NEOPLASMS MALIGNANT ANY SPECIFIED PART OF RESPIRATORY SYSTEM

Summary

The Veteran, an Air Force Veteran who served from August 1959 to August 1967, including a tour in Alaska and TDY to Guam, appeals the denial of service connection for lung cancer, brain tumor, and basal cell carcinoma. The Veteran claimed herbicide exposure in Guam and Mather AFB due to C-123 aircraft, and also asserted exposure to jet fuel. The Board found no evidence of herbicide exposure in Guam or at Mather AFB, and the Veteran's service records did not corroborate his claims of exposure in Guam. While the Veteran's service records indicated exposure to jet fuel, military vehicle exhaust, and other chemicals, the Board noted that the specific claim for herbicide exposure was not supported. A VA medical oncologist provided a positive opinion linking lung cancer to jet fuel exposure, citing studies on diesel exhaust and benzene, but also noted the Veteran's smoking history and family history as significant risk factors. An August 2025 C&P examiner provided negative opinions for basal cell carcinoma and brain tumor, attributing them to factors other than service-related toxic exposures. The Board found the evidence in equipoise for lung cancer, ultimately granting service connection based on the positive opinion, the TERA memorandums, and the benefit of the doubt. However, for the brain tumor and basal cell carcinoma, the Board found the negative opinions probative and the evidence weighed against service connection, leading to denial.

Rationale

Evidence in equipoise; Positive VA medical oncologist opinion; TERA memorandums reflect exposure; Benefit of the doubt applied

Full Decision Text

Citation Nr: A26037307
Decision Date: 04/21/26	Archive Date: 04/21/26

DOCKET NO. 251003-593247
DATE: April 21, 2026

ORDER

Entitlement to service connection for lung cancer is granted.

Entitlement to service connection for brain tumor is denied.

Entitlement to service connection for basal cell carcinoma, claimed as multiple myeloma, face and chest, is denied.

FINDINGS OF FACT

1. Exposure to herbicides is not presumed and is not shown.

2. The evidence is in equipoise as to whether the Veteran's lung cancer is due to in-service exposures, specifically jet fuel. 

3. The persuasive evidence of record is persuasively against a finding that brain tumor manifested during service or within a year of separation from service or is otherwise related to the Veteran's active service to include in-service exposures.

4. The persuasive evidence of record is persuasively against a finding that basal cell carcinoma, claimed as multiple myeloma, face and chest, manifested during service or within a year of separation from service or is otherwise related to the Veteran's active service to include in-service exposures.

CONCLUSIONS OF LAW

1. The criteria for service connection for lung cancer have been met.  38 U.S.C. §§ 1110, 1116, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309.

2. The criteria for service connection for brain tumor have not been met.  38 U.S.C. §§ 1110, 1116, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309.

3. The criteria for service connection for basal cell carcinoma, claimed as multiple myeloma, face and chest, have not been met.  38 U.S.C. §§ 1110, 1116, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from August 1959 to August 1967.

In a September 2024 rating decision, the Agency of Original Jurisdiction (AOJ) denied service connection for lung cancer, brain tumor, and multiple myeloma, face and chest.  In November 2024, the Veteran submitted VA Form 20-0996 Request for Higher-Level Review.  In a March 2025 rating decision, it was determined that there had been a duty to assist error in the September 2024 rating decision.  In a September 2025 rating decision, the Veteran's claims were subject to special review and denied on the merits.  In the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket.  A Board hearing was held in January 2026; the transcript is of record.  Therefore, the Board may only consider the evidence of record at the time of the September 2025 AOJ decision 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, which was subsequently subject to higher-level review 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.  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. 

Service Connection

Service connection may be granted for a disability due to a disease or injury incurred in or aggravated by active military service.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.304.  Service connection may also be granted for any disease diagnosed after discharge when
 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. 

