Citation Nr: 22016138 Decision Date: 03/21/22 Archive Date: 03/21/22 DOCKET NO. 20-29 524A DATE: March 21, 2022 ORDER Entitlement to service connection for acute and chronic cholecystitis s/p cholecystectomy (claimed as a gallbladder disorder) is granted. FINDING OF FACT The Veteran's diagnosed acute and chronic cholecystitis s/p cholecystectomy was at least as likely as not proximately caused by treatment for service-connected malignant melanoma. CONCLUSION OF LAW The criteria for service connection for chronic cholecystitis s/p cholecystectomy are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service in the Marine Corps from February 1952 to February 1954. The appeal originates from a November 2018 decision of a Department of Veterans Affairs (VA) Regional Office. The Veteran appeared for a hearing before the undersigned in February 2022. Service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310. Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). Compensation may also be established for any incremental increase in disability or any additional impairment of earning capacity in nonservice-connected disabilities resulting from service-connected disabilities, above the degree of disability existing before the increase regardless of its permanence. Ward v. Wilkie, 31 Vet. App. 233, 239 (2019). The Veteran contends that he has a gallbladder disorder secondary to immunotherapy he underwent for his service-connected malignant melanoma. See February 2022 Hearing Transcript. Private treatment records confirm that he had a cholecystectomy to treat gallstones in April 2017. There is also evidence that he received vaccine protocol treatment for right axillary adenopathy related to malignant melanoma in the 1990s. See January and February 2019 Medical Treatment Records. The Veteran is service connected for residual scarring from malignant melanoma. As there is a current disability and service-connected disability, the remaining question is whether there is medical evidence of a nexus. In a statement dated in February 2022, A.L.V., M.D., opined that the Veteran's cholecystitis with cholelithiasis was at least as likely as not the result of immunotherapy administered in the 1990s to treat malignant melanoma. The physician explained that the immunotherapy that the Veteran received causes adverse events due to the immune system acting against self-antigens while attaching to cancer cells. The physician noted that gallbladder dysfunction is one of several types of adverse events linked to treatment for Stage III malignant melanoma and that such created an increased risk of cholecystitis due to multiple risk factors, resulting in removal of the gallbladder. There is no competent opinion to the contrary. Accordingly, service connection for a gallbladder disorder is warranted. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Alhinnawi 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.