BVA9507588 DOCKET NO. 93-13 880 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Seattle, Washington THE ISSUE Entitlement to service connection for postoperative residuals of adenocarcinoma with sigmoid colectomy as being due to, or the proximate result of, a service-connected disability. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD John R. Pagano, Counsel INTRODUCTION The veteran retired in April 1970 following completion of more than 20 years of active military service. This matter arises from a July 1992 determination rendered by the Seattle, Washington, Regional Office. Therein, it was held that the veteran's development of adenocarcinoma of the sigmoid colon was unrelated to either the veteran's military service or a service-connected disability. CONTENTIONS OF APPELLANT ON APPEAL The appellant contends that the Department of Veterans Affairs (VA) erred in denying him entitlement to the benefits sought on appeal. He contends that he developed adenocarcinoma of the sigmoid colon secondary to adhesions of the small intestine which resulted from surgery performed during his military service. He asserts that several physicians have told him that such a causal relationship exists. Alternatively, he argues that the VA examination conducted in February 1993 in conjunction with this claim was inadequate, and that further development should be undertaken prior to final appellate disposition. DECISION OF THE BOARD The Board of Veterans' Appeals (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 veteran has not submitted a well-grounded claim with regard to entitlement to service connection for postoperative residuals of adenocarcinoma with sigmoid colectomy. FINDING OF FACT No competent evidence has been presented which would tend to relate the development of adenocarcinoma of the sigmoid colon to the veteran's service-connected postoperative residuals of a small bowel resection. CONCLUSION OF LAW The claim of entitlement to service connection for postoperative residuals of adenocarcinoma with sigmoid colectomy as being secondary to a service-connected disability is not well grounded. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.310(a) (1994). REASONS AND BASES FOR FINDING AND CONCLUSION As a threshold matter, one claiming entitlement to VA benefits has the burden of submitting evidence sufficient to justify a belief that a given claim is well grounded. 38 U.S.C.A. § 5107(a). "[T]he [VA] benefits system requires more than just an allegation"; a claimant must submit supporting evidence sufficient to justify a belief by a fair and impartial individual that a given claim is plausible. See Tirpak v. Derwinski, 2 Vet.App. 609, 611 (1992). The first question thus presented is whether the appellant has met this burden with regard to his appeal. The veteran claims service connection for postoperative residuals of adenocarcinoma with sigmoid colectomy as being secondary to his service-connected postoperative residuals of a small bowel resection. He has not contended, nor does the record otherwise indicate, that adenocarcinoma developed either during military service or within one year following his discharge from military service. See 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1131, 1137 (West 1991); 38 C.F.R. §§ 3.307, 3.309 (1994). Instead, his claim is limited to the parameters set forth in 38 C.F.R. § 3.310(a) which permit a grant of service connection for disability that is proximately due to, or the result of, a service-connected disease or injury. However, the clinical evidence submitted fails to indicate that an etiological relationship exists between the service-connected disability cited and the development of adenocarcinoma of the sigmoid colon. To the contrary, a VA oncologist who examined the veteran in February 1993, indicated that, in his opinion, adenocarcinoma of the sigmoid colon was not the result of adhesions that developed following a small bowel resection during service. That physician indicated further that the development of colon cancer is more common among individuals who suffer from inflammatory bowel disease such as ulcerative colitis. Parenthetically, despite the veteran's reservations regarding the adequacy of that opinion, it appears that the examining physician considered the information in the veteran's claims file, the medical history related by the veteran, and clinical findings made during the examination in question. A medical opinion based upon such a comprehensive review meets the requirements of 38 C.F.R. § 4.1 (1994). The foregoing is the only clinical evidence of record regarding the likely etiology of the veteran's development of adenocarcinoma of the sigmoid colon. The various reports of the veteran's private hospitalization and treatment since 1991 refer only to current treatment for the disability at issue rather than to its etiology. In addition, although the veteran testified at his personal hearing that he believed an etiological relationship existed between the postoperative residuals of the small bowel resection performed during military service and the development of the disability at issue, it must be remembered that the veteran is a layman. His assumptions, therefore, regarding the relationship between various disorders (i.e., questions of medical causation), by themselves, do not constitute evidence sufficient to render a claim well grounded. See Espiritu v. Derwinski, 2 Vet.App. 492, 494-495 (1992). Moreover, the references made by the veteran in his May 1993 statement regarding his conversations with Dr. Mark Robson at Madigan Army Hospital are not probative in this regard; the veteran indicated that the doctor simply reiterated that there was no evidence that the veteran suffered from inflammatory bowel disease, and that the severity of the veteran's service-connected post surgical small bowel adhesions was a contributing factor in the veteran's development of colon cancer. It is not enough that a service- connected disability be a contributing factor in the development of a particular disorder; instead, a disability must be proximately due to, or the result of, a service-connected disease or injury in order to be given service-connected status. See 38 C.F.R. § 3.310(a). The Board has also considered the references by the veteran and his representative to "The Principles and Practice of Oncology" which, they insist, indicates that there is a higher incidence of cancer among those with obstructive disease. Such a statement, however, is too general in nature to be applied to the specific facts in this case. Moreover, the statement does not necessarily imply that a causal relationship exists between prior non cancerous surgeries in the abdominal area and the subsequent development of cancer of the sigmoid colon. See 3.310(a). Since the only probative evidence of record tends to belie rather than corroborate the veteran's allegations, he has not met the burden imposed by 38 U.S.C.A. § 5107(a). See Grottveit v. Brown, 5 Vet.App. 91, 93 (1993). The absence of competent medical evidence in support of his claim, therefore, is fatal to his appeal. It is important to note further, however, that because the veteran did not meet the burden of submitting evidence sufficient to establish a "well-grounded" claim with regard to entitlement to service connection for postoperative residuals of adenocarcinoma of the sigmoid colon, the RO was without statutory authority to carry the claim to full adjudication. See 38 U.S.C.A. § 5107(a). The RO should, therefore, vacate that portion of the rating decision that formally denied service connection for that disability so that the veteran is in a position to begin again, if he can, on a clean slate. See Grottveit, 5 Vet.App. at 93. ORDER The claim of entitlement to service connection for postoperative residuals of adenocarcinoma with sigmoid colectomy is dismissed. WARREN W. RICE, JR. Member, Board of Veterans' Appeals 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.