Citation Nr: 21003368 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 17-41 221 DATE: January 21, 2021 ORDER Entitlement to service connection for a renal disability, to include as due to exposure to herbicides, and to include as secondary to service-connected coronary artery disease, is denied. FINDING OF FACT The evidence of record does not demonstrate that a renal disability is due to service, to include any herbicide agent exposure; and a renal disability has not been shown to be proximately due to or aggravated by service-connected coronary artery disease. CONCLUSION OF LAW The criteria for service connection for a renal disability, to include as secondary to service-connected coronary artery disease, have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service with the United States Army from December 1970 to March 1972, including service in the Republic of Vietnam. For his meritorious service, the Veteran was awarded (among other decorations) the Bronze Star Medal and the Vietnam Service and Campaign Medals. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision. In November 2018, the Veteran provided testimony at a Board hearing. A transcript of the hearing is of record. In June 2019, the Board remanded the claim for further development. The Board finds that the remand directives (namely obtaining an opinion regarding the etiology of the Veteran’s claimed disability) have been substantially complied with and therefore will proceed with this claim. Service Connection To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). A disability may also be service connected on a secondary basis if it is proximately due to or the result of a service-connected disease or injury; or, if it is aggravated beyond its natural progress by a service-connected disease or injury. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.310(a), (b). Additionally, a Veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the Vietnam era shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that such veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307(a). If a Veteran was exposed to an herbicide agent during active military, naval, or air service, certain enumerated diseases shall be service connected if the requirements of 38 U.S.C. § 1116; 38 C.F.R. § 3.307(a)(6)(iii) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 U.S.C. § 1113; 38 C.F.R. § 3.307(d) are also satisfied. 38 C.F.R. § 3.309(e). The Veteran has current diagnoses of nephrosclerosis and chronic renal disease. The service treatment records are negative for any findings or treatment for a renal disease. Private treatment records show that the Veteran was treated in 2010 for abnormal renal function. In an October 2017 opinion, a VA examiner opined that it was less likely than not that the Veteran’s end stage renal disease was related to Agent Orange exposure during service. The examiner explained that a review of the literature does not include end stage renal disease as having any relation to Agent Orange exposure. In a November 2019 opinion, a VA examiner opined that it was less likely than not that the Veteran’s renal functions and end stage renal disease is proximately due to or aggravated by the Veteran’s service-connected coronary artery disease. The examiner stated that the Veteran’s renal disease was secondary to hypertension as noted by a nephrologist in 2016 treatment records. The examiner explained that renal functions and end stage renal disease are not affected by or related to coronary artery disease. Initially, the Board notes that there is no evidence of renal disease in the Veteran’s service treatment records. Post-service medical records show that a renal disability was first diagnosed and treated several years following the Veteran’s discharge from active duty service. Furthermore, the Veteran has not actually set forth any contentions that his renal disability was incurred during military service but has indicated seeking service connection as a result of acknowledged herbicide exposure, or, in the alternative, secondary to a service-connected disability. With respect to herbicide exposure, the Board notes that the Veteran’s renal disability, diagnosed as nephrosclerosis and chronic renal disease, is not listed as one of the disabilities for which presumptive service connection can be granted under 38 C.F.R. § 3.307(a)(6). A VA examiner has opined that the Veteran’s renal disability is not related to herbicide exposure. Moreover, a VA examiner has also opined that the Veteran’s renal disability was not caused or aggravated by his service-connected coronary artery disease. The VA examiners opinions constitute probative evidence on the medical nexus questions based on review of the Veteran’s documented medical history, assertions and physical examination. The preponderance of the evidence is against the claim for service connection for a renal disability, to include as due to exposure to herbicides, and to include as secondary to a service-connected disability. Thus, the claim for service connection must be denied. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Henriquez, 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.