Citation Nr: 18150565 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 17-00 885 DATE: November 15, 2018 ORDER Service connection for bladder cancer is granted. FINDINGS OF FACT 1. The Veteran was present within the land borders of Vietnam during the Vietnam era and therefore is presumed to have been exposed to herbicides. 2. Resolving all doubt in the Veteran’s favor, his bladder cancer is causally related to in-service exposure to herbicides. CONCLUSION OF LAW The criteria for service connection for bladder cancer have been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from August 1969 to February 1972, to include service within the land borders of the Republic of Vietnam during the Vietnam era. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in August 2015 by a Department of Veterans Affairs (VA) Regional Office. Entitlement to service connection for bladder cancer, to include as due to in-service exposure to herbicides Service connection may be established for a disability resulting from diseases or injuries which are clearly present in service or for a disease diagnosed after discharge from service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). A veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. 38 U.S.C. § 1116(f); 38 C.F.R. § 3.307(a)(6)(iii). If a veteran was exposed to an herbicide agent during active military, naval, or air service, the following diseases shall be service-connected if the requirements of 38 C.F.R. § 3.307(a)(6)(iii) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 C.F.R. § 3.307(d) are also satisfied: AL amyloidosis, chloracne or other acneform diseases consistent with chloracne, diabetes mellitus (Type II), Hodgkin’s disease, ischemic heart disease (including, but not limited to, acute, subacute, and old myocardial infarction; atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass surgery; and stable, unstable and Prinzmetal’s angina), hairy cell leukemia and other chronic B-cell leukemias, multiple myeloma, non-Hodgkin’s lymphoma, Parkinson’s disease, early-onset peripheral neuropathy, porphyria cutanea tarda, prostate cancer, respiratory cancers (cancer of the lung, bronchus, larynx, or trachea), and soft-tissue sarcomas (other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma). 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6)(iii), 3.309(e). The Veteran asserts he has bladder cancer due to his exposure to herbicides while serving in Vietnam. First, the medical evidence of record reflects a diagnosis of bladder cancer during the appeal period for service connection purpose. Second, service records show the Veteran served within the land borders of the Republic of Vietnam during the Vietnam era, and as such, the Board presumes his exposure to herbicide agents during service. However, as bladder cancer is not a disease for which service connection may be presumptively granted, the Veteran’s claim cannot succeed under this theory of entitlement. Notwithstanding the foregoing presumption, however, a veteran is not precluded from establishing service connection with proof of direct causation. 38 U.S.C. § 1113(b); Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). In this regard, in an August 2012 letter, a private physician reported the Veteran was seen in consultation for a left ureteral transitional cell carcinoma, which was bladder cancer in the tube itself. The private physician stated that some of the risk factors included exposure to Agent Orange, and in the private physician’s opinion, it was at least as likely as not that such had been a causative factor in the development of cancer. Similarly, a December 2015 physician’s statement reflects the opinion that although “one cannot say exactly how long this condition existed prior to the date of diagnosis or definitively state its cause”, it was as likely as not that the Veteran’s bladder cancer was related to his exposure to Agent Orange in Vietnam. The evidence does not contain an opinion to the contrary. Therefore, resolving all doubt in the Veteran’s favor, the Board finds service connection for bladder cancer is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). M. M. Celli Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Jones, Associate Counsel