Citation Nr: 21006866 Decision Date: 02/05/21 Archive Date: 02/05/21 DOCKET NO. 17-25 557 DATE: February 5, 2021 ORDER Entitlement to service connection for chronic obstructive pulmonary disease (COPD), to include as due to diesel fume exposure is denied. REMANDED Entitlement to service connection for essential tremors, to include as due to herbicide exposure is remanded. 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 exposure to diesel fumes. CONCLUSION OF LAW The criteria for service connection for COPD 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 served on active duty from March1954 to June 1958 and June 1958 to November 1975 in the United States Air Force, to include active duty in the Korean Conflict Era and Vietnam Era. Entitlement to service connection for COPD, to include exposure to diesel fumes is denied. The Veteran contends that his diagnosed COPD is etiologically due to his exposures during active duty service, to include herbicide and diesel fumes. 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. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current diagnosis of COPD, and evidence shows that in-service exposures occurred, the preponderance of the evidence weighs against finding that the Veteran’s COPD began during service or is otherwise related to an in-service injury, event, or disease. VA treatment records show the Veteran was not diagnosed with COPD until 2013, decades after his separation from service. Further, the October 2020 VA examiner opined that the Veteran’s COPD is not at least as likely as not related to an in-service injury, event, or disease, including exposure to diesel fumes. The rationale was that the Veteran’s COPD would “almost certainly manifest during the time of exposure or proximate to it.” The examiner also noted that the prevailing medical consensus does not support diesel fumes as a cause of COPD. Finally, the examiner noted that although the Veteran quit smoking more than 30 years ago, his admitted more than 100 pack per year habit prior to quitting is “far and away the most likely cause of the Veteran’s COPD.” The examiner also noted that the Veteran did not report any in-service respiratory issues and his separation examination was similarly silent for any respiratory condition. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Veteran believes his COPD is related to an in-service injury, event, or disease, specifically exposure to diesel fumes. 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 pathology, and is thus outside the competence of the competence of a lay person. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the October 2020 VA medical opinion. REASONS FOR REMAND Entitlement to service connection for essential tremors, to include as due to herbicide exposure is remanded. The Board cannot make a fully-informed decision on the claim because no VA examiner has opined whether the Veteran’s tremors are distinguishable from symptoms associated with Parkinson’s disease, or represent “Parkinson’s-like” symptoms. Effective March 1, 2021, Parkinsonism is considered a disease subject to presumptive service connection in cases where herbicide exposure is confirmed. See 38 U.S.C. § 1116(a)(2). The Veteran’s representative has raised the contention that the Veteran’s tremors represent a Parkinson’s-like condition. 38 U.S.C. § 1116(a)(2) to include parkinsonism, bladder cancer, and hypothyroidism. The medical opinion on remand should clarify the nature of the Veteran’s essential tremors. The matter is REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s tremors are at least as likely as not related to Parkinson’s disease or can be classified as “Parkinson-like” symptoms. If not, the examiner must clarify the difference between the Veteran’s tremors and tremors associated with Parkinson’s disease. A complete rationale must be provided for all opinions offered. If the examiner cannot provide an opinion, the examiner must specifically state why. Copies of all pertinent records must be made available to the examiner for review. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P.S. McLeod 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.