DIABETES MELLITUS

Summary

The Veteran served from November 1965 to October 1968. The Veteran passed away in July 2023, and this appeal was filed by his surviving spouse. The Veteran's spouse sought service connection for the cause of the Veteran's death, specifically contending that in-service exposure to herbicide agents led to AL amyloidosis, which contributed to his death. The Board reviewed the evidence, including the Veteran's service records, medical treatment records, death certificate, and a hearing transcript. The Board found that the Veteran had qualifying service for presumptive herbicide exposure and that VA had conceded this exposure. The Veteran's AL amyloidosis was documented in medical records and listed on the death certificate as a significant contributing condition. The Board determined that AL amyloidosis is a disease presumptively linked to herbicide exposure under 38 U.S.C. § 1116 and 38 C.F.R. § 3.309(e), thus establishing the nexus requirement. Service connection for the cause of death was granted.

Rationale

AL amyloidosis is a presumptive disease associated with herbicide exposure.; VA conceded Veteran's exposure to herbicide agents.; Death certificate lists AL amyloidosis as significant contributing condition.

Full Decision Text

Citation Nr: A26040670
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 250812-578116
DATE: April 30, 2026

ORDER

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

FINDING OF FACT

The persuasive weight of the evidence is in support of a finding that the Veteran was exposed to herbicide agents while in-service such that his AL amyloidosis, which substantially or materially contributed to his death in July 2023, is presumed to be related to his active service.

CONCLUSION OF LAW

The criteria for entitlement to service connection for the Veteran's cause of death have been met. 38 U.S.C. §§ 1101, 1110, 1116, 1131, 1137, 1310; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309, 3.312.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service from November 1965 to October 1968. Unfortunately, the Veteran passed away in July 2023. The Appellant is his surviving spouse.

This appeal has been advanced on the Board of Veterans' Appeals (Board) docket pursuant to 38 U.S.C. § 7107(b); 38 C.F.R. § 20.800(c).

This matter is on appeal from a May 2024 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) which adjudicated this issue based on the evidence of record at the time of the decision. In September 2024 the Appellant requested higher level review of this issue through the submission of a VA Form 20-0996. The Appellant's claim was then denied in a rating decision issued later in September 2024.

The Appellant subsequently filed a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) (NOD) in July 2025 in which the Veteran requested a hearing with a Veterans Law Judge. Accordingly, this decision has been written consistent with the Appeals Modernization Act (AMA) framework. 

The Appellant testified at a Board hearing in January 2026 before the undersigned Veterans Law Judge. A transcript of that hearing is associated with this file. 

In this case, the Board may only consider the evidence of record at the time of the May 17, 2024, Agency of Original Jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Appellant or her representative at the hearing or within 90 days following the hearing. See 38 C.F.R. §§ 3.2601(f), 20.302(a). 

If evidence was associated with the claims file during a period when additional evidence was not allowed, the Board has not considered it in its decision. Id.

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

The Appellant seeks service connection for the cause of the Veteran's death. Specifically, she contends that the Veteran's in-service exposure to herbicide agents caused the development of AL amyloidosis, which ultimately led to his death. The Board has carefully reviewed the evidence of record and finds the Veteran's AL amyloidosis, which substantially or materially contributed to his death, was at least as likely as not proximately due to his active service. The reasons follow.

Dependency and Indemnity Compensation (DIC) benefits are payable to the surviving spouse of a veteran if the veteran died from a service-connected disability. See 38 U.S.C. § 1310; 38 C.F.R. § 3.5(a)(1). A veteran's death will be considered as being due to a service-connected disability when the evidence establishes that the service-connected disability was either the principal or a contributory cause of death. See 38 C.F.R. § 3.312(a).

Service-connected diseases involving active processes affecting vital organs should receive careful consideration as a contributory cause of death, with debilitating effects and general impairment of health to an extent that would render the person materially less capable of resisting the effects of other disease or injury primarily causing death. See 38 C.F.R. § 3.312 (c).

To be a contributory cause of death, it must be shown that there were "debilitating effects" due to a service-connected disability that made the veteran "materially less capable" of resisting the effects of the fatal disease or that a service-connected disability had "material influence in accelerating death," thereby contributing substantially or materially to the cause of death. Lathan v. Brown, 7 Vet. App. 359 (1995); 38 C.F.R. § 3.312
 cause of death, with debilitating effects and general impairment of health to an extent that would render the person materially less capable of resisting the effects of other disease or injury primarily causing death. See 38 C.F.R. § 3.312 (c).

