## Facts

- A Vietnam veteran was presumed exposed to herbicides, including Agent Orange.
- The veteran developed a malignant brain tumor (glioblastoma) in 1993 and died in 1994.
- The veteran’s widow sought dependency and indemnity compensation based on the theory that herbicide exposure caused the fatal tumor.
- The regional office denied the claim; the Board of Veterans’ Appeals (Board) affirmed.
- The Board relied primarily on a VA medical opinion stating the tumor was less likely than not related to herbicides because epidemiological evidence (including National Academy of Sciences materials used in VA rulemaking) did not show a statistically significant association between herbicides and brain tumors.
- The widow submitted three private medical opinions supporting a causal link; the Board discounted them largely as inconsistent with the epidemiological data and the absence of presumptive status for brain tumors.

## Issues

1. Whether the Board erred by treating the absence of brain tumors from the herbicide presumptive list, and the lack of a statistically significant association in epidemiological materials, as dispositive against direct service connection.
2. Whether the Board provided an adequate statement of reasons or bases for assigning greater probative weight to the VA opinion and rejecting multiple favorable private medical opinions.

## Decision

- The Court vacated the Board’s denial and remanded.
- The Court held that exclusion from the presumptive list cannot be the sole basis to deny service connection; direct service connection must still be considered based on the case-specific evidence.
- The Court found the Board’s reasons or bases inadequate because it relied mechanically on the lack of a statistical association and did not meaningfully assess the private opinions’ reasoning and supporting rationale.
- The Court directed the Board on remand to reassess the evidence without treating epidemiological categories and presumptive rulemaking determinations as conclusive in an individual adjudication.

## Legal Principles

- A claimant may establish service connection on a direct basis even when the claimed condition is not among diseases presumptively associated with herbicide exposure.
- Population-level epidemiological findings and presumptive-disease determinations inform rulemaking but do not, by themselves, resolve whether an individual veteran’s condition is at least as likely as not related to service.
- The Board may not discount a competent medical opinion solely because it relies on statistical analysis or conflicts with general epidemiological conclusions; it must evaluate the opinion’s medical reasoning as applied to the veteran’s facts.
- The Board must provide an adequate statement of reasons or bases that explains its weighing of favorable and unfavorable evidence and permits effective judicial review.

## Conclusion

The Court required the Board to reconsider the cause-of-death claim by addressing direct service connection and by providing a reasoned explanation for the probative weight assigned to competing medical opinions, rather than treating the absence of presumptive status or a statistical association as determinative.


Polovick v. Shinseki, 23 Vet. App. 48 (Vet. App. 2009)