Citation Nr: 21042132 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 16-49 984A DATE: July 12, 2021 ORDER Entitlement to service connection for aneurysm, for the purpose of accrued benefits, is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran's cerebral aneurysm began during active service or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for aneurysm, for the purpose of accrued benefits, have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107, 5121; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.1000. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Navy from October 1962 to October 1966. He died in February 2019. The Appellant is the Veteran's surviving spouse. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts (Agency of Original Jurisdiction (AOJ)). This issue was previously before the Board in March 2019. At that time, the Board dismissed the claim due to the Veteran's death. Since that time, the Veteran's surviving spouse was properly substituted and requested to continue this claim on an accrued benefits basis. Thereafter, the issue came before the Board once more in April 2020; it determined that additional development was necessary prior to adjudication. On remand, the Board sought treatment records from a variety of private facilities, as well as a nexus opinion. The records requests were properly developed (despite being unsuccessful in obtaining any records) and an etiology opinion was received. The Board therefore finds that the AOJ substantially complied with the remand directive in accordance with Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Entitlement to service connection for aneurysm on an accrued benefits basis Accrued benefits are defined as periodic monetary benefits authorized under a law administered by VA, to which a payee was entitled at death under existing ratings or decisions or those based on evidence in the file at the date of death, and due and unpaid. 38 U.S.C. § 5121; 38 C.F.R. § 3.1000; Zevalkink v. Brown, 102 F.3d 1236 (Fed Cir. 1996). For a claimant to prevail on an accrued benefits claim, the record must show that: (i) the individual has standing to file a claim for accrued benefits; (ii) the VA payee had a claim pending at the time of death; (iii) the VA payee would have prevailed on the claim if he or she had not died; and (iv) the claim for accrued benefits was filed within one year of the VA payee's death. 38 U.S.C. §§ 5101(a), 5121; 38 C.F.R. § 3.1000; Jones v. West, 136 F.3d 1299 (Fed. Cir. 1998). Upon the death of a payee of VA benefits, periodic monetary benefits to which he or she was entitled (accrued benefits) may be paid to certain parties. 38 U.S.C. § 5121(a); 38 C.F.R. § 3.1000(a). The statute provides that in certain circumstances accrued benefits may be paid to reimburse the person who bore the expenses of the payee's last sickness and burial. 38 U.S.C. § 5121(a)(6); 38 C.F.R. § 3.1000(a)(5). Payment of monetary benefits begins the first day of the calendar month following the month in which the award became effective. 38 C.F.R. § 3.31. Additionally, VA benefit payments are discontinued on the last day of the month before the payee's death. 38 U.S.C. § 5112; 38 C.F.R. § 3.500(g). In this regard, the Board observes that the Appellant has standing to file a claim for accrued benefits as she has been recognized as the Veteran's surviving spouse and was granted service connection for the cause of the Veteran's death. The Board also finds that the Veteran did have a claim pending at the time of his death. Indeed, his claim for entitlement to service connection for residuals of a cerebral aneurysm had been remanded by the Board and a Supplemental Statement of the Case (SSOC) had been issued less than one month prior to the Veteran's death. However, the Board does not find that the Veteran would have prevailed on his claim had he not passed away. First and foremost, it is acknowledged that the Veteran had a cerebral aneurysm prior to his death. Private treatment records reference his cerebral aneurysms and note they were treated with coil placement. Moreover, a February 2018 VA examination recorded a diagnosis of cerebral aneurysm and listed 2010 as the date of diagnosis. The Veteran's service treatment records (STRs) are silent for any complaints, diagnoses, or treatment for symptoms relating to a cerebral aneurysm. Indeed, his enlistment Report of Medical History and Report of Medical Examination are unremarkable for any conditions or symptoms that would lead one to believe he suffered from a cerebral aneurysm. The physician even documented that the Veteran was "in good health" on the bottom of his enlistment Report of Medical History. Moreover, his separation Report of Medical Examination is similarly silent for any signs of a cerebral aneurysm. The Board acknowledges, though, that VA recently conceded that the Veteran was exposed to herbicides based on his nautical service in offshore eligible waters. Prior to his death, the Veteran did suggest that his cerebral aneurysm was caused by his exposure to herbicide agents. The examiner who performed the February 2018 VA examination, however, opined it was less likely than not that the Veteran's cerebral aneurysm was caused by his military service, to include his exposure to Agent Orange. The physician rationalized, "A cerebral (intracranial) aneurysm is an abnormal focal dilation of an artery in the brain that results from a weakening of the inner muscular layer of a blood vessel wall. A number of causes are believed to contribute to the development of aneurysms, including smoking, hypertension, congenital/genetic, head injury...atherosclerosis, infection, cancer, and drug use. Most commonly, aneurysms are asymptomatic until they are at risk for rupture, making it difficult to determine when an aneurysm developed. Upon review of STRs, I am unable to locate evidence of complaints or treatment in service for symptoms related to an aneurysm. This Veteran's aneurysm developed many years after separation from service. Given the multiple etiologies of aneurysms and the inability to determine when this aneurysm developed, it would be mere speculation to attribute his aneurysm to service or Agent Orange exposure." Additionally, a second opinion was obtained in July 2020 following the Veteran's death. This examiner also opined that the Veteran's cerebral aneurysm was incurred in or caused by his active duty service. The specialist observed that the Veteran's record is silent for any symptoms of cerebral aneurysm in service. He further stated that cerebral aneurysms are of unknown cause, but thought to be congenital. He also provided that cerebral aneurysms are neither caused, aggravated, or worsened by myeloma for which the Veteran was service-connected. Based on these opinions, as well as the other evidence of record, the Board is unable to find that the Veteran would have prevailed in his claim for entitlement to service connection for residuals of a cerebral aneurysm had he not passed away. The evidence does not reflect that he experienced any symptoms associated with a cerebral aneurysm during his active duty service, nor does the evidence support a finding that the Veteran's exposure to herbicide agents or his service-connected multiple myeloma caused or aggravated his cerebral aneurysm. Because there is no evidence to suggest that the Veteran's cerebral aneurysm is etiologically related to his active duty service, the Board must deny the Appellant's claim for residuals of a cerebral aneurysm for the purpose of accrued benefits. J. NICHOLS Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Victoria A. Banis, 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.