Citation Nr: 21026483 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 15-29 743 DATE: May 3, 2021 ORDER Service connection for a disorder of the pancreas, claimed as spots on the pancreas, including as due to lymphoma and exposure to contaminated water at Camp Lejeune, is granted. Service connection for benign growth behind organs is denied. Service connection for high blood pressure due to collapsed artery is denied. Service connection for kidney compressed artery post stent is denied. Service connection for an autoimmune disorder is denied. FINDINGS OF FACT 1. The Veteran has a diagnosis of mild pancreatic ductal dilation which has been attributed to her exposure to contaminated water at Camp Lejeune and her service connected lymphoma. 2. The preponderance of the evidence is against finding that benign growth behind organs, high blood pressure due to collapses artery, kidney compressed artery post stent are related to the Veteran's service, to include her exposure to contaminated water at Camp Lejeune and/or her service connected lymphoma. 3. The preponderance of the evidence is against a finding that the Veteran has a diagnosed autoimmune disorder. CONCLUSIONS OF LAW 1. The criteria for service connection for a disorder of the pancreas are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for benign growth behind organs, high blood pressure due to collapses artery, kidney compressed artery post stent, and an autoimmune disorder are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1974 to February 1977. The Veteran testified before the undersigned Veterans Law Judge at a hearing in May 2019; a copy of the transcript is of record. At the outset, the Board notes that the Veteran originally filed her claim for service connection for spots on her pancreas. However, pursuant to the Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009), the Board has re-characterized the issue on appeal as service connection for a disorder of the pancreas, which will provide the most potentially favorable review of the Veteran's claim in keeping with the Court's holding in Clemons. Service Connection Service connection requires competent evidence showing: (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303(a). Also, effective March 14, 2017, VA amended 38 C.F.R. §§ 3.307 and 3.309 providing a presumption of service connection for certain diseases based on exposure to contaminants present in the water supply at Camp Lejeune. The amendment defines "contaminants in the water supply" as the volatile organic compound trichloroethylene (TCE), perchloroethylene (PCE), benzene and vinyl chloride that were in the on-base water-supply systems located at United States Marine Corps Base Camp Lejeune, during the period beginning on August 1, 1953 and ending on December 31, 1987. In order to qualify for presumptive service connection under these provisions, there must be evidence of: (1) a diagnosis of one of the enumerated diseases under the new provision 38 C.F.R. § 3.309 (f), (i.e., adult leukemia, aplastic anemia and other myelodysplastic syndromes, bladder cancer, kidney cancer, liver cancer, multiple myeloma, non-Hodgkin's lymphoma, and Parkinson's disease), if manifest to a degree of 10 percent or more at any time after service; and (2) service of at least 30 days (consecutive or nonconsecutive) at Camp Lejeune during the period beginning on August 1, 1953, and ending on December 31, 1987. The rulemaking applies to claims received by or pending before VA on or after March 14, 2017. See 82 Fed. Reg. 9, 4173-4185 (January 13, 2017). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. In deciding the Veteran's claim, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event; or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant. In the current mater, though the Veteran was stationed at Camp Lejeune during the applicable period and exposure to contaminated water has been conceded, none of her claimed conditions are on the list of presumptive service connection conditions. Notwithstanding the presumption, however, service connection for a disability claimed as due to contaminated water at Camp Lejeune may be established by showing that a disorder resulting in disability was in fact causally linked to such exposure. Combee v. Brown, 34 F. 3d 1039, 1044 (Fed. Cir. 1994). Disorder of the Pancreas A VA examination in November 2020 as well as July 2020 and February 2021 VA examination opinions all determined that the Veteran had been diagnosed with mild pancreatic ductal dilation, which was associated with her diagnosis of b cell lymphoma. All the VA examiners found that the Veteran's mild pancreatic ductal dilation was due to her service connected b cell lymphoma and her exposure to contaminated water while stationed at Camp Lejeune. As such, service connection for the Veteran's mild pancreatic ductal dilation as due to service connected b cell lymphoma and exposure to contaminated water at Camp Lejeune is granted. Benign Growth Behind Organs High Blood Pressure due to Collapsed Artery Kidney Compressed Artery Post Stent As to the Veteran's claims for service connection for the growth behind her organs, her high blood pressure, and her kidney compressed artery post stent, none of the evidence of record established that these conditions were related to either the Veteran's service, to include her exposure to contaminated water at Camp Lejeune, or her service connected b cell lymphoma. The VA examination in November 2020 and the VA opinions in July 2020 and February 2021 did not find any link between the Veteran's claimed conditions and her active duty service, her exposure to contaminated water, or her service connected lymphoma. The examiners specifically noted that there were no service treatment records (STRs) which showed treatment for or diagnosis of these conditions. Specifically, the Veteran's high blood pressure was not diagnosed until several decades after service. There is no evidence of record which contradicts these reports or establishes a link between the Veteran's service including her exposure at Camp Lejeune or her service connected lymphoma. The Board has considered the Veteran's statements of record, including her hearing testimony. However, while the Veteran is credible in her report of her medical history and symptomology, she has not been shown to possess the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. King v. Shinseki, 700 F.3d 1339, 1345 (Fed.Cir.2012). The Board has concluded that the medical evidence, prepared by skilled professionals, is more probative regarding the etiology of the Veteran's claimed disabilities. As the preponderance of the evidence is against the claims, the benefit-of-the-doubt rule is not for application, and the claims must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Autoimmune Disorder As to the Veteran's claim for an autoimmune disorder, the VA examiners did not find that the Veteran has a diagnosed autoimmune disorder. Further, the Veteran reported in her July 2020 examination that she had not been diagnosed with such a disorder. 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. The Board concludes that the Veteran does not have a current diagnosis of an autoimmune disorder and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Board acknowledges the Veteran's statements however, the Veteran has not been shown to be competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377, n.4 (Fed. Cir. 2007). The Board gives more probative weight to the competent medical evidence which includes medical records and VA examination reports which show no diagnosis of an autoimmune disorder. Therefore, the preponderance of the evidence is against the claim. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish, 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.