Citation Nr: 21027027 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 17-67 066 DATE: May 4, 2021 ORDER Entitlement to service connection for myasthenia gravis is denied. Entitlement to service connection for a heart condition is denied. Entitlement to service connection for peripheral neuropathy of right upper extremity is denied. Entitlement to service connection for peripheral neuropathy for the left upper extremity is denied. Entitlement to service connection for peripheral neuropathy of the right lower extremity is denied. Entitlement to service connection for peripheral neuropathy of the left lower extremity is denied. Entitlement to service connection for a right knee condition is denied. Entitlement to service connection for a left knee condition is denied. Entitlement to service for sleep apnea is denied. Entitlement to service connection for lymphedema of the right lower extremity is denied. Entitlement to service connection for lymphedema of the left lower extremity is denied. Entitlement to service connection for skin cancer is denied. Entitlement to service connection for blisters on the skin is denied. Entitlement to service connection for rashes on the skin is denied. FINDINGS OF FACT 1. The evidence does not show that the Veteran's myasthenia gravis had its onset in service, manifested to a compensable degree within one year of separation, or is otherwise related to service, to include as due to herbicide exposure. 2. The evidence does not show that the Veteran's heart condition is related to service to include as due to herbicide exposure. 3. The evidence does not show that the Veteran's peripheral neuropathy of the right upper extremity is related to service to include as due to herbicide exposure. 4. The evidence does not show that the Veteran's peripheral neuropathy of the left upper extremity is related to service to include as due to herbicide exposure. 5. The evidence does not show that the Veteran's peripheral neuropathy of the right lower extremity is related to service to include as due to herbicide exposure. 6. The evidence does not show that the Veteran's peripheral neuropathy of the left lower extremity is related to service to include as due to herbicide exposure. 7. The evidence does not show that the Veteran's right knee condition had its onset in service, manifested to a compensable degree within one year of separation, or is otherwise related to service. 8. The evidence does not show that the Veteran's left knee condition had its onset in service, manifested to a compensable degree within one year of separation, or is otherwise related to service. 9. The evidence does not show that the Veteran's sleep apnea had its onset in service or is otherwise related to service to include as due to herbicide exposure. 10. The evidence does not show that the Veteran's lymphedema of the right lower extremity had its onset in service or is otherwise related to service. 11. The evidence does not show that the Veteran's lymphedema of the left lower extremity had its onset in service or is otherwise related to service. 12. The evidence does not show that the Veteran's skin cancer had its onset in service or is otherwise related to service to include as due to herbicide exposure.. 13. The evidence does not show that the Veteran's skin condition manifesting in blisters had its onset in service or is otherwise related to service to include as due to herbicide exposure.. 14. The evidence does not show that the Veteran's skin condition manifesting in rashes had its onset in service or is otherwise related to service to include as due to herbicide exposure.. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for myasthenia gravis have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for entitlement to service connection for coronary artery disease have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 3. The criteria for entitlement to service connection for peripheral neuropathy of right upper extremity have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 4. The criteria for entitlement to service connection for peripheral neuropathy for the left upper extremity have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 5. The criteria for entitlement to service connection for peripheral neuropathy of the right lower extremity have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 6. The criteria for entitlement to service connection for peripheral neuropathy of the left lower extremity have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 7. The criteria for entitlement to service connection for a right knee condition have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 8. The criteria for entitlement to service connection for a left knee condition have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 9. The criteria for entitlement to service for sleep apnea have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 10. The criteria for entitlement to service connection for lymphedema of the right lower extremity have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 11. The criteria for entitlement to service connection for lymphedema of the left lower extremity have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 12. The criteria for entitlement to service connection for skin cancer have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 13. The criteria for entitlement to service connection for blisters on the skin. have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 14. The criteria for entitlement to service connection for rashes on the skin