PROSTATE MALIGNANT NEOPLASM

MICHAEL J. SKALTSOUNIS · 2026 · Case ID: A26040684

GRANTED

Summary

The Veteran, a Navy veteran who served from March 1975 to March 1995, appealed the denial of service connection for prostate cancer, coronary artery disease (CAD), diabetes mellitus type II (DM II), hypertension, and erectile dysfunction (ED). The Veteran claimed herbicide exposure, specifically Agent Orange, during service in 1977. While the Board found no presumptive service connection due to lack of Vietnam service or documented AO exposure, it determined that the evidence was in approximate balance regarding the Veteran's direct claim of in-service herbicide exposure. The Board found the Veteran's lay statements credible and probative, supporting his account of handling Agent Orange drums. Giving the Veteran the benefit of the doubt, service connection for prostate cancer, CAD, hypertension, and DM II was granted on a direct basis. For ED, claimed as secondary to DM II, the Board found the evidence weighed in favor of the claim, noting a private medical opinion linking ED to DM II. Service connection for all claimed conditions was granted.

Rationale

Prostate cancer is eligible for presumptive service connection based on herbicide exposure.; No presumptive service connection due to lack of Vietnam service or documented AO exposure.; Board found evidence in approximate balance for direct service connection of herbicide exposure.; Veteran's lay statements regarding AO exposure were found credible and probative.; Benefit of the doubt applied to grant direct service connection.

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

220412-234971

Full Decision Text

Citation Nr: A26040684
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 220412-234971
DATE: April 30, 2026

ORDER

Entitlement to service connection for prostate cancer is granted.

Entitlement to service connection for a heart disability, including coronary artery disease (CAD), is granted.

Entitlement to service connection for diabetes mellitus type II (DM II) is granted.

Entitlement to service connection for hypertension is granted.

Entitlement to service connection for erectile dysfunction (ED), as secondary to service-connected DM II, is granted.

FINDINGS OF FACT

1. The Veteran was exposed to Agent Orange during active service.

2. The evidence is at least in equipoise as to whether the Veteran's prostate cancer is related to service.

3. The evidence is at least in equipoise as to whether the Veteran's CAD is related to service.

4. The evidence is at least in equipoise as to whether the Veteran's DM II is related to service.

5. The evidence is at least in equipoise as to whether the Veteran's hypertension is related to service.

6. The evidence is at least in equipoise as to whether the Veteran's ED is due to his DM II.

CONCLUSIONS OF LAW

1. The criteria for service connection for prostate cancer have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for CAD have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for DM II have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for service connection for ED, as secondary to service-connected DM II, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Navy from March 1975 to March 1995.

These matters come before the Board of Veterans' Appeals (Board) on appeal from the March 2022 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) which denied service connection for a heart disability, prostate cancer, DM II, ED, and hypertension. Additionally, the Board's review of that adjudication reflects that the AOJ proceeded to readjudicate the claims on the merits; thus, the Board finds it unnecessary to address the claims on a new and relevant basis below.

In the April 2022 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on January 6, 2026, and a transcript is in the record. Therefore, the Board may only consider the evidence of record at the time of the March 2022 agency of original jurisdiction (AOJ) supplemental claim decision on appeal, and any evidence submitted by the Veteran or representative at the hearing or within 90 days following the Board hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the 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.

Additionally, due to the Veteran's advanced age, the Board has granted advancement on the docket (AOD) pursuant to 38 C.F.R. § 20.902(c); 38 U.S.C. § 7107(a)(2).

Service Connection

Additionally, due to the Veteran's advanced age, the Board has granted advancement on the docket (AOD) pursuant to 38 C.F.R. § 20.902(c); 38 U.S.C. § 7107(a)(2).

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection requires: (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

Further, lay statements may serve to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C. § 1153(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).

In evaluating the evidence in an appeal, it is the responsibility of the Board to weigh the evidence and decide where to give credit and where to withhold same and, in doing so, accept certain medical opinions over others. Schoolman v. West, 12 Vet. App. 307 (1999). In this regard, the Board has been charged with the duty to assess the credibility and weight given to the evidence. Jandreau v. Nicholson, 492 F.3d 1372 (2007). Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of the matter, VA shall give the benefit of the doubt to the Veteran. Lynch v. McDonough, 21 F.4th 776, 781-82 (2021).

1. Entitlement to service connection for prostate cancer.

2. Entitlement to service connection for a heart disability, including coronary artery disease (CAD).

3. Entitlement to service connection for diabetes mellitus type II (DM II).

4. Entitlement to service connection for hypertension.

The Veteran seeks entitlement to service connection for prostate cancer, CAD, hypertension, and DM II based on his toxic exposure during service. See April 2022 Form 10182. Specifically, the Veteran asserts that he was exposed to herbicides while participating in a disposal operation while assigned to Naval Mobile Construction Battalion seventy-four (NMCB-74) in August 1977. See July 2016 Notice of Disagreement (attached Veteran's Statement); see also March 2022 Veteran's Statement.

Following a review of the evidence, the Board finds that the probative evidence of record is at least in approximate balance to resolve in favor of the Veteran's claims.

Initially, the Board notes that a veteran who, during active military, naval or air service, served in the Republic of Vietnam during the Vietnam Era is presumed to have been exposed during such service to certain herbicidal agents (e.g., Agent Orange) unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during service. If the veteran was exposed to an herbicide agent during service, certain diseases shall be service connected if the requirements of 38 C.F.R. § 3.307(a)(6) are met, even though there was no record of such disease during service, provided further that the rebuttable presumption provisions of 38 C.F.R. § 3.307(d) are also satisfied.

