Citation Nr: 21032865 Decision Date: 05/28/21 Archive Date: 05/28/21 DOCKET NO. 17-25 821 DATE: May 28, 2021 ORDER Service connection for lipomas, to include as due to Agent Orange exposure, is denied. FINDING OF FACT It is less likely than not that the Veteran's lipomas are related to or otherwise caused by his active military service, to include exposure to herbicides. CONCLUSION OF LAW The criteria for service connection for lipomas, to include as due to Agent Orange exposure, have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.309(e). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Air Force from March 1962 to March 1966. The matter is on appeal before the Board from an April 2013 rating decision. The Board previously remanded the issue for further development in January 2021. The development has been completed and the case has returned to the Board for further adjudication. Service Connection Lipomas Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 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). Service connection may also be granted on a presumptive basis for certain diseases resulting from exposure to an herbicide agent (including Agent Orange) for Veterans who, during active military, naval, or air service, served in the Republic of Vietnam between January 1962 and May 1975, so long as the requirements of 38 U.S.C. § 1116 and 38 C.F.R. § 3.307(a)(6)(iii) are met, and the rebuttable presumption provisions of 38 U.S.C. § 1113 and 38 C.F.R. § 3.307(d) are also satisfied. 38 C.F.R. § 3.309(e). Service in Vietnam includes the landmass and the territorial sea, which is defined as the 12 nautical miles surrounding Vietnam. See Procopio v. Wilkie, 913 F.3d 1375-1376, 1379-1380 (Fed. Cir. 2019). The Veteran asserts that his lipomas were caused by his active military service, specifically his exposure to Agent Orange. The Veteran's record reflects that Agent Orange exposure has been conceded. However, lipomas are not one of the diseases that warrant service connection on a presumptive basis. See 38 C.F.R. § 3.309(e). A review of the Veteran's service treatment records (STRs) does not reflect any diagnoses for lipomas. Nor do they show any complaints or treatments that may be related to lipomas. The Veteran's VA treatment records reflect that the Veteran has had lipomas excised in both November 2011 and in April 2012. Pathology reports following each excision provide that the lipomas were benign. A VA medical opinion pertaining to the etiology of the Veteran's lipomas was obtained in February 2021. The VA examiner found that the Veteran's lipomas were less likely than not (less than 50 percent probability) incurred in or caused by his active military service, to include as a result of exposure to herbicides. The examiner rationalized that lipomas are a very common disease among the general populace. The overwhelming majority of those diagnosed with this disease would not have been exposed to Agent Orange. They are most common between the ages of 40 and 60, but can occur at any age. The cause of lipomas is not clear. A medical literature search does not show that Agent Orange has been found to be a cause of lipomas. The Veteran's STRs do not show a diagnosis of lipomas while in service. No medical evidence has been found to support a link to Agent Orange or to support that they are otherwise causally or etiologically related to military service. As noted by the Decision Review Officer, the BVA citation in VBMS did not grant service connection for lipomas due to Agent Orange, but because that particular Veteran had lipomas while still in service. Therefore, less likely than not. The Board finds probative value in the VA examiner's well-reasoned opinion. The VA examiner cited to a previous Board decision in their opinion, which the Veteran had submitted most recently in May 2017. The previous Board decision submitted by the Veteran was from 2008, in which a Veteran was granted service connection for lipomas. However, previous Board decisions do not establish precedent, as each case before the Board contains the unique circumstances of each Veteran. Moreover, the circumstances of the case that the Veteran submitted are different from the circumstances of his case. In the 2008 Board decision, service connection for lipomas was not granted on a presumptive basis due to exposure to herbicides. Rather service connection for lipomas was granted on a direct basis because lay statements from fellow Veteran's indicated that the Veteran had experienced lipomas while in service and had them excised, and because a VA examiner concluded that the "onset of lipoma was certainly during in service tenure." In this case, the Veteran's circumstances are different from the 2008 Board decision that he submitted. Here, the Veteran's lipomas were not shown to have been present during his active military service. The first notation in the Veteran's VA treatment records pertaining to lipomas is from May 2011, when the Veteran was seen for complaints of bothersome masses in his chest and arms that were noted to likely be lipomas, which were excised in November 2011. The surgical pathology reflected them to be benign and consistent with lipomas. This is a little over 45 years after his discharge from active military service. Additionally, the February 2021 VA examiner found that it was less likely than not that the Veteran's lipomas were related to his active military service, to include exposure to herbicides. Consideration is given to the Veteran's contentions that his claimed condition of lipomas was incurred in or caused by his military service, to include exposure to herbicides. While lay persons are competent to provide opinions pertaining to certain medical issues, the etiology of lipomas, as is specific to this case, is outside the realm of common knowledge for someone, such as the Veteran, who does not possess medical training, specialized expertise, or experience. Jandreau v. Nicholson, 492. F.3d 1372, 1377 n.4 (Fed. Cir. 2007). As such, the Veteran's assertions pertaining to the etiology of his lipomas lack probative value. Outside of the Veteran's assertions, there is no indication in the Veteran's record that the Veteran's lipomas are related to his exposure to herbicides while serving in the military. Accordingly, service connection for lipomas, to include as due to Agent Orange exposure, is denied. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Lutgens-Staley, 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.