Citation Nr: 22013387 Decision Date: 03/09/22 Archive Date: 03/09/22 DOCKET NO. 18-29 275 DATE: March 9, 2022 ORDER Entitlement to service connection for carotid artery stenosis is denied. FINDING OF FACT The preponderance of the evidence is against finding that carotid artery stenosis began during active service or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for carotid artery stenosis are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1965 to November 1968 in the United States Army during the Vietnam Era. The Veteran's DD214 verifies service in the Republic of Vietnam. Therefore, Agent Orange exposure is conceded. In his May 2018 Substantive Appeal, the Veteran requested a videoconference hearing before the Board. In November 2021, the Veteran did not attend the scheduled hearing, and submitted a statement afterwards noting that he had a medical reason for not attending the scheduled hearing. In January 2022, VA notified the Veteran that he could reschedule his hearing since he was unable to attend his previously scheduled hearing. However, the Veteran did not respond to the letter as indicated within 30 days from the date of the letter. As such, the Board finds that the Veteran waived his right to a hearing prior to adjudication of this appeal. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a) (2018). 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 the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after service when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). The standard of proof to be applied in decisions on claims for VA benefits is set forth in 38 U.S.C. § 5107 (b). Under that provision, VA shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (b); see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). At the outset, the Board notes that the Veteran does not claim, and the evidence does not reflect, that his carotid artery stenosis was incurred during combat with the enemy. Therefore, the combat provisions of 38 U.S.C. § 1154 are not applicable. Entitlement to service connection for carotid artery stenosis The Veteran is seeking service connection for carotid artery stenosis, and hypertension. Private treatment records from December 2012 shows a diagnosis of carotid artery stenosis, asymptomatic. As such, the first element of service connection, a current disability, has been met. However, the Board finds that the second element of service connection has not been established. The Veteran has not provided any lay evidence that he suffered from carotid artery stenosis problems in service. Service treatment records show normal blood pressure readings, as well as a normal heart and vascular system. Upon separation in August 1968, his blood pressure reading was 120/70. Records are also negative for any treatment, diagnosis, or complaints of carotid artery stenosis. A clinical evaluation of the heart and other areas was normal at separation in August 1968. The Veteran's carotid artery stenosis is not listed in 38 C.F.R. § 3.309 (e) as a disease recognized by VA regulations as being presumptively associated with exposure to certain herbicide agents. Additionally, there is no evidence of a compensable manifestation of any transient carotid artery stenosis within one year following the Veteran's separation from service; therefore, service connection on a presumptive basis would not be warranted in this case. There also is no indication that this disability was noted in service with continuity of symptomatology since service, therefore, the theory of service connection based on continuity of symptomatology is also inapplicable. Regarding a nexus to service, the Veteran has not been afforded an examination in connection with his claims, but VA does not have a duty to provide one here as there is no evidence establishing an event, injury, or symptom onset or an in-service indication that his carotid artery stenosis may be associated with his service. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). There is evidence in the record that the Veteran has carotid artery stenosis, but there is nothing to indicate that there is an association between this condition and his service. The Board acknowledges that the Veteran, in his claim for service connection, indicated that he believed his carotid artery stenosis was related to the drinking water in the Republic of Vietnam. However, he noted in a May 2018 statement that the doctor that diagnosed his carotid artery stenosis was unable to say that his carotid artery stenosis was related to contaminated drinking water in Vietnam. Rather, in December 2012, the doctor noted that the etiology was atherosclerotic and he discussed a dietary plan to prevent further plaque buildup. Accordingly, there is no duty to provide the Veteran with a VA examination. After careful consideration, the weight of the evidence is against a finding that the Veteran's carotid artery stenosis is related to service. The preponderance of the evidence is against the claim, the benefit of the doubt doctrine does not apply, and service connection cannot be established. Therefore, the claim must be denied. 38 U.S.C. § 5107; 38 C.F.R § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1991). Danette Mincey Veterans Law Judge Board of Veterans' Appeals J. Costello, Attorney for the Board of Veterans' Appeals 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.