Citation Nr: 21062864 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 17-65 934 DATE: October 12, 2021 ORDER Entitlement to service connection for a skin disability is denied. Entitlement to service connection for an abnormal growth of the left ear is denied. FINDINGS OF FACT 1. The probative evidence of record does not demonstrate that the Veteran's skin disability is etiologically related to service, to include as due to exposure to herbicides or secondary to his service-connected prostate cancer disability. 2. The probative evidence of record does not demonstrate that the Veteran's abnormal growth of the left ear is etiologically related to service, to include as due to exposure to herbicides or secondary to his service-connected prostate cancer disability. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a skin disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307, 3.309(e), 3.310. 2. The criteria for entitlement to service connection for an abnormal growth of the left ear have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307, 3.309(e), 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Navy from April 1964 to April 1966. The Veteran's claims were before the Board of Veterans' Appeals (Board) in January 2020, September 2020, and June 2021 wherein they were remanded for additional development. The development has been completed and the claims are ready for adjudication. Service Connection 1. Entitlement to service connection for a skin disability is denied. 2. Entitlement to service connection for an abnormal growth of the left ear is denied The Veteran contends that his skin disabilities, to include an abnormal growth on his left ear, are related to exposure to herbicide agents, as well as to sun exposure on the deck of the ship during service. Further, the Veteran contends that his skin conditions are caused or aggravated by his service-connected prostate cancer disability. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if preexisting, such service, was aggravated thereby. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303 (a). Service connection may be granted for a disability that is proximately due to, or aggravated by, a service-connected disease or injury. 38 C.F.R. § 3.310. However, VA will not concede that a nonservice-connected disease or injury was aggravated by a service-connected disease or injury unless the baseline level of severity of the nonservice-connected disease or injury is established by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the nonservice-connected disease or injury. In addition to the criteria for service connection explained above, the governing law provides that a "veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent... unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service." As stated in the September 2020 decision, the Veteran was found to have served in the Republic of Vietnam and is presumed to have been exposed during such service to an herbicide agent. If a Veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases shall be service-connected even though there is no record of such disease during service. 38 C.F.R. § 3.309 (e). Certain forms of cancer are among the listed diseases; however, melanoma and basal cell carcinoma are not among them. However, as explained in the prior remand, the failure to establish service connection on a presumptive basis does not prevent establishing service connection on another basis. 38 U.S.C. § 1113(b); Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). The Board first finds that the Veteran was exposed to the sun aboard a Navy ship and exposed to herbicides during service. Further, the Veteran has diagnosed skin disabilities (melanoma and basal cell carcinoma, status post-recission), to include an abnormal growth of his left ear. Thus, the first two criteria for service connection are met. Shedden, supra. The Veteran's service treatment records (STRs) are silent for any skin conditions during service. Turning to whether these disorders are related to the Veteran's service, the Board will first address the Veteran's contention that exposure to the sun at least as likely as not caused the disorders. A February 2021 VA examiner answered the question in the negative: "per [National Institute of Health], the exposure to ultraviolet (UV) light over lifetime plays [a] role in [the] development of both Melanoma and Basal Cell Carcinoma. The [Veteran] served in the military between 1964 and 1966. While undoubtedly he had exposure to UV light during that period, it is not likely that the amount he was exposed to vastly exceeds the UV light he was exposed to before and after military service and it is the cumulative amount of radiation that's the main factor." Next, turning to whether the disorders are at least as likely as not related to exposure to herbicide agents, a July 2021 clinician again answered the question in the negative: "Medical literature supports that most basal cell and squamous cell skin cancers are caused by repeated and unprotected skin exposure to UV rays from sunlight...The etiology of such diagnosis is well established secondary to UV light/sun exposure and is not known to stem from herbicide exposure. Any skin lesion claimed secondary to chemical exposure while in service will demonstrate significant skin lesion within 10 years range and not 50 years. Hence, a nexus cannot be endorsed." The Veteran's skin disorder was first noted in 2017, not 1977. Finally, a VA clinician in February 2021 addressed whether the Veteran's service-connected disability of prostate cancer caused or aggravated the Veteran's skin conditions. Again, the clinician responded that it is less likely than not related because there is no known interactions between prostate cancer and the Veteran's skin conditions are "malignancies derived from skin tissue, melanocytes and epidermal cells respectively, rather than related to adenocarcinoma of the prostate." The Board gives the VA clinicians' opinions great probative weight because the examiner in each opinion has the medical expertise to make such determinations and reviewed the medical record and relevant research in order to do so. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The examiners also provided the underlying reasons for the conclusions reached. Given the above, the preponderance of the evidence is found to be against the claim. The criteria for service connection for a skin disorder and abnormal growth of the left ear are not met. The Board has considered the Veteran's lay opinion that his skin disorders are related to service, to include as related to herbicide agent exposure and secondary to his service-connected prostate cancer disability. Lay witnesses are competent to provide testimony or statements relating to symptoms or facts of events that the lay witness observed and is within the realm of his or her personal knowledge, but not competent to establish that which would require specialized knowledge or training, such as medical expertise. Layno v. Brown, 6 Vet. App. 465, 470 (1994). Lay evidence may also be competent to establish medical etiology or nexus. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). However, "VA must consider lay evidence but may give it whatever weight it concludes the evidence is entitled to." Waters v. Shinseki, 601 F.3d 1274, 1278 (2010). In the instant case, the Board finds that the Veteran is competent to report his skin disabilities and any experienced symptoms. See Jandreau v. Nicholson, 492 F.3D. 1372, 1377 (Fed. Cir. 2007). However, the Board finds the etiological relationship of the skin conditions and a relationship to service and/or other disabilities to be complex in nature. Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007). Therefore, while the Veteran is competent to describe his symptoms, he cannot, as a layperson, provide competent medical evidence establishing a connection between the two. Consequently, the Board gives more probative weight to the medical evidence discussed above. Thus, the weight of the evidence is against the claim for service connection for a skin disorder and abnormal growth of the left ear. Accordingly, the claim is denied. Bethany L. Buck Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. M. Hitchcock 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.