Citation Nr: 20044648 Decision Date: 07/06/20 Archive Date: 07/06/20 DOCKET NO. 16-32 231 DATE: July 6, 2020 ORDER Entitlement to service connection for prostate cancer as due to Agent Orange exposure, and/or secondary to service-connected hypertension is denied. FINDINGS OF FACT 1. The Veteran was not exposed to herbicides during his active duty service. 2. The probative evidence of record demonstrates that the Veteran’s prostate cancer did not originate in service, or for many years thereafter, and has not been shown to be otherwise etiologically related to any incident during active duty service. 3. The Veteran’s prostate cancer is not etiologically related to, or aggravated by, his service-connected hypertension. CONCLUSION OF LAW The criteria for entitlement to service connection for prostate cancer as due to Agent Orange exposure, and/or secondary to service-connected hypertension have not been met. 38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from June 1966 to May 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a March 2011 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). When this case was last before the Board in October 2018, it was remanded for additional development. Specifically, the RO was instructed to obtain medical opinions regarding the Veteran’s prostate cancer and whether it was secondary to, or aggravated by, his service-connected hypertension. An October 2019 VA prostate cancer examination was obtained which addressed secondary service-connection. As such, the Board finds that the AOJ substantially complied with the directives in the October 2018 remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection—Legal Criteria Service connection may be established for disability resulting from personal injury suffered or disease contracted in the line of duty in the active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be granted for any disease initially diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection may also be granted for chronic disorders, such as diabetes or organic disease of the nervous system, when manifested to a compensable degree within one year of separation from service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). A veteran who, during active military, naval, or air service, served between April 1, 1968, and August 31, 1971, in a unit that, as determined by the Department of Defense, operated in or near the Korean DMZ in an area in which herbicides are known to have been applied during that period, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to show that the Veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307(a)(6)(iv). Presumptive service connection on the basis of herbicide exposure is authorized for specified diseases. 38 U.S.C. § 1116; 38 C.F.R. § 3.309. Atherosclerotic cardiovascular disease, diabetes, and early onset peripheral neuropathy (with an onset within one year of exposure) are among the diseases specified. When a claimed disorder is not included as a presumptive disorder, direct service connection may nevertheless be established by evidence demonstrating that the disease is related to service, to include the in-service herbicide exposure. See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. Analysis In this case, the Board has reviewed all of the evidence of record, with an emphasis on the evidence relevant to this appeal. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that VA must review the entire record, but does not have to discuss each piece of evidence). Hence, the Board will summarize the relevant evidence where appropriate and the Board’s analysis below will focus specifically on what the evidence shows, or fails to show, as to the claims. The Veteran contends that his prostate cancer is due to herbicide exposure while serving in the Republic of Korea, and/or secondary to his service-connected hypertension. The Board briefly observes that the Veteran’s service treatment records (STRs) do not show any treatment for or diagnosis of prostate cancer during service. The Veteran was first diagnosed with this condition 23 years after service in 1993, and as such, direct service connection is not warranted. The central issues that must be resolved is whether the Veteran was exposed to herbicides in Korea, or whether his prostate cancer was caused or aggravated by his service-connected hypertension. Herbicide exposure is presumed for veterans of certain units that served in or near the Korean DMZ anytime between April 1, 1968 and August 31, 1971. 38 C.F.R. § 3.307(a)(6)(iv). If a veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases shall be service-connected, even though there is no record of such disease during service, provided further the rebuttable presumption provisions of 38 U.S.C. §§ 1113, 1116 and 38 C.F.R. §§ 3.307(d), 3.309(e). The record reflects that the Veteran served in the Philippines and was assigned to the 605th Tactical Mobile Control Unit as an Aircraft Control and Warning Operator. The Veteran's unit is not one of those referenced in 38 C.F.R. § 3.307(a)(6)(iv). The record contains contentions from the Veteran that he had a TDY assignment where he was sent to Camp McGovern in Korea and spent time at the DMZ, aiding a radar installation unit. The RO submitted an inquiry to the Defense Personnel Records Information Retrieval System (DPRIS) to determine if the Veteran's unit was near the DMZ in Korea or whether the Veteran was otherwise present in the DMZ or exposed to Agent Orange while on active duty. The DPRIS in April 2016 stated that "[b]ased on a review of the Veteran’s Personnel and [STRs] there were negative findings of Temporary Duty Assignments (TDY) in Korea. There were negative findings of orders or flight itineraries to or from Korea. There were negative findings of credited TDY timeframes in the Veteran’s personnel records… In the absence of credible evidence that corroborates his appeal, we cannot at this time concede herbicide exposure during military service for this Veteran.” As the Veteran was not assigned to one of the units determined by the DoD to have served in an area where herbicides were used, and as there is no supporting evidence that the Veteran was stationed near the DMZ or worked in the DMZ, the Board must conclude that the Veteran was not exposed to herbicides during his active duty. As noted above, the Veteran's service treatment records do not contain any evidence of treatment, diagnosis or finding consistent with a prostate condition. And the Veteran’s medical treatment records show that the Veteran was not diagnosed with prostate cancer until approximately 1993, decades after his separation from service. Thus, his prostate cancer was not shown in service nor within one year following discharge from service; direct service connection is not warranted. The only question that remains for the Board, therefore, is whether the Veteran’s disability is secondary to, or aggravated by, his service-connected hypertension. In this regard, the Board concludes that the preponderance of the evidence weighs against finding that this disability is etiologically related to his service-connected hypertension. 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), (d). The Veteran was provided an October 2019 VA prostate cancer examination. The examiner opined that the Veteran’s prostate cancer was less likely than not (less than a 50 percent probability or greater) caused or aggravated by his service-connected hypertension. The rationale that the examiner provided was that hypertension and prostate cancer are entirely separate disorders that are not medically related. Additionally, the examiner noted that the medical literature does not establish a causal relationship between the two conditions. Further, the examiner indicated that there is no evidence in the Veteran’s claim’s file/medical records that connects his prostate cancer with his hypertension or shows that his hypertension aggravated his prostate cancer beyond the course of its natural progression. Based on the foregoing, the Board finds that the preponderance of the probative and persuasive evidence is against a finding of service connection for prostate cancer on a direct, presumptive, or secondary basis. Thus, the claim for service connection for this disability is denied. In reaching this conclusion, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the Veteran's claim, that doctrine is not applicable in the instant appeal. 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1990). T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Gresham 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.