Citation Nr: 21025536 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 16-26 343 DATE: April 28, 2021 ORDER Entitlement to service connection for a respiratory disability, to include bronchitis is denied. FINDING OF FACT The preponderance of the evidence is against finding that a respiratory disability, to include bronchitis began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for a respiratory disability, to include bronchitis 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 October 1973 to December 1974. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an October 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board previously remanded this issue in October 2018 and August 2019. Entitlement to service connection for a respiratory disability, to include bronchitis is denied. The Veteran seeks service connection for a respiratory disability, to include bronchitis by virtue of his military occupational specialty. In the February 2015 notice of disagreement, the Veteran asserted that his disability is related to heavy dust exposure on a daily basis in his duties as a light wheel mechanic. The Veteran asserts that he received treatment in-service for bronchitis and has continued to experience symptoms since separation. At the May 2019 VA examination, the Veteran reported that he had a respiratory disability in service with symptoms of coughing, fever, shortness of breath, and chills requiring bed rest for 7 days. 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). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. Service treatment records are silent for symptoms, diagnosis or treatment for a chronic respiratory disability. In a February 1974 medical history related to dental treatment, the Veteran selected “no” to having ever had shortness of breath, swelling of ankles, or palpitation of heart, and lung disease. Similarly, in a December 1974 report of medical history at separation, the Veteran checked “no” to having had chronic or frequent colds, shortness of breath, pain or pressure in the chest, and chronic cough. The December 1974 separation examination noted normal lung and chest. In a subsequent December 1974 statement of medical condition, the Veteran indicated that he underwent a separation medical examination more than three days prior to separation from service but there had been no change in his medical condition. Post-service, the Veteran reported a history of acute bronchitis in November 2011. See also December 2013 VA treatment records (reporting past treatment for bronchitis and occasional shortness of breath). The Veteran related his respiratory condition to his smoking history in August 2012. Treatment records note an extensive, 40 year history of smoking one pack per day in May 2014 VA treatment records. In May 2014, the Veteran presented with respiratory symptoms ongoing for the past two weeks, but he denied a history of lung disease, chronic obstructive pulmonary disease (COPD), or asthma. The impression was bronchitis. In May 2016, VA obtained an opinion regarding this claim. The examiner opined that it is less likely than not that the Veteran’s diagnosed chronic bronchitis condition is related to in-service activities, illnesses, or exposures, including inhaled brake dust. In October 2018, the Board found this nexus opinion inadequate for the purposes of adjudicating the current appeal and remanded the claim for a VA examination and another opinion. Pursuant to the Board’s remand, the Veteran was afforded an examination as to respiratory conditions in May 2019 with a medical opinion. The Veteran was noted to have a diagnosis of COPD but not chronic bronchitis. The Veteran reported that his disability had onset in service where he was ill for 7 days and confined to his beds. The Veteran reported symptoms at that time included coughing, fever, shortness of breath, and chills. However, the Veteran reported that he was not seen by medical. The Veteran also reported smoking for 55 years, with one pack per day. Chest X-ray showed air trapping, without suspicious mass, pneumonia, or pneumothorax. In the accompanying medical opinion, the examiner gave a negative opinion as to the relationship between the Veteran’s service and his current disabilities. The examiner noted mostly subjective symptoms. With a normal chest X-ray and normal physical examination, the examiner indicated that there was no diagnosis of chronic bronchitis. Although the Veteran has prior treatment for acute bronchitis, there was no record of continuous care or repeated attacks. In December 2019, the Veteran was afforded another VA examination as to respiratory conditions. The examiner noted a diagnosis of restrictive lung disease and acute bronchitis. The Veteran reported onset of acute bronchitis in 1973, and the examiner noted acute bronchitis in 2011, 2012, 2013, and 2014. In the accompanying medical opinion, the examiner opined that it is less likely than not that the Veteran’s respiratory disability was related to service. The examiner reasoned that there were no chronic bronchitis or lung conditions indicated in the medical record until many years after service. Although there was an acute episode of bronchitis, as reported by the Veteran, in 1973, there was no chronic bronchitis noted. The Veteran’s smoking history totaled 55 years, and is the most likely etiology for his disability. Further, there was no evidence of excessive exposure to brake dust and the current records do not document a significant impact on his lungs in the manner consistent with a history of excessive exposure. The examiner further explained that the most recent disability examination showed no chronic bronchitis. However, the May 2019 disability pulmonary function testing showed restriction as the primary lung diagnosis and not COPD as previously stated. There was no evidence of bronchitis. The Board finds the December 2019 examiner’s opinion probative because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The examiner had the appropriate training, expertise and knowledge to evaluate the claimed disability and provided a cogent rationale based on consideration of the evidence as a whole, the Veteran’s reported symptoms, and the entire clinical history. Furthermore, there are no competent opinions to the contrary. While the Veteran is competent to report having experienced respiratory symptoms, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of his current disability. The issue is medically complex, as it requires knowledge of multiple organ systems in the body and an understanding of internal process, and interpretation of complicated diagnostic medical testing . Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Furthermore, the Veteran reported a prolonged illness in service which included being bedridden for 7 days. However, the Veteran also reported that he did not received treatment for the claimed respiratory condition. The Board notes that the current assertion of having experienced a prolonged respiratory illness during service and the contrary evidence found in service treatment record are inconsistent. See Kahana v. Shinseki, 24 Vet. App. 428, 440 (2011). Such a severe and thus, memorable illness, is inconsistent with the Veteran’s statements of his medical history in February 1974 and his report of medical history at separation. Consequently, the Board gives more probative weight to the December 2019 VA examiner’s opinion and cumulative evidence which does not reflect a significant respiratory condition in service or a causal connection between a current respiratory disorder and military service. In sum, the evidence weighs against a nexus between the Veteran’s current respiratory disability and military service. Accordingly, the benefit of the doubt doctrine does not apply. Service connection is not warranted. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Vuong, 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.