have not been 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 had active duty from February 1969 to January 1971. The Veteran died in April 2020. The Appellant his surviving spouse. Service Connection To establish service connection for a disability, the evidence must show: (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 (Fed. Cir. 2004). For certain chronic disorders, such as coronary artery disease, arthritis, and myasthenia gravis, service connection may be granted if the disease becomes manifest to a compensable degree within one year following separation from service. See 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309. When a disease listed at 38 C.F.R. § 3.309(a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service. See 38 C.F.R. § 3.303(b). However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309(a) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be established on a secondary basis for a disability which is shown to be proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show that a current disability exists and that the current disability was either caused by or aggravated by a service-connected disability. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995). Service connection may also be granted for specific diseases associated with exposure to herbicide agents. 38 C.F.R. § 3.309(e). If a veteran was exposed to a herbicide agent during active military, naval, or air service, the following diseases shall be service-connected if the requirements of 38 C.F.R. § 3.307(a)(6) are met, despite any lack of evidence of such disease during service provided that the rebuttable presumption provisions of 38 C.F.R. § 3.307(d) are also satisfied: AL amyloidosis; chloracne or other acneform disease consistent with chloracne; Type II diabetes; Hodgkin's disease; ischemic heart disease; all chronic B-cell leukemias; multiple myeloma; non-Hodgkin's lymphoma; Parkinson's disease; acute and subacute peripheral neuropathy; porphyria cutanea tarda; prostate cancer; respiratory cancers; and soft-tissue sarcoma. A Veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975 shall be presumed to have been exposed during such service to an herbicide agent unless there is affirmative evidence to establish that the Veteran was not exposed to any such agent during that service. 38 U.S.C. § 1116(f); 38 C.F.R. § 3.307(a)(6). For the purposes of § 3.307, the term herbicide agent means a chemical in an herbicide used in support of the United States and allied military operations in the Republic of Vietnam during the Vietnam era. 38 C.F.R. § 3.307(a)(6)(i). The diseases listed at § 3.309(e) shall have shall have become manifest to a degree of 10 percent or more at any time after service, except that chloracne, porphyria cutanea tarda, and early-onset peripheral neuropathy shall have become manifest to a degree of 10 percent or more within a year after the last date on which the veteran was exposed to an herbicide agent during active military, naval, or air service. 38 C.F.R. § 3.307 (a)(6)(ii). The Veteran asserted that he was exposed to Agent Orange in the 1969 or 1970 in Camp Pendleton, California when he was tasked with cleaning the inside and outside of tactical vehicles that came from Vietnam. See March 2015 Statement. He reported that, "it was obvious the vehicles returned from battle in Vietnam because they had bullet holes and dents in them." During the February 2020 Board hearing, the Veteran reported that the mud on the vehicles he serviced was "different." He reported he did not wear gloves, face masks, or any other protection. The Veteran also asserted that he used dangerous chemicals during cleaning in service. A July 2015 VA Memorandum found the evidence was insufficient to corroborate Agent Orange exposure outside of Vietnam. It was noted that Camp Pendleton, California is not listed on the "Information from Department of Defense on Herbicide Test and Storage Outside of Vietnam" list. In a November 2015 letter, private physician G.A.H. opined that the Veteran may have been exposed to herbicides in service and that exposure may have caused his medical conditions. Dr. G.A.H. reiterated the Veteran's contentions that he was responsible for maintenance of muddy armored vehicles that returned Vietnam. Dr. G.A.H. stated, "[The Veteran] may have had significant exposure to Agent Orange. He says these vehicles came back from Vietnam. He was around the dust, the inside and outside of these vehicles on a daily, very close basis. I am suspicious that many of his symptoms and problems may be related to an exposure during this time of his life." The Veteran also submitted a July 2016 statement from S.J.S., a reported combat marine Veteran from 1966 to 1967, asserting that tanks and Ontos vehicles were exposed to Agent Orange. He asserts, "it should be obvious that both personnel and equipment were exposed to Agent Orange at some point. I have no knowledge of any system that was in place to decontaminate any tracked vehicles that served under those conditions before returning to the United States." The Agency of Original Jurisdiction (AOJ) contacted several agencies in an attempt to verify the Veteran's statements. See March 2017 Correspondence. The AOJ obtained Command Chronologies for the Veteran's unit for 1969 and 1970. The information did not establish that the Veteran had been exposed to herbicides at Camp Pendleton. See also November 2017 Correspondence. May 2017 and November 2017 memorandums concluded that based on the 1969 and 1970 Command Chronologies for Maintenance Battalion, 