Citation Nr: 21002081 Decision Date: 01/12/21 Archive Date: 01/12/21 DOCKET NO. 13-00 067A DATE: January 12, 2021 ORDER Entitlement to service connection for prostate cancer, to include as due to in-service exposure to ionizing radiation is denied. FINDING OF FACT Prostate cancer is not related to a disease or injury during the Veteran’s active duty service, nor is it otherwise related to such service, to include as due to ionizing radiation. CONCLUSION OF LAW The criteria for entitlement to service connection for prostate cancer, to include as due to in-service exposure to ionizing radiation have not been met. 38 U.S.C. §§ 1110, 1131, 1137, 5107; 38 C.F.R. §§ 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1951 to February 1955. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a May 2012 rating decision of the Department of Veteran Affairs (VA) Regional Office (RO). In February 2016, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. The Veteran’s claim for entitlement to service connection for prostate cancer was remanded by the Board in March 2016, and December 2018 for additional development. Most recently in August 2020, the Board remanded the issues on appeal for additional development. The Board finds that the Regional Office (RO) substantially complied with the Board’s remand instructions and an additional remand to comply with the Board’s directives is not required. See Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for prostate cancer, to include as due to in-service exposure to ionizing radiation The Veteran contends that his prostate cancer, diagnosed in 2009, is due to his exposure to ionizing radiation during Operation CASTLE conducted at the Pacific Proving Grounds in 1954. The Veteran contends that the first bomb was detonated and blew the debris and radiation contamination directly at them. He indicated that the other ships had wash down facilities (to wash the contamination off the vessel) which worked but his ship was “jerry-rigged, inadequate and didn’t work the way they were supposed to. Consequently, we were contaminated including inboard and outboard. The detectors ticked when checking out bunks in our sleeping cabin.” See December 2010 correspondence. The Veteran’s participation in Operation CASTLE is verified, as is his diagnosis of prostate cancer. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current diagnosis of prostate cancer, and evidence shows that the preponderance of the evidence weighs against finding that the Veteran’s diagnosis of prostate cancer began during service or is otherwise related to an in-service injury, event, or disease. The Veteran had no complaints, or treatment for prostate cancer while in service. Moreover, there is no evidence of a diagnosis of prostate cancer during military service and the medical evidence confirms the diagnosis was more than a year following discharge of the Veteran’s active duty. Private treatment records show the Veteran was not diagnosed with prostate cancer until March 2009, decades after his separation from service. While the Veteran is competent to report having experienced symptoms since service, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of prostate cancer. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The Defense Threat Reduction Agency confirmed the Veteran participated in Operation CASTLE conducted at the Pacifica Proving Ground in 1954. As a participant it was reported that the Veteran could have received no more than external gamma does 18 rem; external neutron dose 0.5 rem; internal committed dose to the prostate (alpha) 4.5 rem; internal committed dose to the prostate (beta plus gamma) 2 rem. In a December 2006 memorandum, the Chief Public Health and Environmental Hazards officer provided instructions for expedited methodology using worse-case dose assessment. The May 2012 administrative decision revealed that it is unlikely that the Veteran’s prostate cancer resulted from exposure to ionizing radiation while in service because even with an adjusted total prostate dose for Pacific Proving ground at 40 rem, the adjusted total prostate dose is less than the applicable screen doses. In November 20, 2010, the Veteran obtained a private medical opinion regarding his prostate cancer. The doctor indicated that it is unknown whether there is a relationship between the Veteran’s exposure to possible radiation, and the Veteran’s condition. Specifically, the doctor stated, “prostate cancer is an unfortunate common condition, and it is usually not possible to determine the exact cause.” The doctor did not provide a specific opinion as to whether the Veteran's prostate cancer is associated with his radiation exposure in service. Thereby, the Board does not find this opinion probative in determining whether the Veteran's prostate cancer is caused by or related to any radiation exposure in service. In a November 2020, advisory opinion, from the Director, Post 9/11 Era Environmental Health Program (10P4Q) for the Under Secretary for Health (USH) indicated that it is not likely that the Veteran’s prostate cancer was caused by the exposure to ionizing radiation while in military service. The Health Physics Society, in their position statement PS010-3, Radiation Risk in Perspective, revised in May of 2016, states that, The average annual equivalent dose from natural background radiation in the United States is about 3 mSv [0.3 rem]. A person might accumulate an equivalent dose from natural background radiation of about 50 mSv [5 rem] in the first 17 years of life and about 250 mSv [25 rem] during an average 80-year lifetime. Substantial and convincing scientific data show evidence of health effects following high-dose exposures (many multiples of natural background). However, below levels of about 100 mSv [10 rem] above background from all sources combined, the observed radiation effects in people are not statistically different from zero. Finally, the Director indicated that the scientific evidence referenced from the VA USH and the Director’s review of the evidence in the entirety, it is unlikely that the Veteran’s prostate cancer was caused by exposure to ionizing radiation during military service. The Board has also considered medical literature submitted by the Veteran which discusses a relationship between prostate cancer and ionizing radiation exposure. However, the Board finds these articles are of very little probative value because they are general in nature, do not relate to the specific facts of circumstances of the Veteran’s case, and are not accompanied by the opinion of any medical expert. See Sacks v. West, 11 Vet. App. 314, 316-17 (1998) (holding that a medical article or treatise can provide support for a claim, but must be combined with an opinion of a medical professional and be reflective of the specific facts of a case as opposed to a discussion of generic relationships); see also Libertine v. Brown, 9 Vet. App. 521, 523 (1996) (finding that generic medical literature, which does not apply medical principles to the facts of an individual case, does not constitute competent evidence). Thus, the literature is therefore outweighed by the VA advisory opinion which are given far more probative value because the advisory opinion considers the specific facts of the Veteran’s case. Therefore, the Board finds that service connection for prostate cancer as due to ionizing radiation is not warranted as the evidence of record does not demonstrate a medical nexus between the Veteran's radiation exposure and prostate cancer. (Continued on the next page)   In reaching the above conclusions, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the Veteran's claim, that doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107(b). MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Quist, 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.