PROSTATE GLAND DISEASE OF

L.M. YASUI · 2026 · Case ID: A26036894

MIXED

Summary

The veteran, who served in the U.S. Army from August 1961 to August 1963, appeals the denial of service connection for benign prostate hyperplasia and a sinus condition, and the remand of a lower back condition. The Board denied service connection for benign prostate hyperplasia, noting the veteran's diagnosis occurred over 50 years after service and that the VA examiner found no evidence-based link between TERA exposure and the condition, attributing it to age and erectile dysfunction. The Board also denied service connection for a sinus condition, finding the veteran's testimony about in-service complaints was not corroborated by service treatment records, and the diagnosis occurred over 50 years post-service, with current rhinitis likely due to allergy triggers rather than TERA exposure. The lower back condition was remanded because the VA examiner's opinion was deemed inadequate; the examiner focused on the 50-year gap in treatment, but the Board noted the veteran's testimony about seeking treatment two years post-service and a separation examination mentioning a back brace. The case was remanded for a new VA examination to address the etiology of the lower back condition, considering the veteran's statements about in-service injury and post-service treatment.

Rationale

No in-service diagnosis; Diagnosis over 50 years post-service; No evidence-based link between TERA exposure and condition; Likely age-related condition

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250721-560087

Full Decision Text

Citation Nr: A26036894
Decision Date: 04/21/26 Archive Date: 04/21/26

DOCKET NO. 250721-560087
DATE: April 21, 2026

ORDER

Entitlement to service connection for benign prostate hyperplasia (previously denied as prostate cancer) is denied.

Entitlement to service connection for a sinus condition is denied.

REMANDED

Entitlement to service connection for a lower back condition is remanded.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that benign prostate hyperplasia began during active service or is otherwise related to an in-service injury or disease.

2. The evidence of record persuasively weighs against finding that a sinus condition began during active service or is otherwise related to an in-service injury or disease.

CONCLUSIONS OF LAW

1. The criteria for service connection for benign prostate hyperplasia are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for a sinus condition are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in the United States Army from August 1961 to August 1963.

This matter comes before the Board of Veterans' Appeals (Board) from a May 2025 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).

In the July 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. On August 18, 2025, the Veteran withdrew the hearing request.

Therefore, the Board may only consider the evidence of record at the time of the May 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

However, because the Board is remanding the lower back condition claim, any evidence the Board could not consider will be considered by the AOJ in the adjudication of that claim. 38 C.F.R. § 3.103(c)(2)(ii).

The Veteran's testimony from an April 2021 Board hearing involving a prior appeal has been associated with the file.

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

1. Entitlement to service connection for benign prostate hyperplasia (previously denied as prostate cancer) is denied.

The Veteran contends that he is entitled to service connection for a benign prostate hyperplasia. After a careful review of the file, the Board has determined that the matter must be denied. The reasons follow.

The first element of direct service connection is that the Veteran has a current disability. In a May 2025 rating decision, the RO made the favorable finding that the Veteran was diagnosed with benign prostate hyperplasia in a March 17, 2025, VA examination. The Board will not disturb
381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

1. Entitlement to service connection for benign prostate hyperplasia (previously denied as prostate cancer) is denied.

The second element of direct service connection is that there was an in-service event or injury. In a May 2025 rating decision, the RO made the favorable finding that the Veteran participated in a TERA, stating that the Veteran had non-deployment related exposure to hazards inherent in his military occupational specialty. The Veteran's participation in a TERA satisfies the second element of service connection.

The final element of direct service connection requires a nexus between the current disability and the in-service injury or incurrence.

In May 2025, the Veteran was afforded a VA examination. He was diagnosed with benign prostate hyperplasia, with voiding dysfunction that causes urinary frequency.

The VA examiner provided an opinion on direct service connection. She stated that the Veteran was not diagnosed with an enlarged prostate during active duty. The VA examiner stated that according to the Veteran's medical records, he was diagnosed in September 2016, therefore, a nexus cannot be established. She stated that there is also a lack of lay statements to corroborate that the condition was incurred during service. The VA examiner stated that the first date of diagnosis for this condition was over 50 years after separation. Therefore, the VA examiner opined, the condition was less likely than not related to service.

The Board finds that the VA opinion on direct service connection is adequate. The VA examiner relied on the fact that there was no in-service incurrence combined with the fact that the condition did not occur until 50 years after service. The Board notes that the passage of time between the Veteran's discharge and an initial diagnosis for the claimed disorder is one factor that weighs against the Veteran's claim. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000).

