Citation Nr: 0713252 Decision Date: 05/04/07 Archive Date: 05/15/07 DOCKET NO. 05-01 063 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to service connection for malignancies with history of melanoma, basal cell carcinoma and dysplastic nevi due to jet fuel exposure. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Motrya Mac, Associate Counsel INTRODUCTION The veteran had active duty service from August 1966 to July 1970. This case is before the Board of Veterans' Appeals (Board) on appeal from a March 2004 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA). The veteran during his February 2007 videoconference Board hearing withdrew his increased rating claim for tinnitus. Thus this claim is no longer in appellate status. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The veteran is claiming that his skin disorder, to include history of melanoma, basal cell carcinoma and dysplastic nevi, is due to his jet fuel exposure during service. The veteran has a history of malignant melanoma and has had basal cell carcinoma including on his shoulder, neck, chest and back. He was a refueling operator during service and received an award for his meritorious service as a Mobile Refueling Operator in Thailand from May 1968 to May 1969. Service medical records revealed that the veteran was treated for contact dermatitis. A September 1969 entry indicated a possible link between the veteran's contact dermatitis and his exposure to JP-4 jet fuel. Opinions received from the veteran's private doctor dated in October 2003 and April 2005 indicated that there is potential evidence based on studies to support an association between the veteran's exposure to jet fuels and the subsequent development of malignancies. The veteran has submitted articles discussing the link between jet fuel exposure and skin tumors. During a January 2004 VA examination, the examiner provided diagnoses to include malignant melanoma of the skin of the left arm resected, multiple basal cell carcinoma lesion resected or treated with liquid nitrogen and multiple dysplastic nevi of the skin. The examiner opined that while there is some evidence to suggest an effect of jet fuel on the immunity system, the association cannot be established without resort to speculation. During the examination, the examiner found no basal cell carcinoma lesion or evidence of recurrence of melanoma. The veteran has questioned the adequacy of his VA evaluation. Subsequent to the January 2004 VA examination, he was diagnosed with basal cell carcinoma on his mid back in February 2004, in July 2004 he underwent a procedure to apparently destroy a pre-malignant lesion on his left shoulder and in September 2004 he had a diagnosis of basal cell carcinoma, infiltrative type on his left neck. Thus the Board finds that the January 2004 VA examination is inadequate for evaluating the veteran's skin disorder. Hence, under the circumstances of this case, another VA examination is warranted by a different examiner to determine the current nature and etiology of the veteran's skin disorder. Accordingly, the case is REMANDED for the following actions: 1. The veteran should be scheduled for an appropriate VA examination by a new examiner to ascertain the nature and etiology of his current skin disorder, characterized as malignancies with history of melanoma, basal cell carcinoma and dysplastic nevi due to jet fuel exposure. It is imperative that the claims file be made available to and be reviewed by the examiner in connection with the examination. All clinical and any special test findings should be clearly reported. After reviewing the claims file (to specifically include service medical records) and examining the veteran, the examiner should offer an opinion as to whether it is at least as likely as not (a 50% or higher degree of probability) that the veteran's malignancies with history of melanoma, basal cell carcinoma and dysplastic nevi are related to service, to specifically include exposure to jet fuel. The examiner should comment on the conflicting medical opinions of record. A detailed rationale for all opinions expressed should be furnished. 2. After completion of the above and any other development deemed necessary, the RO should review the expanded record and determine if the benefit sought can be granted. Unless the benefit sought is granted, the veteran and his representative should be furnished an appropriate supplemental statement of the case and be afforded an opportunity to respond. Thereafter, the case should be returned to the Board for appellate review. The appellant and his representative have the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2006). _________________________________________________ Robert E. O'Brien Acting Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2006).