Service Connection

Service connection may be granted for a disability due to a disease or injury incurred in or aggravated by active military service.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.304.  Service connection may also 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.  38C.F.R. § 3.303.  To substantiate a claim of service connection there must be evidence of: (1) a present disability; (2) incurrence or aggravation of a disease or injury in service; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service.  Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time.  If chronicity is not established, then a showing of continuity of symptomatology after discharge is required to support the claim.  38 C.F.R. § 3.303(b).  However, the regulatory provisions pertaining to chronicity and continuity of symptomatology are constrained by 38 C.F.R. § 3.309(a), and thus such provisions are only available to establish service connection for the specific chronic diseases listed in 38 C.F.R. § 3.309(a).  See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).  Here, the Board notes that the Veteran has been diagnosed with lung cancer, brain tumor, and basal cell carcinoma, which are subject to service connection based upon continuity of symptomatology under 38 C.F.R. § 3.309(a).

If a veteran was exposed to a herbicide agent during active military, naval, or air service, certain diseases shall be service connected if the requirements of 38 U.S.C. § 1116 and 38 C.F.R. § 3.307 (a)(6)(iii) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 U.S.C. § 1113; 38 C.F.R. § 3.307 (d) are also satisfied.  38 C.F.R. § 3.309 (e).  Such diseases include, among others, tumors, malignant, or of the brain.  38 C.F.R. § 3.309 (e).  

Initially, the Board notes that the evidence of record reflects that the Veteran has been diagnosed with lung cancer, a brain tumor, and basal cell carcinoma.  Specifically, lung cancer was diagnosed in April 2024.  05/21/2024 Medical Treatment Record-Government Facility.  A brain tumor was diagnosed in February 2024.  See 09/05/2024 & 09/15/2025 C&P Exams.  Basal cell carcinoma was diagnosed in or about 2019.  05/10/2024 CAPRI at 105, 996; 09/15/2025 C&P Exam. d

The Board acknowledges that in May 2024 the Veteran claimed service connection for multiple myeloma of the face and chest.  Such condition is a blood cancer, not a skin condition.  At an August 2024 C&P examination, the examiner noted that the Veteran did not have a diagnosis of multiple myeloma and that the Veteran meant to claim melanoma.  The evidence of record does not reflect a diagnosis of melanoma but reflects a diagnosis of basal cell carcinoma.  Thus, the Board will presume that the Veteran is seeking service connection for basal cell carcinoma of the face and chest.  It is also noted that the September 2025 rating decision listed the issue as multiple myeloma but addressed the diagnosis of basal cell carcinoma.  

The issue before the Board is whether these claimed disabilities can be directly or presumptively related to his military service.

The Veteran's DD Form 214 for his period of service with the United States Air Force from August 1959 to August 1963 reflects one year of foreign and/or sea service.  His foreign/sea service
 meant to claim melanoma.  The evidence of record does not reflect a diagnosis of melanoma but reflects a diagnosis of basal cell carcinoma.  Thus, the Board will presume that the Veteran is seeking service connection for basal cell carcinoma of the face and chest.  It is also noted that the September 2025 rating decision listed the issue as multiple myeloma but addressed the diagnosis of basal cell carcinoma.  

The issue before the Board is whether these claimed disabilities can be directly or presumptively related to his military service.

The Veteran's DD Form 214 for his period of service with the United States Air Force from August 1959 to August 1963 reflects one year of foreign and/or sea service.  His foreign/sea service was an Isolated tour in Alaska.  His military occupational specialty (MOS) was air policeman and security guard.  01/26/2016 Military Personnel Record at 14, 16, 17.  

The Veteran asserts that he was exposed to herbicides while stationed in Guam for 90 days from about May to September 1963.  He was part of the 320th Combat Defense Squadron, 320th Bombardment Wing (SAC).  

The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act was enacted on August 10, 2022 which extended the presumption of exposure to herbicides for service performed in Laos, Cambodia, Guam, America Samoa, and the Johnston Atoll regarding diseases listed under 38 C.F.R. § 3.309(e).  Under the PACT Act, Guam was added to locations presumed to include exposure to herbicides when it is between January 1962 and July 1980.  

Service personnel records reflect that in 1963 the Veteran was stationed stateside at Mather Air Force Base (AFB).  An USAF Airman Performance Report reflects that the 'Period of Report' was from April 16, 1963 to April 15, 1964 and he was stationed at Mather AFB.  01/26/2016 Military Personnel Record at 14, 34.  

