Citation Nr: 21025349 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 03-21 773A DATE: April 27, 2021 ORDER Entitlement to service connection for the Veteran’s cause of death is granted. APPELLANT’S CONTENTIONS The appellant contends that service connection should be granted for the cause of the Veteran’s death, internal hemorrhage due to pulmonary tuberculosis. Specifically, the appellant reported that Veteran’s pulmonary tuberculosis had its clinical onset while the Veteran was on active duty. See October 1991 VA Form 9. The appellant and the Veteran began their life together in 1948, two years after the Veteran served on active duty. See January 1948 Marriage Certificate. The Veteran’s wife stated that ever since she knew him, the Veteran told her he had a lung condition. See October 1991 VA Regional Office Hearing Transcript. The Appellant also submitted statements from various doctors that treated the Veteran from 1945 to 1949 who stated that the Veteran was treated for pulmonary tuberculosis. See Dr. H.R. Gacula’s Affidavit and Dr. B. Nerres’ Affidavit. Because the Veteran’s lung problems began in service, and could have been representative of the clinical onset of tuberculosis, she believes that service connection for the cause of his death is warranted. FINDINGS OF FACT 1. The Veteran died in July 1971. According to his death certificate, the immediate cause of death was an internal hemorrhage due to pulmonary tuberculosis; coronary heart disease was listed as a significant condition that contributed to death. 2. The Appellant is the surviving spouse. 3. A May 1974 Affidavit from Dr. R.R. Gacula stated that he began treating the Veteran in April 1946 for pulmonary tuberculosis. See May 1974 Affidavit. Additionally, Dr. Gacula stated that a 1948 chest x-ray revealed a bilateral apical lesion of pulmonary tuberculosis. Id. 4. The January 2021 independent medical expert concluded that although he did not know when the Veteran was infected with pulmonary tuberculosis, the physician noted that it was prevalent in the Philippines during World War II. See January 2021 Opinion. Given the prevalence of tuberculosis at that time, the physician concluded that it was at least as likely as not that the Veteran was infected at that time, and developed a chronic condition as a result. Id. CONCLUSION OF LAW The criteria for service connection for the cause of the Veteran's death are met. 38 U.S.C. §§ 1110, 1154(b), 1310, 5107; 38 C.F.R. §§ 3.102, 3.302, 3.303, 3.312. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the Philippine Commonwealth Army, including service in the Armed Forces of the United States, from December 20, 1941 to May 16, 1946. The Veteran passed away in July 1971. The appellant is the Veteran’s surviving spouse. The claim was denied by the Board in January 1992. This decision became final. A February 2007 Board decision reopened the claim and remanded for further development. The Board remanded this issue in February 2007, June 2010, and December 2020. Entitlement to service connection for cause of death is granted. Service connection for cause of death may be awarded to a veteran's surviving spouse for death resulting from a service-connected disability or a disability related to service. 38 U.S.C. § 1310; 38 C.F.R. § 3.312. To establish service connection for the cause of the Veteran's death, the evidence must show that a disability incurred in or aggravated by service either caused or contributed substantially or materially to cause death. The death of a veteran will be considered as having been due to a service-related disability when the evidence establishes that such disability was either the principal or the contributory cause of death. Id. In the instant case, after reviewing the evidence of record, the Board concludes that the Veteran’s tuberculosis could have been service-connected during his lifetime and that it was one of the causes of his death. In support of this determination, the Board relies upon the opinions of the January 2021 independent medical expert which concluded that the Veteran’s pulmonary tuberculosis was at least as likely as not contracted during the Veteran’s service because of the prevalence of tuberculosis in the Philippines during World War II. Further, the January 2021 independent medical expert explained that that the May 1974 Affidavit from Dr. Gacula, which confirmed that a 1948 x-ray showed the Veteran had tuberculosis, was the best evidence to prove that the Veteran had tuberculosis during service. Id. Further, the Veteran’s July 1942 Service Treatment Records show that the Veteran complained of chest pain and a chronic cough during service. The expert also acknowledged that the Veteran’s chronic cough could have been a symptom of his tuberculosis. See March 2021 Medical Opinion. All of these findings weigh in favor of a finding that the Veteran contracted the tuberculosis which ultimately caused his death while he was on active duty. Moreover, the Board finds that there is no conclusive evidence that the Veteran’s in-service chest pain and chronic pain were not related to his tuberculosis or that the Veteran did not contract tuberculosis during service. The Board acknowledges that the record includes a March 2021 negative nexus opinion. The expert stated that due to the age of the diagnostics and the lack of concrete evidence demonstrating an in-service onset of tuberculosis, it was less likely than not that the Veteran’s tuberculosis had its onset in service. However, the examiner acknowledged that the Veteran’s in-service cough could have been caused by disorders including pulmonary tuberculosis. Further, this examiner failed to address the Veteran’s in-service complaints of chest pain to determine whether it was related to his later diagnosed tuberculosis. See July 1942 Service Treatment Record. As the examiner noted that the Veteran’s in-service cough could have been due to pulmonary tuberculosis, the Board finds that the opinion is internally inconsistent because it contradicts with its negative finding. As such, the March 2021 addendum opinion is of little probative value. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Thus, resolving any existing doubt raised by the conflicting opinions in the Veteran’s favor, the Board finds that the evidence regarding whether his tuberculosis was related to service is at least in equipoise. 38 U.S.C.S. § 5107; 38 C.F.R. § 3.102. Accordingly, service connection for the Veteran’s cause of death is warranted. S.C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Foster, 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.