Citation Nr: 21000674 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 17-23 100 DATE: January 5, 2021 ORDER Service connection for a cardiovascular (CV) disorder is denied. FINDINGS OF FACT 1. The Veteran had active service from November 1962 to November 1982. 2. A CV disorder was not shown in service, was not shown to a compensable degree within one year of service, and symptoms were not continuous since service; a current CV disorder, diagnosed as coronary artery disease (CAD), is not causally or etiologically related to service, to include as due to herbicide exposure, and was not caused by or permanently worsened in severity by a service-connected disability. CONCLUSION OF LAW A CV disorder was not incurred in service, is not presumed to have been incurred in service, to include as due to herbicide exposure, and is not proximately due to, aggravated by, or the result of service-connected disability. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309, 3.310 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSION Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. Service connection may also be granted on a presumptive basis for diseases associated with herbicide exposure under 38 C.F.R. § 3.309 if a veteran: (1) served in the Republic of Vietnam between January 1962 and May 1975, (2) served between April 1968 and August 1971 in or near the Korean Demilitarized Zone; (3) served near the base perimeter of certain Thailand Air Force Bases during the Vietnam War era, or (4) regularly and repeatedly operated, maintained, or served aboard aircraft known to have been used to spray a herbicide agent during the Vietnam War Era. 38 C.F.R. § 3.307(a)(6). Notwithstanding the foregoing provisions regarding presumptive service connection, a veteran is not precluded from establishing service connection with proof of direct causation. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Turning to the medical evidence, the Veteran has been diagnosed with CAD since approximately 2008. Further, he has a history of ischemic cardiomyopathy, paroxysmal atrial fibrillation, hyperlipidemia, and hypertension (HTN). As such, a current CV disorder has been shown and the first element of service connection has been met. As to in-service incurrence, the service treatment records (STRs) do not show, nor does the Veteran contend, that a CV disorder was shown during service. The September 1982 separation examination reflected a normal clinical evaluation of the heart and vascular system. Rather, the main assertion is that he was exposed to herbicides and other chemical agents while on duty that led to the development of the current CV disorder. The record reflects that the Veteran’s military occupational specialty (MOS) was an aircraft fuel systems technician. As a result, he contends that he was exposed to dangerous levels of carcinogens, including jet fuel. To the extent that he asserts a nexus between service and CAD, the competent and probative evidence does not establish a relationship between CAD and service, to include any exposure to jet fuel or other chemicals. There are no medical opinions of record which support this claim. As such, the medical evidence does not support service connection for a CV disorder on a direct basis as due to chemical exposure. Further, the Veteran contends that he was exposed to herbicides, to include Agent Orange, during his service in Thailand. A review of the service personnel records shows that he served at U-Tapao Royal Air Force Base in Thailand between 1970 and 1974 and his MOS was an aircraft fuel systems technician. Accordingly, service in Thailand during the Vietnam War era is established. During October 2020 hearing testimony before the Board, the Veteran asserted that while serving in Thailand, he was in direct contact with aircraft in the flight line that may have transported and sprayed Agent Orange. Further, he stated that his barracks was along the perimeter of the base and was sprayed with Agent Orange. He believed that he was exposed to Agent Orange during his service in Thailand, and recounted witnessing service members spraying herbicides during his time on base. The personnel record reflects the Veteran’s service at U-Tapao Royal Air Force Base during the Vietnam War era; however, the evidence does not reflect that he served as a security policeman, security patrol dog handler, or member of a security police squadron or was otherwise routinely near the base perimeter as anticipated by the regulation. Specifically, a July 1970 performance review noted that the Veteran performed leak detection and repair on integral and bladder type fuel cells. He also inspected, removed, and replaced fuel system components. Further, a January 1974 performance report noted similar duties, including coordinating with the control unit on dispatching of flight line fuel specialists. While the performance reports detailed the Veteran’s responsibilities as an aircraft fuel systems technician, they did not note that he was regularly near the perimeter of the base as a result of his MOS. Further, the record made no indication that he handled or worked with Agent Orange or other herbicides, and he only speculated that aircraft he worked on had been exposed to Agent Orange. Therefore, the evidence does not support exposure on a fact-found basis. To the extent that the Veteran