Citation Nr: 21069741 Decision Date: 11/19/21 Archive Date: 11/19/21 DOCKET NO. 13-21 214 DATE: November 19, 2021 ORDER Service connection for a respiratory disability, including asthma, to include as a result of chemical exposure is denied. Service connection for multiple myeloma, to include as a result of chemical exposure is denied. Service connection for type II diabetes mellitus, to include as a result of chemical exposure is denied. Service connection for glaucoma, to include as a result of chemical exposure is denied. Service connection for peripheral neuropathy of the right upper extremity, to include as a result of chemical exposure is denied. Service connection for peripheral neuropathy of the left upper extremity, to include as a result of chemical exposure is denied. Service connection for peripheral neuropathy of the right lower extremity, to include as a result of chemical exposure is denied. Service connection for peripheral neuropathy of the left lower extremity, to include as a result of chemical exposure is denied. Service connection for hypertension, to include as a result of chemical exposure is denied. FINDINGS OF FACT 1. The Veteran was not exposed to herbicides/chemical agents, such as Agent Orange, during service. 2. The Veteran's respiratory disorder did not have its onset during service and is not etiologically related to an in-service injury, disease, or event. 3. The Veteran's multiple myeloma did not have its onset during or within the initial year of service and is not etiologically related to an in-service injury, disease, or event. 4. The Veteran's type II diabetes mellitus did not have its onset during or within the initial year of service and is not etiologically related to an in-service injury, disease, or event. 5. The Veteran's glaucoma did not have its onset during service and is not etiologically related to an in-service injury, disease, or event. 6. The Veteran's peripheral neuropathy of the upper and lower extremities did not have its onset during or within the initial year of service and is not etiologically related to an in-service injury, disease, or event. 7. The Veteran's hypertension did not have its onset during or within the initial year of service and is not etiologically related to an in-service injury, disease, or event. CONCLUSIONS OF LAW 1. The criteria for service connection for a respiratory disorder are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for multiple myeloma are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for type II diabetes mellitus are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for glaucoma are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 5. The criteria for service connection for peripheral neuropathy of the right upper extremity are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 6. The criteria for service connection for peripheral neuropathy of the left upper extremity are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 7. The criteria for service connection for peripheral neuropathy of the right lower extremity are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 8. The criteria for service connection for peripheral neuropathy of the left lower extremity are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 9. The criteria for service connection for hypertension are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1967 to May 1967. The case is on appeal from July 2008 and August 2013 rating decisions. As noted in the Board's May 2015 remand, the issue with respect to service connection for asthma stems from the Veteran's August 1989 claim. In January 2016, the Veteran testified at a Board hearing. In May 2016, June 2017, and September 2019, the Board remanded the appeal for additional development. The Board notes that, the issue with respect to service connection for sleep apnea is the subject of a separate appeal stream and will be addressed in a future Board decision, if in order. The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). I. Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Certain chronic diseases, including multiple myeloma, diabetes, peripheral neuropathy, and hypertension, are presumed to be incurred in or aggravated by service if manifest to a compensable degree within one year of separation from service. See 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258 (2015). With chronic disease shown as such in service (or within the presumptive period under § 3.307) so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service-connected, unless clearly attributable to intercurrent causes. 38 C.F.R. § 3.303(b). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time. Id. However, if chronicity in service is not established or where the diagnosis of chronicity may be legitimately questioned, a showing of continuity of symptoms after discharge is required to support the claim. 38 C.F.R. § 3.303(b). Service connection may nonetheless be granted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). If a veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases are presumed to be service connected if the requirements of 38 C.F.R. § 3.307(a)(6) are met, even though there is no record of the disease during service. 