Citation Nr: 21027123 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 19-16 835 DATE: May 4, 2021 ORDER Entitlement to service connection for chloracne, to include as due to exposure to toxic herbicide agents, is denied. Entitlement to service connection for multiple myeloma, to include as due to exposure to toxic herbicide agents, is denied. Entitlement to service connection for soft-tissue sarcoma, to include as due to exposure to toxic herbicide agents, is denied. Entitlement to service connection for Parkinson's disease, to include as due to exposure to toxic herbicide agents, is denied. FINDINGS OF FACT 1. The Veteran is presumed to have been exposed to herbicides coincident with service in the Republic of Vietnam. 2. The competent evidence does not demonstrate that the Veteran currently has chloracne, nor has he experienced such a condition during the pendency of the appeal or recent to the filing of the claim. 3. The competent evidence does not demonstrate that the Veteran currently has multiple myeloma, nor has he experienced such a condition during the pendency of the appeal or recent to the filing of the claim. 4. The competent evidence does not demonstrate that the Veteran currently has soft-tissue sarcoma, nor has he experienced such a condition during the pendency of the appeal or recent to the filing of the claim. 5. The competent evidence does not demonstrate that the Veteran currently has Parkinson's disease, nor has he experienced such a condition during the pendency of the appeal or recent to the filing of the claim. CONCLUSIONS OF LAW 1. Service connection for chloracne is not warranted. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. § 3.303, 3.307, 3.309. 2. Service connection for multiple myeloma is not warranted. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. § 3.303, 3.307, 3.309. 3. Service connection for soft-tissue sarcoma is not warranted. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. § 3.303, 3.307, 3.309. 4. Service connection for Parkinson's disease is not warranted. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. § 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1972 to January 1975, with confirmed service in the Republic of Vietnam during the Vietnam War era. These matters were affected by the Blue Water Navy Vietnam Veterans Act of 2019. Adjudication was stayed until January 1, 2020. The stay of adjudication has been lifted, and the Board will proceed with deciding these claims. Of note, the stay also impacted adjudication of the Veteran's claim of service connection for erectile dysfunction. However, as erectile dysfunction is not a condition subject to presumptive service connection pursuant to 38 C.F.R. § 3.307(a)(6), it has been separated from the four remaining issue listed above and will be the subject of a distinct Board decision to be issued in due course. Service Connection Entitlement to service connection requires evidence of three elements: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or nexus between the current disability and the disease or injury incurred or aggravated during active service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Furthermore, certain chronic diseases will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2012); 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). Toxic Herbicide Exposure VA regulations provide that for Veterans who served in Vietnam during a certain time period, selected diseases may be presumed to have resulted from exposure to herbicide agents such as Agent Orange. 38 U.S.C. § 1116(a)(2); 38 C.F.R. § 3.309(e). In relevant part, chloracne, multiple myeloma, soft-tissue sarcoma and Parkinson's disease are all listed under 38 C.F.R. § 3.307(a)(6) as conditions that warrant presumptive service-connection as attributable to herbicide exposure. By way of history, the Veteran in a June 2015 correspondence asserted that while aboard the USS Newport News an explosion occurred off the Cua Viet river; furthermore, he contended that he worked on a helicopter deck aboard the USS Newport News with personnel being transported to and from shore. The Agency of Original Jurisdiction (AOJ) promulgated a July 2015 memorandum determining that despite the Veteran's credible account of exposure to the offshore waters around the Republic of Vietnam during the Vietnam War era, the evidence was against a finding that he was exposed to toxic herbicide agents during service. Of note, a review of available personnel records confirms that the Veteran did serve aboard the USS Newport News. This determination became the basis of an August 2015 rating decision continuing the denial of the Veteran's previously denied claims of service connection for chloracne, multiple myeloma, soft-tissue sarcoma, Parkinson's disease. Following the further denial of the Veteran's appealed claims in an April 2019 statement of the case and the Veteran's formal appeal of those claims in June 2019, the United States Court of Appeals for the Federal Circuit (Federal Circuit) reversed its precedent from over a decade earlier to hold that herbicide agent exposure is presumed for veterans who "served in the Republic of Vietnam" based on service within the territorial sea of that country (so-called "Bluewater" veterans), instead of requiring that they set foot on land or navigated the inland waterways. Procopio v. Wilkie, 913 F.3d 1371 (Fed. Cir. 2019). Since that decision, Congress passed the Blue Water Navy Vietnam Veterans Act of 2019 ("the BWN Act") Pub. L. 116-23, to be codified at 38 U.S.C. § 1116A(c). That legislation supported the decision in Procopio and authorized VA to award disability benefits retroactively to Blue Water Navy Veteran's, or their survivors, who had previously submitted a claim for benefits that was denied by VA for lack of service on the landmass or inland waterways of Vietnam. As stated above, the Veteran's claim that had been certified for adjudication of the Board was stayed until January 1, 2020. In a March 2020 memorandum, a formal determination was made conceding the Veteran's exposure to toxic herbicide agents based on his nautical service in the offshore waters of the Republic of Vietnam during the Vietnam War era, as defined in the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23. (See VA Memorandum, March 23, 2020). Therefore, so long as the Veteran has a confirmed diagnosis of the four disabilities at issue, service connection is presumed for each such diagnosed condition as attributable to his presumed exposure to toxic herbicide agents. 