Citation Nr: 18131208
Decision Date: 08/31/18	Archive Date: 08/31/18

DOCKET NO. 15-23 093A
DATE:	August 31, 2018
ORDER
Service connection for basal cell carcinoma and actinic keratosis (claimed as sores on neck and face due to Agent Orange exposure) with related facial erythema and papular lesions is granted.
FINDING OF FACT
The Veteran's current chronic recurrent skin lesions on his face (basal cell carcinoma and actinic keratosis) with related facial erythema and papular lesions are shown to be etiologically related to his active service.
CONCLUSION OF LAW
Service connection for actinic keratosis and basal cell carcinoma with related facial erythema and papular lesions is established.  38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017).
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty from April 1963 to February 1966, including service in the Republic of Vietnam.  The Veteran contends that his actinic keratosis and basal cell carcinoma were caused by in-service Agent Orange exposure.  
To establish direct service connection, the record must contain: (1) medical evidence of a current disorder; (2) medical evidence, or in certain circumstances, lay testimony, of in-service incurrence or aggravation of an injury or disease; and, (3) medical evidence of a nexus between the current disorder and the in-service disease or injury.  In other words, entitlement to service connection for a particular disorder requires evidence of the existence of a current disorder and evidence that the disorder resulted from a disease or injury incurred in or aggravated during service.  38 U.S.C. §§ 1110, 1131.
Service connection may also be granted for any disease diagnosed after the military discharge, when all the evidence, including that pertinent to the period of military service, establishes that the disease was incurred during the active military service.  38 U.S.C. § 1113(b) (2012); 38 C.F.R. § 3.303(d). 
Where a chronic disease, like a malignant tumor (basal cell carcinoma), is shown in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. 38 C.F.R. § 3.303(b).
The Veteran’s service treatment records show treatment for basal cell carcinoma.  See March 1966 Medical Treatment Record.  
In February 2013, the Veteran underwent a VA examination for skin disorders.  The VA examiner diagnosed basal cell carcinoma and actinic keratosis (diagnosed as potentially pre-cancerous) with related facial erythema and papular lesions.  The VA examiner opined that the Veteran’s diagnosed skin conditions were at least as likely as not (50 percent or greater probability) incurred in or caused by active service.    
Based upon the forgoing, service connection for basal cell carcinoma and actinic keratosis (diagnosed as potentially pre-cancerous) with related facial erythema and papular lesions is granted. 
 
M. C. GRAHAM
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	B. Herdliska 

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