Citation Nr: 21004287 Decision Date: 01/26/21 Archive Date: 01/26/21 DOCKET NO. 17-17 359 DATE: January 26, 2021 ORDER Entitlement to service connection for bladder cancer is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, the Veteran’s bladder cancer is etiologically related to his time in active service. CONCLUSION OF LAW The criteria to establish service connection for bladder cancer have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1967 to March 1970, to include overseas service in the Republic of Vietnam. See DD-214. The Veteran appeals a September 2016 rating decision by the Agency of Original Jurisdiction (AOJ) denying service connection for bladder cancer. See November 2016 Notice of Disagreement (NOD). A hearing was held in April 2020. A transcript is of record. Service Connection A Veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1110. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303 (d). Further, a Veteran who during active military, naval, or air service served in the Republic of Vietnam during the period beginning 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 establishing that the Veteran was not exposed to any such agent. 38 U.S.C. § 1116 (f) 38 C.F.R. § 3.307 (a)(6). To benefit from the presumption of service connection for diseases associated with herbicide agent exposure, the Veteran must have one of the diseases enumerated in 38 C.F.R. § 3.309 (e). However, diseases not enumerated in said regulation do not preclude service connection on a direct basis. See Combee v. Brown, 34 F.3d 1039, 1045 (Fed. Cir. 1994). The Veteran contends that herbicide agent exposure caused his bladder cancer. See November 2016 NOD. The first and second Shedden elements are met and not in dispute. The Veteran had bladder cancer. See January 2017 VA examination report. Further, the Veteran had service in the Republic of Vietnam for just over 11 months. See DD-214. See also Hearing Transcript at 3. Thus, exposure to herbicide agents is conceded. As such, the crux of this case centers on whether the Veteran’s bladder cancer is etiologically related to his herbicide agent exposure. The Veteran submitted a June 2019 private medical opinion by Dr. C.K. Dr. C.K., an oncologist, opined that based on the evidence of the Veteran’s exposure and the medical evidence that it is at least as likely as not that his bladder cancer, recurrences, treatment and complications are associated with his military exposure to the herbicides present during the Vietnam War. See June 2019 Dr. C.K. medical opinion. Dr. C.K. provided a thorough and well-reasoned explanation as to why this Veteran’s bladder cancer was due to his exposure to herbicides, including a specific analysis of his personal risk factors and family history. Additionally, he walked through the chemical makeup of the carcinogens contained in the herbicides used during the Vietnam War and their likelihood of causing this Veteran’s specific cancer. Id. The Board finds the positive medical opinion of record probative as to the nexus element in this particular case. (Continued on the next page)   Therefore, as applicable to the facts in this case, the evidence for and the evidence against the Veteran’s claim is in relative equipoise, and the Board affords him the benefit of the doubt. The Board also finds that there is expert evidence of record in this particular case establishing a link between the Veteran’s bladder cancer and his time on active duty. Accordingly, the Board grants service connection for bladder cancer. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Katie Poe, 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.