KIDNEY NEOPLASM OF MALIGNANT

MATTHEW W. BLACKWELDER · 2026 · Case ID: A26033545

DENIED

Summary

The Veteran, an Army Veteran who served from August 1990 to August 1993, appeals the denial of service connection for kidney cancer and lung cancer, the latter claimed as secondary to kidney cancer. The Veteran contends his kidney cancer resulted from exposure to asbestos and lead during service, specifically as a Cannon Crewmember at Fort Sill, Oklahoma, and Fort Drum, New York. The Board acknowledged favorable findings from the AOJ, including a kidney cancer diagnosis and concession of toxic exposure risk activity (TERA) related to lead ammunition, but noted no acknowledgement of asbestos exposure. The Board denied direct service connection for kidney cancer, finding no evidence of kidney pathology in service records, no continuity of symptomatology, and no malignant tumor within one year of separation. The Board found the October 2024 VA TERA examination adequate, despite its negative nexus opinion regarding lead exposure and lack of discussion on asbestos. The examiner cited general risk factors for kidney cancer, such as age, smoking, and hypertension, and concluded no causal relationship existed with toxic exposure based on available literature. A November 2025 VA physician's opinion, which found a link between the Veteran's kidney cancer and asbestos exposure, was given reduced probative value because it was based on an unconfirmed asbestos exposure and discounted the Veteran's other risk factors. The Board also denied secondary service connection for lung cancer, as the primary kidney cancer claim was denied and no independent nexus to service was established for the lung cancer. Service connection for both conditions was denied.

Rationale

No in-service complaints, treatment, or diagnosis of kidney pathology.; No malignant tumor shown within one year of separation.; No continuity of symptomatology.; VA TERA exam found no nexus between lead exposure and kidney cancer.; VA physician's opinion linking cancer to asbestos had reduced probative value due to unconfirmed exposure and presence of other risk factors.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251120-607901

Full Decision Text

Citation Nr: A26033545
Decision Date: 04/10/26 Archive Date: 04/10/26

DOCKET NO. 251120-607901
DATE: April 10, 2026

ORDER

Service connection for kidney cancer is denied.

Service connection for lung cancer, to include as secondary to kidney cancer is denied.

FINDINGS OF FACT

1. The most probative evidence persuasively favors the conclusion that the Veteran's kidney cancer was not manifested within a year of service discharge, was not incurred during service and was not otherwise related to an in-service event, injury, or disease, to include exposure to asbestos and lead ammunitions and compounds.

2. The most probative evidence persuasively favors the conclusion that the Veteran's lung cancer did not have its onset within a year of service discharge and was not incurred during a period of military service, nor has it been found to be related to any incident of service, such as exposure to asbestos and lead ammunitions and compounds or to a service-connected disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for kidney cancer have not been met. 38 U.S.C. §§ 1101, 1112, 1113, 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for service connection for lung cancer have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in the United States Army from August 1990 to August 1993.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2024 rating decision by the Agency of Original Jurisdiction (AOJ).

This appeal has been processed pursuant to the Appeals Modernization Act (AMA). Here, the Veteran selected the evidence submission docket, meaning that he had 90 days from VA's receipt of his VA Form 10182 to submit new evidence. Thus, in its adjudication of the appeal, the Board may only consider the evidence of record before the AOJ at the time of the November 2024 rating decision on appeal, as well as any evidence submitted by the Veteran with his NOD (VA Form 10182) or within 90 days following its receipt. 38 C.F.R. §§ 20.300(a), 303. The Veteran submitted a VA physician's opinion that is supportive of the appeal within the 90-day prescribed period. The Board has considered this evidence in its adjudication of the appeal.

i) Service connection for kidney cancer is denied.

The Veteran seeks service connection for kidney cancer. He contends that his kidney cancer is the result of having been exposed to asbestos and lead exposure while assigned to Company C 1/7 Field Artillery, Fort Sill, Oklahoma and B 1/33 Field Artillery, Fort Drum, New York from May 1990 to January 1991. He contends that he did not have any pre or post-service employment exposure as a lot attendant, local delivery driver, and forklift operator, respectively. See VA Form 21-4138, Statement in Support of Claim, dated in September 2024.

Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service relationship between the present disability and the disease or injury incurred in or aggravated during service (nexus). Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Service connection may also be granted for "tumors, malignant" when manifested to a compensable degree within one year of separation from service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309.

There is no specific statutory guidance with regard to asbestos-related claims, nor has the Secretary promulgated any regulations in regard to such claims. However, VA has recognized the following: Asbestos is a fibrous form of silicate mineral of varied chemical composition and physical configuration, derived from serpentine and amphibole ore bodies. Common materials that may contain asbestos are steam pipes for heating units and boilers, ceiling tiles, roofing shingles, wallboard, fire-proofing materials, and thermal insulation. Due to concerns about the safety of asbestos, the use of materials containing asbestos has declined in the United States since the 1970s.

Some of the major occupations involving exposure to asbestos include mining, milling, work in shipyards, insulation work, demolition of old buildings carpentry and construction manufacture and servicing of friction products, such as clutch facings and brake linings, and manufacture and installation of products, such as roofing and flooring materials asbestos cement sheet and pipe products, and military equipment. Exposure to any simple type of asbestos is unusual except in mines and mills where the raw materials are produced.

Many people with asbestos-related diseases have only recently come to medical attention because the latent period for development of disease due to exposure to asbestos ranges from 10 to 45 or more years between first exposure and the development of the disease. The exposure may have been direct or indirect; the extent and duration of exposure is not a factor.

As a preliminary matter, the Board notes that in the appealed November 2024 rating decision, the AOJ made the following favorable findings: (i) the Veteran has been diagnosed as a having kidney cancer, per VA treatment records, dated in late August 2024, and October 2024 examination report; (ii) the Veteran's participation in a toxic exposure risk activity (TERA) is conceded (namely exposure to lead munitions, but no acknowledgement that he was exposed to asbestos); evidence shows non-deployment related exposure (such as Military Occupational Specialty; other military duties; garrison exposures). Findings identified as favorable in an AOJ decision are binding on subsequent adjudicators, including the Board. 38 U.S.C. § 5104(b)(4); 5104A; 38 C.F.R. § 20.801(a). Favorable findings can only be rebutted by evidence that identifies a clear and unmistakable error in the favorable finding, 38 C.F.R. § 20.801(a).

Thus, the question that remains is whether the Veteran's diagnosed kidney cancer is the result of his presumed garrison exposures during military service.

At the outset, the Board finds the claim must be denied on a direct service connection theory of entitlement. Here, the Veteran's service treatment records (STRs) do not show any relevant complaints, treatment, or diagnoses referring to any kidney pathology and/or cancer. The claimed condition was not shown upon separation from service. Accordingly, a chronic condition is not shown during service. See 38 C.F.R. §§ 3.303. There is also no evidence of a malignant tumor of the kidney within one year of separation from service. See 38 C.F.R. §§ 3.307, 3.309. The Veteran has not claimed to have had a continuity of symptomatology, and there is no relevant medical evidence dated between the Veteran's separation from service in 1993 and 2024, a period of about 31 years, to support any claim of continuity. There is no competent opinion of record in favor of the claim on a direct or presumptive basis of service connection.

The Veteran primarily argues that service connection is warranted based on exposure to asbestos and lead styphnate exposure. The Board finds that the weight of the evidence is also against this theory of entitlement. There are VA opinions that are against and supportive of this theory of entitlement, respectively.

The Veteran was afforded a VA TERA examination and opinion as to his claimed kidney cancer in October 2024. The October 2024 VA examiner provided a negative nexus opinion between the Veteran's current kidney cancer and his exposure to lead ammunition/compounds from having performed duties during service as a Cannon Crewmember. The VA examiner opined that the Veteran's kidney cancer was less likely than not (likelihood is less than approximately balanced or nearly equal) caused by the indicated toxic exposure risk activity(ies), after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran.

In reaching his conclusion,
are against and supportive of this theory of entitlement, respectively.

In reaching his conclusion, the October 2024 VA examiner reasoned that it was not clear what caused most kidney cancers, and that kidney cancer happened when cells in the kidney developed changes in their DNA. To that end, the VA examiner stated that a cell's DNA holds the instructions that tell the cell what to do, and that in healthy cells, the DNA gives instructions to grow and multiply at a set rate; the instructions tell the cells to die at a set time. In cancer cells, according to the examiner, the DNA changes give different instructions, and that the changes tell the cancer cells to make many more cells quickly. The examiner related that cancer cells can keep living while healthy cells die, which, in turn, causes too many cells. As a result, the cancer cells form a mass called a tumor, which can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it is called metastatic cancer.