While prostate cancer, CAD, hypertension, and DM II are diseases eligible for presumptive service connection based on herbicide agent exposure, the Veteran's service personnel records and his service separation document (DD Form 214) do not document any service in Vietnam or any other area that is eligible for such presumptive service connection. See also June 2016 TERA Memo. Indeed, a September 2021 Records Research Center Response indicates that exposure to herbicides cannot be recognized or conceded based on the Veteran's claimed event. The specialist found evidence that the Naval Construction Battalion Center (NCBC) at Gulfport, Mississippi, stored barrels of Agent Orange (AO) in 1977, but these barrels were stored in an isolated, fenced
While prostate cancer, CAD, hypertension, and DM II are diseases eligible for presumptive service connection based on herbicide agent exposure, the Veteran's service personnel records and his service separation document (DD Form 214) do not document any service in Vietnam or any other area that is eligible for such presumptive service connection. See also June 2016 TERA Memo. Indeed, a September 2021 Records Research Center Response indicates that exposure to herbicides cannot be recognized or conceded based on the Veteran's claimed event. The specialist found evidence that the Naval Construction Battalion Center (NCBC) at Gulfport, Mississippi, stored barrels of Agent Orange (AO) in 1977, but these barrels were stored in an isolated, fenced-in security area two miles from the Gulfport Outport Docks. Additionally, while the specialist conceded that some barrels of Agent Orange were sent out to sea, he/she found that USAF personnel were responsible for the monitoring, re-barreling, and incineration operations from 1973 to 1977, not NCBC. Hence, from the foregoing, the Board must find that presumptive service connection based on herbicide exposure is not for consideration.

However, the Board will therefore assess the Veteran's claims on a direct basis below.

Regarding the first element of the Veteran's service connection claims (a current disability), the Board notes that the record documents diagnoses of CAD, DM II, hypertension, and prostate cancer. See July 2015 Private Examinations; see also January 2026 Private Medical Statement. The first element is thereby met.

As for the second element of the Veteran's claims (an in-service injury or event), the Board acknowledges the research specialist's findings above, which verify the Veteran's assignment and close vicinity to AO during active service. This further supports the Veteran's testimony that he personally collected, palletized, banded, and cataloged drums of AO for shipment while assigned to the NCBC in 1977. See January 2026 Hearing Transcript, pg. 5. Additionally, while the research specialist found that USAF personnel primarily handled the toxic barrels, the Board does not find that such precludes the possibility of the Veteran's involvement. In fact, the Board notes that the Veteran's lay statements are credible and probative, as he recounted details of an event that can be readily observed and described by a lay person. 38 C.F.R. § 3.159(a)(2). Therefore, the Board concludes that the most competent evidence of record is at least in approximate balance regarding whether the Veteran's claimed in-service AO exposure actually occurred. Resolving reasonable doubt in the Veteran's favor, the second element of the Veteran's service-connection claim is met.

Finally, the Board must determine whether the Veteran's current diagnoses are due to, or the result of, his military service.

During the pendency of this appeal, the VA did not issue any relevant examinations. The Veteran submitted private examinations also provided no nexus opinions regarding the issues at hand. See July 2025 Private Examinations. However, the Board concedes that, while 38 C.F.R. § 3.309(e) cannot be used to afford presumptive service connection based on herbicide exposure, the regulation itself establishes a positive causal link between prostate cancer, CAD, hypertension, DM II, and AO exposure.

Accordingly, from the foregoing, the Board finds that the evidence for and against a medical nexus is at least in equipoise and, giving the Veteran the benefit of the doubt, the final element of service connection is met. See 38 U.S.C. § 5107(b). Entitlement to service connection for CAD, DM II, hypertension, and prostate cancer is thus warranted on a direct basis.

5. Entitlement to service connection for erectile dysfunction (ED) as secondary to service-connected DM II.

The Veteran seeks entitlement to service connection for ED as secondary to his DM II. See April 2022 Form 10182.

Service connection may be granted for a disability on a secondary basis if a Veteran has a (1) current disability, (2) a separate disability already subject to service connection, and (3) the first disability is proximately due to, the result of, or aggravated beyond its natural progress by the service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995).

Following a review of the evidence, the Board finds that the most probative evidence of record weighs in favor of the Veteran's claim.

Regarding the first element of the Veteran's claim for secondary service connection (the existence of a current disability), the Board notes that the AOJ conceded a diagnosis of ED in a November 2019 rating decision. The first element is thereby met.

As for the
a Veteran has a (1) current disability, (2) a separate disability already subject to service connection, and (3) the first disability is proximately due to, the result of, or aggravated beyond its natural progress by the service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995).

Following a review of the evidence, the Board finds that the most probative evidence of record weighs in favor of the Veteran's claim.

As for the second element of the Veteran's claim (a separate disability already subject to service connection), the Board notes that the Veteran is service connected for DM II pursuant to the present decision. The second element is thus satisfied.

Finally, the Board must determine whether the Veteran's current ED is proximately due to, the result of, or aggravated by his service-connected DM II. Consequently, the Board must consider and weigh the following medical evidence.

In July 2015, the Veteran submitted a private diabetes examination, in which the examiner diagnosed DM II. The examiner also noted that the Veteran's ED is at least as likely as not due to this diagnosis.

As the only secondary nexus opinion of record is favorable, the Board finds that the most persuasive and probative evidence of record weighs in the Veteran's favor. Consequently, the Board finds that the final element for service connection is satisfied. See 38 U.S.C. § 5107(b). Entitlement to service connection for ED, as secondary to the Veteran's service-connected DM II, is therefore also warranted.

Michael J. Skaltsounis

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Alexander, Lasheyna T.

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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