Citation Nr: 21041656 Decision Date: 07/09/21 Archive Date: 07/09/21 DOCKET NO. 17-35 009 DATE: July 9, 2021 ORDER Entitlement to service connection for bladder cancer is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran's bladder cancer or residuals thereof began during active service or was otherwise caused by service. CONCLUSION OF LAW The criteria for entitlement to service connection for bladder cancer have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty in the U.S. Navy from May 1961 to February 1966. This matter comes before the Board of Veterans' Appeals (Board) from an April 2014 rating decision by the Regional Office (RO) in Atlanta, Georgia. In November 2017, the Veteran's representative submitted a letter indicating that he is no longer representing the Veteran in the Veterans Benefits claim. However, the representative failed to submit a motion to withdraw, demonstrative of good cause, to VA following the certification of this appeal. However, in correspondence in September 2020, the Veteran terminated the representation. The Board acknowledges that in April 2021 the Veteran submitted a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), requesting to opt into the Appeals Modernization Act (AMA). This request was denied in an April 2021 letter and will not be addressed further herein. Entitlement to service connection for bladder cancer Service connection may be established for a disability resulting from personal injury suffered or disease contracted in the line of duty in the active military, naval, or air service. 38 U.S.C. §§ 1110. Certain chronic diseases will be presumed related to service (including malignant tumors), absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). To establish a right to compensation for a present disability, a Veteran 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." Davidson v. Shinseki, 581 F.3d 1313, 1315-16 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran contends that his bladder cancer was the result of in-service exposure to chemicals, including a "special cleaner," involved in the cleaning of external aircraft exhaust structures. The Veteran's Navy rating was aviation electronics technician (radio and radio navigation equipment). The Veteran's service treatment records do not include complaints, treatment, or diagnosis of bladder cancer or related symptoms, including at the time of his February 1966 Report of Medical Examination prior to separation from service. The Veteran does not contend in-service onset of his bladder cancer. The service treatment records are also silent for treatment of acute skin irritation and no skin abnormalities were noted in the examination. He was treated in March 1965 for burns on one hand from touching a soldering iron. VA and private treatment records document bladder cancer in 2008, with subsequent recurrences. The diagnostic and treatment records are silent for any report by the Veteran or comment by clinicians regarding exposure to electronic or structural cleaning solvents in service. In an October 2020 statement, the Veteran discussed his duties in service, which included the use of a "special cleaner" that irritated the skin on his hands. After service, the Veteran had bouts of kidney infection and urinary tract infection. In an October 2020 statement, the Veteran's wife indicated that the Veteran felt that his bladder cancer "might be related to his use of tetrachloroethylene while helping to clean aircraft while stationed in Naples, Italy. I have researched and I did see that in some cases this has been verified. When his cancer metastasized to his brain, we were told that bladder cancer rarely go to the brain." Thus, the Veteran has a current diagnosis of bladder cancer and residuals thereof. The relevant question, therefore, is whether the bladder cancer was incurred in service or otherwise is caused by service. As noted, the Veteran's service treatment records include no diagnosis of bladder cancer or symptoms related to bladder cancer. The Veteran does not claim in-service onset. Similarly, there is not a continuity of symptoms from service. As to the Veteran's contentions that his bladder cancer was caused by in-service chemical exposure, he is competent to report sensory or observed symptoms, but given that he did not have a continuity of symptoms from service and it was not until multiple decades after service that he was diagnosed with bladder cancer the Board finds that the Veteran is not competent to attribute his bladder cancer to in-service chemical exposure. Moreover, service treatment records are silent for any acute skin irritation, and the Veteran did not report this exposure to his treating clinicians as would have been important for his medical history and cancer diagnosis. Such a conclusion is medically complex in nature and beyond the capabilities of a lay person to diagnose. Cf. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) (explaining in footnote 4 that a veteran is competent to provide a diagnosis of a simple condition such as a broken leg, but not competent to provide evidence as to more complex medical questions). As such, the Board affords the Veteran's contentions low probative weight. The Board acknowledges the contentions of the Veteran's wife that she had researched and found "that in some cases" there was a "verified" connection between tetrachloroethylene and bladder cancer. It has not been shown that the chemical was used to clean exhaust from aircraft structures as reported by the Veteran. The Board does not find the foregoing sufficient evidence to grant the Veteran's claim. The evidence of record does not discuss the circumstances that allowed "some cases" to establish a link between tetrachloroethylene and bladder cancer or any circumstances similar to the Veteran's that is, the development of bladder cancer over 40 years after exposure to chemicals in service. Moreover, there also is nothing to demonstrate that the Veteran was exposed to tetrachloroethylene during service. The Veteran has discussed the use of a "special cleaner" that caused his hands to tingle. Even assuming exposure to tetrachloroethylene, for the reasons noted above, there is no competent evidence linking such exposure to the development of bladder cancer more than 40 years after that exposure. For this reason, the Board does not find the evidence sufficient even to rise to the level to trigger the need for a VA examination. See 38 C.F.R. § 3.159(c)(4); see also McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). There is insufficient lay or medical evidence suggesting any link between the Veteran's service, including any chemical exposure therein, and his diagnosis of bladder cancer multiple decades after service. VA must consider lay evidence but may give it whatever weight it concludes the evidence is entitled to" and mere conclusory generalized lay statement that service event or illness caused the claimant's current condition is insufficient to require the Secretary to provide an examination. Waters v. Shinseki, 601 F.3d 1274, 1278 (2010); see also Euzebio v. Wilkie, 31 Vet. App. 394 (2019) In summary, the Veteran's service treatment records show no symptoms or issues related to bladder cancer. There is no evidence of problems related to bladder cancer for many years after separation from service. The sole evidence suggesting a link between the bladder cancer and service are the contentions of the Veteran, including his allegations alleged through his wife's statement, which is not competent for the reasons discussed above. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule does not apply, and the claim must be denied. See 38 U.S.C. § 5107(b); see generally Gilbert v. Derwinski, 1 Vet. App. 49 (1990); Ortiz v. Principi, 274 F.3d 1361 (Fed Cir. 2001). J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. J. Houbeck, 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.