Citation Nr: 21069977 Decision Date: 11/22/21 Archive Date: 11/22/21 DOCKET NO. 16-18 121 DATE: November 22, 2021 ORDER Entitlement to service connection for a heart disability, to include palpitations and supraventricular tachycardia, is denied. FINDING OF FACT The preponderance of the evidence is against finding that a heart disability began during active service, or is otherwise related to an in-service injury or disease, to include the Veteran's presumed exposure to herbicide agents in service. CONCLUSION OF LAW The criteria for service connection for a heart disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from July 1966 to May 1970, to include service in the Republic of Vietnam. The Board previously remanded this claim in October 2019 and again in June 2021, both times for the purpose of obtaining adequate VA medical opinions. The Veteran contends that his heart conditions were caused by service; specifically, to exposure to herbicide agents therein. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). If a veteran was exposed to an herbicide agent during active military, naval, or air service in Vietnam, then certain disease shall be service connected even though there is no record of such disease during service. For the purposes of this section, the term "herbicide agent" means a chemical in an herbicide used in support of the United States and allied military operations in the Republic of Vietnam during the Vietnam era. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6), 3.309(e), 3.313. The Veteran has confirmed duty in the republic of Vietnam and therefore herbicide exposure is conceded. However, for the purposes of this appeal, the Board notes that the Veteran's heart conditionswhich include palpitations and supraventricular tachycardiaare not disabilities for which a statutory presumption is granted secondary to herbicide exposure. It was specifically noted by the January 2020 examiner that the Veteran's heart disabilities did not include ischemic heart disease. Although presumptive service connection is not available, this does not preclude service connection on a direct basis, presuming that a medical nexus is demonstrated. However, for the reasons that follow, the Board finds that a medical nexus has not been shown. In this regard, January 2020 and July 2021 VA medical opinions are of record. The Board previously found the January 2020 opinion to be incomplete insofar as the opinion offered was conclusive without reasons or bases. In that opinion, the examiner reported that the Veteran's echocardiogram was "essentially normal" and that the METs results achieved in association with the examination were "more likely due to possible COPD [chronic obstructive pulmonary disease]." Accordingly, another opinion was obtained in July 2021. In that opinion, a different examiner opined that the Veteran's heart conditions were less likely than not incurred in service. By way of rationale, the examiner explained the difference between sinus and supraventricular tachycardia, noting the various factors responsible for such conditions. Specifically, with regard to supraventricular tachycardia, the examiner noted that the condition could be caused by stress, smoking, excessive consumption of alcohol or caffeine, certain drugs, other heart problems, or a thyroid disorder. The examiner highlighted the Veteran's smoking and other medical history, to include the Veteran's history of tachycardia symptoms, beginning in February 2015. Based on the medical research and the Veteran's prior history, the examiner concluded that the supraventricular tachycardia was associated with his redundant bronchodilator and anticholinergic medications used for the Veteran's COPD, and that overall, the Veteran's claimed heart disabilities were due to his COPD, which was a direct consequence of his extensive and active tobacco use. Thus, the conditions were less likely than not related to any herbicide agent exposure during service. Taken together, the Board finds that both VA opinions are probative as to the question of whether the Veteran's current heart conditions are related to in-service herbicide agent exposure. While the Board recognizes that the January 2020 opinion was previously noted by the Board to be incomplete, the Court has said that "even if a medical opinion is inadequate to decide a claim, it does not necessarily follow that the opinion is entitled to absolutely no probative weight;" "it may be given some weight based upon the amount of information and analysis it contains." Monzingo v. Shinseki, 26 Vet. App. 97, 107 (2012). In this regard, both opinions attributed the Veteran's heart conditions to his non-service-connected COPD. The July 2021 examiner clarified that the Veteran's COPD had been caused by his extensive and active tobacco use, and that his heart symptoms and conditions were related to the COPD. The Board finds that the July 2021 VA opinion, as a whole, contains clear conclusions, and applied medical principles and knowledge to the specific facts of the Veteran's particular circumstances and individual medical history. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The opinion provider also specifically addressed the potential relationship to herbicides and opined against such a relationship. The Board adds that there is no medical opinion evidence contrary to the findings of the examiners. While the Veteran believes that his disability is related to an in-service injury, event, or disease, the Veteran in this case is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has 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 medical evidence of record. For these reasons, the preponderance of the evidence is against the claim of entitlement to service connection for a heart condition. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). V. Chiappetta Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Polly Johnson, 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.