Citation Nr: 21071280 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 17-47 734 DATE: November 30, 2021 ORDER Service connection for ischemic heart disease is denied. FINDING OF FACT A heart condition was not shown in service or for many years thereafter, and the most probative evidence is against a finding that the Veteran's ischemic heart disease is related to service. CONCLUSION OF LAW The criteria for service connection for ischemic heart disease have not been met. 38 U.S.C. §§ 1110, 1112, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1970 to August 1972. The Veteran died in January 2019. The Appellant is his son, who has been substituted as claimant. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In his September 2017 appeal, the Veteran requested a hearing before a Veterans Law Judge. A hearing was scheduled to take place in October 2021 and notice was provided to the Appellant. However, the record shows that the Appellant did not appear for the hearing or provide an explanation for his failure to appear. Accordingly, the hearing request in this case is considered withdrawn. See 38 C.F.R. § 20.704(d). Service connection for ischemic heart disease Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). Moreover, where a Veteran served continuously for 90 days or more during active service, and cardiovascular disease becomes manifest to a degree of 10 percent within one year from date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. In addition to veterans who served in Vietnam during the Vietnam era, a veteran who served between April 1, 1968 and August 31, 1971, in a unit that, as determined by the Department of Defense (DoD), operated in or near the Korean demilitarized zone (DMZ) in an area in which herbicides are known to have been applied during that period, 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. 38 C.F.R. § 3.307(a)(6)(iv). A presumption of service connection exists if a veteran who meets the above criteria is diagnosed with certain enumerated diseases, to include ischemic heart disease, associated with exposure to certain herbicide agents. See 38 C.F.R. §§ 3.307, 3.309(e). Notwithstanding the regulations governing presumptive service connection based on herbicide exposure, service connection may also be established with proof of actual direct causation. 38 U.S.C. § 1110; 38 C.F.R. § 3.303; Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Prior to his death, the Veteran sought service connection for his ischemic heart disease, which he asserted was related to exposure to herbicide agents during service in Korea. The Veteran was diagnosed with ischemic heart disease at a VA examination in November 2011. Accordingly, the first criterion for establishing service connection has been met and the question becomes whether this condition was related to active duty service. Service personnel records indicate that the Veteran served in Korea from July 1971 to August 1972, and was assigned to Company A, 2nd Medical Battalion, 2nd Infantry Division. Although the Veteran's dates of service in Korea show that he served in Korea during the timeframe specified by VA regulation for a presumptive finding, the Veteran's unit has not been determined by the DoD to have operated in or near the DMZ in an area in which herbicides are known to have been applied. In addition, upon review by the Joint Services Records Research Center (JSRRC), in coordination with the National Archives and Records Administration, no evidence of Agent Orange use by the Veteran's unit was found. The JSRRC also found no evidence that the Veteran's unit performed any duties along the DMZ. See May 2017 report. In his October 2011 claim, the Veteran contended that he was assigned to the DMZ "during calendar year of 1971 to 1972." In a December 2012 statement the Veteran asserted that he was exposed to Agent Orange when he served in Korea during 1970-1971. In his July 2013 Notice of Disagreement, the Veteran asserted that he served in Korea from November 1970 to August 1972 and "provided service on the DMZ." In a March 2017 telephone call, the Veteran reported that his unit was stationed eight miles from the DMZ and that he was sent to the DMZ on 30-day maneuvers to medical detachments assigned to prepare meals for troops on the DMZ. In his September 2017 appeal, the Veteran reported that he was a cook with the 2nd Infantry Medical Division from November 1970 to August 1972, that this unit was stationed eight miles from the DMZ, and that once a month the unit was assigned to the DMZ for field exercises. Given the inconsistencies in the Veteran's assertions regarding service dates, locations, and circumstances, the Board finds the JSRRC report to be more probative on the issue of whether the Veteran's unit operated in or near the DMZ. As the Veteran is not entitled to a presumption of herbicide exposure, service connection for ischemic heart disease as presumptively due to herbicide exposure is not warranted. The record in this case also contains no probative evidence supporting service connection on a direct basis. The Veteran's service treatment records are devoid of any complaint, treatment, or diagnosis of heart issues. Likewise, there is no competent evidence of heart disease manifesting within one year of discharge from service. In addition, there is no medical evidence establishing a link between the Veteran's ischemic heart disease and his active duty service. While the Veteran believed that his ischemic heart disease was related to service, as a lay person, the Veteran has not shown that he had specialized training sufficient to render such an opinion. The etiology of ischemic heart disease that was diagnosed many years after the Veteran's service is a medically complex issue that requires medical expertise to determine. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). In the absence of any competent evidence that the Veteran's ischemic heart disease was related to active service, service connection on a direct basis is not warranted. In sum, ischemic heart disease was not shown in service or for many years thereafter and there is no probative evidence showing the Veteran was exposed to herbicide agents during service; therefore, service connection must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit of the doubt doctrine. As the preponderance of the evidence is against the Appellant's claim, the doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). K. A. BANFIELD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Jesteadt, 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.