Citation Nr: 21024926 Decision Date: 04/26/21 Archive Date: 04/26/21 DOCKET NO. 18-43 266 DATE: April 26, 2021 ORDER Service connection for chronic lymphocytic leukemia (CLL) is denied. FINDING OF FACT The Veteran does not have CLL. CONCLUSION OF LAW The criteria for service connection for CLL have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1966 to April 1972. The case is on appeal from a January 2015 rating decision. In March 2020, the Veteran testified at a Board hearing. The claim was last before the Board in March 2020. At that time, the Board dismissed the claims for an initial disability rating in excess of 50 percent for posttraumatic stress disorder (PTSD) prior to May 18, 2017; and in excess of 70 percent thereafter; and, a total disability rating based on individual unemployability (TDIU). The Board also remanded the claims of service connection for leukemia and anemia, to include as secondary to leukemia, for further development. While the case was in remand status, in a September 2020 rating decision, the RO granted service connection for T-cell large granular lymphocytic leukemia (to include anemia). The Board has limited the discussion below to the relevant evidence required to support its finding of fact and conclusion of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Service connection for CLL. Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: “(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 or aggravated during service.” Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Analysis The Veteran contends that he has CLL as a result of herbicide/Agent Orange exposure while serving in Vietnam. The Board notes that the Veteran’s contended leukemia presents overlapping symptoms. As noted previously, service connection for T-cell large granular lymphocytic leukemia with vitamin B12 deficiency and splenomegaly (to include anemia) as due to herbicide exposure was granted an evaluation of 100 percent, effective June 23. A subsequent November 2020 rating decision granted service connection for the same claim, effective February 2, 2015. The current claim before the Board is now specifically service connection for CLL as a result of herbicide exposure. Service treatment records (STRs) are silent for treatment or diagnosis of CLL. Post-service records show the Veteran is currently receiving treatment for T-cell large granular lymphocytic leukemia. Additionally, the Veteran was afforded VA examinations in July 2019 and September 2020. Both examiners provided that even though, in the past, the Veteran was diagnosed with CLL, his actual diagnosis is for T-cell large granular lymphocytic leukemia. CLL is a separate disease group and he does not have CLL. CLL was once shown to be associated with Agent Orange and T-cell lymphocytic leukemia was once considered a subtype of CLL. These examiners’ opinions establish that the Veteran does not have a CLL diagnosis. The examiners’ opinions are probative because they are based on accurate medical history and provide an explanation that contains clear conclusions and supporting data, including a explanation for the difference between CLL and the Veteran’s service-connected T-cell large granular lymphocytic leukemia. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). (Continued on the next page)   While the Veteran believes he has a current CLL diagnosis, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education and knowledge to make a diagnosis. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. In light of this evidence, the Board finds that the Veteran does not have CLL. As such, the preponderance of the evidence is against the claim and the benefit of the doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Accordingly, and service connection is not warranted for CLL. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Becton, 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.