1. Chloracne The Veteran seeks entitlement to service connection for chloracne, which he asserts is attributable to his exposure to toxic herbicide agents while in service in the Republic of Vietnam. Without delving into the question of the potential etiology of the chloracne, the Board finds that the Veteran has never been diagnosed with chloracne and there is no evidence to suggest that such a diagnosis is appropriate; as such, entitlement to service connection must be denied. The Veteran was afforded a VA skin examination in October 2020 to evaluate the nature and likely etiology of any claimed skin condition. When asked about his claimed chloracne, the Veteran reported that he developed chronic skin irritation and itching after his military service and that he would sometimes experience a rash on his side. He acknowledged that he did not receive any treatment for a skin condition. An in-person examination revealed no active abnormalities on the skin. Accordingly, the examiner declined to set forth a diagnosis of a skin condition, to specifically include chloracne. As the examiner reviewed the entirety of the claims file and based their findings on an in-person evaluation, the Board finds the lack of diagnosis to be highly probative. Sklar v. Brown, 5 Vet. App. 140 (1993). A review of available VA and private medical records does not reflect that the Veteran has ever been diagnosed with or treated for chloracne. During a February 2012 gastroenterology consultation, the Veteran denied experiencing any rash or itching. Thereafter, a dermatology consultation note dated in May 2012 shows that the Veteran reported developing numerous dark papules over his body that were diagnosed as seborrheic keratoses. During an August 2016 post-surgery evaluation the Veteran denied experiencing any skin problems. An October 2019 outpatient note indicates that the Veteran reported developing skin lesions all over his body. More recently, an August 2020 outpatient note shows that the Veteran complained of a sore on his ankle that was evaluated as nummular dermatitis or eczema. Ultimately, there is no competent evidence that the Veteran has chloracne or symptomatology that suggests that a diagnosis of the condition would be appropriate. Accordingly, without supporting records, the Board concludes that the Veteran does not have chloracne and has not had such a condition during the appeal period. The Veteran himself does not have the medical training or credentials to offer an opinion as to a diagnosis or its etiology. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Service connection is denied. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). As the preponderance of the evidence is against the Veteran's claim, the benefit-of-the-doubt standard of proof does not apply. 38 U.S.C. § 5107(b). 2. Multiple Myeloma The Veteran seeks entitlement to service connection for multiple myeloma, which he asserts is attributable to his exposure to toxic herbicide agents while in service in the Republic of Vietnam. Without delving into the question of the potential etiology of the multiple myeloma, the Board finds that the Veteran has never been diagnosed with multiple myeloma and there is no evidence to suggest that such a diagnosis is appropriate; as such, entitlement to service connection must be denied. The Veteran was afforded a VA hematologic and lymphatic conditions examination in October 2020 to evaluate the nature and likely etiology of the claimed multiple myeloma. When asked about his claimed multiple myeloma, the Veteran reported that he experienced sweating at night, balance issues, numbness and tingling in his left pain, as well as shoulder pain. The examiner noted that these reported symptoms were not typically associated with multiple myeloma. Indeed, the Veteran expressly denied experiencing many of the symptoms that characterize the condition, to include bone pain, fever, fatigue, nausea, constipation, loss of appetite, and weight loss. Accordingly, the examiner declined to endorse a diagnosis of multiple myeloma. As the examiner reviewed the entirety of the claims file and based their findings on an in-person evaluation, the Board finds the lack of diagnosis to be highly probative. Sklar, supra. A review of available VA and private medical records does not reflect that the Veteran has ever been diagnosed with or treated for multiple myeloma. During a February 2012 gastroenterology consultation, the Veteran reported that he experienced hand numbness. A September 2012 neurology consultation note reflects that the Veteran was evaluated by a neurologist who diagnosed him with upper extremity paresthesias attributable to cervicalgia and suspected cervical radiculopathy. Indeed, cervical spondylosis without myelopathy has continued to be listed as an active problem in the Veteran's VA medical records for the entirety of the appeal period. Ultimately, there is no competent evidence that the Veteran has multiple myelopathy or symptomatology that suggests that a diagnosis of the condition would be appropriate. Although the Veteran has exhibited some neurological deficits, namely, his reported hand paresthesias, this has never been attributed to diagnosable multiple myeloma. Accordingly, without supporting records, the Board concludes that the Veteran does not have multiple myeloma and has not had such a condition during the appeal period. The Veteran himself does not have the medical training or credentials to offer an opinion as to a diagnosis or its etiology. Jandreau, supra. Service connection is denied. Brammer, supra. As the preponderance of the evidence is against the Veteran's claim, the benefit-of-the-doubt standard of proof does not apply. 