Back to BVA DecisionsMIXEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 251009-596632
MALIGNANT NEOPLASMS OF THE DIGESTIVE SYSTEM
M. HYLAND · 2026 · Case ID: A26040823
Summary
The Veteran, who served from August 1965 to January 1969 and again from July 1973 to November 1974, appeals the denial of service connection for colon cancer and a back disability. The Veteran elected the Hearing Review Docket, limiting the Board's review to evidence of record at the time of the AOJ decision or submitted within 90 days following the hearing. The Board granted service connection for adenocarcinoma of the colon as secondary to his service-connected other specified trauma and stressor related disorder, including alcohol use disorder. The Board found the VA examiner's opinion, which initially found the cancer less likely than not related to service, to be persuasive when read in the light most favorable to the Veteran, establishing a nexus to his service-connected alcohol use disorder. The claim for a back disability was remanded. The Board found the September 2025 VA opinion inadequate because the examiner's negative nexus opinion was based on an inaccurate factual premise regarding the Veteran's history of back pain complaints. The Board noted that the Veteran's treatment records showed complaints of back pain dating back to January 2009, not just 2012 as stated by the examiner. Additionally, the Board remanded the back claim to obtain outstanding VA treatment records, including community care records, and to secure a new VA opinion on the back condition, instructing the examiner to assume the Veteran's statements are credible unless inconsistent with medical evidence or principles.
Rationale
VA examiner opinion found persuasive when read in light most favorable to Veteran; Establishes nexus to service-connected alcohol use disorder
Full Decision Text
Citation Nr: A26040823 Decision Date: 04/30/26 Archive Date: 04/30/26 DOCKET NO. 251009-596632 DATE: April 30, 2026 ORDER Entitlement to service connection for adenocarcinoma of the colon, as secondary to service-connected other specified trauma and stressor related disorder to include alcohol use disorder, is granted. REMANDED Entitlement to service connection for a back disability is remanded. FINDING OF FACT The evidence establishes that the Veteran's colon cancer is at least as likely as not due to his service-connected other specified trauma and stressor related disorder to include alcohol use disorder. CONCLUSION OF LAW The criteria for entitlement to service connection for adenocarcinoma of the colon have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1965 to January 1969 and July 1973 to November 1974. In the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing Review Docket. Therefore, the Board may only consider the evidence of record at the time of the September 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative at his hearing or within 90 days following his hearing. 38 C.F.R. § 20.302(a). The Veteran appeared at a Board hearing in January 2026. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date of the Board hearing, or (2) more than 90 days following the date of the Board hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302, 20.801. As to the claim of entitlement to service connection for adenocarcinoma of the colon, if the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. As to the claim of entitlement to service connection for a back disability, because the Board is remanding this claim, any evidence the Board could not consider will be considered by the AOJ in the adjudication of this claim. 38 C.F.R. § 3.103(c)(2)(ii). Entitlement to service connection for adenocarcinoma of the colon, as secondary to service-connected other specified trauma and stressor related disorder to include alcohol use disorder, is granted. Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303. Establishing service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted when a claimed disability is found to be due to or the result of a service-connected disability, or when any increase in severity (aggravation) of a nonservice-connected disease or injury is found to be due to or the result of a service-connected disability. 38 C.F.R. § 3.310. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. A VA opinion was obtained in September 2025 in which the VA examiner found that it was less likely than not that the Veteran's adenocarcinoma of the colon was due to the Veteran's service, to include his in-service toxic exposure risk activities. In this regard, the examiner noted that the evidence established that the Veteran to or the result of a service-connected disability. 38 C.F.R. § 3.310. