Citation Nr: 21009695 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 17-38 504 DATE: February 23, 2021 ORDER Service connection for a respiratory condition, to include occupational asthma, is granted. FINDING OF FACT The evidence is in equipoise as to whether the Veteran’s current respiratory condition is the result of his active service. CONCLUSION OF LAW The criteria for service connection for a respiratory condition, to include occupational asthma, have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 1137, 5103, 5103a, 5107; 38 C.F.R. §§ 3.102, 3.103, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from July 1982 to November 1984. At a February 2021 hearing, the Veteran testified before the undersigned Veterans Law Judge. This case is being processed under the Board’s One-Touch Initiative. A transcript of the hearing will be associated with the claims file at a later time. The Veteran submitted his original December 2014 claim for service connection for emphysema. He has been diagnosed with various respiratory illnesses throughout the record. The Board has taken an expansive view of the claim pursuant to Clemons, and recharacterized the claim as shown above. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). The Board has limited the discussion below to the relevant evidence required to support its finding of fact and conclusion of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Service Connection The Veteran has contended that his respiratory condition is the result of exposure to toxic substances in service, including asbestos and liquid chemicals used for electroplating without protection or overhead air ducts. 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). This means that the facts establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). 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). VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Turning to the evidence of record, the Veteran’s service treatment records (STRs) contained one report of cold symptoms, one diagnosis of rhinitis, and one notation of hay fever and allergies. At separation, an evaluation of the lungs and chest was normal. The Veteran’s military occupational specialty (MOS) was machine repairman and personnel records reflected that he was stationed at Pearl Harbor. Post-service, the Veteran reported being diagnosed with asthma in the late 1980s or early 1990s. VA treatment records reflected an ongoing diagnosis of asthma as early as May 2001. A chest x-ray was conducted in August 2013 which reflected that the lungs were mildly emphysematous. Pulmonary function testing (PFT) conducted in June 2014 demonstrated moderate airway obstruction which was significantly improved with use of a bronchodilator. In December 2014, the Veteran was seen by VA clinicians for an occupational asthma consultation. He described frequent work with electroplating in service which entailed exposure to various liquid metals including copper, nickel, silver, and chromium in a confined work environment. He stated that during such exposures he did not wear respiratory personal protective equipment (PPE). Following separation, he worked as a machinist but wore PPE. Clinicians noted his history of reported respiratory symptomology since the late 1980s to early 1990s. He stated that he was diagnosed with asthma at that time and started on bronchodilators and anti-inflammatory inhaled corticosteroids (ICS) which he continued to the present. The clinician determined that there was an association, although poorly characterized at the time, between electroplating with metals and occupational asthma. In particular, the literature supported exposure to nickel and chromium. It was difficult to determine the exact underlying etiology in the Veteran’s case, however, based on his report of occupational exposure, his symptoms developed in the years after such exposure. He denied childhood asthma or asthma prior to the military. As such, it was possible that his current symptoms were related to some degree of the aforementioned exposures. Based on his lack of smoking history, PFTs and imaging, his likely diagnosis was asthma. In a December 2014 statement, the Veteran described working with liquid chemicals for electroplating during his service at Pearl Harbor. He stated that there were no overhead air ducts to remove fumes. As such, he inhaled the dangerous fumes and had his hands contaminated with liquid metals and cleaning solutions. He also stated that he worked in the shipyard to take measurements for parts and was exposed to many airborne particles which he believed contained asbestos. He submitted several internet treatises regarding the chemicals used in electroplating, metal toxicity in nickel, machining fluids and cancer incidence, and shipyards and asbestos. A lay statement from a friend of the Veteran’s stated that prior to service, he was active and hard-working without any physical health problems. Shortly after returning from service, she and his family noticed that he had difficulty breathing and was using an inhaler. He had reported that this was due to inhaling fumes while electroplating and exposure to asbestos. She noted that he had never smoked and that his symptoms had worsened over time. The Veteran underwent a VA examination in March 2017. He repeated to the clinician that his MOS of machinist exposed him to liquid chemicals including nickel, silver, cobalt, and copper, and that he also worked in a shipyard and was unsure about asbestos exposure but saw it wrapped around pipes that he was working on. He noted that they had poor ventilation and poor respiratory protection. Prior to service, he reported that he did not have any breathing problems, but a few years after separation, he began to develop shortness of breath and was prescribed an albuterol inhaler. Since that time his breathing had gotten progressively worse. The examiner diagnosed occupational asthma, supported by the December 2014 VA treatment records. She stated that the Veteran’s MOS was a minimal risk for asbestos exposure. Although he stated that he observed asbestos when working on pipes, his radiographs did not show any of the classic findings associated with asbestos exposure, such as pleural plaques. As such, it was less likely than not that his current respiratory condition was caused by any exposure to asbestos during his active service. However, based on his MOS and reports of exposure to liquid chemicals without appropriate ventilation and protection, his lack of breathing problems prior to service and the onset of respiratory difficulties and diagnosis of asthma shortly after service, and his lack of a smoking history, it was at least as likely as not that his current respiratory condition was caused by toxic environmental exposures during his active service. Service connection for a respiratory condition, to include occupational asthma, is granted. Based on the foregoing, the Board finds that the evidence is in equipoise as to whether the Veteran’s current respiratory condition, including occupational asthma, is related to his active service. There is no clinical evidence of asbestos exposure, but he does have a current diagnosis of occupational asthma. Although there is no evidence of in-service complaints, the nature of the Veteran’s MOS and his credible reports of his duties, supported by treatises regarding the nature of the work, supports his exposure to environmental toxins including those used in electroplating. There are no medical records reflecting the exact onset of relevant symptoms; however, the Veteran is competent to describe when his breathing difficulties began. VA treatment records suggested a history of asthma treated with bronchodilators and ICS, beginning prior to 2001 and consistent with the Veteran’s reported history. Based on the totality of evidence, including the timeline of symptomology, the VA examiner determined that it was at least as likely as not that his current occupational asthma was the result of in-service exposures. The Board attaches significant probative value to the medical opinion as it is well-reasoned, consistent with the other evidence of record, and included consideration of the Veteran’s pertinent medical history and lay statements. Accordingly, the Board finds that the evidence is balanced as to whether service connection is established. Therefore, and affording the Veteran the benefit of the doubt, service connection for a respiratory condition, to include occupational asthma, is warranted. Shereen M. Marcus Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Rachel E. Jensen, 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.