Citation Nr: 21072393 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 17-26 364 DATE: December 3, 2021 ORDER Service connection for residuals of a left shoulder melanoma is denied. FINDING OF FACT The preponderance of the evidence is against finding that a left shoulder melanoma began during active service, or is otherwise related to an in-service injury, disease or herbicide agent exposure. CONCLUSION OF LAW The criteria for service connection for residuals of a left shoulder melanoma are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service in the U.S. Air Force from February 1970 to February 1990. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2015 rating decision. The Veteran testified before the undersigned Veterans Law Judge at a Board hearing in February 2020. The matter was then remanded for additional development in June 2020. The Veteran contends that he developed a left shoulder melanoma because of either herbicide agent exposure or excessive ultraviolet radiation exposure during service. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 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. The Board concludes that, while the Veteran has residuals of a melanoma excision, including scarring, and evidence shows that he was exposed to herbicide agents during service, the preponderance of the evidence weighs against finding that the Veteran's current condition began during service or is otherwise related to an in-service injury, event, or disease. VA regulations provide that certain conditions are presumed to be associated with herbicide agent exposure. 38 C.F.R. § 3.309(e). Melanoma is not among those listed conditions. The Board has considered whether the evidence otherwise establishes a direct connection between melanoma and herbicide agent exposure. However, an August 2020 VA examiner stated that such a connection was less likely than not to exist. He noted that the committee responsible for assessing health effects of herbicide agents on veterans found that there was inadequate or insufficient information whether there was an association between such agents and skin cancer. Additional updates to the committee's initial determination did not change the underlying conclusion. Notably, the Veteran submitted a January 2016 letter from a private physician cited two studies which showed an increased incidence of cancer for veterans exposed to herbicide agents. He stated that it was "within reason" that Agent Orange "could have contributed" to the development of the malignant melanoma in his left shoulder. As discussed at the Veteran's hearing, the use of the language "could have" in the opinion is too speculative to be considered probative evidence. See Obert v. Brown, 5 Vet. App. at 30, 33 (1993). The same doctor completed a disability benefits questionnaire in April 2020 but did not include an opinion with any supporting rationale regarding the link between herbicide agents and melanoma. Therefore, the overall weight of the competent medical evidence is against a finding that the Veteran's melanoma was related to his exposure to herbicide agents in service. The Veteran also contends that his melanoma is the result of excessive ultraviolet radiation (sun) exposure during service. In his January 2016 opinion, the Veteran's private physician noted that the Veteran had one year of service in Vietnam and had prolonged sun exposure which predisposed him to malignant melanoma. In contrast, the VA examiner stated in September 2021 that while excessive ultraviolet radiation is known to cause melanoma, the site of the Veteran's melanoma on his left shoulder was covered almost 100 percent of the time with a military uniform during his period of active duty. Therefore, there was little to no exposure to ultraviolet radiation at that site, and the melanoma was less likely than not due to service. The Board has weighed these opinions and finds the VA examiner's opinion more probative. While the private physician linked melanoma to sun exposure generally, the VA examiner was more specific in discussing the location of the Veteran's melanoma and how the circumstances of his service made it less likely than not that the condition was related to service. Therefore, the most probative medical evidence is against a finding of service connection. Separate from the theories of herbicide agent exposure and sun exposure, the Board notes that the Veteran's service treatment records are negative for any complaints, treatment or diagnoses related to the left shoulder melanoma. He underwent numerous examinations during his lengthy period of service which showed normal findings, and he denied the presence of any skin diseases, cysts, or other related symptoms on multiple medical history reports. To the extent that the Veteran himself has asserted a link between his melanoma and service, he has not shown the necessary medical knowledge or expertise to establish such a connection. The issue is medically complex, as it requires knowledge of anatomical relationships and pathology. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Shamil Patel, 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.