Citation Nr: 21022925 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 16-20 825 DATE: April 19, 2021 ORDER Service connection for a cardiovascular (CV) disorder is denied. Service connection for an acquired psychiatric disorder is denied. FINDINGS OF FACT 1. The Veteran had active service from April 1972 to January 1974. 2. A CV disease, diagnosed as coronary artery disease (CAD), was not shown in service, was not shown to a compensable degree within one year of service, and symptoms were not continuous since service; a CV disorder is not causally or etiologically related to service, to include as due to herbicide exposure. 3. An acquired psychiatric disorder, diagnosed as depressive disorder, is not causally or etiologically related to service and was not caused by or permanently worsened in severity by a service-connected disability. CONCLUSIONS OF LAW 1. A CV disorder was not incurred in service and is not presumed to have been incurred in service, to include as due to herbicide exposure. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309 (2020). 2. An acquired psychiatric disorder was not incurred in service and is not proximately due to, aggravated by, or the result of a service-connected disability. 38 U.S.C. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.310 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) 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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. Service connection may also be granted on a presumptive basis for diseases associated with herbicide exposure under 38 C.F.R. § 3.309 if a veteran served in the Republic of Vietnam between January 1962 and May 1975. Notwithstanding the foregoing provisions regarding presumptive service connection, a veteran is not precluded from establishing service connection with proof of direct causation. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Cardiovascular Disorder Turning to the medical evidence, a November 2016 private physician diagnosed the Veteran with CAD. As such, a current CV disorder has been shown and the first element of service connection has been met. As to in-service incurrence, the service treatment records (STRs) do not reflect complaints of, treatment for, or a diagnosis of a CV disorder. Importantly, the December 1973 separation examination reflected a normal clinical evaluation of the heart and vascular system. As such, the medical evidence does not support the in-service incurrence of a CV disorder. Rather, the Veteran’s main contention is that CAD is due to exposure to herbicides during service. While ischemic heart disease is associated with herbicide exposure under 38 C.F.R. § 3.309, the objective evidence of record does not show that the Veteran was exposed to herbicides during service. The personnel records confirm that the Veteran served in Guam between 1972 and 1974. Though he does not claim that he served in Vietnam, he asserts that he stepped foot in Vietnam during active service. In April 2017 lay statements, he indicated that he physically visited Vietnam in September 1973. While on a MAC flight from Guam to Thailand, the plane landed in Vietnam to unload equipment and he was required to exit the plane. As such, he argues that he was on the ground for approximately five hours and was exposed to Agent Orange. After a request for records, Defense Personnel Records Information Retrieval System (DPRIS) indicated in a September 2017 response that the Veteran’s unit records were unable to be located. As such, due to the lack of unit records, DPRIS was unable to document that the Veteran was on a flight which landed for several hours in Vietnam. Further, there is nothing in the Veteran’s personnel records to indicate that he stepped foot on the ground in Vietnam after a September 1973 flight, or at any other time. His MOS was a clerk typist and there is no evidence to suggest that he was required ot travel to Vietnam as part of his duties. The overall evidence provided by official sources, including DPRIS and the personnel records, outweighs the lay statements provided by the Veteran. Therefore, exposure to herbicides is not conceded on the basis that the Veteran stepped foot into Vietnam. In addition, there is no credible evidence that the Veteran was exposed to herbicide agents during service. In May 2019, he requested consideration for exposure to herbicides on the basis that he served at Andersen Air Force Base in Guam, which he claimed was a Superfund site containing contaminants. In December 2020, a professional researcher from the Veterans Benefits Administration Records Research Center completed a comprehensive search on the claimed exposure at Anderson Air Force Base. The researcher concluded that there was no evidence to support documentation of any exposure incident. Accordingly, the objective evidence of record does not support exposure to herbicides during service. In addition, there is no medical evidence which supports the claim that a CV disease was due to herbicide exposure. As such, the evidence does not support service connection due to herbicide exposure on a direct or presumptive basis. As to presumptive service connection based on continuity or chronicity of symptoms, no chronic disease was shown in service. As noted above, the evidence does not show any symptoms of CAD or a CV disorder during service. Therefore, the medical evidence does not support presumptive service connection on a “chronic disease or injury shown in service” basis. Next, the medical evidence does not support presumptive service connection based on continuity of symptomatology since service. Specifically, the Veteran was discharged from service in January 1974 with no report of CAD or heart problems. Moreover, the evidence does not show treatment for CAD until 2016, some 40+ years later. As such, the medical evidence does not support service connection on a “continuity of symptomatology” basis. Further, the disorder did not manifest itself to a degree of 10 percent or more within one year from the date of separation from service. The Veteran separated from service in 1974 but was not diagnosed with CAD until 2016, more than 40 years after discharge. Therefore, the medical evidence does not support presumptive service connection on any basis. Acquired Psychiatric Disorder Turning to the medical evidence, a January 2017 private examiner diagnosed the Veteran with acute/reactive depression. Further, a November 2018 VA examiner confirmed a diagnosis of depressive disorder unspecified and mild neurocognitive disorder unspecified. As such, an acquired psychiatric disorder has been shown and the first element of service connection is met. Next, as to in-service incurrence, the STRs do not reflect a diagnosis of an acquired psychiatric disorder. An April 1972 personnel record showed that the Veteran was seeing a psychotherapist for emotional problems; however, there is no record of a diagnosis of any psychiatric disorder during service. Specifically, the December 1973 separation examination reflected a normal clinical psychiatric evaluation. Further, while the Veteran reported a motorcycle accident in 1973, he was not admitted to the hospital and there was no mention of a head injury or mental disorder on the injury report. In addition, no residuals were noted in the STRs or on the separation examination. As such, the medical evidence does not support the in-service incurrence of an acquired psychiatric disorder. To the extent that the Veteran asserts a nexus between service and a current psychiatric disorder, the weight of the medical evidence does not support the claim. On one hand, in support of the claim, a January 2017 private clinician stated that an in-service head injury after a motor vehicle accident was more likely than not a contributing factor in the development of dementia and depression. On the other hand, a November 2018 VA examiner found it was less likely than not that a current psychiatric disorder was caused by service, to include the motor vehicle injury. Based on the records and STRs, the examiner concluded that there was no evidence of a mental disorder diagnosis in service in proximity to the motor vehicle injury. Further, the separation examination was silent for any mental disorder diagnosis. As such, the examiner concluded that current depression and neurocognitive disorder were most likely the result of ischemic heart disease and prostate cancer. Although the January 2017 private clinician opined that the Veteran’s psychiatric disorder was caused by a head injury, the contemporaneous in-service medical evidence does not show that a head injury occurred during the in-service accident. As such, the basis of the private opinion is not supported in the record and is assigned less probative value. Rather, the VA examiner’s opinion is afforded more probative value because it offers a more thorough rationale based on the objective medical evidence, including the Veteran’s medical history and STRs. Accordingly, the weight of the medical evidence is against direct service connection. As to secondary service connection, both a private examiner and a VA examiner have opined that an acquired psychiatric disorder was likely the result of a CV disorder. However, the Veteran is not currently service-connected for CAD or any other CV disorder. Therefore, service connection for an acquired psychiatric disorder is not warranted on a secondary basis. The Board has considered the Veteran’s lay statements that his disorders were caused by service. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his current disorders due to the medical complexity of the matter involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claims for service connection and there is no doubt to be otherwise resolved. As such, the appeals are denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Kokolas, 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.