Citation Nr: 21023635 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 16-26 042 DATE: April 21, 2021 ORDER Entitlement to service connection for a lung disability is granted. FINDING OF FACT Resolving all doubt in favor of the Veteran, the evidence is at least in equipoise that the Veteran’s lung disability is a result of active duty. CONCLUSION OF LAW Resolving all reasonable doubt in favor of the Veteran, the criteria for service connection for a lug disability have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5103(a), 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1953 until May 1974. He saw service in Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 Department of Veterans Affairs (VA) regional office (RO) rating decision. This matter was previously before the Board in May 2019 when it was remanded for further development. Service Connection To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a).  Entitlement to service connection for a lung disability The Veteran contends that his lung disability is related to his active duty service, to include exposure to herbicides while serving in Vietnam and to several toxins as a supply specialist. The Veteran’s MOS of supply specialist is confirmed by his DD 214. The Veteran’s medical records indicate that he is diagnosed with several lung disabilities to include chronic obstructive pulmonary disorder (COPD), restrictive lung disease, diffusion dysfunction, interstitial lung disease and exertional dyspnea. Therefore, the first Holton element is satisfied. Furthermore, as the Veteran has confirmed service in Vietnam, the presumption regarding exposure to herbicide attaches. 38 C.F.R. § 3.309(e). Additionally, his MOS in service is confirmed to be a supply specialist. As a supply specialist, the Veteran worked in supplies and delivery – which required cleaning weapons and conducting maintenance on vehicles, brake pads, aircraft parts, aircraft repair, as well as exposure to gases, lead paints, paint thinners, and the cleaning solutions acetone and zinc oxide, dust mold, ventilation work, and insulation. Exposure to such elements is consistent with the type and circumstances of the Veteran’s MOS. Falzone v. Brown, 8 Vet. App. 398, 403 (1995). Therefore, the second Holton element is satisfied. In April 2017 VA treatment records, the Veteran’s treating physician opined that his COPD is directly related to his exposure to herbicides while in Vietnam. No further rationale was given. In an August 2017 private treatment record, the Veteran’s physician stated that the etiology of the Veteran’s interstitial lung disease is “likely multifactorial” to include COPD, tobacco use, and occupational exposure with cleaning materials, fires, herbicides, and other material management exposure from 21 years in the military. The private physician also opined that the Veteran’s restrictive lung disease was due to these multiple exposures, “and while he does have a [history] of tobacco use, he quit in 1969, and his activity and function seem to have continued to decline.” In a January 2020 VA examination, the VA examiner opined that the Veteran’s COPD was less likely than not related to service. The VA examiner reasoned that his COPD could not be “definitively linked at this time” to service, as the Veteran did not seek treatment until 2015. The VA examiner also reasoned that while the Veteran was exposed to herbicides in service, the literature available does not support a direct causation between COPD and exposure to herbicides. The VA examiner additionally noted that the Veteran had a history of tobacco use. After a review of the record, the Board finds that the evidence in this case is at least in equipoise with regard to whether the Veteran’s lung disability, however diagnosed, is related to service. The Board affords probative weight to the August 2017 private treatment record as it is based on the physician’s familiarity with the Veteran and his course of treatment. See Black v. Brown, 10 Vet. App. 279 (1997). Although these records indicate that the Veteran’s lung disability has an etiology that is “likely multifactorial,” to include tobacco use and his post-service occupational history, one of those factors is the Veteran’s active duty period (via exposure to herbicides and other material management toxins as a supply specialist). Such is sufficient to satisfy the third Holton prong. The Board does not afford the January 2020 VA examination probative weight as it is inadequate. While the VA examiner considered the Veteran’s exposure to herbicides, he did not consider and discuss his exposure to several material management toxins while serving as a supply specialist in the miliary. Furthermore, the VA examiner failed to provide an etiology regarding all of the Veteran’s lung disabilities. See McLain v. Nicholson, 21 Vet. App. 319, 321 (2007). For these reasons, the Board cannot afford the January 2020 VA examination any weight. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s lung disability is related to service. Accordingly, after resolving all reasonable doubt in favor of the Veteran, the Board finds that service connection is warranted. 38 U.S.C. § 5107. The nature and extent of the Veteran’s lung disability is not before the Board at this time. Caroline B. Fleming Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Finelli, 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.