Citation Nr: 18156921 Decision Date: 12/11/18 Archive Date: 12/11/18 DOCKET NO. 16-57 930 DATE: December 11, 2018 ORDER Service connection for prostate cancer and residuals is granted. Service connection for diabetes mellitus, type II (diabetes) is granted. Service connection for hypertension is granted. FINDINGS OF FACT 1. An August 2016 deferred rating decision noted that tactical herbicide testing was conducted at Fort Gordon, Georgia from December 1966 to October 1967. A September 2016 statement from the Armed Forces Pest Management Board shows that Agent Orange was tested at Fort Gordon in July 1967. During his August 2016 Decision Review Officer (DRO) hearing, the Veteran provided competent and credible testimony that he sat on a grassy outside area during training at Fort Gordon from June 1968 to September 1968. The Veteran also submitted treatise evidence indicating that the half-life of the sprayed herbicide agent could be one to three years on the soil surface. Considering this testimony and evidence and resolving reasonable doubt in the Veteran’s favor the Board of Veterans’ Appeals (Board) makes a finding on the specific facts here (including the details of the Veteran’s training at Fort Gordon, the dates of the spraying, and the half-life of the herbicide agent), that the evidence is at least in equipoise that the Veteran was exposed to herbicide-contaminated foliage and/or soil during his service at Fort Gordon. 2. A January 2015 VA treatment record establishes a current diagnosis of prostate cancer. In a December 2015 written statement, the Veteran reported that his treating urologist had told the Veteran that his prostate cancer is related to herbicide agent exposure and advised the Veteran to seek disability benefits. Based on the foregoing (including the Board’s finding above that the Veteran was exposed to herbicide agents during service at Fort Gordon), the Board finds that service connection is warranted for prostate cancer, to include all its residuals. 3. An October 2015 VA treatment record shows Veteran has a current diagnosis of diabetes. Based on the foregoing (including the Board’s finding above that the Veteran was exposed to herbicide agents during service at Fort Gordon), the Board finds that service connection is warranted for diabetes. 4. An October 2015 VA treatment record establishes that the Veteran has a current diagnosis of hypertension. The Board’s finding above establishes that the Veteran was exposed to herbicide agents during his service at Fort Gordon. In the 2018 Congressionally-mandated report on health problems related to herbicide agent exposure, the National Academy of Sciences, Engineering, and Medicine found that there was sufficient evidence of an association between herbicide agent exposure and hypertension. This categorization means that epidemiological evidence is sufficient to conclude that there is a positive association between the exposures and hypertension. Notably this upgrades the association for hypertension from its former categorization as limited/suggestive, a category still occupied by ischemic heart disease, a disease for which service connection may be granted presumptively (unlike hypertension). In this case, the Board finds that the evidence here (including the specific facts of the Veteran’s medical and military history and the updated National Academies report), is at least equipoise that the Veteran’s hypertension is related to his directly established herbicide agent exposure. Accordingly, the Board finds that a remand for additional nexus evidence would unnecessarily delay adjudication, and that that the medical evidence showing hypertension and the competent and credible lay statements in support of the claim establish that direct service connection for hypertension is warranted on a facts-found (non-precedential) basis. CONCLUSIONS OF LAW 1. The criteria for service connection for prostate cancer and all prostate cancer residuals, secondary to herbicide exposure, have been met. 38 U.S.C. 1101, 1110; 38 C.F.R. 3.303, 3.304, 3.307, 3.309. 2. The criteria for service connection for diabetes, secondary to herbicide exposure, have been met. 38 U.S.C. 1101, 1110; 38 C.F.R. 3.303, 3.304, 3.307, 3.309. 3. The criteria for service connection for hypertension, secondary to herbicide exposure, have been met. 38 U.S.C. 1101, 1110; 38 C.F.R. 3.303; See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994) (Service connection can still be established on a direct basis even if not established on a presumptive basis.); see also Veterans and Agent Orange: Update 11 (2018). Washington, DC: The National Academies Press. https://doi.org/10.17226/25137. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from March 1968 to March 1970. These matters are before the Board on appeal from a November 2015 rating decision. The Board notes that the Veteran filed a premature VA Form 9 in which he requested an optional Board hearing. In November 2016, the Veteran perfected his appeal by filing a Form 9 in which he declined a Board hearing. After a careful review of the record (including the Veteran’s August 2016 testimony during a DRO hearing), the Board is comfortable relying on the Veteran’s second Form 9 and seeks to avoid an unnecessary delay associated with scheduling another hearing. In addition, because benefits sought are being granted in full, there is no prejudice to the Veteran with the adjudication above. 1. Service connection for prostate cancer 2. Service connection for diabetes 3. Service connection for hypertension For the reasons outlined above, these three claims for service connection are granted. VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Robinson, Associate Counsel