09-47 358
09-47 358
| Board of Vet. App. | Mar 22, 2017Background
- Veteran served on active duty Dec 1971–Nov 1974 and appeals a April 2009 VA RO rating decision denying service connection for prostate cancer.
- Veteran reported in-service gonorrhea (confirmed in service records) and credible exposure to asbestos aboard ship; he also asserted herbicide exposure.
- Multiple medical articles and studies were submitted by the Veteran suggesting associations between gonorrhea/asbestos and prostate cancer.
- The Board ordered further development and obtained a December 2016 VHA urology expert opinion after remands in 2010 and 2014.
- The December 2016 VHA opinion (Chief of Urology) reviewed the claims file, found plausible mechanisms and epidemiologic support linking gonorrhea and asbestos to increased prostate cancer risk, and concluded the Veteran’s exposures more likely than not caused his prostate cancer.
- The Board found the VHA opinion persuasive, resolved reasonable doubt in the Veteran’s favor, and granted service connection for prostate cancer.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Service connection for prostate cancer | Prostate cancer caused by in-service exposures: gonorrhea, asbestos, and herbicides | VA previously found no nexus; questioned medical support for gonorrhea/asbestos link | Granted: Board found nexus based on persuasive December 2016 VHA opinion and resolved doubt for Veteran |
Key Cases Cited
- Holton v. Shinseki, 557 F.3d 1362 (Fed. Cir.) (defines elements required for VA service connection)
- Shedden v. Principi, 381 F.3d 1163 (Fed. Cir.) (discusses nexus requirement for service connection)
- Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (Vet. App.) (explains factors giving a medical opinion probative weight)