Citation Nr: 21074669 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 17-43 685 DATE: December 16, 2021 ORDER Entitlement to service connection for the cause of the Veteran's death is granted. FINDINGS OF FACT 1. The Veteran died in May 2015. The Veteran's death certificate states the primary cause of death was sepsis due to sacral decubitus ulcer. It listed peripheral vascular disease (PVD) as a contributory cause of death. 2. The August 2021 VA opinion shows the Veteran's hypertension was a likely cause of his PVD. 3. The Veteran is presumed to have been exposed to herbicide agents in service. 4. There is evidence that the Veteran's hypertension is related to his service. 5. The Veteran's hypertension caused or contributed substantially to the Veteran's death. CONCLUSION OF LAW 1. The criteria for service connection for the cause of the Veteran's death have been met. 38 U.S.C. §§ 1310, 5107; 38 C.F.R. §§ 3.6 (a), 3.102, 3.303, 3.312. REASONS AND BASES OF FINDINGS AND CONCLUSION The Veteran had active service from November 1966 to November 1986. He died in May 2015, and the Appellant is his surviving spouse. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a June 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In November 2019, the Board denied the Appellant's claim. The Veteran appealed the November 2019 Board decision to the Court of Appeals for Veterans Claims (CAVC), and, through a Joint Motion for Remand, the case was remanded to the Board. In July 2021 the Board remanded the claim for further development. SERVICE CONNECTION FOR CAUSE OF DEATH In a claim of service connection for a veteran's cause of death, i.e., Dependency and Indemnity Compensation (DIC), evidence must be presented that links the fatal disease to a period of service or to an already service-connected disability. 38U.S.C. §§1110, 1310; 38 C.F.R. §§ 3.303, 3.312. Evidence must be presented showing that a service-connected disability is either the principal or contributory cause of death. 38 U.S.C. § 1310; 38 C.F.R. § 3.312. DIC is also awarded if the veteran's death can be service connected. 38 U.S.C. § 1310; 38 C.F.R. § 3.312. That is, service connection for the cause of a veteran's death is granted, postmortem, and DIC is awarded, if the evidence shows that a fatal disease or injury was actually incurred or aggravated in service, though service connection had not been granted for the disease or injury prior to a veteran's death, was either the principal or a contributory cause of death. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. To establish service connection for the cause of a veteran's death, due to a cause not already service connected, the evidence must show that a disability that either was incurred in or aggravated by service, or which was proximately due to or the result of a service-connected condition, was either a principal or contributory cause of death. 38 U.S.C. §§ 1101, 1112, 1113, 1310; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310 (a), 3.312 (a); see also Allen v. Brown, 7 Vet. App. 439, 448 (1995); Cuevas v. Principi, 3 Vet. App. 542, 548 (1992), citing Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). 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. 38 C.F.R. § 3.312 (c). The Veteran died in May 2015. According to the death certificate, the primary cause of death was sepsis due to sacral decubitus ulcer. It listed peripheral vascular disease as a contributory cause of death. At the time of the Veteran's death, service connection was in effect for residuals, injury of left thumb (minor) as zero percent disabling. There is no evidence that his service-connected disability materially or substantially contributed to his death. The Veteran's representative argued that there is evidence of an association between hypertension and herbicide agent exposure. It is established that the Veteran served in Vietnam and was presumed to have been exposed to herbicides. VA regulations do not provide hypertension as a presumptive disability associated with herbicide exposure; however, there is some evidence suggestive of a relationship between the two. Accordingly, when resolving reasonable doubt in the Veteran's favor, service connection for hypertension is warranted. In an August 2021 opinion, the VA examiner stated the Veteran's PVD was likely caused by hypertension and heavy cigarette smoking. The examiner stated that sustained elevated blood pressure causes damage to the inner lining of the artery resulting in hardening of the walls and in worst case will lead to total occlusion of the blood flow. In a letter dated January 2020, Dr. V.Y. stated the Veteran's PVD led to bilateral above-the-knee amputations. The Veteran remained bedbound due to this and developed sacral decubitus ulcerations which led to sepsis and the Veteran's demise. The Board finds that the evidence is, at minimum, in equipoise regarding the question of whether the Veteran's PVD, which contributed to his death, was caused or aggravated by hypertension. See 38 C.F.R. § 3.303. The benefit-of-the-doubt will be conferred in the Appellant's favor and her claim for service connection for cause of death is granted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Service connection for the Veteran's cause of death is warranted. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. St. Laurent, 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.