07-20 504
07-20 504
| Board of Vet. App. | Sep 30, 2016Background
- Veteran served Jan 1944–Mar 1946 and died Aug 2006; immediate cause of death listed as complications of blunt force head injury with a motor vehicle crash as the underlying cause.
- At death, Veteran had multiple service-connected conditions including shrapnel residuals of the left and right eyes (noncompensable), cold injuries, pes planus, and individual unemployability.
- Appellant (surviving spouse) sought Dependency and Indemnity Compensation (DIC), alleging the service-connected left-eye shrapnel shifted in the 2005 motor vehicle accident and caused or contributed to death.
- Medical records (CT, MRI, prior exams) showed operative changes and subdural hematoma but no retained metallic foreign body in the head; 1945–1947 records showed removal of a right corneal foreign body and no left-eye disease.
- VA obtained a September 2014 medical opinion concluding it is less likely than not that the eye shrapnel caused or contributed to death; the examiner found no evidence of retained shrapnel in the brain/head.
- Board found no competent medical evidence linking death to a service-connected disability, concluded VA met its notice and assistance duties, and denied service connection for cause of death.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Veteran's death was caused or contributed to by a service‑connected condition (left‑eye shrapnel) | Appellant: shrapnel residuals in left eye shifted during 2005 MVA and led to fatal complications | VA: medical evidence and imaging show no retained shrapnel or causal link; death due to blunt head trauma from MVA | Denied — no competent medical evidence linking service‑connected eye conditions to death; VA opinion is most probative |
| Whether appellant’s lay statements suffice to establish etiology | Appellant: her observations and belief that shrapnel shifted support claim | VA: etiology requires medical expertise; lay speculation insufficient | Denied — lay statements insufficient to establish medical causation |
| Whether VA satisfied duty to assist and provide required notices (Hupp factors) | Appellant: (implicit) claim adequately developed? | VA: provided 2006 notice responsive to DIC based on previously service‑connected condition and completed necessary development including medical opinion | Held — VA satisfied notice and assistance obligations; further development not necessary |
| Adequacy of VA medical opinion | Appellant: (contested causation) | VA: opinion was based on full record review, imaging, and rationale; appellant did not challenge adequacy | Held — VA medical opinion adequate and persuasive |
Key Cases Cited
- Duenas v. Principi, 18 Vet.App. 512 (2004) (lay evidence insufficient to render medical etiology opinions)
- Stadin v. Brown, 8 Vet.App. 280 (1995) (medical expertise required for causation opinions)
- Woehlaert v. Nicholson, 21 Vet.App. 456 (2007) (limitations of lay evidence on medical questions)
- Gilbert v. Derwinski, 1 Vet.App. 49 (1990) (benefit‑of‑the‑doubt rule and weighing of evidence)
- Barr v. Nicholson, 21 Vet.App. 303 (2007) (standards for adequacy of VA medical examinations)