Citation Nr: 21075897 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 20-25 664 DATE: December 21, 2021 ORDER Entitlement to service connection for prostate cancer is granted. FINDING OF FACT Affording the Veteran the benefit of reasonable doubt, his prostate cancer is at least as likely as not the result of his presumed exposure to contaminated water while stationed at Camp Lejeune, North Carolina. CONCLUSION OF LAW The criteria for service connection for prostate cancer have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1965 to February 1966. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2019 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2020, the Board issued a decision denying the Veteran's claim for service connection for prostate cancer. The Veteran appealed the August 2020 decision to the Court of Appeals for Veterans Claims (Court). The Court granted a Joint Motion for Remand (JMR) in April 2021. The case has been returned to the Board for further appellate review. Entitlement to service connection for prostate cancer is granted. Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1131; 38 C.F.R. § 3.303. Establishing service connection generally requires 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 current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Consistent with this framework, service connection is warranted for a disease first diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. § 3.303(d). When there is an approximate balance of positive and negative evidence regarding any material issue, reasonable doubt will be resolved in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. The record establishes the Veteran has prostate cancer and he is presumed to have been exposed to contaminated water while at Camp Lejeune. See 38 C.F.R. § 3.307. Although prostate cancer is not listed in 38 C.F.R. § 3.309 as a disease presumptively linked to the Veteran's established in-service exposure, the Veteran is not precluded from establishing service connection with proof of direct causation. Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). In November 2021, the Veteran submitted an opinion dated October 2021 from private physicians Dr. R.P., Ph.D., and Dr. V.K., M.D., which cited to the Veteran's medical records, as well as medical literature, to support their opinion that it is at least as likely as not that the Veteran's prostate cancer was due to his presumed in-service exposure to contaminated water while at Camp Lejeune. In March 2020, a VA examiner opined that it was less likely than not that the Veteran's prostate cancer was caused by his presumed in-service exposure to contaminated water while at Camp Lejeune. The Board finds these two medical opinions to be equally competent and credible, and assigns them roughly equal probative value. Thus, affording the Veteran the benefit of reasonable doubt, the evidence is at least in equipoise as to whether his prostate cancer was caused by his presumed in-service exposure to contaminated water while at Camp Lejeune, and the Board finds that service connection for prostate cancer is warranted on the unique facts of this Veteran's case. M. HYLAND Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Elias, 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.