The October 2024 VA examiner recited the following factors that may increase the risk of kidney cancer in an individual: (i) Older age; the risk of kidney cancer increases with age; (ii). Smoking tobacco; individuals who smoke have a greater risk of kidney cancer than those who do not, although the risk decreases after quitting; (iii) Obesity; people who are obese have a higher risk of kidney cancer than people who are considered to have a healthy weight; (iv) High blood pressure, also called hypertension, increases the risk of kidney cancer; (v) Certain inherited conditions; people who are born with certain inherited conditions may have an increased risk of kidney cancer (e.g., von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, tuberous sclerosis complex, hereditary papillary renal cell carcinoma and familial renal cancer); and (vi) Family history of kidney cancer; the risk of kidney cancer is higher if a blood relative, such as a parent or sibling, has had the disease. The VA examiner concluded that given that the literature does not support a causal relationship between toxic exposure and renal cell carcinoma, no nexus is reasonable. See October 2024 VA examiner's opinion.

The Board finds the October 2024 VA opinion adequate and probative, as it is based on review of the claims file, reflects consideration of the Veteran's prior medical history, cites relevant medical research (i.e., Mayo Clinic treatise evidence discussing the etiology of kidney cancer) and includes detailed rationale in support of its conclusions. The Board notes that the October 2024 VA TERA examination and opinion did not address the Veteran's alleged exposure to asbestos during service. The Board finds, however, that examination and opinion addressing the claimed additional asbestos exposure is not required as there is no probative evidence that the Veteran participated in a TERA with regard to his alleged asbestos exposure. However, the AOJ prepared a TERA Memorandum and concluded that the Veteran was exposed to garrison exposure, notably lead ammunition (not asbestos) from having served as a Cannon Crewmember. See October 2024 TERA Memorandum. Significantly, the only evidence pertaining to this alleged asbestos exposure are the Veteran's statements as to such submitted during the appeal period, as well as medical treatise evidence discussing a relationship between asbestos exposure and the development of kidney cancer. Consequently, a remand is not required to obtain a VA examination and opinion specifically addressing the Veteran's alleged asbestos exposure under the TERA opinion standards. As such, the Board finds the October 2024 VA examiner's absence of a discussion of the relationship between asbestos and the development of kidney cancer does not render the October 2024 VA opinion inadequate.

Evidence in support of the claim includes a November 2025 VA physician's opinion. The VA physician noted that he had treated the Veteran for the management of his kidney cancer since July 2023. The VA physician stated that he was familiar with the Veteran's history, and that he did not have any other significant risk factors that might have precipitated his current condition. After a review of the pertinent records, it was the VA physician's professional opinion that it was more likely than not that the Veteran's
exposure under the TERA opinion standards. As such, the Board finds the October 2024 VA examiner's absence of a discussion of the relationship between asbestos and the development of kidney cancer does not render the October 2024 VA opinion inadequate.

Evidence in support of the claim includes a November 2025 VA physician's opinion. The VA physician noted that he had treated the Veteran for the management of his kidney cancer since July 2023. The VA physician stated that he was familiar with the Veteran's history, and that he did not have any other significant risk factors that might have precipitated his current condition. After a review of the pertinent records, it was the VA physician's professional opinion that it was more likely than not that the Veteran's condition of Stage IV metastatic clear cell renal cell carcinoma was a direct result of his asbestos exposure during his years of military service in the years 1990 through 1994. In support of his opinion, the VA physician cited several medical articles. See November 2025 VA physician's opinion.

