BLADDER NEOPLASM OF

Summary

The Veteran, an Army Veteran who served from May 1970 to December 1971, appeals the denial of service connection for bladder cancer, leukemia, and prostate cancer. The Veteran contended that his leukemia might have been caused by contaminated drinking water at Forts Knox and Jackson, and that his bladder and prostate cancers were due to his leukemia. The Regional Office (RO) decision denied these claims. The Veteran's service records confirmed his presence at Forts Knox and Jackson and his foreign service in Germany, but did not document any toxic exposure or contaminated water. The Board noted the Veteran's current diagnoses of chronic lymphocytic leukemia and high-grade urothelial carcinoma, as well as prostatic adenocarcinoma from private treatment records. However, the Board found no competent evidence linking these conditions to service or any toxic exposures. The Board also noted the absence of any specific allegations of in-service events or diagnoses beyond a general, unsupported assertion about contaminated water. The Board concluded that a VA medical opinion was not required because the evidence did not suggest any link to service, and therefore denied service connection for all three conditions.

Rationale

No competent evidence of in-service incurrence.; No evidence of toxic exposure or contaminated water.; No persuasive medical or lay evidence linking condition to service.

Full Decision Text

Citation Nr: A26031052
Decision Date: 04/06/26	Archive Date: 04/06/26

DOCKET NO. 251126-619575
DATE: April 6, 2026

ORDER

Entitlement to service connection for bladder cancer is denied.

Entitlement to service connection for leukemia is denied.

Entitlement to service connection for prostate cancer is denied.

FINDINGS OF FACT

1. The Veteran's bladder cancer, leukemia, and prostate cancer are not related to his service. 

2. The Veteran did not have any toxic exposures while in service.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for bladder cancer have not been met. 38 U.S.C. §§ 1110, 1112, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309.

2. The criteria for entitlement to service connection for leukemia have not been met. 38 U.S.C. §§ 1110, 1112, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309.

3. The criteria for entitlement to service connection for prostate cancer have not been met. 38 U.S.C. §§ 1110, 1112, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service in the United States Army from May 1970 to December 1971. 

This matter comes before the?Board of Veterans' Appeals?(Board) from a September 2025 Appeals Modernization Act (AMA) rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran timely appealed this decision to the Board in November 2025 by filing a notice of disagreement (NOD) in which he requested direct review.? 

As this is a?Direct Review?appeal under the AMA, the record closed on the date of notice (September 4, 2025) of the September 2025 rating decision.?

The Board notes that in August 2025 correspondence, while filing claims for the above issues, he attempted to reopen his claim for the issue of entitlement to service connection for hearing loss, which was previously denied in an April 2022 rating decision. Although he also included this issue in his November 2025 NOD, the RO has not adjudicated this issue since April 2022. The Veteran may file a Supplemental Claim so that the VA will issue another decision on the claim. Specific instructions for filing a Supplemental Claim are included with this decision.

The Board notes this case has been advanced on the docket. Based on this, the Board will interpret this as reflecting an intent to have this matter reviewed in an expeditious manner and thus finds this to be an implicit waiver of the Veteran's right to change Board dockets under Williams v. McDonough, 37?Vet. App.?305 (2024).

Service Connection

Generally, to establish service connection a Veteran must show: "(1) the existence of a present disability; (2) 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."?Davidson v. Shinseki, 581 F.3d 1313, 1315-16 (Fed. Cir. 2009);?Shedden?v.?Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service.?38?C.F.R. §?3.303(d).?????? 

VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits.?38?U.S.C. §?1154(a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional.?Jandreau?v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).?????? 

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the Veteran.?38?U.S.C. §?5107(b
.S.C. §?1154(a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional.?Jandreau?v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).?????? 

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the Veteran.?38?U.S.C. §?5107(b); 38 C.F.R. §?3.102;?see?Gilbert v.?Derwinski,?1?Vet. App.?49, 53 (1990).??? 

1. Entitlement to service connection for bladder cancer.

2. Entitlement to service connection for leukemia.

3. Entitlement to service connection for prostate cancer.

The Veteran contends his leukemia might have been from exposure to drinking water that was contaminated at Forts Knox and Jackson, and that his bladder and prostate cancers are due to his leukemia. 

Favorable findings from the September 2025 rating decision include that the Veteran has current diagnoses of chronic lymphocytic leukemia and high-grade urothelial carcinoma (bladder cancer).  The Board notes that private treatment records from July 2025 show the Veteran also has a diagnosis of prostatic adenocarcinoma (prostate cancer). 

