NEOPLASMS OF LYMPHATIC SYSTEM

L.M. YASUI · 2026 · Case ID: A26038204

MIXED

Summary

The Veteran, who served from July 1969 to January 1972, appeals the denial of service connection for lymph node metastases and entitlement to special monthly compensation (SMC) under 38 U.S.C. § 1114(s). The Veteran has a service-connected diagnosis of prostate cancer. The primary issue on appeal is whether lymph node metastases are secondary to the service-connected prostate cancer. The Board reviewed medical evidence, including a December 2024 positron emission tomography study showing metastatic prostate cancer to the lymph nodes and a February 2025 VA examination that diagnosed prostate cancer and found metastasis to the lymph nodes as a residual of the prostate cancer. The Board found the evidence in approximate balance regarding the secondary connection of lymph node metastases to prostate cancer. Applying the benefit of the doubt, the Board granted service connection for lymph node metastases as a residual of the service-connected prostate cancer. The claim for SMC under § 1114(s) was remanded, as it is inextricably intertwined with the rating and effective date for the newly granted service connection for lymph node metastases.

Rationale

Medical evidence shows metastasis to lymph nodes.; VA examination found metastasis as residual of prostate cancer.; Benefit of the doubt applied due to approximate balance of evidence.

Special Benefit

SMC

Docket No.

260126-628323

Full Decision Text

Citation Nr: A26038204
Decision Date: 04/23/26 Archive Date: 04/23/26

DOCKET NO. 260126-628323
DATE: April 23, 2026

ORDER

Entitlement to service connection for lymph node metastases, to include as due to the service-connected prostate cancer, is granted.

REMANDED

Entitlement to special monthly compensation (SMC) under 38 U.S.C. § 1114(s) is remanded.

FINDING OF FACT

The competent and probative evidence persuasively shows that the Veteran's current lymph node metastases is a residual of the service-connected prostate cancer.

CONCLUSION OF LAW

The criteria for entitlement to service connection for lymph node metastases are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from July 1969 to January 1972. This matter is before the Board of Veterans' Appeals (Board) on appeal from a January 2026 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

The Veteran selected the Direct Review docket without a Board hearing in the Appeals Modernization Act (AMA) review system by submitting a VA Form 10182 (Decision Review Request: Board (Notice of Disagreement)) in January 2026. Based upon the selection of the Direct Review option, the Board may consider the evidence of record as of January 26, 2026 - the date of the rating decision on appeal. See 38 C.F.R. §§ 20.301. If the Veteran submitted evidence that was added to the record after January 26, 2026, the Board did not consider it. If the Veteran wishes to have VA consider any evidence that was not considered, a supplemental claim should be submitted identifying such evidence. See 38 C.F.R. § 3.2501.

The Board acknowledges the decision by the United States Court of Appeals for Veterans Claims (CAVC) in Williams v. McDonough, 37 Vet. App. 305. In Williams v. McDonough, the Court held the Board must refrain from deciding a case until the case proceeds to the point where a docket switch is no longer permitted under the terms of 38 C.F.R. § 20.202(c)(2). The deadline to request an AMA docket switch is 1 year from the date of notice of the AOJ decision or 60 days from the date the VA Form 10182 was received by the Board, whichever is later. Williams, 37 Vet. App. 305. In this case, the notice of the rating decision on appeal was received on May 6, 2025. Although less than one year has passed, in approximately one month, the deadline will approach. The Veteran is 75 years old (DOB: April 25, 1949) and his appeal is advanced on the docket (AOD). In the interest of time and with consideration that the case is AOD, the Board will thus proceed to adjudicate the appeal at this time.

Moreover, the Board must consider entitlement to SMC when fairly raised by the record. See Akles v. Derwinski, 1 Vet. App. 118 (1991). In this case, the issue of entitlement to SMC has been raised by the record. See 1/26/2026 VA Form 10182. The Board has accordingly added entitlement to SMC as an issue on appeal.

Service Connection

Service connection will be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Where a disease is first diagnosed after discharge, service connection will be granted when all the evidence, including that pertinent to service, establishes it was incurred in active service. 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d). Service connection requires evidence showing: (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 disability incurred or aggravated by service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Regulations provide that service connection is warranted for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Further, a disability which
§ 1113(b); 38 C.F.R. § 3.303(d). Service connection requires evidence showing: (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 disability incurred or aggravated by service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Regulations provide that service connection is warranted for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Further, a disability which is aggravated by a service-connected disorder may be service connected to the degree that the aggravation is shown. Allen v. Brown, 7 Vet. App. 439, 449 (1995); 38 C.F.R. § 3.310(b). In order to establish entitlement to secondary service connection, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; (3) medical evidence establishing a nexus between the service-connected disability and the current disability. Wallin v. West, 11 Vet. App. 509, 512 (1998).

The Veteran is competent to report symptoms and experiences observable by his senses. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). In relevant part, 38 U.S.C. § 1154(a) requires that VA give "due consideration" to "all pertinent medical and lay evidence" in evaluating a claim for disability benefits. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009).

Service connection for lymph node metastases, to include as due to prostate cancer.

The Veteran contends entitlement to a separate rating for lymph node metastases, to include as due to the service-connected prostate cancer. See 1/26/2026 VA Form 10182.

The record reflects that service connection is in effect for prostate cancer.

Turning to the competent and probative evidence of record, a December 2024 positron emission tomography diagnostic imaging study showed that the Veteran had metastatic prostate cancer to the lymph nodes. See 2/7/2025 CAPRI, at page 4.

During a February 2025 VA examination, the Veteran was diagnosed with prostate cancer. The examiner found that the Veteran had an active malignant neoplasm and as a residual of the prostate cancer, the examiner found that the Veteran had metastasis to the lymph nodes. See 2/13/2025 C&P Examination.

Upon review of the record, while the Veteran does not have a primary lymphatic cancer, the Board finds that the evidence is in approximate balance (or nearly equal) as to whether the Veteran has lymph node metastases associated with his service-connected prostate cancer. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that the competent and probative evidence is in favor that lymph node metastases is a residual of the service-connected prostate cancer and the Veteran's claim is granted. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 3.310(a).

REASONS FOR REMAND

SMC under 38 U.S.C. § 1114(s).

The Veteran contends entitlement to SMC under 38 U.S.C. § 1114(s). The Board has herein granted a separate rating for lymph node metastases, to include as due to the service-connected prostate cancer. As such, the Board finds that the claim for entitlement to SMC is inextricably intertwined with the pending assignment of the rating and effective date for service connection for lymph node metastases, to include as due to prostate cancer. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991).

Therefore, the adjudication of the claim for entitlement to SMC is deferred pending assignment of the rating and effective date for lymph node metastases.

This matter is REMANDED for the following action:

After the RO effectuates the rating and effective date for the Veteran's service connection for lymph node metastases (granted herein), adjudicate the claim for entitlement to SMC under 38 U.S.C. § 1114(s).

L.M. YASUI

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board J.F.

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
1991).