38 U.S.C. § 1116(a); 38 C.F.R. § 3.309(e). These diseases include multiple myeloma, diabetes, and early-onset peripheral neuropathy. Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. See 38 C.F.R. § 3.310. II. Analysis 1. Service connection for a respiratory disability, including asthma, to include as a result of chemical exposure. 2. Service connection for multiple myeloma, to include as a result of chemical exposure. 3. Service connection for type II diabetes mellitus, to include as a result of chemical exposure. 4. Service connection for glaucoma, to include as a result of chemical exposure. 5. Service connection for peripheral neuropathy of the right upper extremity, to include as a result of chemical exposure. 6. Service connection for peripheral neuropathy of the left upper extremity, to include as a result of chemical exposure. 7. Service connection for peripheral neuropathy of the right lower extremity, to include as a result of chemical exposure. 8. Service connection for peripheral neuropathy of the left lower extremity, to include as a result of chemical exposure. 9. Service connection for hypertension, to include as a result of chemical exposure. The Veteran contends that all of disorders claimed on appeal are a result of service, to include alleged exposure to chemical agents/herbicides while stationed at Fort Lewis in the State of Washington. He asserts he handled large drums marked with an X and containing what he believed to be chemicals/herbicides during service, for which he was issued full body protective gear to wear while handling the containers and ordered to report any leakage. See January 2016 Board hearing testimony. As reflected in the May 2016 Board remand, the Veteran did not serve overseas. His DD FORM 214 reflects no foreign service and October 1998 and February 2012 Personnel Information Exchange System (PIES) responses note no service in Vietnam. See August 2017 service personnel records (SPRs). Further, pursuant to the September 2019 Board remand, the RO submitted a request to the Military Records Research Center (MRRC) (formerly known as the JSRRC) to attempt to verify the Veteran's exposure to chemical agents/herbicides while stationed at Fort Lewis, Washington, from February 1967 to May 1967. The March 2021 response from the MRRC states that a professional researcher from the MRRC completed comprehensive research on the Veteran's claimed exposure to herbicides while stationed at Fort Lewis, Washington, with the 4th Battalion, 3rd Brigade, from February 1, 1967 through May 31, 1967. The National Archives and Records Administration (NARA), the custodian of Army unit records, reported that no documentation was located to support the claimed herbicide/chemical exposure, noting records for the unit and dates the Veteran provided were not located. Additionally, Fort Lewis is not a location listed on a 2019 DoD (Department of Defense) List of Locations Where Tactical Herbicides and Their Chemical Components were Tested, Used or Stored. See July 2020 Military Personnel Record. In this case, the evidence, including the Veteran's SPRs, does not demonstrate that the Veteran was exposed to chemical agents/herbicides during service; therefore, herbicide exposure is not established. See, e.g., 38 U.S.C. § 1116(f); 38 C.F.R. § 3.307(a)(6)(iii) and (iv). Further, other than the Veteran's statements, there is no evidence that the Veteran was actually exposed to chemical agents/herbicides or other environmental hazards during service. There is no indication in the Veteran's service records of issuance of protective gear or of duties that involved handling large drums containing chemicals/liquids. The Board notes that the Veteran's SPRs reflect that he was in training throughout his period of active duty. See August 2017 SPRs. In addition, an April 1967 PERSONAL CLOTHING REQUEST, DA FORM 3078, reflecting issuance of basic clothing/personal items is absent reference to protective gear. See August 2017 SPRs. The Board notes that duties handling large drums containing hazardous chemicals with issuance of protective gear in association with such duties would ordinarily be noted in the service records. Accordingly, the Board finds that the Veteran's service records and the information from the MRRC and the service department to be more probative and persuasive with respect to the circumstances of the Veteran's active service, as they are from official sources. See Bardwell v. Shinseki, 24 Vet. App. 36 (2010). Therefore, the Board finds that service connection is not established for the conditions on appeal based on alleged exposure to chemical agents/herbicides or any other environmental hazards at Fort Lewis because the evidence of record does not establish either actual or presumed exposure. In addition, and although multiple myeloma, type II diabetes mellitus, peripheral neuropathy and hypertension are conditions included in the list of chronic diseases under 38 C.F.R. § 3.309(a), there is no evidence that the conditions either manifested during or within one year of service. The Veteran's service treatment records (STRs) do not contain complaints, treatment, or diagnoses