Citation Nr: 18145972 Decision Date: 10/30/18 Archive Date: 10/30/18 DOCKET NO. 14-34 973A DATE: October 30, 2018 ORDER Service connection for bladder cancer is granted. FINDINGS OF FACT 1. The Veteran was stationed at Camp Lejeune from April 1966 to June 1966 and from November 1967 to February 1968, and as a result, is presumed to have been exposed to contaminated water. 2. The Veteran’s bladder cancer is presumed to have been caused by in-service exposure to contaminated water. CONCLUSION OF LAW Bladder cancer is presumed to have been incurred in service. 38 U.S.C. §§ 1101, 1110, 1310, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from February 1966 to February 1968, stationed at Camp Lejeune and with service in the Republic of Vietnam. He was awarded the National Defense Service Medal, Vietnam Service Medal with one Bronze Star, and Vietnam Campaign Medal. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for bladder cancer, to include as due to contaminated water exposure. Service connection may be established for disability resulting from personal injury suffered or disease contracted in the line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service. 38 U.S.C. § 1110. Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). To establish service connection for a disability resulting from a disease or injury incurred in service, or to establish service connection based on aggravation in service of a disease or injury which pre-existed service, there must be (1) competent evidence of the current existence of the disability for which service connection is being claimed; (2) competent evidence of incurrence or aggravation of a disease or injury in active service; and (3) competent evidence of a nexus or connection between the current disability and the disease or injury incurred or aggravated in service. Horn v. Shinseki, 25 Vet. App. 231, 236 (2010); Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. Sept. 14, 2009); cf. Gutierrez v. Principi, 19 Vet. App. 1, 5 (2004) (citing Hickson v. West, 12 Vet. App. 247, 253 (1999)). Service connection may be granted on a presumptive basis for certain diseases associated with exposure to contaminants (defined as the volatile organic compounds trichloroethylene (TCE), perchloroethylene (PCE or PERC), benzene, and vinyl chloride) in the on-base water supply located at Camp Lejeune, even though there is no record of such disease during service, if they manifest to a compensable degree at any time after service, in a veteran, former reservist, or a member of the National Guard, who had no less than 30 days (consecutive or nonconsecutive) of service at the United States Marine Corps Base Camp Lejeune and or Marine Corps Air Station New River in North Carolina, during the period beginning on August 1, 1953, and ending on December 31, 1987. 38 C.F.R. § 3.307(a)(7). The following diseases are deemed associated with exposure to contaminated water at Camp Lejeune: kidney cancer, liver cancer, Non-Hodgkin’s lymphoma, adult leukemia, multiple myeloma, Parkinson’s disease, aplastic anemia and other myelodysplastic syndromes, and bladder cancer. 38 C.F.R. § 3.309(f). For disabilities not presumed by regulation to be due to exposure to contaminated water at Camp Lejeune, the Veteran may still establish service connection by showing that any such disability is, in fact, directly and causally linked to exposure to contaminated water at Camp Lejeune, or any other incident or injury in service. See Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). There are two issues to determine if service connection is warranted in this claim on a presumptive basis: whether the Veteran had no less than 30 days of service at Camp Lejeune and whether the Veteran’s bladder cancer was due to an enumerated disease associated with exposure to contaminated water at Camp Lejeune. The record reflects the Veteran was stationed at Camp Lejeune during active service from April 1966 to June 1966 and from November 1967 to February 1968. Therefore, the Board finds the Veteran met the threshold duration of service during the applicable time period required under 38 C.F.R. § 3.307(a)(7)(iii). Next, the Board notes that diagnoses and treatment for bladder cancer and its residuals, are confirmed by post-service treatment records. An October 2011 oncology treatment note documented CT scan findings that were suspicious for malignancy of the bladder and documented lesions of the bilateral iliac bones and liver. In November 2011, the Veteran was diagnosed with a small bladder tumor. A July 2012 note also documented cancer of the bladder, with treatment and follow-up visits throughout 2013. Although a VA examiner opined in April 2014 that the Veteran’s age, gender, hypertension, former occupation, and ex-smoking status represent “far more significant risk factors” for bladder cancer than the Veteran’s “very short tenure” at Camp Lejeune, the Board finds that opinion does not overcome the regulatory presumption in favor of service connection. The Veteran’s duration of service at Camp Lejeune entitles him to the presumption pursuant to 38 C.F.R. § 3.309(f). As bladder cancer is considered associated with exposure to contaminated water at Camp Lejeune under 38 C.F.R. § 3.309(f), the Veteran’s disability is presumed to have been incurred in service. Based upon the evidence of record, and with application of the pertinent regulations, the Board concludes that entitlement to service connection for bladder cancer is warranted. JEBBY RASPUTNIS Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Bilstein, Associate Counsel