5th Force Service Regiment, FMF, Camp Pendleton, CA from the Marine Corps Historical Center, there is no evidence of contaminated vehicles or exposure to tactical herbicides. It was further noted that there is no scientific evidence showing the being in the vicinity of an aircraft or equipment previously used in Vietnam can be considered exposure to active Agent Orange or can result in long-term health effects. The Veteran also submitted articles and photos regarding the Ontos tracked armored vehicles, maps detailing where defoliants were sprayed in Vietnam, and an article discussing the potential health effects associated with certain chemicals in cleaning supplies. Medical treatise evidence can, in some circumstances, constitute competent medical evidence. Wallin v. West, 11 Vet. App. 509, 514 (1998); see also 38 C.F.R. § 3.159(a)(1). However, the articles submitted by the Veteran does not contain any information or analysis specific to the Veteran's case. As such, this evidence is of limited probative value. The Board has considered the Veteran's statement regarding the onset of his disabilities and concludes that many of the assertions are inconsistent with the objective medical evidence of record. As such, the Board finds the evidence insufficient to conclude that the Veteran was exposed to herbicides in service. Furthermore, for the reasons described below, the Board finds that the evidence does not show that the Veteran's conditions had their onset in service or are otherwise related to service. 1. Entitlement to service connection for myasthenia gravis. The Veteran claims entitlement to his myasthenia gravis is related to herbicide exposure in service. The evidence shows that during the appeal period the Veteran had a diagnosis of myasthenia gravis in remission. As a diagnosis is shown, the issue that remains disputed is whether the Veteran's condition is related to service or manifested to a compensable degree within one year of separation. The preponderance of the evidence is against the claim. As an initial matter, herbicide exposure is not established by the record. Notably, myasthenia gravis is not a disability for which presumptive service connection based on herbicide exposure can be granted. Service connection on a direct basis is also not warranted. Service treatment records are silent for complaints of or treatment for myasthenia gravis. Finally, the Board has also considered whether the service connection is warranted on a presumptive basis based on chronic disability. However, the evidence does not show that the Veteran's myasthenia gravis manifested to a compensable degree within one year of separation. See 38 C.F.R. §§ 3.307, 3.309. A November 1986 private treatment note indicates the Veteran reported that his myasthenia gravis symptoms began in 1985 with drooping of the right eyelid. In a July 2015 statement, the Veteran reported that he was diagnosed with myasthenia gravis in 1986. As the Veteran's condition did not begin until approximately 14 years after separation, service connection based on a chronic disability is not warranted. The only evidence suggesting a relationship between the Veteran's myasthenia gravis disability and service are his statements, and the Veteran is not competent to provide an opinion on issues requiring medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). The Veteran was not afforded a VA examination because the evidence was insufficient to trigger an examination. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); see 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(i). In sum, there is no legal basis for which service connection for myasthenia gravis is established. As the preponderance of the evidence is against the Veteran's claim, the doctrine of reasonable doubt does not apply. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 2. Entitlement to service connection for a heart condition. The Veteran asserts that his heart condition is related to herbicide exposure in service. The Veteran showed heart diagnosis of cardiomyopathy. As a diagnosis is shown, the issue that remains disputed is whether the Veteran's condition is related to service or manifested to a compensable degree within one year of separation. The preponderance of the evidence is against the claim. As herbicide exposure is not established by the record, presumptive service connection based on such exposure is not warranted. Service connection on a direct basis is also not warranted. Service treatment records are silent for complaints of or treatment for a heart condition. Private treatment records show that the Veteran was diagnosed with a heart condition in the 1990s. Notably, he reported a family history of heart disease in his mother. See June 2015 Private Treatment Records. The Board has also considered whether the service connection is warranted on a presumptive basis based on a chronic disability. However, the evidence does not show and the Veteran does not assert that his heart condition manifested to a compensable degree within one year of separation. See 38 C.F.R. §§ 3.307, 3.309. The only evidence suggesting a relationship between the Veteran's heart condition and service are his statements, and the Veteran is not competent to provide an opinion on issues requiring medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). The preponderance of the evidence does not show that the Veteran's heart condition is related to service to include as due to herbicide exposure. As the preponderance of the evidence is against the Veteran's claim, the doctrine of reasonable doubt does not apply. