BLADDER NEOPLASM OF

Summary

The Veteran served in the United States Army from January 1971 to January 1977. This case involves an appeal from a February 2024 rating decision, with the Veteran electing the Hearing docket and testifying in January 2026. The Veteran claims service connection for bladder cancer and hypertension, asserting exposure to herbicide agents in Panama. He also claims service connection for left kidney removal secondary to his bladder cancer. The Board reviewed evidence of record up to the February 2024 decision and evidence submitted by the hearing date. The Veteran provided testimony about herbicide exposure in Panama, including swimming in Gatun Lake and witnessing spraying operations. A VA examination in December 2023 diagnosed bladder cancer, left kidney removal, and hypertension, and opined that bladder cancer is presumptively linked to herbicide exposure. The Board found the Veteran's testimony credible and supported by a TERA memorandum, concluding that bladder cancer and hypertension are caused by herbicide exposure. The Board also found the left kidney removal was caused by the service-connected bladder cancer, based on the VA examiner's opinion. Service connection for bladder cancer and hypertension was granted, as was service connection for left kidney removal secondary to bladder cancer.

Rationale

Veteran's testimony regarding herbicide exposure in Panama is credible.; TERA memorandum supports herbicide exposure.; Bladder cancer is associated with herbicide exposure.; Benefit of the doubt resolved in Veteran's favor.

Full Decision Text

Citation Nr: A26035456
Decision Date: 04/16/26	Archive Date: 04/16/26

DOCKET NO. 250218-517623
DATE: April 16, 2026

ORDER

Entitlement to service connection for bladder cancer is granted.

Entitlement to service connection for hypertension is granted.

Entitlement to service connection for left kidney removal is granted.

FINDINGS OF FACT

1. Resolving the benefit of the doubt in favor of the Veteran, he was exposed to herbicide agents while serving in Panama.

2. The Veteran's bladder cancer is caused by exposure to herbicide agents. 

3. The Veteran's hypertension is caused by exposure to herbicide agents. 

4. The Veteran's left kidney removal is caused by his service-connected bladder cancer. 

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for bladder cancer have been met.  38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for entitlement to service connection for hypertension have been met.  38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

3. The criteria for entitlement to service connection for left kidney removal have been met.  38 U.S.C. §§ 1110, 1131, 5107(b);  38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from January 1971 to January 1977.  This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in February 2024 by a Department of Veterans Affairs (VA) Regional Office under the modernized appeals system known as the Appeals Modernization Act (AMA).

Subsequently, the Veteran filed the February 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) and elected the Hearing docket.  The Veteran testified at a Board hearing on January 5, 2026, and a transcript of the hearing is associated with the record.  

Therefore, the Board may only consider the evidence of record at the time of the February 2024 Agency of Original Jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing.  38 C.F.R. § 20.302(a).  If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision.  38 C.F.R. §§ 20.300, 20.302(a), 20.801.

1. Entitlement to service connection for bladder cancer.

2. Entitlement to service connection for hypertension.

The Veteran contends that he was exposed to herbicide agents while serving in Panama, and that his bladder cancer and hypertension are related to the herbicide agent exposure.  

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service.  38 U.S.C. § 1110; 38 C.F.R. § 3.303(a).  Service connection may also be granted for any disease diagnosed after discharge, 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).  Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury.  Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff'd, 78 F.3d 604 (Fed. Cir. 1996).

The Board notes that a claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence.  Lynch v. McDonough, 21 F.4th 776, 781 (Fed. Cir. 2021).  If "the positive and negative evidence is in approximate balance (which includes but is not limited to equipoise) the claimant receives the benefit of the doubt."  Id.

On review of the evidence of
 and the present disease or injury.  Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff'd, 78 F.3d 604 (Fed. Cir. 1996).

The Board notes that a claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence.  Lynch v. McDonough, 21 F.4th 776, 781 (Fed. Cir. 2021).  If "the positive and negative evidence is in approximate balance (which includes but is not limited to equipoise) the claimant receives the benefit of the doubt."  Id.

On review of the evidence of record and resolving the benefit of the doubt in favor of the Veteran, the Board finds that the Veteran has a current diagnosis of bladder cancer and hypertension and a causal nexus exists between the Veteran's bladder cancer and hypertension, and his herbicide agent exposure. 

