Citation Nr: 20064366 Decision Date: 10/02/20 Archive Date: 10/02/20 DOCKET NO. 17-53 316 DATE: October 2, 2020 ORDER Entitlement to service connection for tubulointerstitial nephropathy is granted. FINDING OF FACT Resolving all doubt in the Veteran’s favor, the Veteran’s tubulointerstitial nephropathy is causally related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for tubulointerstitial nephropathy have been met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1967 to August 1969. The Board is aware that the Veteran has requested a hearing. In light of delays in hearings scheduling caused by COVID-19, the Board ordered a review of some of the oldest docket legacy cases in our hearing queue that may be fully granted with evidence of record. Based on the grant of the appeal, the Veteran’s request for a hearing is no longer necessary and will be cancelled. Entitlement to service connection for tubulointerstitial nephropathy The Veteran contends that his kidney condition, diagnosed as tubulointerstitial nephropathy, is causally related to his military service. The Board finds that the Veteran’s tubulointerstitial nephropathy was caused by the Veteran’s active service, to include as due to exposure to herbicides. 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. See Davidson v. Shinseki, 581 F.3d 1313 (Fed.Cir.2009); Hickson v. West, 12 Vet. App. 247, 253 (1999). 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, is presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to the contrary. 38 C.F.R. § 3.307 (a)(6)(iii). The Veteran had verified service in Vietnam where he was assigned to a riverboat and awarded a Combat Action Ribbon and Purple Heart during his active service. Certain diseases associated with exposure to certain herbicide agents used in support of military operations in the Republic of Vietnam (Vietnam) during the Vietnam era will be considered to have been incurred in service. 38 U.S.C. § 1116 (a)(1); 38 C.F.R. § 3.307(a)(6). Tubulointerstitial nephropathy is not a listed disease under 38 C.F.R. § 3.307(e), thus the Veteran is not entitled to service connection for tubulointerstitial nephropathy on a presumptive basis. However, the Veteran still may be entitled to service connection for tubulointerstitial nephropathy on a direct basis. The Veteran’s service treatment records, including entrance and separation examination reports are silent for any complaints, treatment or diagnosis for any kidney conditions during service. On VA examination in June 2017, the Veteran was diagnosed with chronic renal disease and tubulointerstitial nephropathy. The examiner provided a negative opinion stating there was no nexus between agent orange/herbicidal exposure and tubular interstitial nephropathy. The Veteran submitted a private opinion September 2020 that the underlying pathology for his chronic kidney disease was tubulointerstitial nephropathy. The opinion provider stated that the Veteran’s tubulointerstitial nephropathy was caused by his exposure to herbicides, namely dioxin. The opinion cited to several studies that showed a relationship between dioxin exposure and chronic kidney disease. Evidence against the Veteran’s claim is the June 2017 medical opinion. However, the June 2017 medical opinion states that there is no current medical literature to support a medical relationship between herbicides and tubulointerstitial nephropathy. In contrast, the September 2020 did cite to medical literature and studies that show a link between the Veteran’s chronic kidney disease of tubulointerstitial nephropathy and his presumptive exposure to herbicides. The Board finds the competent and probative evidence to be in relative equipoise as to whether the Veteran’s tubulointerstitial nephropathy caused or aggravated by his active service. Thus, affording all reasonable doubt in the appellant’s favor, service connection for tubulointerstitial nephropathy is warranted. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. G. Perkins, 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.