The Veteran asserts that while stationed at Mather AFB in California, he went TDY to Anderson AFB in Guam.  As an Air Police he would guard the planes on the base and when the planes landed at Guam the police were told to guard them.  The Veteran watched as airman would carry things on and off the plane in protective gear including face breathing masks or respirators.  The Veteran was given TDY orders quickly via telephone and stated that the orders are not in his records.  

A professional researcher from the Veterans Benefits Administration, Office of Field Operations, Records Acquisition & Research (RAR), completed comprehensive research on the Veteran's claimed herbicide exposure incident/event, claiming that while serving with the 320th Combat Defense Squadron, 320th Bombardment Wing from May 5, 1963, to September 1, 1963, the Veteran states they were exposed to herbicides during service in Guam.  In an attempt to substantiate the Veteran's claimed herbicide exposure event, RAR partnered with the Air Force Historical Research Agency (AFHRA), custodian of Air Force unit for the Veteran's claimed herbicide exposure incident/event.  A VA researcher assigned to review records at AFHRA stated the following: We were unable to locate the unit histories for the 320th Combat Defense Squadron.  We reviewed the May to September 1963 histories of the 320th Bombardment Wing, the higher headquarters of the 320th Combat Defense Squadron.  The histories reviewed did not document the herbicide exposure incident as described by the Veteran.  In conclusion, no evidence was located to support documentation of the claimed herbicide exposure incident.  08/01/2025 Records Research Center Response.

The Board has reviewed service treatment records, which reflect treatment for a non-productive cough at Mather AFB on June 10, 1963, and pains in his chest on July 20, 1963.  He had dental treatment at Mather AFB on June 4, 1963 and June 7, 1963.  12/06/2001 STR-Medical at 27, 32.

In an August 2001 VA 21-526 Veterans Application for Compensation or Pension the Veteran checked the 'No' box with regard to whether he was exposed to Agent Orange or other herbicides.  

In June 2015, the Veteran claimed entitlement to service connection for diabetes mellitus and claimed exposure to herbicides while stationed at Mather AFB due to C-123 planes returning from spraying Agent Orange in the Republic of Vietnam.  He did not claim exposure to herbicides in Guam.  In support of his present claim, the Veteran has not
 AFB on June 4, 1963 and June 7, 1963.  12/06/2001 STR-Medical at 27, 32.

In an August 2001 VA 21-526 Veterans Application for Compensation or Pension the Veteran checked the 'No' box with regard to whether he was exposed to Agent Orange or other herbicides.  

In June 2015, the Veteran claimed entitlement to service connection for diabetes mellitus and claimed exposure to herbicides while stationed at Mather AFB due to C-123 planes returning from spraying Agent Orange in the Republic of Vietnam.  He did not claim exposure to herbicides in Guam.  In support of his present claim, the Veteran has not made the same assertions regarding exposure to herbicides due to planes returning to Mather AFB from the Republic of Vietnam.  

In June 2015, VA published an interim final rule establishing a presumption of exposure to certain herbicide agents for veterans who performed service in the Air Force or Air Force Reserve under circumstances in which they had regular and repeated contact with C-123 aircraft known to have been used to spray an herbicide agent, such as Agent Orange, during the Vietnam era and who later developed certain diseases.  See 80 Fed. Reg. 35, 246 (June 19, 2015) (codified at 38 C.F.R. § 3.307(a)(6)(v)); see also Institute of Medicine, National Academy of Sciences, Post-Vietnam Dioxin Exposure in Agent Orange Contaminated C-123 Aircraft 10 (2015).

Specifically, the regulation states that an individual who performed service in the Air Force or Air Force Reserve under circumstances in which the individual concerned regularly and repeatedly operated, maintained, or served onboard C-123 aircraft known to have been used to spray an herbicide agent during the Vietnam era shall be presumed to have been exposed during such service to an herbicide agent.  For purposes of this paragraph, "regularly and repeatedly operated, maintained, or served onboard C-123 aircraft" means that the individual was assigned to an Air Force or Air Force Reserve squadron when the squadron was permanently assigned one of the affected aircraft and the individual had an Air Force Specialty Code (AFSC) indicating duties as a flight, ground maintenance, or medical crew member on such aircraft.  38 C.F.R. § 3.307 (a)(6)(v).

