Citation Nr: 21010015 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 16-31 024 DATE: February 23, 2021 ORDER Entitlement to service connection for a mental disorder, claimed as depression and post-traumatic stress disorder (PTSD), is denied. Entitlement to service connection for metastatic esophageal cancer is denied. FINDINGS OF FACT 1. The Veteran’s depression neither began during service nor is it otherwise related to service. 2. The Veteran’s metastatic esophageal cancer neither began during service nor is it otherwise related to service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a mental disorder, claimed as depression and PTSD, are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 2. The criteria for entitlement to service connection for metastatic esophageal cancer are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1973 to August 1993. He died in 2011. The appellant is the Veteran’s surviving spouse and she has been determined to be a valid substitute claimant. This matter comes before the Board of Veterans Appeals (Board) on appeal from a September 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia. This matter was previously before the Board, most recently in June 2020. At that time, the Board remanded the claims for service connection for depression and esophageal cancer in order to obtain adequate VA medical opinions as the etiology of those conditions. As the record reflects that adequate VA medical opinions were obtained in October 2020, the Board finds that there has been substantial compliance with the remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The Appellant’s Contentions The appellant contends that the Veteran’s aircraft maintenance duties during active service caused his depression and esophageal cancer. In November 2019 hearing testimony before the Board, the appellant recalled the Veteran sleeping in odd places throughout the house (or even in the car) during the 14-15 years they were together. She described how he had difficulty sleeping, and that she suspected he was having nightmares, possibly related to service. She emphasized, however, that the Veteran would not talk to her about his time in the military. The appellant’s daughter, also present at the Board hearing, recalled the child-like things the Veteran would sometimes say or do, but she also did not recall the Veteran ever talking about his time in the military. Service Connection Generally, service connection will be granted if the evidence demonstrates that a current disability resulted from a disease or injury incurred in active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection requires evidence of a current disability, an in-service incurrence, disease or injury and a causal relationship between the current disability and the in-service incurrence, disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Service connection may also be granted where a disability is proximately due to or aggravated by an already service-connected disability. 38 C.F.R. § 3.310. To establish secondary service connection for a disability there must be (1) a current disability (for which secondary service connection is sought); (2) an existing service-connected disability; and (3) evidence that the current disability for which service connection is sought was either (a) caused or (b) aggravated by the service-connected disability. 38 C.F.R. § 3.310. See Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518 (1996). Depression and Esophageal Cancer The record reflects that the Veteran was diagnosed with depression and esophageal cancer, and the appellant is thus able to satisfy the first element for service connection for both claims. Specifically, VA treatment records note the Veteran’s complaints of and treatment for depression starting in March 2005. The January 2020 and October 2020 VA medical opinions also recognize the Veteran’s depression diagnosis. Private treatment records reflect that the Veteran was diagnosed with esophageal cancer in March 2010. This diagnosis is confirmed by the October 2020 VA medical opinion. As to the second element, the Veteran’s military personnel records confirm his exceptional service as an aircraft mechanic for 10 years during active service. The Veteran submitted lay statements in support of his claim describing the stress of his position, including long hours and exposure to loud noises, propellers, intakes, fuels and hot oil. A May 2010 environmental assessment in the VA treatment records confirm that the Veteran was exposed to “burning chemical from burning oil/fuel.” The appellant is thus able to establish the second element for service connection for the depression and esophageal cancer claims. With respect to the nexus elements, the October 2020 VA medical examiner concluded that the Veteran’s depression was less likely than not incurred in or caused by service. The examiner thoroughly reviewed the records, including the Veteran’s lay statements. The examiner noted the lack of evidence that the Veteran experienced depression or mental health issues prior to 1994, noting that he initially endorsed depression in 2005 due to relationship issues and situational stressors related to his work. The examiner also noted that the Veteran’s depression from 2010 was secondary to his cancer diagnosis. Based on the foregoing, the VA examiner concluded that the Veteran’s depression was not caused or incurred during service, and was more likely than not attributable to psychosocial problems noted twelve years following his separation from active service. With respect to esophageal cancer, the October 2020 VA examiner concluded that Veteran’s esophageal cancer was less likely than not incurred in or caused by the claimed in-service injury, event or illness. The examiner noted that the literature regarding the health effects of jet fuel exposure reflected major findings in skin irritation and defatting, neurotoxicity and renal cancer. The literature provided no evidence of an association between jet engine fuel and esophageal cancer. The examiner also noted that the literature regarding esophageal cancer noted that the cause of the condition is unclear and that risk factors can include diet, drinking very hot liquids and other conditions that did not apply to the Veteran. An addendum VA medical opinion was obtained in October 2020 specifically addressing the Veteran’s risk factors and noting that the only identifiable risk factor present in the Veteran was a body mass index (BMI) measurement indicating obesity in 2008. The addendum VA examiner noted that there were no other identifiable risk factors, but that there was also no objective evidence linking the Veteran’s cancer to his active duty. The Board finds the opinions of the October 2020 VA examiners probative and entitled to weight. As noted, the examiners reviewed the relevant records, addressed the Veteran’s lay statements and offered an adequate rationale for the conclusion that the Veteran’s depression and esophageal cancer were not related to service. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-04 (2008) (holding that it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion). Notably, there are no contradictory medical opinions of record. The Board acknowledges that the Veteran, the appellant, and the appellant’s daughter are able to report the Veteran’s observable symptoms, but there is no indication that they have the requisite medical training or knowledge to offer etiological opinions. See Layno v. Brown, 6 Vet. App. 465, 470 (1994); Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Even with their descriptions of the Veteran’s behavior, however, there is no competent evidence demonstrating that the behavioral oddities the Veteran exhibited, or his depression, were in any way related to his military service. As the weight of the evidence is against a finding that the Veteran’s depression and esophageal cancer were related to service, the claims for service connection are denied. Moreover, as the claim for service connection for esophageal cancer is denied as part of this decision, there is no basis to find secondary service connection for depression as related to that condition. 38 C.F.R. § 3.310. As the preponderance of evidence is against the Veteran’s claims, the benefit of the doubt doctrine is inapplicable. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. S.C. KREMBS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Snyder, 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.