The Board notes the Veteran has not provided any evidence to support his contention that he was exposed to contaminated water, nor has he contended his claimed conditions are due to another toxic exposure or directly related to service. Service personnel records confirm the Veteran was stationed at Forts Knox and Jackson, but do not document any exposure to contaminated water. These records also show his only foreign service was in Germany from October 1970 to December 1971. Additionally, although no toxic exposure risk activity (TERA) memo is in the file, August 2025 correspondence shows the RO requested an Individual Longitudinal Exposure Record (ILER), which showed no exposures or deployments.

Although the law establishes a presumption of service connection for diseases associated with exposure to certain herbicide agents, the Veteran was not stationed in the Republic of Vietnam from January 1962 to May 1975, between September 1967 and August 1971 in a unit that operated in or near the Korean DMZ in an area in which herbicides were known to have been applied during that period, or has met any of the other qualifications for presumption of exposure to an herbicide agent. 38 C.F.R. § 3.307(a)(6). Additionally, although the Veteran could still establish service connection for his conditions with competent evidence that it was incurred in service, was present during other presumptive periods, or by submitting medical or scientific evidence that it was in fact due to toxic exposures during service, the Board reiterates that he has not provided such evidence. Stefl v. Nicholson, 21 Vet. App. 120 (2007); see Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994).

The Veteran has not provided any specific details alleging any in-service event or diagnosis beyond a general, unsupported assertion that there may have been toxins in the drinking water at the bases where he served, Forts Knox and Jackson. Beyond this conclusory generalized statement, there is no competent evidence of an in-service incurrence. Waters v. Shinseki, 601 F.3d 1274, 1278-79 (Fed. Cir. 2010) (holding that a claimant's mere "conclusory generalized statement" that an in-service illness caused his current disability did not trigger VA's requirement to obtain an examination, and it rejected the theory that "medical examinations are to be routinely and virtually automatically provided to all veterans in disability cases involving nexus issues").

Additionally, the Board finds there is no persuasive medical evidence or persuasive credible lay evidence that the Veteran's claimed disorder manifested to a compensable degree within a year of his separation from service or had its onset in service and continued ever since service. The Veteran was not diagnosed with his claimed conditions until 2025, as indicated in private treatment records. Additionally, there is no evidence the Veteran had symptoms of these conditions during service. Thus, service connection based on presumptive service connection for a chronic disease, or based on a theory of continuity of symptomatology is not warranted.

The Board acknowledges that the Veteran was not afforded a VA examination or medical opinion with respect to his claims for service connection. However, the Board finds no such medical opinion was required because the evidence does not indicate
 there is no persuasive medical evidence or persuasive credible lay evidence that the Veteran's claimed disorder manifested to a compensable degree within a year of his separation from service or had its onset in service and continued ever since service. The Veteran was not diagnosed with his claimed conditions until 2025, as indicated in private treatment records. Additionally, there is no evidence the Veteran had symptoms of these conditions during service. Thus, service connection based on presumptive service connection for a chronic disease, or based on a theory of continuity of symptomatology is not warranted.

The Board acknowledges that the Veteran was not afforded a VA examination or medical opinion with respect to his claims for service connection. However, the Board finds no such medical opinion was required because the evidence does not indicate that the claimed disability, or symptoms thereof, may be associated with the Veteran's active service. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). 

Under McLendon, VA is obligated to provide an examination and medical opinion when the record contains (1) competent evidence of a current disability (or persistent or recurrent symptoms of a disability), (2) evidence establishing that an event, injury, or disease occurred in service, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service, but (4) there is insufficient competent medical evidence on file to decide the claim. 38 U.S.C. § 5103A (d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). 

Additionally, under the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act) Section 303, as implemented through 38 U.S.C. § 1168 (August 10, 2022) requires that a disability examination and medical opinion be requested for certain non-presumptive conditions involving a Toxic Exposure Risk Activity (TERA). When a Veteran submits a claim for compensation, has evidence of a disability, had evidence of participation in a TERA, and such evidence is not sufficient to establish service connection for the disability, then the Veteran can claim participation in a TERA explicitly or implicitly through service in a location presumed associated with toxic exposure, or records showing participation in a TERA; or, if VA has conceded exposure in a prior claim, or the file has a claim attributable to toxic exposure. Other ways to claim or establish participation in a TERA include, when a Veteran's military occupational specialty (MOS) is associated with toxic exposure; when medical records suggest exposure to a toxic substance, chemical, or airborne hazard such as a VHA exposure screening; or, with any other relevant evidence of record to include garrison exposures.

For the reasons stated above, the Board finds that there is no competent evidence showing that the Veteran's claimed conditions may be related to service or that the Veteran had any toxic exposures. As such, the Board finds a VA medical opinion, to include a TERA opinion, is not necessary to decide the Veteran's claims. Thus, service connection for bladder cancer, leukemia, and prostate cancer is denied. 

 

TANYA SMITH

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Papacalos, Angelic

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.