A review of the Federal Register reveals that only some C-123s were used to actually spray herbicides in Vietnam.  80 Fed. Reg. 35,246 (June 19, 2015).  For this reason, the presumption of herbicide exposure under 38 C.F.R. § 3.307 (a)(6)(v) is limited to contact with C-123 aircraft known to have been used to spray an herbicide agent during the Vietnam era.

VA published a list of military units who had regular and repeated exposure to contaminated Operation Ranch Hand C-123s, used to spray Agent Orange in Vietnam, as flight, maintenance, or medical crew members.  VA also published a list of specialty codes for military personnel who had regular and repeated exposure to contaminated Operation Ranch Hand C-123s, used to spray Agent Orange in Vietnam, as flight, maintenance, or medical crew members.  Thus, to warrant presumptive exposure based on contact with a C-123, a Veteran must have been stationed at one of the identified bases during the specified time period with one of the listed units.  The Veteran must also have a military occupational specialty that entailed that he regularly and repeatedly operated, maintained or served onboard C-123 aircraft.

In a February 2016 rating decision, service connection for diabetes mellitus was denied.  In the rating decision, the AOJ acknowledged that exposure to herbicides from former Operation Ranch Hand (ORH) C-123 aircraft used to spray Agent Orange in Vietnam can be presumed to have occurred for an Air Force Veteran or Air Force Reservist who had regular and repeated duties flying on or maintaining contaminated ORH C-123 aircraft from 1969 through 1986.  The AOJ determined that the evidence was insufficient for VA to acknowledge Agent Orange exposure. Lay evidence indicates exposure to herbicides based on service aboard a C-123 aircraft.  However, this exposure cannot be confirmed by the objective evidence of record, including his units or Air Force Specialty Code.  C-123 aircrafts landing at Mather AFB were not known to have been used to spray an herbicide agent during the Vietnam era.  Further, regular and repeated duties aboard C-123 aircraft is not shown as by his Air Force Specialty Code of air policeman.

Again, the Board notes that the current claim does not stem from an assertion of exposure to C-123 aircraft that sprayed herbicides.  Notwithstanding this
 1986.  The AOJ determined that the evidence was insufficient for VA to acknowledge Agent Orange exposure. Lay evidence indicates exposure to herbicides based on service aboard a C-123 aircraft.  However, this exposure cannot be confirmed by the objective evidence of record, including his units or Air Force Specialty Code.  C-123 aircrafts landing at Mather AFB were not known to have been used to spray an herbicide agent during the Vietnam era.  Further, regular and repeated duties aboard C-123 aircraft is not shown as by his Air Force Specialty Code of air policeman.

Again, the Board notes that the current claim does not stem from an assertion of exposure to C-123 aircraft that sprayed herbicides.  Notwithstanding this, however, the evidence of record does not support a finding that the Veteran was exposed to such aircraft.  

While the Veteran has made lay assertions, to include in his hearing testimony, pertaining to his claim that he had active service and was exposed to herbicides in Guam, he has not submitted any other evidence, to include documentation or lay statements, in support of his assertions.  

Based on the above, the records generated during the Veteran's active service do not provide support for the finding that he had service and exposure to herbicides in Guam, or that he had exposure to herbicides while serving stateside.  Service personnel records do not reflect that he had active service in Guam as he was stationed at Mather AFB during the period in which he asserts he was in Guam.  The Veteran asserts that he was in Guam for a 90 day period which included June 1963, but he underwent medical and dental treatment at Mather AFB in June and July 1963.  He had also previously claimed exposure to herbicides in January 2015 but did not assert that such exposure occurred in Guam.  Notwithstanding the above, the RAR reviewed the May to September 1963 histories of the 320th Bombardment Wing, the higher headquarters of the 320th Combat Defense Squadron, which did not document the herbicide exposure incident as described by the Veteran.  VA's determination of whether a claimant's service meets the threshold statutory requirements usually is dependent upon service department records verifying the character of a claimant's service.  38 C.F.R. § 3.203; Duro v. Derwinski, 2 Vet. App. 530 (1992).

While consideration has been given to the Veteran's assertions, he has offered information that is not consistent with that contained in his service personnel and treatment records.  Again, the service personnel records reflect that he was stationed stateside at Mather AFB during the period in which he reported service in Guam.  Given the foregoing, the evidence of record does not establish exposure to herbicides on a presumptive basis, thus service connection is not warranted on a presumptive basis.  