of multiple myeloma, diabetes, peripheral neuropathy of the bilateral upper or lower extremities, or hypertension. The May 1967 separation examination report reflects no diagnoses or defects. Blood pressure was 130/70, he denied having or having had high blood pressure, and results of laboratory testing were noted to show that sugar was negative. To the extent the record reflects the Veteran's reported history of the disorders since service, see January 1998 Medical Treatment Record Government Facility; August 2017 Medical Treatment Record Furnished by SSA, a medical opinion is inadequate when it is unsupported by clinical evidence. Black v. Brown, 5 Vet. App. 177, 180 (1995); see also LeShore v. Brown, 8 Vet. App. 406, 409 (1995) (a bare transcription of lay history, unenhanced by additional comment by the transcriber, does not become competent medical evidence merely because the transcriber is a health care professional). The Board notes that VA treatment records in 1972 reflect treatment for back and hand left hand symptoms. See June 1972 VA 10-10 Forms; August 1984 VAMC Other Output/Reports. Further, the Veteran's representative stated that multiple myeloma was diagnosed in 2008, that diabetes was diagnosed in 2002, that peripheral neuropathy of the bilateral upper and lower extremities was diagnosed in 2005, and that hypertension was diagnosed in 1978. See January 2016 Board hearing testimony. See also January 1998 Medical Treatment Record Government Facility; October 2012 Medical Treatment Record Non-Government Facility; February 2010 VA examination report. The fact that many years passed before any of these conditions manifested weighs against a finding of service-connection due to continuity of symptomatology. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331, 1338-40 (Fed. Cir. 2013). Thus, the presumption of service connection for chronic diseases does not apply to these conditions. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307(a), 3.309(a). The Board notes that asthma and glaucoma are not among the diseases listed as chronic. Further, the evidence does not establish a nexus between any of the disorders claimed on appeal and the Veteran's active duty. An October 1966 pre-induction examination report was normal. See July 2015 STRs. Blood pressure was 120/68 and laboratory testing was noted to show sugar was negative. Although occasional blurred vision was noted, vision was 20/20. He was assigned a profile of "1" in all PULHES categories, including the eyes, physical capacity and stamina, and the upper and lower extremities. See Odiorne v. Principi, 3 Vet. App. 456, 457 (1992) (observing that the 'PULHES' profile reflects the overall physical and psychiatric condition of the Veteran on a scale of 1 (high level of fitness) to 4 (a medical condition or physical defect which is below the level of medical fitness for retention in the military service)). In addition, as noted above, the May 1967 separation examination was normal. See August 2017 STRs. He was assigned a profile of "1" in all PULHES categories. See Odiorne, 3 Vet. App. at 457. He denied having or having had eye trouble, asthma, shortness of breath, pain or pressure in the chest, chronic cough, high blood pressure, frequent urination, and neuritis. See August 2017 STRs. Further, the July 2013 VA examination report reflects no diagnosis of peripheral neuropathy of the bilateral upper and lower extremities, noting that numbness/tingling in the Veteran's hands and feet had its onset in 2010 after treatment for multiple myeloma. The examiner reported that multiple myeloma, diabetes, glaucoma, and hypertension were diagnosed many years after service, and the conditions were not related to service. The Board notes that although July 2021 VA treatment records reflect a current diagnosis of neuropathy involving the extremities secondary to diabetes, as the Board finds in this decision that diabetes and the other disorders claimed on appeal are not related to service, service connection for cannot be established on a secondary basis. The Board notes that the Veteran's only service connected disability is tinnitus for which there is no indication that a claimed condition on appeal is potentially linked. With respect to asthma, as reflected in the May 2016 Board remand, although hay fever was noted in April 1967, there is no reference to asthma during service. The Board notes that seasonal and other acute allergic manifestations subsiding on the absence or removal of the allergen are generally to be regarded as acute diseases, healing without residuals. 