Citation Nr: 21014031 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 15-44 664 DATE: March 11, 2021 ORDER Entitlement to service connection for asbestosis, claimed as pulmonary fibrosis (lung disability) is denied. FINDING OF FACT The Veteran does not have a current diagnosis of asbestosis, and the Veteran’s current lung disability is not related to an in-service event, disease, or injury. CONCLUSION OF LAW The criteria for service connection for lung disability have not been satisfied. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Navy from June 1968 to April 1972 to include service in the Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) from a July 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The case was remanded in June 2019 and has since been returned to the Board for appellate review. As the requested development has been completed, no further action is necessary to comply with the Board’s remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection The Veteran asserts that he has a current asbestosis or pulmonary fibrosis diagnosis that is due to asbestos exposure while serving in the vicinity of Vietnam onboard the USS Tripoli and USS Frederick. VA has conceded the Veteran’s exposure to asbestos during active duty. Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). VA has established certain rules and presumptions for chronic diseases. See 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a); Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). With chronic diseases shown as such in service so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless attributable to intercurrent causes. 38 C.F.R. § 3.303(b). If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. § 3.303(b). In addition, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, chronic diseases are presumed to have been incurred in service if they manifested to a compensable degree within one year of separation from service. 38 C.F.R. §§ 3.307(a)(3), 3.309(a). The Veteran’s claimed lung disability is not a type of chronic disease recognized by the VA for service connection based on presumption purposes. The Veteran has a current diagnosis of a lung disability. At his January 2020 VA examination, he was diagnosed with pulmonary fibrosis, but the examiner explained that he does not meet the diagnostic criteria for asbestosis, as he has no pleural plaques and also had a normal DLCO at the time of his pulmonary fibrosis diagnosis. Thus, the remaining question is whether the current lung disability, pulmonary fibrosis, is related to service. Service treatment records show no complaints, diagnosis, or treatment related to a lung disability. As the Veteran reported other ailments during service, and lung problems are the type that a reasonable person would report, if the Veteran was experiencing problems with the lung during service the Board would expect that he would have reported these problems to medical professionals. During the April 1972 separation examination, evaluation of the lungs and chest was normal. There is no corresponding report of medical history. A lung disability is not shown by medical evidence until approximately November 2012, many years after the Veteran’s separation from service. Regarding onset of symptoms related to a lung disability, post-service the Veteran has reported that the doctor called the Veteran up and told him to stop taking methotrexate because “he had lost half of [his] lungs.” The Veteran reported to having had rheumatoid arthritis since about 1998 and on methotrexate since about 1999 or 2000. The Veteran presented for VA examinations in July 2015 and January 2020, at which time he was interviewed by the examiners who also reviewed the pertinent medical history and performed an examination. The July 2015 examiner opined that the Veteran’s lung disability was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In support of this conclusion, the examiner explained that the Veteran’s lung disability did not correlate with the protocol of him having asbestos related lung disease. The examiner indicated that the chest CT scan does not indicate any asbestos related findings such as plaques, and the examiner also referred to the staff pulmonologist’s note regarding the etiology in November 2012, which stated that the Veteran’s pulmonary fibrosis is most likely related to the Veteran’s rheumatoid arthritis. The statement the examiner relied upon however, gave some doubt as to whether asbestos-related interstitial lung disease could be excluded; nonetheless, the examiner and pulmonologist agreed that this was most likely rheumatoid arthritis associated. Following the Board’s remand, the Veteran reported for another examination in January 2020. The January 2020 examiner opined that the Veteran did not have a current diagnosis of asbestosis and explained that the Veteran did not meet the diagnostic criteria for asbestosis. Regarding the current pulmonary fibrosis diagnosis and its etiology, the examiner opined that the Veteran’s lung disability was not caused due to asbestos exposure. In support of this conclusion, the examiner explained that his pulmonary fibrosis is noted with honeycombing but with no pleural plaques. The examiner explained that absence of pleural plaques indicates that asbestos exposure is not playing a role in his pulmonary fibrosis. The examiner referenced November 2012 pulmonologist and July 2014 pulmonologist consultations noting rheumatoid arthritis as the most likely cause. Lastly, regarding whether the Veteran’s lung disability has its onset in service or is otherwise related to service, the examiner opined that the Veteran’s lung disability is less likely than not (less than 50 percent probability) caused by or a result of military service. In support of this conclusion, the examiner explained that there was no subjective or objective evidence of pulmonary fibrosis in service or within a year of service. The examiner also explained that there is no evidence that the Veteran’s military service or any exposure in service resulted in the development of pulmonary fibrosis. The Board finds this opinion highly probative as it was made by a medical professional with consideration of the specific facts in this case and after examination of the Veteran. The opinion is also supported by other evidence of record. For example, the Veteran’s lung disability was not diagnosed until 2012. Service records do not show any indication of a lung disability or lung problems during service. There is no medical opinion or competent and credible evidence in significant conflict with the VA medical opinion. The Board has considered the Veteran’s statements, to include his assertions that his exposure to asbestos during service caused his lung disability. As the Veteran is not shown to have medical education or experience, he is a lay person and is competent to report (1) symptoms that are observable to a layperson, e.g., _[pain]_; (2) symptoms at the time supporting a later diagnosis by a medical professional; or (3) a contemporaneous medical diagnosis. See Davidson v. Shinseki, 581 F.3d 1313 (2009). The Veteran is not competent to independently render a medical diagnosis or opine as to the specific etiology of a condition as these are medically complex issues. Thus, his lay assertions do not constitute evidence upon which service connection can be granted. The Board ultimately assigns greater probative weight to the medical evidence of record, to include the opinion rendered by a trained medical professional based on appropriate diagnostic testing and reasonably drawn conclusions with supportive rationale. To the extent the Veteran asserts a continuity of symptomatology beginning during service, the Board finds these statements to lack credibility as they are in direct conflict with the Veteran’s service treatment records. The Board finds the report of medical history at separation from service to be more reliable than more recent assertions as it was done contemporaneous to service and for the purpose of identifying disability at that time. For the above reasons, the preponderance of the evidence is against the claim and service connection is denied. The Board has duly considered the benefit-of-the-doubt doctrine. However, the preponderance of the evidence is against the Veteran’s claim, so that doctrine is not applicable. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 54 (1990). A. ADAMSON Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. J. Kim, 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.