Case A26040547

Summary

The Veteran served on active duty from November 1965 to November 1967, including service in Vietnam. The surviving spouse appeals the denial of service connection for the Veteran's cause of death, which was glioblastoma (brain tumor). The Veteran passed away in November 2015. The Board found that the Veteran had presumed conceded in-service herbicide exposure due to his Vietnam service. Although glioblastoma is not a presumptive condition related to herbicide exposure, the Board considered private medical opinions submitted by the appellant. Dr. E.G. opined that herbicide exposure is linked to cancer cells, including brain cells. Dr. C.K., an oncology consultant, reviewed the Veteran's file, acknowledged the conceded herbicide exposure, and opined that the glioblastoma was at least as likely as not caused by this exposure, citing scientific literature. The Board gave little weight to a negative VA opinion due to lack of rationale. Applying the benefit of the doubt, the Board found the evidence persuasively weighed in favor of service connection for the cause of death. Service connection for the cause of death is granted.

Rationale

Veteran served in Vietnam during the Vietnam Era.; VA conceded herbicide exposure based on Vietnam service.; Private medical opinions linked glioblastoma to herbicide exposure.; VA opinion lacked rationale and was given little weight.

Full Decision Text

Citation Nr: A26040547
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 260108-613245
DATE: April 30, 2026

ORDER

Entitlement to service connection for the Veteran's cause of death is granted.

FINDINGS OF FACT

1. The Veteran's glioblastoma (brain tumor) is due to his in-service herbicide exposure.

2. The Veteran passed away in November 2015; his cause of death was due to a brain tumor. 

CONCLUSION OF LAW

The criteria for service connection for the cause of the Veteran's death have been met.  38 U.S.C. § 1310; 38 C.F.R. §§ 3.102, 3.312.

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The Veteran served on active duty from November 1965 to November 1967. He passed away in November 2015, and the Appellant is his surviving spouse. 

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

In the January 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Appellant elected the Evidence Submission docket.

Therefore, the Board may only consider the evidence of record at the time of the June 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Appellant or her representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801. 

Accrued Benefits

VA death benefits are payable to the surviving spouse of a veteran if the veteran died from a service-connected disability. 38 U.S.C. § 1310; 38 C.F.R. §§ 3.5, 3.312. 

To establish service connection for the cause of a veteran's death, the evidence must show that a disability incurred in or aggravated by active service was the principal or contributory cause of death. 38 C.F.R. § 3.312.

To be considered a principal cause of death, a service-connected disability must have been singly or jointly with some other condition the immediate or underlying cause of death or have been etiologically related to the cause of death. For a service-connected disability to be a contributing cause, it must have substantially or materially contributed to a veteran's death; it is not sufficient to show that it casually shared in producing death, but rather there must be a causal connection. A contributory cause of death is inherently one not related to the principal cause. 38 U.S.C. § 1310; 38 C.F.R. § 3.312 (b) (c).

For purposes of establishing service connection for a disability resulting from exposure to herbicide agents, a veteran who had active service in the Republic of Vietnam during the Vietnam Era, beginning on January 9, 1962, and ending on May 7, 1975, will be presumed to have been exposed to an herbicide agent during that service, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service.  38 U.S.C. § 1116(f); 38 C.F.R. §§ 3.307(a), 3.309(e). 

VA is responsible for determining whether the evidence supports the claim, with the veteran prevailing, or whether the evidence weighs persuasively against the claim, in which case the claim is denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (b).

1. Entitlement to service connection for cause of death is granted.

The Appellant seeks entitlement to service connection for the Veteran's cause of death. 

A review of the Veteran's private medical records show that he was diagnosed with a brain tumor in October 2015. The Veteran died in November 2015. The death certificate documents
 in which case the claim is denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (b).

1. Entitlement to service connection for cause of death is granted.

The Appellant seeks entitlement to service connection for the Veteran's cause of death. 

A review of the Veteran's private medical records show that he was diagnosed with a brain tumor in October 2015. The Veteran died in November 2015. The death certificate documents that the Veteran died of a brain tumor due to cardiorespiratory arrest. 

