Citation Nr: 21021867 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 19-31 563 DATE: April 14, 2021 ORDER Entitlement to service connection for chronic myelomonocytic leukemia with acute myelogenous leukemia (leukemia), to include as due to exposure to benzene fuel aviation, is granted. FINDINGS OF FACT 1. The evidence is at least in equipoise as to whether the Veteran was exposed to benzene during service. 2. Resolving all reasonable doubt in favor of the Veteran, the evidence demonstrates that the currently diagnosed leukemia is etiologically related to his active duty service, to include benzene fuel exposure. CONCLUSION OF LAW The criteria for service connection for leukemia, to include as due to exposure to benzene, have been met. 38 U.S.C.§§ 1131, 5107(b) (West 2012); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from December 1990 to May 1991. In April 2021, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. The transcript of that hearing will be processed and associated with the claims file in the normal course of business. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a link between the claimed in-service disease or injury and the present disability. Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013). Service connection may be granted for any disease initially diagnosed after service when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). In the present case, the Veteran contends that during his service, he was a crew chief aircraft mechanic, during which he was exposed to aviation fuels on a daily basis. As an aircraft mechanic, the Veteran was tasked with working with fuel, hydraulic, pneumatic, engines, and on general repairs of systems of aircrafts. The Veteran would refuel aircrafts daily, at which fuel would leak onto his hands. The Veteran also helped with maintenance on fuel bladders, during which he was soaked with aviation fuel a couple of times. Since his discharge, he worked in the computer technology field; and thus, was not exposed to any hazardous chemicals. See April 2017 Statement to Support Claim. Here, the Board finds that the Veteran has a current diagnosis of acute myelogenous leukemia (AML). See May 2017 VA examination report. As such, the first element of service connection, a current diagnosis, is satisfied. A review of the service personnel records shows that the Veteran served in an occupation, as a strategic aircraft maintenance technician, that would have exposed him to benzene fuel. Thus, the second element, an in-service occurrence or event, is satisfied. Therefore, the dispositive issue in this case is with respect to the third element, a causal relationship, i.e., nexus between the claimed in-service disease or injury and the current disability. The Board finds that the medical evidence of record is in equipoise as to whether the Veteran’s leukemia was incurred in or aggravated by active service. Here, in a June 2017 VA medical opinion, the VA examiner opined that the Veteran’s leukemia was less likely than not related to the Veteran’s service. The VA examiner noted that there is a significant latency period between the Veteran’s claimed exposure to benzene fuel and his development of leukemia. In an August 2017 non-VA medical opinion, Dr. S.M. noted that the Veteran has leukemia characterized by an SF3B1 mutation. This is strongly associated with a subtype of MDS known as refractory anemia with ringed sideroblasts. This subtype of MDS is characterized by a slowly progressive course. Thus, after reviewing the Veteran’s military background, and the Veteran’s timeline of exposure, Dr. S.M. opined that the Veteran’s exposure to benzene compounds, as part of his service duties, contributed to him developing leukemia. Dr. S.M. noted that the development of leukemia and benzene exposure is well supported by medical literature. Dr. S.M. included the citations to several articles to support his opinion. Furthermore, Dr. S.M. provided more clarifying testimony during the April 2021 Board hearing with respect to the latency period associated with the development of leukemia after his benzene fuel exposure years prior. Based on the foregoing, and the unique facts of this claim, the Board finds that the August 2017 non-VA medical opinion by Dr. S.M, as well has his April 2021 Board hearing testimony, which link the Veteran’s leukemia to his in-service exposure to benzene fuel, supports a finding that the Veteran’s leukemia is at least as likely as not related to the Veteran’s service. Thus, the third element of service connection is satisfied. The Board acknowledges, when considering all the evidence of record, some of it is favorable and some of it is unfavorable and thus in equipoise. A claim will be denied only if the preponderance of the evidence is against the claim. If the evidence for and against a claim is in equipoise, the claim will be granted. See 38 U.S.C. § 5107. Resolving reasonable doubt in the Veteran’s favor, entitlement to service connection for leukemia is warranted. YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Abdelbary, 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.