Case A26040940

Summary

The veteran, who served in the United States Marine Corps from April 1966 to April 1968, passed away on November 24, 2023. His surviving spouse appealed the denial of service connection for the cause of death. The veteran was service-connected for PTSD and hypertension. The death certificate listed cardiopulmonary arrest as the immediate cause of death. The Board reviewed the evidence, including a VA opinion from April 2024 which found it less likely than not that hypertension and PTSD substantially contributed to death. However, the appellant submitted a private opinion in April 2026, which found a clear, biologically plausible link between chronic hypertension and cardiopulmonary arrest, concluding a direct causal nexus. The Board found the evidence to be in equipoise regarding the contribution of hypertension to the cardiopulmonary arrest. Applying the benefit of the doubt, service connection for the cause of death was granted.

Rationale

Evidence in equipoise regarding hypertension's contribution to death; Benefit of the doubt applied in favor of the appellant; Private opinion found a direct causal nexus between hypertension and cardiopulmonary arrest

Full Decision Text

Citation Nr: A26040940
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 260120-634847
DATE: April 30, 2026

ORDER

Service connection for cause of death is granted.

FINDING OF FACT

The evidence is in equipoise as to whether the Veteran's cardiopulmonary arrest is etiologically related to his service-connected hypertension.

CONCLUSION OF LAW

The criteria for service connection for the cause of the Veteran's death are met. 38 U.S.C. §§ 1110, 1310; 38 C.F.R. §§ 3.50, 3.303, 3.312.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service in the United States Marine Corps from April 1966 to April 1968. He passed away on November 24, 2023. The Appellant is his surviving spouse.

In November 2024, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of service connection for cause of death most recently addressed in an April 2024 rating decision. In March 2025, the agency of original jurisdiction (AOJ) issued the supplemental claim decision on appeal, which found that new and relevant evidence had been received and denied the claim based on the evidence of record at the time of that decision. 

In the January 20, 2026, VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the April 2024 AOJ decision on appeal, as well as any evidence submitted by the Appellant or 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. 

If the Appellant 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. 

To establish entitlement to service connection for the cause of a Veteran's death, the evidence of record must show that a disability incurred in or aggravated by service either caused or contributed substantially or materially to cause death. 38 C.F.R. § 3.312(a). For a service-connected disability to be considered the principal or primary cause of death, it must singly, or with some other condition, be the immediate or underlying cause, or be etiologically related thereto. 38 C.F.R. § 3.312(b). In determining whether a service-connected disability contributed to death, it must be shown that it contributed substantially or materially; that it combined to cause death; or that it aided or lent assistance to the production of death. It is not sufficient to show that it casually shared in producing death, but rather, it must be shown that there was a causal connection. 38 C.F.R. § 3.312(c)(1). The debilitating effects of a service-connected disability must have made the veteran materially less capable of resisting the fatal disease or must have had a material influence in accelerating death. See Lathan v. Brown, 7 Vet. App. 359 (1995).

At the time of his death the Veteran was service connected for posttraumatic stress disorder (PTSD) and hypertension. The death certificate lists the immediate cause of death to be cardiopulmonary arrest.

The Appellant argues that the Veteran suffered from acute myeloid leukemia which was the result of his service-connected hypertension. A VA opinion was obtained in April 2024 to determine if there was any connection between the cause of the Veteran's death and his service connected disabilities. The examiner stated that it was less likely than not that the Veteran's service connected hypertension and PTSD substantially, materially contributed to death, or that it combined to case death. The Appellant subsequently submitted an April 2026 private opinion. This opinion found
 (1995).

At the time of his death the Veteran was service connected for posttraumatic stress disorder (PTSD) and hypertension. The death certificate lists the immediate cause of death to be cardiopulmonary arrest.

The Appellant argues that the Veteran suffered from acute myeloid leukemia which was the result of his service-connected hypertension. A VA opinion was obtained in April 2024 to determine if there was any connection between the cause of the Veteran's death and his service connected disabilities. The examiner stated that it was less likely than not that the Veteran's service connected hypertension and PTSD substantially, materially contributed to death, or that it combined to case death. The Appellant subsequently submitted an April 2026 private opinion. This opinion found the totality of the medical literature supports a clear, biologically plausible, and epidemiologically validated link between chronic hypertension and cardiopulmonary arrest. Given the Veteran's established diagnosis of service-connected hypertension, it is at least as likely as not that this condition caused, or substantially and materially contributed to, the cardiac structural changes, electrical instability, and/or ischemic processes that culminated in his fatal cardiopulmonary arrest. Therefore, the private examiner concluded that a direct causal nexus between his service-connected hypertension and his cause of death is medically related. 

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?

On review of the record, the Board finds the evidence to be in equipoise as to whether the Veteran's service connected hypertension contributed to the cardiopulmonary arrest which ultimately caused his death. Therefore, resolving any doubts in the Appellant's favor, service connection for the cause of the Veteran's death is granted.

 

 

JOHN Z. JONES

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Jorge Barroso, 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.