Citation Nr: 21002845 Decision Date: 01/15/21 Archive Date: 01/15/21 DOCKET NO. 17-30 315 DATE: January 15, 2021 ORDER Service connection for lung cancer, on the basis of substitution, is denied. Service connection for prostate cancer, on the basis of substitution, is denied. FINDINGS OF FACT 1. It is less likely than not, that the Veteran’s lung cancer was incurred in or otherwise caused by his active military service, to include exposure to contaminated water at Camp Lejeune. 2. It is less likely than not, that the Veteran’s prostate cancer was incurred in or otherwise caused by his active military service, to include exposure to contaminated water at Camp Lejeune. CONCLUSIONS OF LAW 1. The criteria for service connection for lung cancer, on the basis of substitution, have not been met. 38 U.S.C. §§ 1110, 5121A; 38 C.F.R. §§ 3.303, 3.307(a)(7) and 3.309(f). 2. The criteria for service connection for prostate cancer, on the basis of substitution, have not been met. 38 U.S.C. §§ 1110, 5121A; 38 C.F.R. §§ 3.303, 3.307(a)(7) and 3.309(f). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Marine Corps from September 1950 to September 1953. Unfortunately, he passed away in December 2019. The appellant is the Veteran’s surviving spouse. Due to the Veteran’s death, the Board previously dismissed the issues of service connection for prostate cancer and lung cancer in January 2020. In March 2020, the appellant submitted an application for substitution, and in June 2020 the RO granted the appellants request to be substituted as claimant in place of the Veteran. See 38 U.S. C. § 5121A. The Board notes that the Veteran had requested a hearing before the Board in conjunction with the appeal. In June 2020, the appellant was sent a reminder that a Board hearing had been requested in connection with the appeal. In August 2020, the appellants daughter, having power of attorney over the appellant, withdrew the request for a hearing. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection requires competent evidence showing: (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Additionally, service connection may be granted on a presumptive basis for Veterans, former reservists, and former National Guard members who served at Camp Lejeune for no less than 30 days (either consecutive or nonconsecutive) during the period from August 1, 1953 to December 31, 1987, and who have been diagnosed with any of the following eight diseases: adult leukemia, aplastic anemia and other myelodysplastic syndromes, bladder cancer, kidney cancer, liver cancer, multiple myeloma, non-Hodgkin’s lymphoma, and Parkinson’s disease. 38 C.F.R. §§ 3.307(a)(7) and 3.309(f). The Veteran asserted that both his lung cancer and his prostate cancer were caused by drinking contaminated water while serving at Camp Lejeune. A review of the Veteran’s service treatment records (STRs) does not provide any diagnoses for either lung cancer or prostate cancer, nor do they show any complaints or treatments that may be related to either lung cancer or prostate cancer. The record does confirm the Veteran’s service at Camp Lejeune from June 10, 1953 to September 26, 1953, and thus his exposure to contaminated water. However, neither lung cancer nor prostate cancer are diseases that warrant presumptive service connection based upon exposure to contaminated water at Camp Lejeune. Regardless, service connection on a direct basis is to be considered. To that end, a VA medical opinion was obtained in July 2013. The VA examiner reported that the Veteran’s medical record supported the diagnoses of lung cancer and prostate cancer. It was noted that the Veteran had not served more than 120 days at Camp Lejeune. The examiner relayed that they did not see evidence to document exposure levels beyond domestic and work related exposure through working/residing on the base on which there was known to be drinking water contamination with PCE/TCE; nor did they see evidence that the Veteran worked in settings of higher level exposure than that described in the NAS NRC Report. The examiner explained that there was evidence in the scientific literature suggesting potential relationships between PCE/TCE and related chemicals of the sort involved in the Camp Lejeune groundwater contamination and subsequent lung cancer; however, the evidence is established in studies involving relatively higher doses and more prolonged exposure in comparison to those experienced in the Veteran’s case. There was no evidence in the scientific literature suggesting potential relationships between PCE/TCE and related chemicals of the sort involved in the Camp Lejeune groundwater contamination and subsequent prostate cancer. It was noted that the Veteran had a 40-year history of smoking. As to lung cancer, the examiner opined that while there is evidence in the scientific literature for associations between TCE/PCE in drinking water and related chemicals of the nature involved in the Camp Lejeune groundwater contamination and subsequent lung cancer, in this case, given the comparatively low dose of exposure and short potential duration of exposure and given the presence of other known carcinogenic exposures (smoking), it is less likely than not that the Veteran’s lung cancer is related to exposure to TCE/PCE or related chemicals contaminating the ground water while the Veteran was stationed at Camp Lejeune. Pertaining to prostate cancer, the examiner posited that given the lack of evidence in the scientific literature for associations between TCE/PCE in drinking water and related chemicals of the nature involved in the Camp Lejeune groundwater contamination and subsequent prostate cancer, it is less likely than not that the Veteran’s prostate cancer was related to exposure to TCE/PCE or related chemicals contaminating the ground water while the Veteran was stationed at Camp Lejeune. A review of the Veteran’s VA treatment records reflects that in March 2016, the Veteran requested a letter from his physician to address any link between his exposure to drinking water at Camp Lejeune and his cancers. The Veteran’s cardiothoracic surgeon submitted an opinion in March 2016 that the Veteran’s lung cancer was much more likely to be due to smoking, not water ingestion. The earliest notations pertaining to the Veteran’s lungs and prostate are found in the Veteran’s private treatment records. In February 1989, right upper lobe biopsies showing bronchiectasis with acute and chronic pneumonitis and progressing organizing bronchopneumonia. In May 1998, after a bronchoscopy and left thoracotomy with partial lobectomy, a diagnosis was rendered of poorly differentiated adenocarcinoma with vascular invasion involving the left lingular lobe. The Veteran was first diagnosed with prostate cancer in 2005. A further review of both the Veteran’s VA and private treatment records does not provide any greater findings than those relayed above. The Veteran’s record does not provide any medical opinions linking either the Veteran’s lung cancer or his prostate cancer to his military service. Consideration is given to both the Veteran’s and the appellant’s contentions that the Veteran’s claimed conditions of lung cancer and prostate cancer were incurred in or caused by his military service, to include exposure to contaminated water at Camp Lejeune. While lay persons are competent to provide opinions pertaining to certain medical issues, determining the etiology of both lung cancer and prostate cancer, is outside the realm of common knowledge for someone, such as the Veteran or the appellant, who are not shown to possess medical training, specialized expertise, or experience. Jandreau v. Nicholson, 492. F.3d 1372, 1377 n.4 (Fed. Cir. 2007). As such, both the Veteran’s and the appellant’s contentions lack probative value. Based upon the foregoing, service connection for both lung cancer and prostate cancer is not warranted. The VA examiner provided a reasoned opinion in finding that the Veteran’s lung cancer and prostate cancer were less likely than not to have been caused by exposures during his active service. Additionally, the Veteran’s cardiothoracic surgeon provided an opinion that the Veteran’s lung cancer was more likely due to smoking than having ingested contaminated water. Both opinions are probative. In addition, no medical opinions linking the Veteran’s lung cancer or prostate cancer to his military service have been provided. Accordingly, service connection for both lung cancer and prostate cancer is denied. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Lutgens-Staley, 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.