The VA examiner also provided a TERA opinion. The VA examiner stated that there is not any evidence-based research indicating a cause-and-effect relationship between the Veteran's condition and his exposures during service. She stated that the Veteran's enlarged prostate is most likely the result of advanced age, as well as his erectile dysfunction. She states that because there is not a cause-and-effect relationship between the Veteran's condition and exposures while in service, a nexus cannot be established. The VA examiner stated that the prostate gland is located beneath the bladder and the tube that moves urine from the bladder out of the penis is called the urethra. She explained that this tube passes through the center of the prostate and when the prostate gets bigger, it starts to block urine flow. She stated that the prostate gland continues to grow throughout life, and this growth often enlarges the prostate enough to cause symptoms or to block urine flow. The VA examiner stated that it is unclear what causes the prostate to increase in size, but it may be due to the balance of sex hormones as one grows older. She cited an article from the Mayo Clinic which stated risk factors for an enlarged prostate including aging, family history, diabetes, heart disease, and obesity.

The Board finds the VA TERA opinion to be adequate and probative. The VA examiner concluded that there was no evidence-based research supporting that the Veteran's condition is the result of exposures during service and explained that an enlarged prostate is likely an age-related condition. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (holding that a medical opinion obtains probative weight from "factually accurate, fully articulated, sound reasoning for the conclusion").

As no nexus has been established between the Veteran's condition and service, based either on the direct service connection opinion or the TERA opinion, the third element for service connection has not been met, and service connection must be denied.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for benign prostate hyperplasia is warranted. Rather, the evidence persuasively weighs against service connection for benign prostate hyperplasia. The benefit of the doubt doctrine, see 38 U.S.C. §5107(b),
. App. 295, 304 (2008) (holding that a medical opinion obtains probative weight from "factually accurate, fully articulated, sound reasoning for the conclusion").

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for benign prostate hyperplasia is warranted. Rather, the evidence persuasively weighs against service connection for benign prostate hyperplasia. The benefit of the doubt doctrine, see 38 U.S.C. §5107(b), is therefore not for application. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001). Thus, the claim for service connection for a benign prostate hyperplasia is denied.

2. Entitlement to service connection for a sinus condition is denied.

The Veteran contends that he is entitled to service connection for a sinus condition. After a careful review of the record, the Board determines that the matter must be denied. The reasons follow.

In an April 2021 Board hearing transcript on an earlier appeal of denial of service connection for a sinus condition, the Veteran testified that his sinus condition began 15 years ago. It was at that time that the Veteran was found to have sinus drainage. He stated that, at one time, he was stationed in Virginia when the weather was cold, and that is when his problems began.

The first element for service connection is that the Veteran have a current disability. In a May 2025 rating decision, the RO made the favorable finding that the Veteran was diagnosed with rhinitis at a March 17, 2025, VA examination. The Board will not disturb this favorable finding. 38 C.F.R. § 3.104(c). The first element has been satisfied.

Next, an in-service event or incurrence is required. In a May 2025 rating decision, the RO made the favorable finding that the Veteran participated in a TERA, stating that the Veteran had non-deployment related exposure to hazards inherent in his military occupational specialty. The Veteran's participation in a TERA satisfies the second element of service connection.

Finally, there must be a nexus between the current disability and the in-service event or incurrence.

In May 2025, the Veteran was afforded a VA examination. The Veteran was diagnosed with allergic rhinitis. The Veteran stated that the condition occurred approximately 20 years ago. He began experiencing congestion, his ears being stopped up, and a nasal drip, which still continues. He uses sinus spray and prescription medication to treat his condition. The Veteran stated that he has sinus issues year-round, but not as frequent during the summer. He stated that it affects his quality of life.

The VA examiner issued an opinion on direct service connection. She stated that the Veteran was not diagnosed with allergic rhinitis until February 2016, which was over 50 years post-service. The VA examiner stated that because the condition did not have its onset during the active-duty period a nexus cannot be established. She stated that there is a lack of lay statements to corroborate the condition having been incurred during service. The VA examiner also stated that in the Board's February 2025 remand, it was stated that the Veteran was subject to colds, wax in ears, sinus troubles, occasional shortness of breath with running, and a cough. However, the VA examiner noted that the Veteran's medical record does not convey this as there was a lack of repeated treatment and complaints for these symptoms.

The Board finds the May 2025 VA opinion on direct service connection to be adequate. The VA examiner relied on the fact that there was a lack of repeated treatment for the Veteran's sinus symptomology, as well as the fact that the sinus issues were not diagnosed until over 50 years post-service. The passage of time is a factor to be considered. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000).