While the evidence of record does not establish exposure to herbicides during active service there are Toxic Exposure Risk Activity (TERA) memorandums which reflect other in-service exposures.  

Specifically, an April 2025 TERA memorandum reflects that as an Air Policeman the Veteran was responsible for controlling access to nuclear loaded aircraft, maintenance on security police vehicles, conducted flight classes, responsible for upkeep and cleanliness of small arms.  He was exposed to military vehicles, jet fuels, gasoline, diesel, kerosene, and lubricating oils, fuels, CS riot-control agent, cleaning, degreasing, paint stripping, and thinning oil-based paints.  Aircraft pollutants such as benzene, toluene, and chlorinated compounds.  Unburned jet engine lubrication oil was a major component of emissions from aircraft such as Organophosphate esters (OPEs), dibutyl phenyl phosphate, triphenyl phosphate and tricresyl phosphate from turbine and hydraulic oils as well as aerosol/vapors.  Polycyclic aromatic hydrocarbons (PAH) and carbon monoxide inhalation.  

A July 2025 TERA memorandum reflects that as an AFSC Air Police in the Air Force he was potentially exposed to jet fuel, hydrocarbon compounds, jet fumes/diesel exhaust based on duties due to operates communications equipment, vehicles, intrusion detection equipment, crew-served weapons, and other special purpose equipment.  Operates SF armories.  Controls and safeguards arms, ammunition and equipment.  Instructs ground weapons qualification training.  Provides guidance on weapons placement to security forces and ground defense force commanders.  Inspects ground weapons and replaces unserviceable parts.  Analyzes malfunctions by inspection and serviceability testing.  Uses precision gauges, testing instruments, and special tools to adjust parts and operating mechanisms.  Function-fires weapons for accuracy and serviceability.  Controls and operates firing ranges and associated facilities to include supervising construction and rehabilitation.  

As will
carbon compounds, jet fumes/diesel exhaust based on duties due to operates communications equipment, vehicles, intrusion detection equipment, crew-served weapons, and other special purpose equipment.  Operates SF armories.  Controls and safeguards arms, ammunition and equipment.  Instructs ground weapons qualification training.  Provides guidance on weapons placement to security forces and ground defense force commanders.  Inspects ground weapons and replaces unserviceable parts.  Analyzes malfunctions by inspection and serviceability testing.  Uses precision gauges, testing instruments, and special tools to adjust parts and operating mechanisms.  Function-fires weapons for accuracy and serviceability.  Controls and operates firing ranges and associated facilities to include supervising construction and rehabilitation.  

As will be detailed below, the Board finds that service connection is warranted for lung cancer, and service connection is not warranted for a brain tumor and basal cell carcinoma.  

Service treatment records do not reflect any complaints of or treatment for lung cancer, brain tumor, or a skin condition.  The Veteran, however, has not asserted that such conditions manifested during service, but rather that such conditions are due to in-service exposures. 

In May 2024, a board-certified VA medical oncologist, Dr. C.N., reviewed the Veteran's medical history and reviewed the circumstances and events of his military service.  It was noted that the Veteran had been a patient since April 2024 when he was diagnosed with lung cancer.  Dr. C.N. proffered a positive opinion to exposure to herbicides.  However, as detailed the evidence of record does not establish in-service exposure to herbicides.  Dr. C.N. also referenced the Veteran's regular exposure to jet fuel.  Dr. C.N. cited to a study that found a statistically significant increased incidence of lung cancer in miners regularly exposed to diesel exhaust, and heavy exposure to diesel exhaust has shown to cause lung cancer in rats.  The examiner cited to a study regarding the health effects of workers who were exposed to benzene, toluene and xylene.  The researchers concluded there was an increased risk for the development of lung cancer in workers who were exposed to one or more of the BTX chemicals.  After review of the pertinent medical records, literature and the Veteran's self-reported medical history, the examiner opined it is at least as likely as not that his condition, lung cancer could be a result of his exposure to jet fuel while serving in the Air Force.  

