Citation Nr: 21005683 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 19-33 149 DATE: February 2, 2021 ORDER Entitlement to service connection for chronic obstructive pulmonary disease (COPD), to include as due to asbestos exposure is denied. FINDING OF FACT The preponderance of the evidence is against finding that COPD began during active service or is otherwise related to an in-service injury or disease, to include asbestos exposure. CONCLUSION OF LAW The criteria for service connection for COPD have not been 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 served on active duty in the United States Navy from January 1960 to December 1963. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). In December 2020, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. Service Connection Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § § 1110, 1131; 38 C.F.R. § 3.303. Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). To establish service connection for a disability, there must be competent evidence of the following: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or nexus between the present disability and the disease or injury incurred or aggravated during service. Horn v. Shinseki, 25 Vet. App. 231, 236 (2010); Shedden, 381 F.3d at 1167; Gutierrez v. Principi, 19 Vet. App. 1, 5 (2004) (citing Hickson v. West, 12 Vet. App. 247, 253 (1999)). In many cases, medical evidence is required to meet the requirement that the evidence be “competent”. However, when a condition may be diagnosed by its unique and readily identifiable features, the presence of the disorder is not a determination “medical in nature” and is capable of lay observation. Barr v. Nicholson, 21 Vet. App. 303, 309 (2007). Entitlement to service connection for COPD, to include as due to asbestos exposure The Veteran contends that his current COPD is etiologically related to his active duty service. More specifically, the Veteran has alleged that the COPD is due to asbestos exposure during service. At the outset, the Board notes that the Veteran has been diagnosed with COPD and chronic bilateral pleural plaques due to asbestos exposure without evidence of asbestosis and has been receiving treatment for both. See February 2017 VA examination. The Veteran is separately service-connected for chronic bilateral pleural plaques due to asbestos exposure without evidence of asbestosis and that issue is not before the Board. The Veteran’s service treatment records do not indicate that the Veteran complained of or received treatment for any respiratory conditions while in service. Nevertheless, the Veteran’s military occupational specialty (MOS) was boiler room helper, which has been determined is highly probably for asbestos exposure. Therefore, asbestos exposure is conceded. The Veteran underwent a VA respiratory conditions examination in February 2017. The examiner diagnosed COPD and asymptomatic bilateral pleural plaques. The Veteran reported smoking one pack of cigarettes per day from ages 15 to 28, and again between age 41-59 until he quit in approximately 2004. The VA examiner opined that the Veteran’s COPD was less likely than not caused by or aggravated beyond normal progression by asbestos exposure during service nor the bilateral pleural plaques seen on chest imaging. The examiner further opined that the Veteran’s COPD was most likely due to his past history of chronic smoking. In this regard, the Board finds that the examiner’s opinion rendered in February 2017 is entitled to great probative weight as such considered all of the pertinent evidence of record, to include the statements of the Veteran, and provided a detailed rationale, relying on and citing to the records reviewed. The examiner offered clear conclusions with supporting data as well as reasoned medical explanations connecting the two. See Nieves-Rodriguez, supra. Moreover, there is no contrary medical opinion of record. The Board cannot ignore what appears to be a more than a three-decade history of smoking. The detailed nature of the medical opinion makes clear that the Veteran’s COPD is not the result of his military service more than 55 years ago, but a long history of smoking. While the Veteran’s likely exposure to asbestos is clear, the evidence on what caused the Veteran’s COPD is unusually clear and unambiguous. Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), the specific issue in this case, determining the etiology of COPD, falls outside the realm of common knowledge of a lay person because it involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. Therefore, based on the foregoing, the Board finds that the Veteran’s COPD is not shown to be causally or etiologically related to any disease, injury, or incident during service. As such, service connection for such disorders are not warranted. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim for service connection for COPD, that doctrine is not applicable John J. Crowley Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board V. Woehlke 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.