Citation Nr: 21014102 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 14-33 174 DATE: March 11, 2021 ORDER Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is granted. Entitlement to service connection for right leg peripheral arterial disease (PAD) is granted. Entitlement to service connection for left leg PAD is granted. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. The Veteran’s respiratory disorder, diagnosed as COPD, is related to in-service exposure to solvents and other cleaning materials in service 2. The Veteran’s bilateral disorder, diagnosed as PAD, is caused or aggravated beyond its natural progression by his service-connected diabetes mellitus. 3. The preponderance of the evidence of record is against finding that the Veteran has had a diagnosis of PTSD, or any other acquired psychiatric disorder, at any time during or approximate to the pendency of the claim. CONCLUSIONS OF LAW 1. The criteria for service connection for COPD are met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 2. The criteria for service connection for right leg PAD as secondary to service-connected diabetes mellitus are met. 38 U.S.C. § 1110; 38 C.F.R. § 3.310. 3. The criteria for service connection for left leg PAD as secondary to service-connected diabetes mellitus are met. 38 U.S.C. § 1110; 38 C.F.R. § 3.310. 4. The criteria for service connection for an acquired psychiatric disorder, to include PTSD are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.125. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1962 to October 1966. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a June 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2018, the Board remanded the issues on appeal for further development; there was substantial compliance with the remand directives. This case has been advanced on the docket pursuant to 38 C.F.R. § 20.800(c). Service Connection 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). Additionally, service connection may be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. 1. Entitlement to service connection for a respiratory disorder. The Veteran seeks entitlement to service connection for a respiratory disorder due to exposure to solvents and other cleaning materials in service. For the reasons explained below, service connection for COPD is warranted. The Board concludes that the Veteran has a current disability that is related to exposure to solvents and other cleaning materials in service. 38 U.S.C. § 1110; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). A July 2009 private treatment record from Dr. S.G. notes that the Veteran is diagnosed as having a history of COPD. The May 2019 VA examination report confirms that the Veteran has a current diagnosis of COPD. Thus, the question becomes whether the current disability is related to service. The September 2020 VA examiner opined that the Veteran’s respiratory condition is at least as likely as not related to exposure to solvents and other cleaning materials used to clean aircrafts and engines as well as his history of smoking. The VA examiner provided a cogent rationale shown below: [A]lthough the Veteran’s long smoking history (“a smoker for 40 years with a 20 pack year history and quit in 2003”) is likely the major contributor to the Veteran’s COPD, exposure to solvents and other cleaning materials used to clean aircrafts and engines can also cause or contribute to the development of COPD. The Veteran’s military duties as an aviation machinist’s mate [confirmed by his service personnel records] exposed the Veteran to solvents and other cleaning materials used to clean aircrafts and engines. Aircraft maintenance workers are often exposed to trichloroethylene (TCE) and other hydrocarbons and chemicals. According to Radican et al., regarding exposure to trichloroethylene and other chemicals: “[f]or low level exposures in men, there was an increase in relative risk of 0.30 or more for continuous compared to intermittent exposure for death from Hodgkin’s disease and cancer of the buccal cavity/pharynx, central nervous system and the lymphatic/hematopoietic system, and from non-malignant respiratory disease, bronchitis and emphysema.” Chronic obstructive pulmonary disease is comprised of chronic bronchitis and/or emphysema. Therefore, it appears that exposure to trichloroethylene and other chemicals is associated with an increased risk of developing bronchitis and emphysema, the two components of chronic obstructive pulmonary disease. (“Mortality of aircraft maintenance workers exposed to trichloroethylene and other hydrocarbons and chemicals: extended follow up”; Larry Radican, PhD, MPH, Aaron Blair, PhD, MPH, Patricia Stewart, PhD, and Daniel Wartenberg, PhD; Journal of Occupational and Environmental Medicine; November 2008; 50(11): 1306-1319.) Therefore, the development of the Veteran’s COPD is likely contributed to by the Veteran’s history of smoking, as well as the Veteran’s chemical exposures during his military service. The Board notes that there are no opposing medical opinions whose probative weight outweighs this favorable nexus opinion. Based on this competent, favorable, and persuasive nexus opinion, the Veteran’s current respiratory disorder, diagnosed as COPD, is found to be etiologically related to service. Accordingly, service connection for COPD, is warranted. 