The VA examiner also issued a TERA opinion. She stated that the information reviewed shows that the Veteran was exposed to an herbicide agent. She indicated that immune response was a risk factor outside of military service. The VA examiner noted that personal protection equipment was reportedly not used. The Veteran reported daily exposure. The Veteran reported inhaled exposures from August 1961 to August 1963. The Veteran worked as a supply handler and stock clerk with explosives, demolitions, field mines, booby traps, and individual and crew-served weapons. The VA examiner stated that the Veteran's service treatment records were void for chronic complaints of allergic rhinitis during service or immediately thereafter. Further, she stated, there is no evidence-based research indicating a cause-and-effect relationship between the Veteran's exposure in service and the onset of allergic rhinitis. The VA examiner stated that allergic rhinitis is an IgE mediated condition, meaning it transpires in reaction to an allergen, and the immune system induces symptoms. The VA examiner stated that the Veteran's rhinitis is related to current allergy triggers, which outweigh the TERA exposure. The VA examiner cited to the Mayo Clinic, which explained that when an individual has hay fever, the immune system identifies a harmless airborne substance as being harmful. The article went on to note these substances as allergens, and the immune system protects itself by producing IgE antibodies to protect against the allergen. The next time that an individual comes in contact with these allergens, these antibodies signal the immune system to release chemicals such as histamine into your bloodstream, which causes hay fever. The article listed a number of conditions which can increase the risk of developing hay fever, including having other allergies or asthma, having atopic dermatitis or eczema, having a relative with allergies or asthma, living or working where there is constant exposure to allergens, being exposed to smoke, and having a mother who smoked during the first year of the child's life. In conclusion, the VA examiner opined that the Veteran's rhinitis was not related to the Veteran's TERA exposure.

The Board finds the May 2025 TERA opinion to be adequate and probative of the issue of service connection. The VA examiner explained that there is no evidence-based research linking the Veteran's rhinitis with his TERA exposure. The VA examiner also explained that current allergy triggers are a more likely cause for the Veteran's symptomatology. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (holding that a medical opinion obtains probative weight from "factually accurate, fully articulated, sound reasoning for the conclusion").

Given that neither the direct service connection opinion nor the TERA opinion linked the Veteran's current diagnosis of rhinitis with service, there is no nexus and the claim must be denied.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for rhinitis is warranted. Rather, the evidence persuasively weighs against service connection for rhinitis. The benefit of the doubt doctrine, see 38 U.S.C. §5107(b), is therefore not for application. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001). Thus, the claim for service connection for rhinitis is denied.

REASONS FOR REMAND

1. Entitlement to service connection for a lower back condition is remanded.

The Veteran states that he is entitled to service connection for a lower back condition. After a careful review of the record, the Board determines that this matter must be remanded. The reasons follow.

In an April 2021 Board hearing from a prior appeal regarding service connection for a lower back condition, the Veteran testified that he began having lower back problems while in service. He testified that his back issues began when he was driving a forklift. He stated that he never went to any sick calls while in service for his back. He stated that he went to a private doctor for his back complaints approximately two years after separating from service, and he has been having back problems since that time.

In May 2025, the Veteran was afforded a VA examination. The Veteran was
service connection for a lower back condition. After a careful review of the record, the Board determines that this matter must be remanded. The reasons follow.

In May 2025, the Veteran was afforded a VA examination. The Veteran was diagnosed with lumbosacral strain. He states that the condition began 40 years ago. The Veteran stated that he started to have pain in service related to strenuous duties. He currently has low back pain affecting standing and walking. He takes Gabapentin and uses lidocaine patches.

The VA examiner stated that medical examinations during service in September 1960, August 1960, and June 1963, were void for any complaints of a back condition. The VA examiner stated that because the condition did not have its onset in, nor was it caused by service, a nexus cannot be established. The VA examiner stated that there was also a lack of lay statements to corroborate the condition having been incurred during service. Finally, the VA examiner stated that the condition was diagnosed over 50 years post-discharge, and while the Veteran stated that he injured his back during service in a forklift incident, they do not opine the Veteran would wait 50 years to address this issue.

The Board finds the May 2025 VA examination to be inadequate as it found that the Veteran waited nearly 50 years to obtain treatment. However, in the Veteran's April 2021 testimony, the Veteran stated that he sought treatment for a lower back condition two years after separating from service and that he has had back problems since that time. Where VA provides the veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). It was a predecisional duty to assist error for the RO not to afford the Veteran with an adequate VA examination for the lower back, which must be corrected on remand. 38 C.F.R. § 20.802(a). Specifically, the examiner must address the Veteran's lay statement that he sought treatment for a lower back condition two years after separating from service and that he has had back problems since that time.

The matters are REMANDED for the following action:

Obtain a medical opinion from an appropriate clinician to determine the nature and etiology of the Veteran's lower back condition. The examiner must provide an opinion regarding whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's lower back condition had onset in, or is otherwise related to, his active miliary service.

The examiner must specifically consider and discuss the Veteran's April 2021 Board hearing testimony, where he testified that he sought treatment for a lower back condition two years after separating from service and that he has had back problems since that time, as well as the statement made to the May 2025 VA examiner that the Veteran injured his back during service in a forklift accident. The examiner must also consider the Veteran's June 1963 separation examination, in which it was stated that the Veteran wore a back brace for support.

The examiner is asked to provide a rationale for each opinion given, including providing the medical principles and evidence relied upon for each opinion. If the examiner is unable to provide an opinion without resorting to speculation, he or she should explain why this is so and what, if any, additional evidence would be necessary before an opinion could be rendered.

L.M. YASUI

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Fleming, Shelley M.

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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