that OSHA had not classified felt-tipped pens or commercial artists’ illustrating tools as hazardous materials. A December 2019 VA medical opinion reveals the finding that the COPD was less likely than not incurred in or caused by service. The physician noted that the Institute of Medicine has completed comprehensive studies of the effects of chemical compounds in Agent Orange (Chemicals of Interest or COI's) and determined that “there is inadequate or insufficient evidence to determine whether there is an association between exposure to the COIs and respiratory disorders” and that there is inadequate or insufficient evidence of an association between exposure to the COIs and prevalence of respiratory disorders or mortality from COPD. After review of the record, the Board finds service connection is not warranted for COPD. The service medical records do not suggest the existence of COPD, and the Veteran has not alleged symptoms attributed to COPD during and since service. Furthermore, the probative evidence does not suggest that the COPD is related to service. The record does not include any medical findings linking the COPD to service. The appellant has contended that the COPD is due to herbicide exposure or exposure to artistic materials. However, the appellant has not submitted medical evidence in support of these contentions, COPD is not presumptively linked to herbicide exposure, and the VA examiner determined that the lipoma is not related to service, including the in-service exposure to artistic materials and herbicide exposure. The examiner noted that medical literature does not identify herbicide exposure or artistic materials as a cause of COPD. Accordingly, the claim must be denied. In reaching this decision, the Board has considered the doctrine of reasonable doubt but has determined that it is not applicable because the preponderance of the evidence is against the claim. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Snyder, 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.