An August 2025 C&P examiner reviewed the claims folder and opined that basal cell carcinoma is less likely than not caused by the indicated TERA after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERA of the Veteran.  The examiner explained that basal cell carcinoma is the most common type of skin cancer, and typically occurs on sun-exposed areas.  According to the medical literature, the primary cause is too much exposure to ultraviolet (UV) rays from sunlight or tanning beds.  Furthermore, there is insufficient medical literature to support toxic exposures as a cause.  

The examiner noted that medical records indicate a diagnosis of right upper lobe lung cancer in March 2024, which is being treated with radiation and chemotherapy.  However, the claimed condition was less likely than not (likelihood is less than approximately balanced or nearly equal) caused by the indicated TERA after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERA of the

Veteran.  According to the medical literature, while many factors can increase one's risk of lung cancer, smoking any tobacco product, including cigarettes, cigars, or pipes, is the most significant single risk factor.  Other risk factors include secondhand smoke exposure, family history, and radon, asbestos, silica, coal products, and toxins in the air.  The Veteran's 35-year history of smoking and family history (father) of lung cancer contributed to the development.  There is insufficient medical evidence to support toxic exposures (JET FUEL, HYDROCARBON COMPOUNDS, JET FUMES/DIESEL EXHAUST) as a cause or risk factor.

The examiner noted that an MRI/Brain done in May 2024 indicated secondary malignant neoplasm of the brain, which was treated with radiation in May 2024.  However, the claimed condition is less likely than not (likelihood is less than approximately balanced or nearly equal) caused by the indicated TERA after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERA of the Veteran.  According to the medical literature, secondary brain tumors, also known as metastatic brain tumors, occur when cancer from another part of the body spreads to the brain.  Common sites of metastatic lung cancer include the brain
/DIESEL EXHAUST) as a cause or risk factor.

The examiner noted that an MRI/Brain done in May 2024 indicated secondary malignant neoplasm of the brain, which was treated with radiation in May 2024.  However, the claimed condition is less likely than not (likelihood is less than approximately balanced or nearly equal) caused by the indicated TERA after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERA of the Veteran.  According to the medical literature, secondary brain tumors, also known as metastatic brain tumors, occur when cancer from another part of the body spreads to the brain.  Common sites of metastatic lung cancer include the brain, liver, and adrenal glands.  

The Board finds that the evidence is in equipoise as to whether the Veteran's lung cancer is due to his in-service jet fuel exposure.  The evidence that weighs against the claim is that the August 2025 C&P examiner proffered a negative etiological opinion.  The evidence that weighs in favor of the claim is the Veteran's lay assertions, the TERA memorandums which reflect exposure to aircraft pollutants and jet fuel, and the May 2024 positive etiological opinion from the Veteran's treating VA physician.  In light of the Veteran's in-service exposures, the May 2024 positive etiological opinion with adequate rationale, and affording the Veteran the benefit of the doubt, the Board finds that service connection for lung cancer is warranted.  38 U.S.C. § 5107; 38 C.F.R. § 3.102.

With regard to the brain tumor and basal cell carcinoma, the Board finds the August 2025 etiological opinions of record are probative, as such were based on examinations of the Veteran and review of the claims folder, to include service treatment records and TERA memorandums, and consideration of the lay assertions of the Veteran.  The opinions contain clear conclusions and supporting data for the negative etiological opinion.  Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).  There are no contrary opinions of record with regard to his brain tumor and basal cell carcinoma.  

While the Veteran may believe he has a brain tumor and basal cell carcinoma due to service, he is not competent to provide nexus opinions regarding these issues.  The issues are medically complex, as such requires knowledge of the interaction between multiple organ systems in the body/anatomical relationships/pathology/interpretation of complicated diagnostic medical testing.  Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to make such determinations.  Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011).  The Veteran is competent to report his recollections and symptomatology regarding his claimed brain tumor and basal cell carcinoma.  However, as detailed, negative opinions have been proffered.

Accordingly, the weight of the evidence is against a finding that his brain tumor and basal cell carcinoma are due to service.  Indeed, the overall collective conclusion of the trained medical examiner was that his brain tumor and basal cell carcinoma are not due to in-service exposures.  Therefore, the claims of service connection for brain tumor and basal cell carcinoma are denied. 

 

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Kreindler, Marcy W.

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.