38 C.F.R. § 3.380. The evidence does not support the Veteran's assertion of having been treated for asthma attacks during service, to include in May 1967 at the Madigan Army Medical Center (AMC) or in January or February 1967 at the Fort Polk Army Hospital in Louisiana. See August 1989 VA 21-526. The Board notes that records in April 1967 show treatment at the Madigan AMC for a skin condition, see July 2015 STRs, and at the dispensary in Fort Lewis for sleep difficulty, noting an apparent attempt to change "# 1" to "# 11" on a prescription for a sleeping pill. Moreover, a September 2016 PIES response notes no available records with respect to the alleged asthma attacks during service. The Board notes that, although the Veteran's sister recalled a letter in 1969 notifying their mother that the Veteran was in the hospital at Fort Lewis being treated for asthma, the Veteran was not on active duty in 1969. See September 2008 Buddy/Lay Statement. Further, the 37-year history of asthma noted in January 1998, see August 1989 VA 10-1000 Hospital Summary, dates the onset of asthma prior to service which is inconsistent with not only the normal October 1966 pre-induction examination report, but also the Veteran's testimony and the statement from the Veteran's friend noting that the Veteran did not have asthma during the four years they played basketball together during high school. See April 2011 Buddy/Lay Statement. Asthma was not noted at service entrance and there is no clear and unmistakable evidence that asthma existed prior to service. Thus, the presumption of soundness at service entrance applies. Further, none of the lay statements, including from E.G., who noted having driven the Veteran to a VA facility on several occasions after service for treatment of asthma, see February 2016 Buddy/Lay Statement, reflects medical expertise and is not competent evidence of a causal connection between asthma and service. Ultimately, the evidence does not show treatment for asthma during service. Moreover, all available records have been obtained and are associated with the Veteran's claims file. See April 2020 Correspondence. The Board acknowledges a June 1972 VA treatment record noting a history asthma, a May 1985 record noting a 20-year history of bronchospastic disease and smoking, a February 1998 record noting the Veteran's history of having not worked since 1980 because of difficulty he attributed to asthma, and an October 1998 VA treatment record noting a 33-year history of asthma and chronic obstructive pulmonary disease (COPD) exacerbated by smoking. However, as noted above, a bare transcription of lay history, unenhanced by additional comment by the transcriber, does not become competent medical evidence merely because the transcriber is a health care professional. LeShore, 8 Vet. App. at 409. The competent evidence does not establish that asthma had its onset during service or is otherwise related to in-service disease, injury, or event. Further, the July 2016 VA asthma examiner reported that the initial documented diagnosis was in 1985. In addition, the impression of a May 2016 chest x-ray examination was no active disease, and no change compared to imaging in January 2015 was noted. Additionally, a September 2017 VA addendum opinion notes no nexus between the Veteran's asthma, obstructive pulmonary disease, or pneumonia and his active duty. The Board notes that, although a January 1998 Social Security Administration (SSA) record reflects that the Veteran was granted Supplemental Security Income (SSI) benefits in February 1998, the records upon which the determination was based are unavailable. Regardless, VA is not bound by a determination of the SSA. See Collier v. Derwinski, 1 Vet. App. 413, 417 (1991); see also Martin v. Brown, 4 Vet. App. 136, 140 (1993). With respect to the Veteran's assertion that he should have been medically discharged from service, he reported having had no injuries during service. See February 2010 VA examination report. As noted above, the May 1967 separation examination was normal and there is no evidence that the Veteran was separated due to an of the disorders claimed on appeal. Rather, the Veteran's SPRs reflect an administrative separation for unsuitability, noting a personality disorder. See August 2017 SPRs. Although the Veteran is competent to report his symptoms, a determination as to whether asthma, multiple myeloma, diabetes, glaucoma, peripheral neuropathy of the bilateral upper and lower extremities, or hypertension is related to service is a complex matter requiring related medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (holding that a lay person is not considered competent to testify regarding medically complex issues). As the Veteran has no known or reported medical expertise, he is not legally competent to establish a nexus between these disabilities and service. In this case, the Board finds the medical evidence, to include the contemporaneous medical records, VA examination reports and opinions, and treatment records, cumulatively, is probative evidence against the Veteran's claims. That is, the medical evidence outweighs the Veteran's report of in-service onset and/or a continuity of symptomatology or and his lay opinion on the matter, even if such a theory is intuitively plausible to a lay person. In reaching the conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claims, that doctrine is not applicable in this case. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Accordingly, service connection is not warranted for asthma, multiple myeloma, type II diabetes, glaucoma, peripheral neuropathy of the bilateral upper and lower extremities, and hypertension. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Taylor 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.