Citation Nr: A25035954 Decision Date: 04/18/25 Archive Date: 04/18/25 DOCKET NO. 240930-478862 DATE: April 18, 2025 ORDER Service connection for atrial fibrillation is granted. Service connection for squamous cell carcinomas on the head and neck is granted. FINDINGS OF FACT 1. The Veteran's atrial fibrillation disability is due to his service-connected diabetes mellitus type II (diabetes). 2. The Veteran's squamous cell carcinomas on the head and neck are related to in-service exposure to herbicides. CONCLUSIONS OF LAW 1. The criteria for service connection for atrial fibrillation as secondary to the Veteran's service-connected diabetes are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310. 2. The criteria for service connection for squamous cell carcinomas on the head and neck have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1963 to October 1966. In the September 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. The Veteran, through his attorney, withdrew his request for a Board hearing on December 11, 2024. December 2024 VA Form 20-10208 (Document/Evidence Submission). Therefore, the Board may only consider the evidence of record at the time of the July 2024 AOJ decision on appeal, as well as any evidence submitted by the Veteran or his attorney within 90 days following the hearing request withdrawal. 38 C.F.R. § 20.302(b). Evidence was associated with the file during the period after the AOJ issued the decision on appeal and prior to the withdrawal of the request for a Board hearing. The Board did not consider this evidence in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 20.801. If the Veteran would like VA to consider any evidence that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. This appeal has been advanced on the Board's docket pursuant to 38 U.S.C. § 7107(b); 38 C.F.R. § 20.800(c). The Veteran's attorney asserts that the VA medical opinion regarding the claim for service connection for atrial fibrillation is inadequate. As this claim is granted in full below, the Board need not reach this issue. Neither the Veteran nor his attorney have raised any issues with the duty to notify or duty to assist that occurred prior to the rating decision on appeal. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Service Connection Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may also be granted for a disability that is proximately due to, the result of, or aggravated by a service-connected disability. 38 C.F.R. § 3.310. For disabilities aggravated by a service-connected disability, the Veteran may be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b); see Allen v. Brown, 7 Vet. App. 439, 448 (1995). The benefit of the doubt rule provides that an appellant will prevail in a case where the positive evidence is in approximate balance with the negative evidence. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. It is only when the weight of the evidence is persuasively against the claim that the claim must be denied. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). 1. Service connection for atrial fibrillation is granted. The Veteran asserts that his atrial fibrillation is caused by his service-connected diabetes. See December 2024 brief. Alternatively, the Veteran asserts his atrial fibrillation is related to herbicide exposure on active duty. See April 2024 VA Form 21-526EZ (Fully Developed Claim). As an initial matter, the Board is bound by the favorable findings reached by the AOJ in its rating decision. See 38 U.S.C. § 5104(b)(4); 5104A; 38 C.F.R. § 20.801(a). Here, the AOJ favorably found that the Veteran participated in a toxic exposure risk activity (TERA) on active duty and that the Veteran has a current atrial fibrillation disability. The Board concludes that the Veteran's conceded atrial fibrillation disability is due to his service-connected diabetes. The Veteran submitted a December 2024 private medical opinion, which opined that the Veteran's atrial fibrillation is caused by the service-connected diabetes. In support of this conclusion, the private clinician cited medical evidence specific to the Veteran, as well as scholarly sources regarding the relationship between diabetes and atrial fibrillation. The Board therefore assigns this opinion great probative weight. There is no medical evidence of record weighing against the Veteran's claim that his atrial fibrillation disability is secondary to his service-connected diabetes. Upon review of the record, the Board finds the evidence persuasively demonstrates the Veteran's current atrial fibrillation disability is due to the service-connected diabetes. Accordingly, the Board finds that service connection for atrial fibrillation is warranted. 2. Service connection for squamous cell carcinomas on the head and neck is granted. The Veteran asserts his squamous cell carcinomas of the head and neck are related to herbicide exposure on active duty. See April 2024 Fully Developed Claim, December 2024 brief. As an initial matter, the Board is bound by the favorable findings reached by the AOJ in its rating decision. See 38 U.S.C. § 5104(b)(4); 5104A; 38 C.F.R. § 20.801(a). Here, the AOJ favorably found that the Veteran participated in a TERA on active duty and that the Veteran has a current squamous cell carcinoma disability. The Board concludes that the Veteran's current disability of squamous cell carcinomas of the head and neck is related to an in-service TERA, specifically his conceded exposure to herbicides. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The evidence in favor of the claim includes a December 2024 private medical opinion, which opined that the Veteran's squamous cell carcinomas of the head and neck are related to in-service exposure to herbicides. In support of this conclusion, the private clinician cited medical evidence specific to the Veteran, as well as scholarly sources regarding the relationship between herbicide exposure and squamous cell carcinomas. The Board therefore assigns this opinion great probative weight. There is no medical opinion of record weighing against the claim. Upon review of the record, the Board finds the evidence persuasively demonstrates the Veteran's current disability of squamous cell carcinomas of the head and neck is related to service. Accordingly, the Board finds that service connection for squamous cell carcinomas of the head and neck is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Carmichael, A. 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.