Citation Nr: 22012182 Decision Date: 03/02/22 Archive Date: 03/02/22 DOCKET NO. 15-07 842 DATE: March 2, 2022 ORDER Service connection for alcohol abuse is denied. Service connection for liver disease is denied. Service connection for a spleen condition is denied. FINDINGS OF FACT 1. The Veteran's alcohol abuse was not caused or aggravated by his service-connected major depressive disorder and unspecified anxiety disorder. 2. Service connection is not in effect for the condition contended as causing the Veteran's liver disease and spleen condition. CONCLUSIONS OF LAW 1. The criteria for service connection of alcohol abuse have not been met. 38 U.S.C. §§ 101, 1131, 5107; 38 C.F.R. §§ 3.301, 3.102, 3.303, 3.310. 2. The criteria for service connection for liver disease have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 3. The criteria for service connection for a spleen condition have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1962 to January 1963. The case is on appeal from an October 2014 rating decision. In March 2018, the Veteran testified at a Travel Board hearing. The case was last before the Board in October 2021. At that time, the Board remanded the issues of service connection for a psychiatric disorder, alcohol abuse, liver disease, and a spleen condition for further development. While the case was in remand status, in a November 2021 rating decision, the RO granted service connection for major depressive disorder with unspecified anxiety disorder with an evaluation of 30 percent, effective January 17, 2014. Thus, that issue is no longer before the Board. The Board has limited the discussion below to the relevant evidence required to support its finding of fact and conclusion of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Service Connection Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(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." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. See 38 C.F.R. § 3.310. In addition, in determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 1. Service connection for alcohol abuse. The Veteran asserts that his alcohol abuse is secondary to his service-connected psychiatric disorder. Service treatment records (STRs) are silent for any complaints, findings, treatment, or diagnosis of alcohol abuse. Medical records from October 2013 provide "traumatic event in past/hx heavy etoh use/hx suicide attempts in remote past." Additionally, the Veteran was noted as having thrombocytopenia, "referred to hemetologist, per records felt due to etoh use." He reported that upon returning home from service, he began using alcohol and behaving in a manner that, at times, jeopardized his life, including alcohol use. Further medical records from November 2013 provide the Veteran had a substance abuse history in his family of origin. Records from November 2014 provide he began drinking as a result of the events surrounding his discharge where he was told he "was not going anywhere." The Veteran reported drinking most of the time to forget about it. The Veteran was afforded a VA medical opinion in November 2021. Having reviewed the records, the examiner opined the Veteran's alcohol abuse is less likely than not proximately due to or the result of his service-connected major depressive disorder and unspecified anxiety disorder. As rationale, the examiner provided that the severity of the Veteran's symptoms is increased based on the frustration he has in not receiving the claims the way he wants them. He did not state that his mental health symptoms were increasing due to triggers, memories, and military-related stressors. The examiner also provided that, given his mental health issues beginning 50 years after his discharge, he had numerous other experiences that may have caused his alcohol abuse. The examiner also noted a discrepancy in the evidence of record, noting that while a July 2015 statement of support provided the Veteran's alcohol use began upon discharge, the Veteran reported his symptoms began as a result of his training. After careful review of the evidence, the Board finds that the preponderance of evidence is against the Veteran's claim of service connection for alcohol abuse. The most persuasive evidence of record is the November 2021 VA medical opinion which provided a thorough rationale in determine that the Veteran's alcohol abuse was not proximately due to or the result of his service-connected psychiatric disorder. It is apparent the entire record was reviewed, as the examiner specifically referenced numerous medical records, including lay statements from the Veteran, along with statement of support. The examiner's opinion is based on an accurate medical history and contains a well-reasoned explanation in support of the conclusions. As such, the opinion is entitled to significant probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (holding that it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value to a medical opinion). Significantly, there are no medical opinions of record linking the Veteran's alcohol abuse to his service-connected major depressive disorder and unspecified anxiety disorder. The Board acknowledges the Veteran's and his representative's statements in support of his claims. The Board also acknowledges the severity of the Veteran's symptoms. While the Veteran and his representative have offered assertions which are consistent, as lay persons they have not been shown to have specialized training sufficient to render opinions as to the etiology of alcohol abuse, as such are complex medical questions. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Therefore, the Board accords greater probative weight to the November 2021 VA medical examiner's opinion than to the lay statements in support. Moreover, "direct" service connection is precluded for alcohol abuse to the extent it would be a primary condition. See 38 U.S.C. § 101; 38 C.F.R. § 3.301. In sum, the Board determines the November 2021 VA medical opinion the most probative evidence of record and weighs against the Veteran's claim. Thus, the persuasive evidence is against the claim and the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. As such, service connection for alcohol abuse is not warranted. 2. Service connection for liver disease. 3. Service connection for a spleen condition. The Veteran asserts his liver disease and spleen condition are secondary to his alcohol abuse. The Board finds the Veteran's claims fails under a theory of secondary service connection as the Veteran is not service connected for alcohol abuse. Thus, as secondary service connection presupposes that the underlying condition is service connected, the preponderance of the evidence is against a finding of service connection for liver disease and a spleen condition, and there is no reasonable doubt to resolve. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Accordingly, service connection is not warranted for liver disease or a spleen condition on a secondary basis. See 38 C.F.R. § 3.310. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Becton, 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.