Citation Nr: 21003785 Decision Date: 01/22/21 Archive Date: 01/22/21 DOCKET NO. 15-22 015 DATE: January 22, 2021 ORDER Entitlement to service connection for bladder cancer is granted. FINDING OF FACT The evidence is in at least relative equipoise as to whether the Veteran’s bladder cancer was incurred in or is otherwise related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for bladder cancer have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1958 to July 1978. This appeal to the Board of Veterans’ Appeals (Board) arose from an October 2012 rating decision issued by the Department of Veterans Affairs (VA). See September 2013 Notice of Disagreement (NOD); May 2015 Statement of the Case (SOC); June 2015 Substantive Appeal (VA Form 9). Unfortunately, the Veteran passed away during the pendency of the Appeal. The Veteran’s spouse has been substituted as the Appellant for the appeal. In November 2018, the Board denied the Appellant’s claim. November 2018 Board decision. The Appellant appealed the November 2018 Board decision to the United States Court of Appeals for Veterans Claims (CAVC), and, through a Joint Motion for Partial Remand, the claim was remanded. October 2019 CAVC decision. In July 2020, the Board remanded the claim for further development. July 2020 Board decision. The Agency of Original Jurisdiction developed the evidence and continued the denial of the Appellant’s claim. November 2020 Supplemental Statement of the Case. The claim is now back before the Board. Entitlement to service connection for bladder cancer The Appellant asserts that entitlement to service connection for bladder cancer is warranted due to the Veteran’s exposure to herbicide agents during service. See September 2013 NOD; June 2015 VA Form 9. Service connection may be established for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Service connection is established when there is competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). 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 C.F.R. § 3.307(a)(6)(iii). If a veteran was exposed to a 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) 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 disease consistent with chloracne; Type II diabetes; Hodgkin’s disease; ischemic heart disease (to include coronary artery disease); all chronic B-cell leukemias; multiple myeloma; non-Hodgkin’s lymphoma; Parkinson’s disease; early-onset peripheral neuropathy; porphyria cutanea tarda; prostate cancer; respiratory cancers; and soft tissue sarcoma. 38 C.F.R. § 3.309(e). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). The Board finds that the evidence supports the Veteran had bladder cancer during the period on appeal and that he is presumed to have been exposed to herbicide agents based on the time and place of his service. 38 C.F.R. § 3.307(a)(6); July 1978 DD Form 214; June 2011 VA treatment evidence. While the Veteran’s bladder cancer is not a disease currently listed at 38 C.F.R. § 3.309(e), the question remaining for the Board is whether the evidence supports a medical link to service on a direct basis. See Combee v. Brown, 34 F.3d 1039, 1043-1044 (Fed. Cir. 1994). The October 2020 VA examiner found that there is no available study to support bladder is caused by Agent Orange herbicide agent, but that the studies do show Agent Orange is a carcinogen. October 2020 VA examination medical opinion. Based on this evidence, the VA examiner opined that it is at least as likely as not that the Veteran’s bladder cancer was caused by his in-service exposure to herbicide agents. Id. The October 2020 VA examiner is a medical professional qualified to opine on the cause of the Veteran’s bladder cancer, who provided detailed rationale to support the opinion. The Board finds the VA examiner’s opinion to be probative. The Board, therefore, finds that the evidence is at least in relative equipoise as to whether the Veteran’s bladder cancer was incurred in or otherwise due to service. Accordingly, entitlement to service connection for bladder cancer is warranted. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Lin 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.