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 3. Entitlement to service connection for peripheral neuropathy of right upper extremity. 4. Entitlement to service connection for peripheral neuropathy for the left upper extremity The Veteran asserts that his peripheral neuropathy had its onset in service or is related to herbicide exposure. During the February 2020 Board hearing, he reported he began to experience numbness and a burning sensation in his hands shortly after separation from service. A June 2015 private treatment note shows a diagnosis of peripheral neuropathy of the upper extremities. As a diagnosis is shown, the issue that remains disputed is whether the Veteran's condition is related to service to include herbicide exposure in service. The preponderance of the evidence is against the claim. As herbicide exposure is not established by the record, presumptive service connection based on such exposure is not warranted. Service connection on a direct basis is also not warranted. Service treatment records are silent for complaints of or treatment for complains of or treatment for symptoms up the arms or hands. The Veteran's 1971 clinical evaluation at separation showed normal upper extremities. Notably, a September 2002 treatment note indicates the Veteran reported the he had not had any neurologic symptoms since his myasthenia gravis had been in remission. In June 2004, the Veteran complained of decreased sensation in the wrists bilaterally. The medical service provider noted that this was more consistent with peripheral neuropathy. The neurologist further stated, "Interestingly, he tells me that he has now found a couple other people in his family that have the same thing. This is likely familial in his case." A May 2015 private treatment note indicates the Veteran complained of cramping and loss of strength in his hands. He reported dropping things. He reported cramping had been present for approximately a year. It was noted that the exact etiology of his progressive peripheral neuropathy had not been determined. The only evidence suggesting a relationship between the Veteran's peripheral neuropathy of the right and left upper extremities and service are his statements, and the Veteran is not competent to provide an opinion on issues requiring medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). The preponderance of the evidence does not show that the Veteran's peripheral neuropathy of the right and left upper extremities is related to service to include as due to herbicide exposure. As the preponderance of the evidence is against the Veteran's claim, the doctrine of reasonable doubt does not apply. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 5. Entitlement to service connection for peripheral neuropathy of the right lower extremity 6. Entitlement to service connection for peripheral neuropathy of the left lower extremity The Veteran asserts that his peripheral neuropathy is related to herbicide exposure in service. During the February 2020 Board hearing, he reported he began to experience burning and reduced sensation in his feet shortly after separation from service. A February 2003 EMG showed a diagnosis of peripheral neuropathy of the lower extremities. As a diagnosis is shown, the issue that remains disputed is whether the Veteran's condition is related to service to include herbicide exposure in service. The preponderance of the evidence is against the claim. As herbicide exposure is not established by the record, presumptive service connection based on such exposure is not warranted. Service connection on a direct basis is also not warranted. Service treatment records are silent for complaints of or treatment for complains of or treatment for symptoms of the legs or feet. The Veteran's 1971 clinical evaluation at separation showed normal lower extremities. In June 2004, the Veteran complained of severe cramping in the legs. He reported decreased sensation just below the knees bilaterally. The medical service provider noted that this was more consistent with peripheral neuropathy. The neurologist further stated, "Interestingly, he tells me that he has now found a couple other people in his family that have the same thing. This is likely familial in his case." The only evidence suggesting a relationship between the Veteran's peripheral neuropathy of the right and left lower extremities and service are his statements, and the Veteran is not competent to provide an opinion on issues requiring medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). The preponderance of the evidence does not show that the Veteran's peripheral neuropathy of the right and left lower extremities is related to service to include as due to herbicide exposure. As the preponderance of the evidence is against the Veteran's claim, the doctrine of reasonable doubt does not apply. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 7. Entitlement to service connection for a right knee condition 8. Entitlement to service connection for a left knee condition The Veteran asserted that his bilateral knee condition was related to injuries in service. During the appeal period, the Veteran had diagnoses of osteoarthritis of the bilateral knees. The issue that remains disputed is whether the Veteran's condition had its onset in service, manifested to a compensable degree within one year of separation or is otherwise related to service. The preponderance of the evidence is against the claim. On the November 1968 entrance examination, the Veteran reported having a knee operation prior to enlisting. On clinical evaluation there was no sequelae shown. Service treatment records are silent for complaints of or treatment for a knee injury in service. The January 1971 separation clinical evaluation showed normal lower extremities. A June 2008 private treatment record indicates the Veteran was seeking recommendations for bilateral knee pain. He reported having difficulty with his knees for many years including undergoing a meniscectomy on the left knee in 1965. He reported having his left knee scoped again in 1985 and a right knee arthroscopy in 1968. The Veteran had a bilateral knee replacement in 2008. In a July 2015 statement, the Veteran reported that whenever he opened the armored vehicle Ontos for maintenance purposes, the hatch would hit him in both knees. In the February 2020 hearing, he stated that his right and left knee conditions are related to an incident in service when he fell backwards. However, a private treatment note indicates that the Veteran sustained an injury to both of his knees in June 2003. The Veteran was working as an insurance fire inspector and had to jump over a landing area that was not intact when he landed. He twisted his right knee and felt pain in his left knee also. The attended physical therapy through Workman's Compensation for his knee disabilities. The only evidence suggesting a relationship between the Veteran's bilateral knee disability and service are his statements, and the Veteran is not competent to provide an opinion on issues requiring medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). The Board has also considered whether the service connection is warranted on a presumptive basis. However, the evidence does not show and the Veteran does not assert that his osteoarthritis if the bilateral knees manifested to a compensable degree within one year of separation. See 38 C.F.R. §§ 3.307, 3.309. In sum, the evidence is not sufficient to show that the Veteran's right and left knee conditions are related to service. Thus, service connection for right and left knee conditions is denied. 9. Entitlement to service for sleep apnea. The Veteran asserts that his sleep apnea had its onset in service or is related to herbicide exposure in service. During the February 2020 he reported that his roommate in service complained about his snoring. In a July 2015 statement, P.A.H. stated that she met the Veteran in 1971 and they were married in 1972. She reported that he was always a heavy snorer. The evidence shows the Veteran was diagnosed with sleep apnea in July 2001. The issue that remains disputed is whether Veteran's condition is related to service, to include as due to herbicide exposure. The preponderance of the evidence is against the claim. As herbicide exposure is not established by the record, service connection based on such exposure is not warranted. Service connection on a direct basis is also not warranted. Service treatment records are silent for complaints of or treatment for a sleep or breathing disorder. Private treatment records show the Veteran reported a family history of sleep apnea in his brother. Although the Veteran reported he snored since service, the evidence is not sufficient to establish that his sleep apnea had its onset in service. The only evidence suggesting a relationship between the Veteran's sleep apnea and service are his statements, and the Veteran is not competent to provide an opinion on issues requiring medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). The preponderance of the evidence does not show that the Veteran's sleep apnea is related to service to include as due to herbicide exposure. As the preponderance of the evidence is against the Veteran's claim, the doctrine of reasonable doubt does not apply. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 10. Entitlement to service connection for lymphedema of the right lower extremity. 11. Entitlement to service connection for lymphedema of the left lower extremity. The Veteran asserts that his lymphedema of the bilateral lower extremities is related to herbicide exposure in service. As private treatment records show a current diagnosis of lymphedema of the bilateral lower extremities. The issue that remains disputed is whether the Veteran's condition is related to service. The preponderance of the evidence is against the claim. Service treatment records are silent for complaints of pain or swelling in the bilateral lower extremities and there is no diagnosis of lymphedema shown. The January 1971 separation clinical evaluation showed normal lower extremities. As there is no evidence of that the Veterans lymphedema had its onset in service, service connection on a direct basis is not warranted. An April 2009 private treatment note indicates that the Veteran's lymphedema of the bilateral lower extremities was due to his October 2008 bilateral knee replacement surgery. As the Veteran is not service connected for a right or left knee condition, service connection on a secondary basis is not warranted. In sum, the evidence does not show that the Veteran's lymphedema had its onset in service or is related to a service-connected condition. As such, service connection for lymphedema of the right and left lower extremities is denied. 