Board Denial of Claims Related to Chemical Exposure Contained Legal Error

Summary of the Case

The Veteran served on active duty in the United States Coast Guard from July 1959 to May 1963.  Following service, the Veteran filed claims for benefits for coronary artery disease (CAD), atrial fibrillation, and essential tremors of the hands as due to chemical exposure.  In May 1993, a VA examiner wrote that he reviewed the current medical literature and found “one case of Parkinson’s related to exposure to carbon tetrachloride.”  On that basis, the examiner concluded that it was possible that carbon tetrachloride exposure triggered a chronically progressive essential tremor disorder.  A decade later, another examiner also stated there may be a connection between carbon tetrachloride exposure and hand tremors.  However, the Veteran did not follow through with his claims on appeal.

In April 2016, the Veteran sought to reopen his previously denied claims for benefits for CAD, atrial fibrillation, and essential tremors of the hands, which he alleged were the result of in-service exposure to chemicals, including carbon tetrachloride.  A VA physician assistant provided a medical opinion in May 2016.  The examiner concluded that any comment on the actual causation of the Veteran’s essential tremor, CAD, and atrial fibrillation conditions due to his exposure to chemicals could only be done by resorting to speculation.  Three days later, a VA Regional Office reopened the Veteran’s claims, but denied them on the merits.  The Regional Office determined that there was no link between the Veteran’s service and his claimed conditions.  The Veteran ultimately perfected his appeal to the Board and testified at a hearing before a Board member in March 2018.

Board Denies Service Connection for CAD, Atrial Fibrillation, and Essential Tremors

In May 2018, the Board issued a decision denying the veterans’ claims on the merits.  The Board accepted the Veteran’s reports of in-service chemical exposure, as well as the diagnoses of CAD, atrial fibrillation, and essential tremors.  In its decision, the Board relied predominantly on the May 2016 VA medical opinion to deny the Veteran’s claims.  The Board acknowledged the May 1993 and June 2006 VA medical examination reports, but found them “inconclusive.”

CCK Appeals to the CAVC

CCK successfully appealed to the Court of Appeals for Veterans Claims (CAVC) the Board decision that denied service connection for CAD, atrial fibrillation, and essential tremors of the hands based on exposure to chemicals.  CCK argued that the Board erred in relying on the May 2016 VA medical opinion for two reasons: (1) the examiner applied too stringent a standard of proof – requiring a “conclusive link” between chemical exposure and his conditions, rather than assessing whether it was “at least as likely as not” that his conditions were related to chemical exposure; and (2) the examiner relied on general medical articles to conclude that there was no nexus, but did not apply the info contained in those articles to the specifics of this Veteran’s case.  Furthermore, CCK argued that the Board provided inadequate reasons or bases for its reliance on the May 2016 VA medical opinion.

Court Agrees with CCK’s Arguments

CCK argued, and the Court agreed, that the Board appears to have adopted the May 2016 VA medical opinion that the Veteran’s conditions were not related to in-service chemical exposure because there was no “clear and concise causation conclusion” in the medical community, without first examining, given its language, whether that opinion reflects an assessment under the benefit of the doubt standard.  The Court concluded that this constituted a legal error.  As such, remand is warranted for the Board to reconsider the May 2016 VA medical opinion, along with the other evidence of record, and expressly assess whether the evidence is at least in equipoise (i.e. of equal weight).