Citation Nr: 21067935 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 18-43 529 DATE: November 8, 2021 ORDER Entitlement to service connection for skin cancer, to include as due to herbicide exposure, is denied. FINDING OF FACT The weight of the evidence fails to show that it is at least as likely as not that the Veteran had incurred his skin cancer in or due to service, to include due to his presumptive exposure to herbicide agents. CONCLUSION OF LAW The criteria for service connection for skin cancer have not been met. 38 U.S.C. §§ 1101, 1110, 1116, 1154; 38 C.F.R. §§ 3.103, 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1965 to November 1967. The Veteran testified before the undersigned at a May 2021 Virtual Board hearing. The hearing transcript is of record The issue was remanded for further development in July 2021, that development has been accomplished and the appeal is ready for adjudication. Service Connection for Skin Cancer The Veteran contends that he has currently diagnosed skin cancer, related to herbicide exposure in Vietnam. Because the Veteran served in Vietnam, his exposure to herbicides is presumed. 38C.F.R. §3.307 (a)(6)(iii). However, the evidence does not show that his skin cancer had its onset in service or within a year of service. In this regard, during his November 2018 Virtual Board hearing, the Veteran reported that he had skin rashes during active duty in Vietnam. His wife affirmed that she noticed his skin rashes upon returning from Vietnam. However, service treatment records do not contain evidence of a skin condition during active duty or at discharge. Post-service treatment records show that he was initially treated for skin cancer (squamous cell carcinoma) in 2016. Therefore, despite his presumed exposure to herbicides, presumptive service connection under 38C.F.R. §§3.307 (a)(3) and 3.309(a) is not applicable. Nevertheless, the Veteran may still show entitlement to service connection for skin cancer on a direct basis, including as due to herbicide agent exposure. Combee v. Brown, 34 F.3d 1039, 1043-1044 (Fed. Cir. 1994). The Veteran is shown to have a current disability, thus, in this case, establishing service connection in this case would require the evidence to show with a probability of 50 percent or greater that the Veteran's service (to include exposures therein) caused his skin cancers. Neither the Veteran's STRs nor his post-service treatment records reflect any skin cancer prior to 2016. Nor does the evidence of record show with the requisite probability that his skin cancers are etiologically related to his service, to include his exposure to herbicide agents presumed here. In June 2016 following examination for disabilities of the skin, an examiner concluded that it was less likely that the Veteran's skin condition was related to medical service, noting that there was no evidence in the Veteran's service treatment records or separation examination demonstrating a skin disability. In a June 2021 examination report, the examiner noted that the Veteran reported skin rashes during active duty in Vietnam but that service treatment records were silent for rash or other skin conditions and the separation examination was also silent for skin conditions and the Veteran stated that he was in excellent health in his October 1967 report of medical history. The examiner noted that the Veteran's claims file demonstrates that the Veteran was first treated for skin cancer in 2016, forty-nine years after separation. The examiner stated that there was no objective evidence to support the claim because a significant number of years passed between separation and the onset of the Veteran's first symptoms. The examiner concluded that it was less likely than not that the Veteran's skin cancer was incurred in or caused by service and that a nexus had not been established. In a September 2021 addendum to that report, the examiner found that it was less likely than not that skin cancer was related to service, to include the Veteran's conceded exposure to herbicide agents while in service. As discussed, a mere suggestion that such a causal link is possible fails to meet the requisite evidentiary threshold. It follows that the requisite causal link has not been established and thus the legal criteria for the sought benefit have not been met. Regarding the Veteran's testimony and statements and those of his spouse, while it is clear they sincerely believe that the Veteran's skin cancer is related to service, in this case they are not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of the interaction between exposure and skin cancer decades thereafter as well as an understanding of complicated medical relationships. Therefore, it is outside the competence of the Veteran and his spouse in this case because the record does not show that they have the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the examination findings. In reaching this conclusion, the Board has considered all other bases for service connection, but ultimately found that none apply to the circumstances of this case. See 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310. Accordingly, absent any legal basis for a grant of the sought benefit, service connection for skin cancer must be denied. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Slovick, 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.