**§3.312 Cause of death.**

\(a\) *General.* The death of a veteran will be considered as having
been due to a service-connected disability when the evidence establishes
that such disability was either the principal or a contributory cause of
death. The issue involved will be determined by exercise of sound
judgment, without recourse to speculation, after a careful analysis has
been made of all the facts and circumstances surrounding the death of
the veteran, including, particularly, autopsy reports.

\(b\) *Principal cause of death.* The service-connected disability will
be considered as the principal (primary) cause of death when such
disability, singly or jointly with some other condition, was the
immediate or underlying cause of death or was etiologically related
thereto.

\(c\) *Contributory cause of death.*

\(1\) Contributory cause of death is inherently one not related to the
principal cause. In determining whether the service-connected disability
contributed to death, it must be shown that it contributed substantially
or materially; that it combined to cause death; that it aided or lent
assistance to the production of death. 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.

\(2\) Generally, minor service-connected disabilities, particularly
those of a static nature or not materially affecting a vital organ,
would not be held to have contributed to death primarily due to
unrelated disability. In the same category there would be included
service-connected disease or injuries of any evaluation (even though
evaluated as 100 percent disabling) but of a quiescent or static nature
involving muscular or skeletal functions and not materially affecting
other vital body functions.

\(3\) Service-connected diseases or injuries involving active processes
affecting vital organs should receive careful consideration as a
contributory cause of death, the primary cause being unrelated, from the
viewpoint of whether there were resulting debilitating effects and
general impairment of health to an extent that would render the person
materially less capable of resisting the effects of other disease or
injury primarily causing death. Where the service-connected condition
affects vital organs as distinguished from muscular or skeletal
functions and is evaluated as 100 percent disabling, debilitation may be
assumed.

\(4\) There are primary causes of death which by their very nature are
so overwhelming that eventual death can be anticipated irrespective of
coexisting conditions, but, even in such cases, there is for
consideration whether there may be a reasonable basis for holding that a
service-connected condition was of such severity as to have a material
influence in accelerating death. In this situation, however, it would
not generally be reasonable to hold that a service-connected condition
accelerated death unless such condition affected a vital organ and was
of itself of a progressive or debilitating nature.

\[26 FR 1582, Feb. 24, 1961, as amended at 54 FR 34981, Aug. 23, 1989;
54 FR 42803, Oct. 18, 1989\]

**Cross references:** Reasonable doubt. See §3.102. Service connection
for mental unsoundness in suicide. See §3.302.