To be a contributory cause of death, it must be shown that there were "debilitating effects" due to a service-connected disability that made the veteran "materially less capable" of resisting the effects of the fatal disease or that a service-connected disability had "material influence in accelerating death," thereby contributing substantially or materially to the cause of death. Lathan v. Brown, 7 Vet. App. 359 (1995); 38 C.F.R. § 3.312(c)(1).

In determining whether service connection for cause of death is warranted, the laws and regulations generally applicable to compensation for service-connected disability apply. See 38 U.S.C. § 1310. To that end, under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131. Generally, the evidence must show: (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 disease or injury incurred or aggravated during service, also known as the "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010).

Additionally, service connection may also be established by presumption. Veterans exposed to Agent Orange or other listed herbicide agents in service are presumed service-connected for certain diseases, including AL amyloidosis. See 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6), 3.309(e). 

As will be addressed below, the Board finds that service connection for the Veteran's AL amyloidosis is warranted on a presumptive basis so the Board will not address direct service connection further herein.

As to the first element of service connection, a current disability, the evidence of record demonstrates that the Veteran suffered from AL amyloidosis which was a "significant condition [which] contribut[ed] to [his] death." See April 2026 Death Certificate. Moreover, the Veteran's treatment records include diagnostic testing results "suggestive of amyloidosis." See January 2026 Medical Treatment Record - Government Facility (24 pages). Accordingly, the first element of service connection, a current disability, has been met. See Holton, 557 F.3d at 1366.

With regard to an in-service event, the evidence of record indicates that the Veteran had qualifying service such that exposure to herbicide agents is presumed. See August 2023 Certificate of Release or Discharge From Active Duty (e.g. DD 214, NOAA 56-16, PHS 1867); see also 38 U.S.C. § 1116(d)(1). Moreover, VA has conceded that the Veteran was exposed to herbicide agents during his active service. See November 2023 other. The Board may not disturb this favorable finding. See 38 C.F.R. §§ 3.104(c), 20.801(a). Accordingly, the Board finds the in-service event criteria for service connection has been met. See Holton, 557 F.3d at 1366.

Therefore, the remaining question is whether there is a medical nexus demonstrating that the Veteran's cause of death was proximately due to his exposure to herbicide agents while in service. 

As to this matter, a nexus between the Veteran's AL amyloidosis and his in-service exposure to herbicide agents is presumed. As noted above, certain diseases are automatically presumed associated with herbicide agent exposure in service. These diseases include AL amyloidosis. See 38 C.F.R. §§ 3.307(a)(6), 3.309(e). Consequently, no further evidence of nexus is required. Moreover, the Veteran's AL amyloidosis was specifically listed on his death certificate as a "significant condition[] contributing to [his] death." April 2026 Death Certificate; see also 38 C.F.R. § 3.312(c)(1).

Given the above, the Board therefore finds that the persuasive weight of the evidence is in support of a finding that the Veteran's AL amyloidosis was proximately related to his active service. See Holton, 557 F.3d at 1366. The medical evidence of record indicates that the Veteran suffered from AL amyloidosis. Further, the Veteran had such that exposure to herbicide agents is presumed. Moreover, AL amyloidosis is automatically presumed
 nexus is required. Moreover, the Veteran's AL amyloidosis was specifically listed on his death certificate as a "significant condition[] contributing to [his] death." April 2026 Death Certificate; see also 38 C.F.R. § 3.312(c)(1).

Given the above, the Board therefore finds that the persuasive weight of the evidence is in support of a finding that the Veteran's AL amyloidosis was proximately related to his active service. See Holton, 557 F.3d at 1366. The medical evidence of record indicates that the Veteran suffered from AL amyloidosis. Further, the Veteran had such that exposure to herbicide agents is presumed. Moreover, AL amyloidosis is automatically presumed, as per the relevant statutes and regulations, to be associated with herbicide agent exposure. Additionally, the Board further finds that the persuasive weight of the evidence is in support of a finding that the Veteran's AL amyloidosis "substantially or materially" contributed to his death. Lathan, 7 Vet. App. at 359; 38 C.F.R. § 3.312(c)(1). The Veteran's death certificate specifically notes AL Amyloidosis as a significant condition which contributed to his death. Notably, there is no medical evidence to the contrary. Accordingly, the Board finds that compensation is warranted based on the cause of the Veteran's death. See 38 C.F.R. §§ 3.303, 3.312.

 

 

A. S. CARACCIOLO

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Doyle, Stephan C.

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.