asserts that he was exposed to Agent Orange as a result of the location of his barracks, the regulations do not anticipate that service connection is warranted based on living quarters. To do so would render the qualifiers (security policeman, security patrol dog handler, member of a security police squadron, or others who served near the base perimeter) meaningless as presumable nearly every person on base lived in the barracks. As such, the evidence does not support exposure to an herbicide agent in Thailand and thus does not support service connection on a presumptive basis for DM. Thus, to the extent that the Veteran asserted that his duties regularly involved service at or near the perimeter of the base or that he was exposed due to the location of his barracks, such statements are inconsistent with, and outweighed by, additional evidence of record that does not otherwise document regular duties on or near the base perimeter as anticipated by the regulation, including consideration of his personnel records and MOS duties. Next, service connection will be considered as due to herbicide exposure on the basis of direct causation. In October 2020, a private physician stated that the Veteran was exposed to Agent Orange during service and that this exposure had been associated with an increased chance of developing ischemic heart disease. In addition, he stated that exposure to Agent Orange may have been a contributing factor in the development of a CV disorder. This opinion is not probative as it merely establishes a possible association between herbicide exposure and a current CV disorder. The physician did not state that herbicide exposure more likely than not led to the development of a CV disorder. Further, as noted above, the objective evidence does not show that the Veteran was exposed to herbicides during service. As herbicide exposure has not been conceded, the evidence does not support service connection based on direct causation. As to presumptive service connection based on chronicity/continuity, no chronic disease related to a CV disorder was shown in service. As noted above, the evidence does not show any complaints, treatment, or diagnoses of a CV disorder while on active duty, or any symptoms reasonably attributed to the disorder, nor has the Veteran so claimed. Therefore, the medical evidence does not support presumptive service connection on a “chronic disease or injury shown in service” basis. Next, the record does not support presumptive service connection based on continuity of symptomatology since service. Specifically, the medical evidence shows that the Veteran was diagnosed with a CV disorder, to include CAD, in 2008. As he was discharged in 1982 and not diagnosed until 2008, nearly 25 years later, the record does not support service connection on a “continuity of symptomatology” basis. Further, the disorder did not manifest itself to a degree of 10 percent or more within one year from the date of separation from service. The Veteran separated from active service in 1982 but was not diagnosed with a CV disorder until 2008. Therefore, the evidence does not support presumptive service connection on this basis. Next, the Veteran has contended that a CV disorder is due to Hodgkin’s disease; however, he is not currently service-connected for Hodgkin’s disease. Currently, he is service connected for tinnitus, bilateral hearing loss, status/post-operative pterygium, and status/post-operative scars. There is no medical evidence which links a CV disorder to any of these service-connected disabilities. As such, the medical evidence does not support service connection on a secondary basis. The Board has considered the Veteran’s lay statements that his disorder was caused by service. In addition, he submitted a buddy statement and several internet pictures of the base showing his barracks in relation to the perimeter. It is difficult to judge the distance from the barracks to the perimeter and the regulations do not define the distance of “near” the perimeter but the photograph shows that the barracks is some distance off the perimeter which the Board finds does not meet the standard of on or near the perimeter as anticipated by the regulations. The Veteran also testified that he had photographs of servicemembers spraying Agent Orange around the perimeter but no other photographs except from the internet were submitted in support of the claim. The Veteran also submitted an email thread from his fellow servicemember purporting to show a 500 meter herbicide drift zone that he was recommending that the Veteran use (by adding his name and file number on the picture) to show duties near the perimeter; however, without an interpretation of the content of the photographs or an understanding of a “drift zone,” which is not part of the regulation, the email threat is assigned lesser probative value. The Veteran is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his current disorder due to the medical complexity of the matters involved. Such competent evidence has been provided by the service records, clinical evidence, and examination obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claim for service connection and there is no doubt to be otherwise resolved. As such, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Kokolas, 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.