12. Entitlement to service connection for skin cancer. The Veteran asserts that his skin cancer is relate to herbicide exposure in service. A private treatment note shows the Veteran was diagnosed with and treated for basal cell skin cancer in October 2010. The issue that remains disputed is whether Veteran's condition is related to herbicide exposure in service. The preponderance of the evidence is against the claim. As herbicide exposure is not established by the record, service connection based on such exposure is not warranted. Service connection on a direct basis is also not warranted. Service treatment records are silent for complaints of or treatment for a skin condition and the evidence does not show that the Veteran was treated for skin cancer until over 30 years after separation. The only evidence suggesting a relationship between the Veteran's skin cancer and service are his statements, and the Veteran is not competent to provide an opinion on issues requiring medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). The preponderance of the evidence does not show that the Veteran's skin cancer is related to service to include as due to herbicide exposure. As the preponderance of the evidence is against the Veteran's claim, the doctrine of reasonable doubt does not apply. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 13. Entitlement to service connection for blisters on the skin. The Veteran asserts that his chronic blisters are related to herbicide exposure in service. He asserted that after cleaning muddy armored vehicles in service he would get blisters on his hands and lips. See July 2015 Correspondence. He reported he would go to sick bay and was treated with a white salve. He reported that blisters would resolve for a short period and then return. He stated that he continued to have blisters after separation. The evidence shows that the Veteran had diagnosis of seborrheic keratosis and treatment for chronic blisters. The issue that remains disputed is whether the Veteran's condition is related to service to include as due to herbicide exposure. The preponderance of the evidence is against the claim. As herbicide exposure is not established by the record, service connection based on such exposure is not warranted. In addition, the evidence does not support service connection on a direct basis. Service treatment records are silent for complaints of or treatment for a skin condition. The Veteran's 1971 clinical evaluation at separation showed normal skin. In a July 2015 statement the Appellant reported that when she first met the Veteran in September 1991, he was being treated for severe blistering conditions. However, the objective medical evidence does not show that continuity of treatment for a blistering condition from service. The preponderance of the evidence does not show that the Veteran's seborrheic keratosis is related to service to include as due to herbicide exposure. As the preponderance of the evidence is against the Veteran's claim, the doctrine of reasonable doubt does not apply. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 14. Entitlement to service connection for rashes on the skin. The Veteran asserts that his chronic rashes are related to herbicide exposure in service. During the February 2020 Board Hearing, the Veteran reported that after cleaning mud off armored vehicles in service he got a severe, bleeding rash on his hand. He reported it was treated at sick bay but kept coming back and continued to get worse. He reported years later he was tested for allergies and was found to be allergic to rubber, adhesive on band aids, gas, and any other petrol products. See also July 2015 Correspondence. The evidence shows a diagnosis of eczema. The issue that remains disputed is whether the Veteran's condition is related to service to include as due to herbicide exposure. The preponderance of the evidence is against the claim. As herbicide exposure is not established by the record, service connection based on such exposure is not warranted. Service connection on a direct basis is also not warranted. Service treatment records are silent for complaints of or treatment for a skin condition in service. The Veteran's 1971 clinical evaluation at separation showed normal skin. A November 1986 treatment record indicate the Veteran reported eczema of the hands for the past 2 to 3 years. He reported a family history of pemphigus, which is a group of chronic, relapsing, sometimes fatal autoimmune diseases of the skin, characterized clinically by successive crops of vesicles and blisters. See DORLAND'S ILLUSTRATED MEDICAL DICTIONARY (DORLAND'S), 1404 (32nd ed. 2012). In a July 2015 statement, P.A.H. stated that she met the Veteran in 1971 and they were married in 1972. She reported that he always had problems with skin rashes. In a July 2015 statement the Appellant reported that when she first met the Veteran in September 1991, he was being treated for rashes on the skin and that since she had known him, he experienced rashes on most of his body. She reported that any product that contained parabens would cause immediate rash. She reported that during his knee surgery it was discovered that he was allergic to polymer and glue. The objective evidence of record does not show that the Veteran experienced rash symptoms in service that continued after separation. The preponderance consistently showed that the Veteran had a family history of skin conditions and that he has numerous allergies that often resulted in skin rashes. The preponderance of the evidence does not show that the Veteran's skin rashes are related to service to include as due to herbicide exposure. As the preponderance of the evidence is against the Veteran's claim, the doctrine of reasonable doubt does not apply. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.A. Williams, 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.