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. A VA opinion was obtained in September 2025 in which the VA examiner found that it was less likely than not that the Veteran's adenocarcinoma of the colon was due to the Veteran's service, to include his in-service toxic exposure risk activities. In this regard, the examiner noted that the evidence established that the Veteran was a current drinker and that "[p]er the literature, epidemiologic and meta-analytic data consistently demonstrate that higher levels of alcohol consumption and greater intensity and duration of smoking are associated with increased risk of colorectal cancer, including adenocarcinoma of the colon." Reading this opinion in the light most favorable to the Veteran, the Board finds that it establishes that the Veteran's adenocarcinoma of the colon is at least as likely as not due to his service-connected other specified trauma and stressor related disorder to include alcohol use disorder. Accordingly, service-connection is warranted for adenocarcinoma of the colon. REASONS FOR REMAND Entitlement to service connection for a back disability is remanded. This matter was remanded by the Board in May 2025 in order to obtain a VA opinion regarding the Veteran's back condition. A VA opinion was obtained in September 2025 in which the VA examiner noted that a February 19, 2022 VA treatment record reflects that the Veteran had "a 10 year history of progressive low back pain radiating down the lateral anterior aspect of the proximal thigh." The VA examiner provided a negative nexus opinion, noting that, the Veteran reported a 10 year history of back pain in 2022, which is inconsistent with complaints of back pain while he was in the military. The Board finds the September 2025 VA opinion to be inadequate as the VA examiner's negative nexus opinion is based on an inaccurate factual premise. Specifically, the VA examiner relied on the February 2022 VA treatment record to establish that the Veteran had only experienced back pain since 2012, 10 years prior to 2022. However, the Veteran's VA treatment records establish that he has complained of back pain since at least January 2009. Specifically, a January 2009 VA treatment record reflects that the Veteran "continues to have significant low back ... discomfort with some burning pain into right groin." Accordingly, the Board finds that remand is warranted to obtain a new VA opinion. The Board also notes that remand is warranted as there appear to be relevant treatment records that have not been associated with the claims file in a manner reviewable by the Board. Specifically, the Veteran has stated that he had back surgery in 2020 at a private facility to which he was referred by VA. His treatment records reflect that community care treatment records were scanned in June 2020, however, they do not appear to have been associated with the claims file in a manner reviewable by the Board. Accordingly, remand is warranted to associate these relevant treatment records with the claims file in a manner reviewable by the Board. This matter is REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate them with the claims file, including for treatment through the VA Community Care program and/or those only available as electronic health records. 2. Obtain an opinion regarding the Veteran's claim for a back disability. The Veteran should only be scheduled for an examination if deemed necessary by the selected clinician. Following review of the claims file, and examination of the Veteran if deemed necessary, the examiner should opine whether it is at least as likely as not (at least an approximate balance of the positive and negative evidence) that the Veteran's disability began in or is otherwise caused by the Veteran's active service, including as due to heavy lifting while serving in the Republic of Vietnam. For the purposes of the opinion, the examiner should assume the Veteran's statements in the record about his symptoms are credible, unless they are inconsistent with the medical evidence or with medical principles concerning his condition. The Board emphasizes that this does not constitute a positive credibility determination, as the Board will weigh the evidence if the appeal returns. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. In doing so, the examiner may identify any discrepancies, inconsistencies, or contradictions contained in the evidence of record, and may state whether or not the Veteran's lay statements are supported by medical or other evidence. The examiner may to heavy lifting while serving in the Republic of Vietnam. For the purposes of the opinion, the examiner should assume the Veteran's statements in the record about his symptoms are credible, unless they are inconsistent with the medical evidence or with medical principles concerning his condition. The Board emphasizes that this does not constitute a positive credibility determination, as the Board will weigh the evidence if the appeal returns. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. In doing so, the examiner may identify any discrepancies, inconsistencies, or contradictions contained in the evidence of record, and may state whether or not the Veteran's lay statements are supported by medical or other evidence. The examiner may not dismiss the Veteran's statements about his symptoms solely because they are not documented in contemporaneous treatment records. All findings must be reported in detail and all opinions must be accompanied by a clear rationale. If any of the above issues cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. M. HYLAND Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Elias, M 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.