Citation Nr: 22013686 Decision Date: 03/10/22 Archive Date: 03/10/22 DOCKET NO. 18-44 017 DATE: March 10, 2022 ORDER Entitlement to service connection for the cause of the Veteran's death is granted. FINDINGS OF FACT 1. The Veteran served in the U.S. Air Force at U-Tapao Royal Thai Air Force Base (RTAFB) from June 1971 to July 1972. 2. The Veteran died in January 2016 from multiple myeloma. 3. The evidence of record persuasively weighs in favor of finding that the Veteran was exposed to herbicides at the RTAFB in U-Tapao while performing maintenance, repairs, inspection, cleaning, assembling, and testing of jet engines, to include on the flight-line near the base perimeter. 4. Multiple myeloma is presumptively associated with exposure to herbicide agents and was the principal cause of the Veteran's death. CONCLUSION OF LAW The criteria for entitlement to service connection for the cause of the Veteran's death have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1137, 1310; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.312. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty in the United States Air Force from June 1970 to January 1991. For his meritorious service, the Veteran was awarded (among other decorations) the Air Force Commendation Medal and the Vietnam Service and Campaign Medals. The Veteran died in January 2016. The appellant is his surviving spouse. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2017 decision of a Department of Veterans Affairs (VA) Regional Office (RO). The appellant presented testimony before the undersigned Veterans Law Judge in August 2021. Service Connection for Cause of Death The Veteran's immediate cause of death is identified as multiple myeloma. At the time of his death, service connection was in effect for tinnitus, bilateral hearing loss, and calcified azygos lymph node. The appellant contends that the Veteran's fatal multiple myeloma was the result of herbicide agent exposure while he was stationed in Thailand during the Vietnam Era. To establish service connection for the cause of a Veteran's death, the evidence must show that a disability incurred in or aggravated by active military service was the principal or contributory cause of death. 38 U.S.C. § 1310; 38 C.F.R. § 3.312(a). A principal cause of death refers to the immediate or underlying cause, or a cause etiologically related to the cause of death. 38 C.F.R. § 3.312(b). A contributory cause of death exists when the debilitating effects of a service-connected disability made the Veteran materially less capable of resisting the effects of the fatal disease, or when a service-connected disability had a material influence in accelerating death, thereby contributing substantially or materially to the cause of death. Lathan v. Brown, 7 Vet. App. 359 (1995); 38 C.F.R. § 3.312(c)(1). It is not sufficient to show that a service-connected disability casually shared in producing death; rather, it must be shown there was a causal connection. 38 C.F.R. § 3.312(c)(1). However, if the service-connected disability affected a vital organ, consideration must be given to whether the debilitating effects of the service-connected disability rendered the Veteran less capable of resisting the effects of other diseases. 38 C.F.R. § 3.312(c)(3). Here, the cause of death multiple myeloma was not previously awarded service connection, although the appellant argues that service connection nonetheless is warranted since the terminal disease was traceable to the Veteran's service in Thailand and consequent exposure to herbicide agents (especially the dioxin in Agent Orange) while there. Service connection is granted for disability resulting from disease or injury incurred in or aggravated by active military service in the line of duty. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or an injury; and (3) a causal relationship ("nexus") between the current disability and the disease or injury in service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). A veteran who, during active military, naval or air service, served in the Republic of Vietnam between January 9, 1962, and May 7, 1975 (the Vietnam Era) shall be presumed to have been exposed during that service to an herbicide agent, unless there is affirmative evidence to the contrary. 38 U.S.C.§ 1116 (f); 38 C.F.R. § 3.307 (a)(6)(iii). Multiple myeloma is service connected if the requirements of 38 C.F.R. § 3.307 (a) are met, even if there is no record of such disease during service. 38 C.F.R. § 3.309 (e). A Veteran also may have been exposed to herbicides at locations outside of Vietnam, including at certain times and at certain specific locations in Thailand. VA procedures for verifying exposure to herbicide agents in Thailand during the Vietnam Era are detailed. VA has determined that there was significant use of herbicide agents on the fenced-in perimeters of military bases in Thailand intended to eliminate vegetation and ground cover for base security purposes. Special consideration of herbicide-agent exposure on a facts-found or direct basis should be extended to those veterans whose duties placed them on or near the perimeters of Thailand military bases. Regarding herbicide-agent exposure in Thailand during the Vietnam Era, "herbicide" is understood to mean "herbicide agent" as used in the regulation. Rating specialists are directed to concede herbicide agent exposure to those who served in the United States Air Force at a number of RTAFBs. The majority of troops in Thailand during the Vietnam Era were stationed at the RTAFBs U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang. If a veteran served on one of these air bases as a security policeman, security patrol dog handler, member of a security police squadron, or otherwise served near the air base perimeter, as shown by military occupational specialty (MOS), performance evaluations, or other credible evidence, then herbicide exposure should be acknowledged on a facts-found or direct basis. In this case, the Veteran's MOS was not in security; however, his duties and responsibilities as a jet engine mechanic with the 307th Field Maintenance Squadron, to include along the flight line, brought him into contact with the perimeter of U-Tapao RTAFB. A lay statement from a fellow service member who served with the Veteran confirmed that the Veteran worked on the flight-line, along the base perimeter, on a daily basis. The record contains performance evaluations for the Veteran dated from June 1971 to July 1972 at U-Tapao RTAFB. His duties included cleaning, inspections, servicing, testing, assembling, and maintenance on jet engines. The evaluation noted the Veteran performed "direct support of the Southeast Asian Conflict." The Appellant submitted photographs of the Veteran sitting on 55 gallon drum barrels on base and the planes he worked on along the flight-line perimeter. As such, the evidence tends to establish the Veteran worked on aircraft equipment during the Vietnam Era that likely were located on or near airfields situated on the perimeter of U-Tapao RTAFB. Thus, when resolving all reasonable doubt in the appellant's favor, particularly as concerning whether the Veteran was exposed to herbicide agents during his time in Thailand, she has established entitlement to service connection for the cause of his death since his multiple myeloma is presumptively associated with exposure to herbicides. 38 U.S.C. §§ 1310, 5107; 38 C.F.R. §§ 3.102, 3.312(a). Entitlement to service connection for the cause of the Veteran's death is thus warranted. Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. L. Wallin, 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.