BVA9501245 DOCKET NO. 92-13 022 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Newark, New Jersey THE ISSUE Entitlement to service connection for the cause of the veteran's death. REPRESENTATION Appellant represented by: Military Order of the Purple Heart ATTORNEY FOR THE BOARD M. G. Mazzucchelli, Associate Counsel INTRODUCTION The veteran served on active duty from February 1943 to May 1945. This appeal arises from a September 1991 rating decision of the Newark, New Jersey, regional office (RO). That rating decision denied the appellant's claim for service connection for the cause of the veteran's death. In December 1993, the Board of Veterans' Appeals (Board) remanded the case for additional development. Subsequently, an April 1994 rating decision continued the prior denial. CONTENTIONS OF APPELLANT ON APPEAL The appellant, widow of the veteran, contends that the myocardial infarction which caused the veteran's death in July 1991 was caused in part by the severe stress that he suffered after a fall and injury in May 1991 resulting from his service connected left leg conditions. She contends that service connection for the cause of the veteran's death should be granted. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against the appellant's claim for service connection for the cause of the veteran's death. FINDINGS OF FACT 1. The RO has obtained all relevant evidence necessary for an equitable disposition of the appeal. 2. The veteran died in July 1991, at age 72, of acute myocardial infarction due to ventricular septal rupture. 3. The veteran had no cardiac complaints in service or for several decades after his separation from service. 4. There is no etiologic connection between the disabilities for which service connection had been granted and the veteran's fatal acute myocardial infarction or ventricular septal rupture. CONCLUSION OF LAW A disability incurred in or aggravated by service did not cause death or contribute substantially or materially to the cause of the veteran's death. 38 U.S.C.A. §§ 1310, 5107(a) (West 1991); 38 C.F.R. §§ 3.102, 3.3.12 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION The appellant asserts that the veteran's acute myocardial infarction due to ventricular septal rupture was caused by or arose from stress caused by a fall due to his service connected left leg condition. The threshold question to be answered in this case is whether the appellant has presented evidence of a well-grounded claim, that is, one which is plausible. If she has not presented a well- grounded claim, her appeal must fail and there is no duty to assist her further in the development of her claim because such additional development would be futile. 38 U.S.C.A. § 5107(a) (West 1991). When the claim was previously before the Board, preliminary review indicated that it could have been well- grounded. Further development of the medical record was accomplished pursuant to the Board's remand. In the final analysis, as will be explained below, the appellant's claim is not well grounded. The death certificate shows that the veteran died in July 1991 at age 72. The immediate cause of death was acute myocardial infarction due to ventricular septal rupture. The hospital records of his terminal hospitalization at Clara Maass Medical Center show that he was admitted on an emergency basis on July 1, 1991, and died the same day. The diagnoses were acute myocardial infarction, cardiogenic shock, hepatic infarction, acute renal failure, and acidosis. Service connection for the cause of the veteran's death may be granted if the evidence shows that disability incurred in or aggravated by service either caused or contributed substantially or materially to cause death. For a service connected disability to be the cause of death, it must singly or with some other condition be the immediate or underlying cause, or be etiologically related. For a service connected disability to constitute a contributory cause, it is not sufficient to show that it casually shared in producing death, but rather it must be shown that there was a causal connection. 38 U.S.C.A. § 1310 (West 1991); 38 C.F.R. § 3.312 (1993). The veteran's service medical records do not contain any indications of treatment or complaints for any cardiovascular disorders. During his lifetime, service connection was established for: paralysis of the left common peroneal nerve, evaluated as 30 percent disabling; gunshot wounds scars and postoperative scars of the left thigh, evaluated as 10 percent disabling; gunshot wound scar of the left thumb, evaluated as 10 percent disabling; and bilateral trench foot, evaluated as 10 percent disabling. The veteran's cardiac complaints began decades after service. Although the appellant contends that the veteran's service-connected leg conditions led to his death, she has provided no medical evidence to support her claim. Lay evidence alone will not support a finding on a medical question requiring special experience or special knowledge. Espiritu v. Derwinski, 2 Vet.App. 492, 495 (1992); Tirpak v. Derwinski, 2 Vet.App. 609, 611 (1992). None of the veteran's service connected conditions affected his cardiovascular system. In the absence of any medical evidence to support the appellant's contention as to the etiology of the veteran's myocardial infarction and ventricular septal rupture, her claim cannot stand. See Williams v. Brown, No. 91-1777, slip op. at 2 (U.S. Vet. App. Feb. 17, 1993). Since the appellant has presented no medical evidence to support her claim, the evidence for and against the claim is not in relative equipoise, and the reasonable doubt doctrine does not apply. 38 U.S.C.A. § 5107 (a) (West 1991); 38 C.F.R. § 3.102 (1993). Consequently, the Board has concluded that the appellant's claim for service connection for the cause of the veteran's death is not warranted. ORDER Entitlement to service connection for the cause of the veteran's death has not been established. The benefit sought on appeal is denied. JAN DONSBACH Member, Board of Veterans' Appeals CONTINUED ON NEXT PAGE The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.