The Board finds the November 2025 VA physician's opinion to be of reduced probative value in its adjudication of the claim. First, the VA examiner's favorable opinion is based on an inaccurate premise, namely that the Veteran's kidney cancer is the result of confirmed in-service asbestos exposure. As noted in the preceding paragraph, there is no probative evidence that the Veteran participated in a TERA with regard to his alleged asbestos exposure. Second, the VA physician emphatically opined that the Veteran did not have any other risk factors that could have led to the development of his kidney cancer. In doing so, the VA physician cited to a medical article, which had also been submitted by the Veteran in support of his appeal, titled, "Workplace exposure to asbestos and the risk of kidney cancer in Canadian men." It was also noted that kidney cancer was the fifth most common cancer in men. This article specifically lists the risk factors for the development of kidney cancer to include: cigarette smoking and hypertension. These two factors are clearly demonstrated in the Veteran's medical history. See VA treatment records listing hypertension and cigarette smoking in his "Problem List." It was also noted that the Veteran had smoked daily for approximately 20 years after leaving the military, although smoking approximately one pack per week. In addition, the VA physician did not relate the Veteran's kidney cancer to his confirmed exposure to lead ammunition as a Cannon Crewmember. For these reasons, the Board finds the November 2025 VA physician's opinion to be of reduced probative value in its adjudication of the claim.

The Board has considered the medical article submitted by the Veteran titled, "Workplace exposure to asbestos and the risk of kidney cancer in Canadian men." The United States Court of Appeals for Veterans Claims (Court) has held that a medical article or treatise "can provide important support when combined with an opinion of a medical professional" if the medical article or treatise evidence discusses generic relationships with a degree of certainty such that, under the facts of a specific case, there is at least "plausible causality" based upon objective facts rather than on an unsubstantiated lay medical opinion. Mattern v. West, 12 Vet. App. 222, 228 (1999). In the present case, the treatise evidence submitted by the Veteran discusses the probability of an etiological relationship between the development of kidney cancer and Canadian men who were exposed to asbestos. As stated previously herein, there is no confirmed evidence that the Veteran was exposed to asbestos during service. The Veteran also submitted an article titled, "Lead and Lead Compounds," which discussed the development of benign and malignant kidney tumors in mice and rats (not humans) that were exposed to lead orally, by injection, or perinatally (via the placenta or lactation). The medical articles submitted are general in nature and do not reasonably approximate the facts and circumstances of the Veteran's case. The Board therefore concludes that this information is insufficiently probative to warrant a grant of the claim. Id.

With regard to the Veteran's own contentions, and the lay statement, lay persons are competent to provide opinions on some medical issues. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). However, the issues of diagnosis and etiology of kidney cancer fall outside of the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The Veteran's service treatment records and post-service medical records have been discussed. A VA examiner provided a competent opinion of record that specifically addressed the Veteran's development of kidney cancer in light of his confirmed exposure to lead ammunition during service and found no relationship. The Veteran's kidney cancer was first shown many years following separation from active duty service. Given the
opinions on some medical issues. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). However, the issues of diagnosis and etiology of kidney cancer fall outside of the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The Veteran's service treatment records and post-service medical records have been discussed. A VA examiner provided a competent opinion of record that specifically addressed the Veteran's development of kidney cancer in light of his confirmed exposure to lead ammunition during service and found no relationship. The Veteran's kidney cancer was first shown many years following separation from active duty service. Given the foregoing, the Board finds that the medical evidence outweighs the Veteran's contentions, and the lay statement, to the effect that he has kidney cancer due to his service. Madden v. Gober, 125 F. 3d 1477, 1481 (Fed. Cir. 1997).

Here, it is noted that the evidence of record does not confirm asbestos exposure during the Veteran's military service, and the Veteran had two of the prevalent risk factors for developing kidney cancer. As discussed, the evidence of record weighs against his claim. Accordingly, service connection for kidney cancer is denied.

Service connection for lung cancer as secondary to kidney cancer is denied.

The Veteran seeks service connection for lung cancer. An October 2024 VA examiner indicated that the Veteran's lung cancer was a result of his kidney cancer. However, as the Board has denied service connection for kidney cancer herein, secondary service connection cannot be granted for lung cancer on this basis. See 38 C.F.R. § 3.310 (a); Sabonis v. Brown, 6 Vet. App. 426, 430 (1994).

The evidence also fails to suggest that the Veteran's lung cancer was present in service or is otherwise related to service. There is no opinion of record that relates the Veteran's lung cancer to his period of military service.

As discussed, the most probative evidence of record weighs against a finding that the Veteran's lung cancer is either related to a service-connected disability or is otherwise related to service. Therefore, service connection for lung cancer is denied.

MATTHEW W. BLACKWELDER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Carole Kammel, 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.

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