2. Entitlement to service connection for right leg PAD. 3. Entitlement to service connection for left leg PAD. The Veteran seeks entitlement to service connection for a bilateral leg disorder secondary to his service-connected diabetes mellitus. For the reasons explained below, service connection for PAD of the bilateral legs is warranted. A July 2009 private treatment record from Dr. S.G. notes that the Veteran is diagnosed with PAD. The May 2019 VA examination report confirms that the Veteran has a current diagnosis of bilateral lower extremity PAD. The September 2020 VA examiner opined that the Veteran’s bilateral PAD is at least as likely as not aggravated beyond its natural progression by his service-connected diabetes mellitus/pre-diabetic state. The VA examiner’s rationale noted that bilateral lower extremity PAD is a known complication of diabetes and prediabetes. The Board notes that there are no opposing medical opinions whose probative weight outweighs this favorable nexus opinion. Based on this competent, favorable, and persuasive nexus opinion, the Veteran’s current bilateral leg disorder, diagnosed as PAD, is found to be secondary to his service-connected diabetes mellitus. 38 C.F.R. § 3.310. Accordingly, service connection for a bilateral leg disorder, diagnosed as PAD, is warranted. 4. Entitlement to service connection for an acquired psychiatric disorder, to include PTSD. The Veteran seeks entitlement to service connection for an acquired psychiatric disorder, claimed as PTSD. For the reasons explained below, service connection is not warranted. Service connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). The existence of a current disability is the cornerstone of a claim for VA disability compensation. In the absence of proof of a claimed disability at any time during the period on appeal, there is no valid claim of service connection. Degmetich v. Brown, 104 F. 3d 1328 (1997). As set forth in a February 2012 stressor statement, the Veteran maintains that he was exposed to bombs exploding and incoming small arms fire during his two flights to Vietnam. For the limited purposes of the April 2018 remand, the Board found those stressors credible and consistent with the circumstances of the Veteran’s service and remanded the matter to conduct a VA examination. The initial question for the Board then is whether the Veteran has a current diagnosis of an acquired psychiatric disability, to include PTSD. The Board concludes that the Veteran does not have a current diagnosis of PTSD, or any other acquired psychiatric disorder, and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The April 2019 VA examiner evaluated the Veteran and determined that he had never been diagnosed with a mental disorder, nor did he meet the criteria for any psychiatric diagnosis. The VA examination report indicates that the Veteran denied feeling depressed or anxious or suffering from PTSD and denied any mental health issues. The examination report is probative as the VA examiner reviewed the file and conducted an evaluation. The examiner, a psychologist, has the appropriate training, expertise and knowledge to evaluate the claimed mental health disability. Further, service treatment records are negative for any complaints, findings or treatment of any psychiatric disorder during active military service. VA treatment records likewise do not contain a diagnosis of PTSD or any other acquired psychiatric disorder. Additionally, the Veteran has not submitted any private treatment records containing a diagnosis of PTSD or any other acquired psychiatric disorder. To the extent the Veteran, a lay person, may have believed he has an acquired psychiatric disorder, to include PTSD, due to his military service; he is not competent to do so. As this is a complex medical determination, lay statements are not probative to establish a clinical diagnosis of an acquired psychiatric disorder, to include PTSD, in accordance with 38 C.F.R. § 4.125. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). As there is no competent medical evidence showing the Veteran has a current diagnosis of PTSD, or any other acquired psychiatric disorder, he has not met the criteria for entitlement to service connection. 38 C.F.R. §§ 3.303, 3.304(f); see also Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Degmetich v. Brown, 104 F.3d 1328, 1332 (Fed. Cir. 1997). As the preponderance of the evidence is against the claim, there is no doubt to be resolved. Service connection for an acquired psychiatric disorder, to include PTSD is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Caban, 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.