Citation Nr: 20004272 Decision Date: 01/17/20 Archive Date: 01/17/20 DOCKET NO. 17-60 840 DATE: January 17, 2020 ORDER Entitlement to service connection for a thyroid condition, to include as papillary carcinoma and residuals of a post total thyroidectomy, is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his thyroid condition is at least as likely as not related to his in-service exposure to herbicide agents. CONCLUSION OF LAW The criteria for service connection for a thyroid condition are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from July 1968 to May 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions in September 2013, July 2015, September 2016, and February 2017. The Veteran originally requested a hearing before the Board when he filed his substantive appeal but withdrew his hearing request in August 2019 correspondence. 1. Entitlement to service connection for a thyroid condition, to include as papillary carcinoma and residuals of a post total thyroidectomy The Veteran contends that his thyroid cancer, and the subsequent thyroidectomy he underwent as a form of treatment, was the result of his in-service exposure to herbicide agents. In this regard, the Board concludes that the Veteran has a current disability that is related to his in-service exposure to herbicide agents. 38 U.S.C. §§ 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The Veteran’s private and VA treatment records document that the Veteran developed thyroid problems in 2011 and subsequently underwent a thyroidectomy. A November 2016 letter from the Veteran’s private physician indicates that he will require replacement hormone treatment as a result for the remainder of his life. The Veteran’s exposure to herbicide agents during service has been conceded and acknowledged as the cause of other service-connected disabilities, including diabetes. Thus, the question becomes whether the thyroid condition is related to this in-service exposure. On this question, there are probative opinions in favor of and against the claim. The evidence against the claim includes a September 2016 C&P examination that appears to have provided a negative opinion, but the only rationale for that opinion is the simple remark that VA regulations do not provide a presumption that thyroid cancers are linked to exposure to herbicide agents. The evidence in favor of the claim includes a November 2016 private opinion that addresses the alternative theory of direct service connection—that is that, under the facts of this specific case, this Veteran’s thyroid cancer was due to his in-service exposure to herbicide agents. The opinion cited referenced review of the medical research in the field of endocrinology that convinced this physician that there was a link between this Veteran’s condition and his in-service exposure. While it is true that there is no presumption provided by VA regulation, an opinion as to whether a condition is nonetheless related directly to herbicide agent exposure is appropriate, relevant, and required for a proper a determination of service connection. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Upon review of the record, the Board finds the evidence to be at least be in equipoise as to whether the Veteran’s current thyroid condition is related to his service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for his thyroid condition is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Steven Johnston, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.