PROSTATE MALIGNANT NEOPLASM

Summary

The Veteran, who served honorably in the United States Marine Corps from August 1960 to February 1961, appeals the February 2024 rating decision concerning service connection for prostate cancer. The Veteran claims his prostate cancer is attributable to exposure to contaminated water while stationed at Camp Lejeune. While prostate cancer is not presumptively linked to Camp Lejeune water under 38 C.F.R. § 3.309(f), the Veteran's claim can still be granted if a medical link is established. The Board found that the Veteran did serve at Camp Lejeune for the requisite 30 days during the contamination period, from December 15, 1960, to February 23, 1961. The February 2024 VA examination provided a favorable nexus opinion, stating the prostate cancer was at least as likely as not related to toxic exposure at Camp Lejeune, citing studies supporting this link. The Board afforded significant weight to this opinion, establishing the necessary causal relationship. Given the approximate balance of evidence weighing in the Veteran's favor and applying the benefit of the doubt, service connection for prostate cancer was granted.

Rationale

Veteran served 30+ days at Camp Lejeune during contamination period; Prostate cancer not presumptively linked to Camp Lejeune water; February 2024 VA exam established nexus to toxic exposure

Full Decision Text

Citation Nr: A26040768
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 241114-490038
DATE: April 30, 2026

ORDER

Entitlement to service connection for prostate cancer is granted.

FINDING OF FACT

The Veteran's prostate cancer is etiologically related to service.

CONCLUSION OF LAW

The criteria for entitlement to service connection for prostate cancer have been met.  38 U.S.C. §§ 1110, 5107, 1112, 1113; 38 C.F.R. §§ 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served honorably in the United States Marine Corps from august 1960 to February 1961 with additional service in the Marine Corps Reserve.  This matter comes before the Board of Veterans' Appeals (Board) on appeal from February 2024 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO).

In the November 2025 VA Form 10182, Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket.  A Board hearing was held on March 20, 2026, and a transcript is of record.  Therefore, the Board may only consider the evidence of record at the time of the February 2024 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran 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 on appeal 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. 

Service Connection

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.  38 U.S.C. §§ 1110, 1131; 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. §§ 3.303(a), 3.304, 3.307, 3.309, 3.310.  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.  Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995).

VA has recognized that veterans who served at Camp Lejeune for no less than 30 days, either consecutive or non-consecutive, between August 1, 1953, and December 21, 1987, have potential exposure to contaminants present in the base water supply prior to 1988.  Certain diseases shall be presumed to be the result of exposure to Camp Lejeune base water and service connected provided additional requirements are satisfied.  38 C.F.R. § 3.309 (f).  Prostate cancer has not been associated with exposure to Camp Lejeune base water for purposes of the presumption.  Id.

While there some presumptions are not applicable to for periods of active duty for training (ACDUTRA) or inactive duty for training (INACDUTRA), the VA Adjudicative Procedures Manual, M21-1, clearly advises that this presumption "also applies to former reservists and National Guard members if their military record includes orders or other records of no less than 30 days service (consecutive or nonconsecutive) at Camp Lejeune during the contamination period." M21-1, Part VIII.iii.8.A.1.a (July 24, 2023).  

A non-presumptive disease may still be entitled to service connection on a direct basis if the medical evidence supports a relationship between that disease and exposure to an herbicide agent.  See Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994).

1. Entitlement to service connection for prostate cancer.

The Veteran contends that his prostate cancer is attributable to exposure to contaminated water while stationed at Camp Leje
 or other records of no less than 30 days service (consecutive or nonconsecutive) at Camp Lejeune during the contamination period." M21-1, Part VIII.iii.8.A.1.a (July 24, 2023).  

A non-presumptive disease may still be entitled to service connection on a direct basis if the medical evidence supports a relationship between that disease and exposure to an herbicide agent.  See Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994).

1. Entitlement to service connection for prostate cancer.

The Veteran contends that his prostate cancer is attributable to exposure to contaminated water while stationed at Camp Lejeune.  After a review of the evidence, the Board agrees.

As an initial matter, the Veteran does not contend, nor does the evidence show that prostate cancer symptoms began during or shortly after active service.  Instead, he argues that the onset of prostate cancer many years after separation from service is attributable to exposure to toxic chemicals.  Indeed, the record does not show treatment for any prostate related symptoms during service and he was not diagnosed with prostate cancer until 2016.  

Next, the Board notes that service connection on a presumptive basis is not warranted as prostate cancer has not been associated with exposure to Camp Lejeune base water for purposes of VA compensation benefits.  38 C.F.R. § 3.309 (f).  However, the Veteran may still be subject to compensation if the medical evidence supports a relationship between prostate cancer and exposure to contaminated water while stationed at Camp Lejeune.  See Combee, 34 F.3d at 1043.  In this regard, the Board finds the evidence weighs in the Veteran's favor.

The February 2024 rating decision states that service records do not show that the Veteran served within the borders of the entirety of United States Marine Corps Camp Lejeune during the affected period of contamination.  However, a review of personnel records show that after basic training the Veteran's initial combat training took place at Camp Lejeune from December 15, 1960, to February 23, 1961.  Hence, it is clear to the Board that the Veteran served for the requisite amount of time (minimum 30 days) during the period in which contamination has been conceded (between August 1, 1953, and December 31, 1987).  Hence, service connection is warranted if a medical link is established between the Veteran's service at Camp Lejeune and his development of prostate cancer.

As required by VA's duty to assist, the Veteran was afforded a VA examination in February 2024.  There, the examiner opined that the Veteran's prostate cancer was at least as likely as not related to toxic exposure while stationed at Camp Lejeune.  The examiner cited several studies showing a positive association between the development of prostate cancer and exposure to toxic water at Camp Lejeune.

The Board affords significant probative weight to the opinion rendered by the February 2024 VA examiner.  The opinion was provided by a qualified medical professional after review of the claims file and application of the facts to current medical knowledge.  Accordingly, a nexus has been established.

In summation, the approximate balance of positive and negative evidence weighs in the Veteran's favor.  Accordingly, service connection for prostate cancer is warranted.  The claim is granted.  See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.  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.

 

 

B.T. KNOPE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Ballinger, Daniel