At the time of the Veteran's death, he did not have a service-connected disability. Although service connection was not established for the cause of the Veteran's death during his lifetime, service connection for the cause of death may still be granted if the evidence demonstrates that a disability of service origin was either the principal or contributory cause of death.  38 U.S.C. §§ 1110, 1131, 1310; 38 C.F.R. §§ 3.303, 3.312(a).

In a statement submitted with her claim application on October 31, 2024, the Appellant stated that the Veteran died due to glioblastoma, he served in Vietnam and was exposed to Agent Orange, an herbicide agent, during service. 

The Board notes that in a February 2025 memorandum, VA conceded that the Veteran was exposed to herbicide agents based on his service in the Republic of Vietnam. Further, military personnel records show the Veteran received the Vietnam Service Medal and the Vietnam Campaign Medal. Although glioblastoma is not included in the list of enumerated diseases that are acknowledged to be presumptively related to herbicide exposure, the Appellant is not precluded from establishing service connection with proof of direct causation. 38 U.S.C. § 1116(a)(2); 38 C.F.R. § 3.309(e); Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994).

In October 2024, the Appellant submitted a letter from a private physician, Dr. E.G., who opined that after an extensive review of the scientific literature, it is at least as likely as not that cancer development among veterans who served in the Vietnam War may be attributed to Agent Orange exposure. In support of the opinion, Dr. E.G. provided an in-depth discussion based on medical literature regarding herbicide exposure being tightly linked to cancer cells, and in particular brain cells. 

Then, in January 2026, the Appellant submitted another private medical opinion from Dr. C.K., with the VA Form 10182, Notice of Disagreement. Dr. C.K., who is a private oncology consultant, affirmed that he reviewed the Veteran's claims file, acknowledging the Veteran's service in Vietnam and his conceded exposure to herbicide agents, which he noted are confirmed human carcinogens. He further discussed the Veteran's family and medical history, including his October 2015 glioblastoma diagnosis. Dr. C.K. stated that the Veteran's pathology records show the tumor was the result of an acquired mutation in adulthood that is not inherited but is triggered by carcinogen exposure. The Veteran passed away in November 2015 before his treatment plan could be implemented. After providing a detailed discussion of relevant medical literature and studies regarding the connection between herbicide exposures and cancer, Dr. C.K. opined that the Veteran's cause of death from glioblastoma was at least as likely as not caused by his conceded exposure to herbicides while in military service in Vietnam. 

The Board acknowledges that there is a June 2025 negative VA medical opinion of record that is against the claim, as the VA examiner determined that "there is no evidence in current medical literature supporting [Agent Orange] exposure caused brain tumors...". However, the Board affords little probative weight to the opinion, as the VA examiner did not provide any rationale in support of the opinion. 

In sum, the Veteran had presumed conceded in-service herbicide exposure when serving in Vietnam, and while glioblastoma is not a presumptive disability, a nexus may be established based on competent evidence that links the Veteran's development of a non-presumptive disability to the presumed exposure.  See Combee, 34 F.3d at 1044 (Fed. Cir. 1999). The record contains medical opinions with sufficient, detailed rationale based on scientific and medical literature in favor of finding a nexus between the Veteran's glioblastoma, which caused his death, and his
 However, the Board affords little probative weight to the opinion, as the VA examiner did not provide any rationale in support of the opinion. 

In sum, the Veteran had presumed conceded in-service herbicide exposure when serving in Vietnam, and while glioblastoma is not a presumptive disability, a nexus may be established based on competent evidence that links the Veteran's development of a non-presumptive disability to the presumed exposure.  See Combee, 34 F.3d at 1044 (Fed. Cir. 1999). The record contains medical opinions with sufficient, detailed rationale based on scientific and medical literature in favor of finding a nexus between the Veteran's glioblastoma, which caused his death, and his presumed herbicide exposure. 

Accordingly, the evidence persuasively weighs in favor of the claim, and the claim for entitlement to service connection for the Veteran's cause of death must be granted.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

 

 

Cynthia M. Bruce

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	N. Miller, 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.