Citation Nr: 18145318
Decision Date: 10/26/18	Archive Date: 10/26/18

DOCKET NO. 16-08 307
DATE:	October 26, 2018
ORDER
Entitlement to service connection for acute myeloid leukemia (AML), to include residuals of its treatment, is granted.
FINDING OF FACT
The Veteran did not have other risk factors for development of AML, and it is at least as likely as not that exposure to herbicide agents and their constituent chemicals contributed to the development of the Veteran’s AML.
CONCLUSION OF LAW
The criteria for service connection for acute myeloid leukemia are met.  38 U.S.C. § 1110; 38 C.F.R. § 3.303.
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty in the United States Army from May 1968 to May 1970.  The Veteran received both the Army Commendation Medal and a Purple Heart for his service in the Republic of Vietnam.  The Board thanks the Veteran for his service.  
This matter is before the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision.
In October 2018, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge.  
This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c).  38 U.S.C. § 7107(a)(2).
1. Entitlement to service connection for AML
The Veteran asserts that his AML was caused by exposure to herbicide agents while serving in Vietnam.  He acknowledged in a December 2014 writing to the VA that AML is not on the presumptive list for herbicide agent exposure and that he was not seeking service connection on that basis.    
In order to establish service connection for a claimed disorder on a direct basis, the following must be shown: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service.  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).
The medical evidence of record shows that the Veteran was diagnosed with AML in February 2014 by a private cancer treatment facility.  See Letter from Treating Physician (dated Feb. 6, 2016).  Because the Veteran was stationed in the Republic of Vietnam from October 1968 to October 1969, he is presumed to have been exposed to herbicide agents in service.  Accordingly, the only issue in this case is whether the Veteran’s exposure to herbicide agents has a causal relationship with his diagnosed AML.  
Of record is a positive nexus opinion written by the Veteran’s treating oncologist in October 2017.  The oncologist opined that “it is more likely than not that exposure to Agent Orange and its constituents contributed to the development of [the Veteran’s] acute myeloid leukemia.”  Her rationale was that (1) the Veteran did not have other risk factors for developing AML; (2) Agent Orange is a known carcinogen with links to other cancers, and so could not be dismissed as a potential cause to the Veteran’s AML; and (3) benzene, a constituent chemical of Agent Orange, had recently been specifically linked to an increased risk of developing AML (with citations provided to relevant studies).  The Board finds the opinion probative, as it provides a well-reasoned rationale that is both specific to the Veteran’s circumstances and based on scientific research.  
The Board notes that an August 2015 letter from the Veteran’s doctor explained that the Veteran is experiencing serious ongoing residual medical complications as a direct result of the treatment from his AML, to include chronic graft versus host disease.  
Based on the foregoing, service connection for AML, to include its residuals from treatment, is granted.  

 
M. C. GRAHAM
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	C. Anderson, Associate Counsel