Citation Nr: 21004313 Decision Date: 01/26/21 Archive Date: 01/26/21 DOCKET NO. 16-15 890 DATE: January 26, 2021 ORDER Entitlement to service connection for a pulmonary disability is denied. FINDING OF FACT The preponderance of the evidence is against finding that a pulmonary disability began during active service or is otherwise related to an in-service injury, event, or disease, to include exposure to contaminated water at Camp Lejeune. CONCLUSION OF LAW The criteria for entitlement to service connection for a pulmonary disability. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1982 to May 1986. In December 2019, the Board remanded this case for additional development. The Board finds that there has been substantial compliance with the remand requests. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for a pulmonary disability The Veteran asserts that a pulmonary disability, to include diagnosed pulmonary granulomas, is the result of service, to include exposure to Camp Lejeune contaminated water (CLCW). The service medical records show no pulmonary complaints during service. An April 1986 record shows a normal chest X-ray. A December 1999 post-operative record shows that the Veteran underwent a right thoracotomy after a chest X-ray showed a nodular density in the right middle lobe. In June 2020, a VA subject matter expert reviewed the claims file, confirmed a diagnosis of pulmonary granulomas, and opined that pulmonary granulomas were less likely as not caused by or related to exposure to CLCW. The opinion was based on a “search for medical literature relating granuloma to benzene, vinyl chloride, trichloroethylene, or tetrachloroethylene exposure [which] revealed no relevant articles [and]…no known association between pulmonary granulomas and exposure to TCE, PCE, benzene, or vinyl chloride.” In September 2020, a VA examiner opined that the claimed pulmonary disability was less likely than not incurred in or caused by an in-service, injury, event, or illness. The examiner explained that based upon the Veteran’s reports and a review of the record, the Veteran did not have any occupational exposure in service that could have contributed to the development granulomas. The examiner noted that the Veteran did not have a lung condition or respiratory complaints at separation from service and pulmonary granulomas were not noted until 13 years after separation from service. The examiner opined that because of the time frame, pulmonary granulomas likely developed after separation from service. The Board finds that service connection is not warranted on a presumptive basis. The service personnel records confirm service of at least 30 days at Camp Lejeune during the applicable time period, and exposure to contaminated drinking water is conceded. However, the Veteran was diagnosed with pulmonary granulomas which are not one of the qualifying chronic diseases listed under 38 C.F.R. §§ 3.309(a), (e), (f), or 3.307. Further, a June 2020 subject matter expert opined that pulmonary granulomas were not caused by or related to exposure to CLCW. Therefore, presumptive service connection based on exposure to CLCW is not warranted. Nevertheless, the Veteran is not precluded from establishing service connection with proof of direct causation, or on any other recognized basis. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). The Board finds that the preponderance of the evidence is against the claim for direct service connection for a pulmonary disability. The probative evidence of record shows that a pulmonary disability is not related to service. The Board finds the September 2020 VA opinion highly probative of the fact that pulmonary granulomas were less likely as not incurred in or caused by in-service injury, event, or illness and likely developed after service. The opinion is highly probative because it was provided by a trained medical professional who considered the lay and medical evidence; and the opinion was supported by clear conclusions and data, as well as a reasoned medical explanation connecting the two. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The Board finds that the opinion is also supported by the evidence of record which shows no in-service pulmonary complaints, a normal chest X-ray at separation from service in April 1986, and no pulmonary findings until a December 1999 chest X-ray. There are no contrary medical opinions of record. The Board has considered the Veteran's lay statements. The Veteran is competent to report observable symptoms. Layno v. Brown, 6 Vet. App. 465 (1994). However, the question of etiology of a pulmonary disability is a medical issue that requires medical training and expertise which the Veteran has not been shown to possess. The Veteran is not competent to address etiology in the present case. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Therefore, the Veteran's assertions regarding etiology is not competent and is afforded little probative value. Accordingly, as the preponderance is against a finding that a pulmonary disability is causally or etiologically related to any disease, injury, or incident of service, to include exposure to CLCW, the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Department of Veterans Affairs 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.