In the February 2024 rating decision on appeal, the AOJ favorably found that the Veteran has a current diagnosis of bladder cancer and hypertension.  In support of these findings, the Board notes that the December 2023 VA examiners reported diagnoses of urothelial carcinoma involving bladder, left ureter, and left kidney s/p radical nephro-ureterectomy and immunotherapy (with resultant adrenal insufficiency and hypothyroidism from immunotherapy) and hypertension. 

Regarding in-service incurrence, the Veteran's service records document service in Panama from January 1975 to October 1976.  

In October 2023 the Veteran submitted a statement that he was exposed to herbicide agents all over the Panama Canal Zone, and that while serving there he remembered hiking through the jungle and swimming in Gatun Lake.  Additionally, the Veteran reported that he witnessed a completely cleared out area of the jungle, devoid of vegetation and bugs. 

An October 2023 toxic exposure risk activity (TERA) memorandum documents that the Veteran was exposed to herbicide agents and mustard gas coincident with his service.  

In December 2023, a VA examiner opined that it is at least as likely as not that the Veteran's bladder cancer is related to service.  The examiner reasoned that bladder cancer is considered a presumptive condition associated with herbicide exposure. 

During the January 2026 hearing, the Veteran reported that he was exposed to herbicides while he served in the Panama canal zone.  Specifically, he reported that he swam in Gatun lake when he was off-duty and that it was contaminated with herbicide agents.  Additionally, he reported walk through the jungle to other barracks and that he would "leave as soon as the trucks passed that were spraying."  He noted that "quite often when they were spraying, we could smell the spray, and feel the spray blowing into the barracks while we were watching for the trucks to finish spraying."  

Upon review and in resolving the benefit of the doubt in favor of the Veteran, the Board finds that the Veteran was exposed to herbicide agents during his active duty service, and that his bladder cancer and hypertension are caused by this herbicide exposure.  Specifically, the Veteran competently and credibly reported exposure to herbicide agents.  See October 2023 statement; January 2026 Board hearing.  These statements are further supported by the October 2023 TERA memorandum acknowledging herbicide exposure.  Regarding nexus, the Board notes that both bladder cancer and hypertension are well established as associated with herbicide exposure.  See December 2023 VA medical opinion; see also 38 U.S.C. § 1116; 38 C.F.R. § 3.309.  Accordingly, service connection is warranted for bladder cancer and hypertension.  38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

3. Entitlement to service connection for left kidney removal.

The Veteran contends that service connection for his left kidney removal is warranted secondary to his service-connected bladder cancer. 

Service connection may be established on a secondary basis for a disability which is shown to be proximately due to or the result of a service-connected disability.  38 C.F.R. § 3.310 (a).  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 caused by or aggravated by a service-connected disability.  38 C.F.R. § 3.310 (a); Allen v. Brown, 7 Vet. App. 439 (1995).

In the February 2024 rating decision, the AOJ favorably found that the Veteran has been diagnosed with left kidney removal. 
 bladder cancer. 

Service connection may be established on a secondary basis for a disability which is shown to be proximately due to or the result of a service-connected disability.  38 C.F.R. § 3.310 (a).  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 caused by or aggravated by a service-connected disability.  38 C.F.R. § 3.310 (a); Allen v. Brown, 7 Vet. App. 439 (1995).

In the February 2024 rating decision, the AOJ favorably found that the Veteran has been diagnosed with left kidney removal.  In support of this finding, the Board notes that the December 2023 VA examination report documents a diagnosis of left kidney removal. 

Additionally, the Board notes that the Veteran is now in receipt of service connection for bladder cancer. 

Thus, the only remaining inquiry is whether the Veteran's left kidney removal is related to his service-connected bladder cancer. 

During the December 2023 VA kidney examination, the examiner noted that the Veteran's left kidney was removed due to his bladder cancer spreading to his left kidney. 

(Continued on the next page)

?

Upon review, the Board finds that the evidence of record indicates that the Veteran has currently diagnosed left kidney removal that was caused by his service-connected bladder cancer.  Here, the Board places significant probative value on the December 2023 VA examination confirming that the Veteran's bladder cancer spread to his left kidney.  Accordingly, service connection for such is warranted.  38 C.F.R. §§ 3.102, 3.303, 3.310.

 

 

Melanie J. Mann

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Webster, Rebecca

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.