Citation Nr: 21068333 Decision Date: 11/10/21 Archive Date: 11/10/21 DOCKET NO. 18-32 846 DATE: November 10, 2021 ORDER Entitlement to service connection for the cause of the Veteran's death is granted. FINDING OF FACT Resolving reasonable doubt in the appellant's favor, the Veteran's hypothyroidism, which was an underlying cause of the Veteran's death and a result of his active military service. CONCLUSION OF LAW The criteria for entitlement to service connection for cause of death have been met. 38 U.S.C. §§ 1110, 1131, 1310, 5107(b) (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.312 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1959 to March 1982. The Veteran died in January 2016. The appellant is the Veteran's surviving spouse. These matters come before the Board of Veterans' Appeals (Board) on appeal from a January 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In March 2017, the appellant filed a timely notice of disagreement (NOD) and in April 2018 the RO issued a statement of the case. In June 2018, the appellant submitted a substantive appeal. In November 2021, the appellant testified at a virtual hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that proceeding will be associated with the record. The Board acknowledges that 90 days from the date of the hearing has not elapsed. However, as the instant decision grants the benefit sought in full, there is no prejudice to the appellant by proceeding without the hearing transcript or the 90-day time period. This appeal has been advanced on the docket. 38 U.S.C. § 7107(a)(2) (2012); 38 C.F.R. § 20.900(c) (2020). 1. Entitlement to service connection for the cause of the Veteran's death is granted. The appellant contends that service connection is warranted for the Veteran's cause of death. The Veteran died in January 2016. His death certificate lists hypothyroidism as an "other" significant condition at the time of his death. At the time of his death, the Veteran was not service connected for hypothyroidism. The appellant contends the Veteran served in the Republic of Vietnam (Vietnam) during his active duty service, and thus presumptive service connection for hypothyroidism and cause of death is warranted. To grant service connection for the cause of the Veteran's death, it must be shown that a service-connected disability caused the death, or substantially or materially contributed to it. A service-connected disability is one which was incurred in or aggravated by active service, one which may be presumed to have been incurred during such service, or one which was proximately due to or the result of a service-connected disability. 38 U.S.C. § 1310; 38 C.F.R. § 3.312. The death of a veteran will be considered as having been due to a service-connected disability when such disability was either the principal or contributory cause of death. 38 C.F.R. § 3.312(a). For a service-connected disability to be a contributory cause of death, it must be shown that it contributed substantially or materially, that it combined to cause death, or aided or lent assistance to the production of death. In this regard, it is not sufficient to show that the service-connected disability casually shared in producing death; rather, it must be shown that there was a causal connection. 38 C.F.R. § 3.312(c)(1). To establish service connection for a disability, the evidence must show: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease of injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service - the so-called 'nexus' requirement." Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). VA conceded exposure to herbicides based on the Veteran's nautical service in the offshore eligible waters as defined in the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23. See Memorandum dated May 29, 2020. If a veteran was exposed to an herbicide agent (to include Agent Orange) during active military, naval, or air service, the following diseases shall be service-connected if the requirements of 38 C.F.R. § 3.307(a)(6) are met, even if there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 C.F.R. § 3.307(d) are also satisfied: AL amyloidosis, chloracne or other acneform disease consistent with chloracne, type 2 diabetes, Hodgkin's disease, ischemic heart disease (IHD), all chronic B-cell leukemias, multiple myeloma, non-Hodgkin's lymphoma, Parkinson's disease, early-onset peripheral neuropathy, porphyria cutanea tarda, prostate cancer, respiratory cancers, and soft-tissue sarcoma. 38 C.F.R. § 3.309(e). More recently, bladder cancer, hypothyroidism, and Parkinsonism were added to the list. See William M. Thornberry National Defense Authorization Act for Fiscal Year 2021, Public Law 116-283. Turning to the evidence of record, in a July 2021 VA memo, the AOJ conceded exposure to herbicides during service based on the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23. In an August 2021 private treatment record, the Veteran was noted to be diagnosed with hypothyroidism. In addition, as noted in the January 2017 rating decision on appeal, the Veteran's death certificate recorded the Veteran's cause of death as malnutrition, dysphagia, left internal carotid artery stroke, atrial fibrillation, with contributing factors of pneumonia, clostridium difficile, GI bleed, hypothyroidism, anemia, sepsis, enterococcus bacteremia, and urosepsis. Based on the foregoing and following a review of the relevant legal criteria, the Board finds that service-connection for hypothyroidism on a presumptive basis is warranted and that hypothyroidism was a contributory cause of death. Accordingly, service connection for cause of death is warranted. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Kaufer, 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.