38 U.S.C. § 5107(b). 3. Soft-tissue Sarcoma The Veteran seeks entitlement to service connection for soft-tissue sarcoma, which he asserts is attributable to his exposure to toxic herbicide agents while in service in the Republic of Vietnam. Without delving into the question of the potential etiology of the soft-tissue sarcoma, the Board finds that the Veteran has never been diagnosed with soft-tissue sarcoma and there is no evidence to suggest that such a diagnosis is appropriate; as such, entitlement to service connection must be denied. As stated previously, the Veteran was afforded a VA hematologic and lymphatic conditions examination in October 2020. Although his claimed soft-tissue sarcoma was not explicitly addressed during this examination, the examiner also did not note that there was any evidence of any diagnosable condition, to include soft-tissue sarcoma. A review of available VA and private medical records does not reflect that the Veteran has ever been diagnosed with or treated for soft-tissue sarcoma. Without reiterating the evidence detailed above regarding the Veteran's history of complaints related to various dermatological symptoms he has experienced during the appeal period, the Board highlights that at no point have any of these symptoms ever been characterized as reflecting soft-tissue sarcoma. Ultimately, there is no competent evidence that the Veteran has soft-tissue sarcoma or symptomatology that suggests that a diagnosis of the condition would be appropriate. Accordingly, without supporting records, the Board concludes that the Veteran does not have multiple myeloma and has not had such a condition during the appeal period. The Veteran himself does not have the medical training or credentials to offer an opinion as to a diagnosis or its etiology. Jandreau, supra. As there is no evidence to suggest that the Veteran has a diagnosable soft-tissue sarcoma, remand is not necessary in order to afford him a new VA examination to specifically evaluate whether he has a soft-tissue sarcoma. McLendon v. Nicholson, 20 Vet. App. 79 (2006). Service connection is denied. Brammer, supra. As the preponderance of the evidence is against the Veteran's claim, the benefit-of-the-doubt standard of proof does not apply. 38 U.S.C. § 5107(b). 4. Parkinson's Disease The Veteran seeks entitlement to service connection for Parkinson's disease, which he asserts is attributable to his exposure to toxic herbicide agents while in service in the Republic of Vietnam. Without delving into the question of the potential etiology of the Parkinson's disease, the Board finds that the Veteran has never been diagnosed with Parkinson's disease and there is no evidence to suggest that such a diagnosis is appropriate; as such, entitlement to service connection must be denied. The Veteran was afforded a VA Parkinson's disease examination in October 2020. When queried, the Veteran did not detail any symptomatology that would typically characterize Parkinson's disease as indicated by the examiner's review. The examiner carried out an in-person evaluation, which confirmed that the Veteran did not exhibit any symptomatology that would form the basis of a diagnosis of Parkinson's disease. Accordingly, the examiner declined to set forth a diagnosis of Parkinson's disease. As the examiner reviewed the entirety of the claims file and based their findings on an in-person evaluation, the Board finds the lack of diagnosis to be highly probative. Sklar, supra. A review of available VA and private medical records does not reflect that the Veteran has ever been diagnosed with or treated for Parkinson's disease. Without reiterating the evidence detailed above regarding the Veteran's history of complaints related to various neurological symptomatology he has experienced during the appeal period, the Board highlights that at no point have any of these symptoms ever been characterized as reflecting Parkinson's disease. As noted above, the Veteran's neurological symptomatology has instead been attributed to cervicalgia and resulting cervical radiculopathy. Indeed, in a recent October 2020 outpatient record, the Veteran requested an evaluation to determine whether he had Parkinson's after reporting that he was experiencing a hand tremor; Parkinson's was not suspected per the treating physician's report. Ultimately, there is no competent evidence that the Veteran has Parkinson's disease or symptomatology that suggests that a diagnosis of the condition would be appropriate. Accordingly, without supporting records, the Board concludes that the Veteran does not have Parkinson's disease and has not had such a condition during the appeal period. The Veteran himself does not have the medical training or credentials to offer an opinion as to a diagnosis or its etiology. Jandreau, supra. Service connection is denied. Brammer, supra. As the preponderance of the evidence is against the Veteran's claim, the benefit-of-the-doubt standard of proof does not apply. 38 U.S.C. § 5107(b). T. V. CASEY Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Christopher M. Collins, 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.