Citation Nr: 22018007 Decision Date: 03/27/22 Archive Date: 03/27/22 DOCKET NO. 20-22 481 DATE: March 27, 2022 ORDER Entitlement to service connection for myelodysplastic syndrome and acute myeloid leukemia, related to herbicide agent exposure, is granted. FINDING OF FACT Myelodysplastic syndrome and acute myeloid leukemia have been shown to have originated during active service. CONCLUSION OF LAW The criteria for service connection for myelodysplastic syndrome and acute myeloid leukemia, related to herbicide agent exposure, have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from February 1965 to August 1966. He served in the Republic of Vietnam and was awarded the Purple Heart. The Veteran died in June 2019. In March 2020, the Veteran's surviving spouse was substituted as the Appellant in this appeal. Service Connection for Acute Myeloid Leukemia Service connection may be granted for recurrent disability arising from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110. Service connection may 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). Where a veteran was exposed to herbicide agents during active service, and AL amyloidosis; chloracne or other acneform disease consistent with chloracne; Type 2 diabetes (also known as Type II diabetes mellitus or adult-onset diabetes); Hodgkin's disease; ischemic heart disease (including, but not limited to, acute, subacute, and old myocardial infarction; atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass surgery; and stable, unstable and Prinzmetal's angina); all chronic B-cell leukemias (including, but not limited to, hairy-cell leukemia and chronic lymphocytic leukemia; multiple myeloma; non-Hodgkin's lymphoma; Parkinson's disease; early-onset peripheral neuropathy; porphyria cutanea tarda; prostate cancer; respiratory cancers (cancer of the lung, bronchus, larynx, or trachea); and soft tissue sarcoma (other than osteosarcoma, chondrosarcoma, Kaposi's sarcoma, or mesothelioma) becomes manifest to a degree of 10 percent or more at any time after service, service connection shall be established for such disability if the requirements of 38 C.F.R. § 3.307(a)(6) are met even though there is no record of that disease during service, provided that the rebuttable presumption provisions of 38 C.F.R. § 3.307(d) are also satisfied. 38 U.S.C. § 1116; 38 C.F.R. § 3.309(e). A veteran who, during active 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. The last date on which that veteran shall be presumed to have been exposed to an herbicide agent shall be the last date on which he or she served in the Republic of Vietnam during the period beginning on January 9, 1962 and ending on May 7, 1975. 38 C.F.R. § 3.307(a)(6)(iii). Service connection may 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. Presumptive periods are not intended to limit service connection to diseases so diagnosed when the evidence warrants direct service connection. The presumptive provisions of the statute and VA regulations implementing them are intended as liberalizations applicable when the evidence would not warrant service connection without their aid. 38 C.F.R. § 3.303(d). The Veteran served in the Republic of Vietnam. Therefore, he is presumed to have been exposed to herbicide agents. A June 2017 bone marrow report from North York General indicates the Veteran was diagnosed with myelodysplastic syndrome and acute myeloid leukemia. An August 2017 written statement from K. Yee, M.D., notes that the Veteran was exposed to herbicide agents in the Republic of Vietnam and was diagnosed with myelodysplastic syndrome. The doctor opined that the medical literature established a relationship between herbicide agent exposure and the development of myelodysplastic syndrome. An April 2019 written statement from S. Gore, M.D. states that he was a Professor of Hematology and Director of Hematologic Malignancies at Yale School of Medicine and had reviewed the Veteran's clinical record. The doctor reported that: the Veteran was diagnosed with myelodysplastic syndrome and acute myeloid leukemia which "most authorities, himself included, continue these two conditions one and the same; at least a continuum of the same disease process." The doctor commented that "dioxin has been epidemiologically linked as a cause of both myelodysplastic syndrome and acute myeloid leukemia" and "the Veteran had exposure to dioxin through Agent Orange in Vietnam." Dr. Gore opined that "the Veteran's acute myeloid leukemia was related to his exposures to dioxin and benzene through his service in Vietnam." The Veteran served in the Republic of Vietnam and is presumed to have been exposed to herbicide agents. He was diagnosed with myelodysplastic syndrome and acute myeloid leukemia. Drs. Yee and Gore have attributed the diagnosed myelodysplastic syndrome and acute myeloid leukemia to the Veteran's presumed in service herbicide agent exposure exposures. The evidence is in at least equipoise as to whether the diagnosed myelodysplastic syndrome and acute myeloid leukemia originated during active service. Therefore, the Board concludes that service connection for myelodysplastic syndrome and acute myeloid leukemia is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Emily A. Kotroco 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.