Bladder Cancer & Benign Prostatic Hypertrophy due to Agent Orange Exposure Denial Contained Error

Summary

The Veteran served in the United States Army from May 1967 to May 1969. During his service in Vietnam, the Veteran was exposed to herbicides on multiple occasions, including Agent Orange. In March of 2009, he was diagnosed with bladder cancer and filed a claim for service-connected benefits. The Veteran also filed a claim for service connection for his prostate condition. A regional office denied service connection for both conditions and the Veteran continued to appeal these issues to the Board of Veterans’ Appeals. In March of 2017, the Board denied service connection as well.

Board denies service connection for bladder cancer & benign prostatic hypertrophy due to Agent Orange exposure

In its decision, the Board relied heavily on the June 2014 VA examination. Specifically, the examiner stated the Veteran’s bladder condition was most likely caused by his history of cigarette smoking. To support this conclusion, the examiner cited medical literature that indicated cigarette smoking is the most significant risk factor of bladder cancer in the United States. Furthermore, in regards to the Veteran’s prostate condition, the examiner concluded that benign prostatic hypertrophy (BPH) is common in older males and likely due to hormonal effects and possible genetic tendencies. In both instances, the examiner referenced medical literature that points away from Agent Orange exposure as a causative factor.

CCK appeals bladder cancer and BPH denial to the Court

CCK successfully appealed to the Court of Appeals for Veterans Claims the Board decision that denied service connection for the Veteran’s bladder cancer and BPH. CCK argued that the June 2014 VA examination was inadequate because the examiner relied solely on medical literature that found that smoking caused approximately 50% of bladder cancers. While the Veteran had a significant history of smoking, there is still a possibility that exposure to Agent Orange caused his bladder cancer. In regards to service connection for BPH, CCK argued that the examiner’s reference to other potential risk factors such as hormonal effects and genetic tendencies was inadequate insofar as the examiner did not explain whether or not the Veteran had those risk factors.

CAVC Agrees with CCK’s arguments and Remands Veteran’s Claim

CCK argued, and the Court agreed, that the Board erred by failing to return the June 2014 VA examination for further clarification regarding the appellant’s bladder cancer. Namely, the medical literature that the examiner cited to also stated that “occupational chemical exposure to polycyclic aromatic hydrocarbons and aromatic amines represents the next most important risk factor” in developing bladder cancer. Therefore, the Board must clarify the similarities of these chemicals and dioxins to determine the potential causal relationship between the Veteran’s bladder cancer and exposure to Agent Orange. Furthermore, the Court remanded service connection for BPH because the examiner failed to address whether the Veteran’s bladder cancer may have caused hormonal changes, which was listed as a risk factor of BPH. The Court acknowledges that if the Veteran is granted service connection for bladder cancer, that decision may have a significant impact on the adjudication of his BPH claim.