93 Decision Citation: BVA 93-01518 Y93 BOARD OF VETERANS' APPEALS WASHINGTON, D.C. 20420 DOCKET NO. 92-55 264 ) DATE ) ) ) THE ISSUE Entitlement to service connection for the cause of the veteran's death. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Nancy S. Kettelle, Associate Counsel INTRODUCTION This matter comes to the Board of Veterans' Appeals (Board) on appeal from a July 1990 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Los Angeles, California. The appellant is the widow of the veteran, who had active service from January 1952 to December 1974. The appellant's notice of disagreement was received in September 1990, and the RO issued a statement of the case in September 1991. The appellant's substantive appeal was received in October 1991. The appellant testified at a hearing at the RO in January 1992, and the hearing officer's decision was issued later that month. The case was received and docketed at the Board in February 1992. The appellant's representative, Disabled American Veterans, submitted written argument on her behalf in January and April 1992. REMAND The appellant claims that the veteran's death was caused by illness which had its origin during military service. The Certificate of Death shows that the veteran died in March 1990 and that the immediate cause of death was cardiopulmonary arrest due to renal cell carcinoma metastatic to lungs and brain. In an October 1989 memorandum, a staff internist/nephrologist at David Grant United States Air Force Medical Center, Travis Air Force Base, stated that the veteran had recently been hospitalized at the Medical Center for evaluation of a mass involving his left kidney and adrenal gland, and, at that time, he was found to have an advanced renal cell carcinoma, with metastases to the frontal lobes of the brain. The appellant has stated that a physician subsequently advised her that the veteran's renal tumor had been encapsulated and that this type of encapsulation could take 10 to 15 years from its date of origin to metastasize. She argues that the 15 years would place the time of origin of the veteran's cancer to when he was still on active duty. The appellant requests that the VA seek expert medical opinion as to the possibility of such a delayed appearance of this type of tumor. We also note that on a VA Form 21-4142, dated in March 1990, the appellant authorized release of information regarding the veteran from the David Grant United States Air Force Medical Center and reported that he had received treatment at that facility in the 1980's. However, there is no indication that any attempt was made to obtain the records to which the appellant referred. We believe that those records, and any additional records that the appellant may be able to identify concerning treatment of the veteran's fatal cancer, should be obtained. At the January 1992 hearing, the appellant argued that the veteran's fatal cancer could have arisen as a result of the traumatic head injury he sustained in an automobile accident in service in 1954. She testified that she had been told by a physician at the Air Force hospital that an injury to the pituitary gland has a direct correlation with the adrenal gland and that a tumor could lay encapsulated for many years before it metastasized. She stated that she thought that the veteran's cause of death was either related to his inservice head injury or to exposure to radiation as a weapons systems inspector in service. She testified that shortly before his death the veteran stated that he thought that he could have been exposed to radiation when he was involved in several covert operations involving nuclear warheads in the 1960's. He told her that he was involved in testing at George Air Force Base with respect to modifications of the F-106 to carry nuclear armaments. We note that the veteran's service personnel records show that he was assigned to the 329th Fighter Interceptor Squadron, George Air Force Base, California, from September 1963 to July 1966. Although attempts to obtain radiation exposure information for the veteran from other sources have been unsuccessful, we believe an attempt should be made to obtain such information directly from George Air Force Base through unit histories for the veteran's squadron and any other pertinent sources which may be available. Accordingly, the case is REMANDED to the RO for the following actions: 1. After obtaining any necessary authorization from the appellant, the RO should attempt to obtain and associate with the claims file all outpatient records, hospital summaries, laboratory reports and pathology reports for the veteran from David Grant United States Air Force Medical Center, Travis Air Force Base, California 94535, dated from January 1975 to March 1990. 2. The RO should contact the appellant and request that she identify the names, addresses, and approximate dates of treatment for all health care providers, other than David Grant United States Air Force Medical Center, from which the veteran received medical treatment which she believes may be pertinent to her claim. With any necessary authorization from the appellant, the RO should attempt to obtain copies of the medical records identified by the appellant which are not currently in the file. 3. The RO should attempt to obtain and associate with the claims file unit histories for the 329th Fighter Interceptor Squadron, George Air Force Base, California, covering the period from September 1963 to July 1966. The RO should review the histories and follow any lead with respect to exposure of the veteran to ionizing radiation to its logical conclusion. If it is determined that the veteran was exposed to ionizing radiation, the RO should proceed with appropriate development under 38 C.F.R. § 3.311b (1991). 4. Thereafter, the RO should arrange for review of the record by a VA nephrologist and request that that physician offer an opinion, with complete rationale, as to whether it is at least as likely as not that the veteran's renal cell carcinoma had its onset before January 1975. 5. Thereafter, in light of the evidence obtained pursuant to the requested development, the RO should readjudicate the issue of entitlement to service connection for the cause of the veteran's death. If the appellant disagrees with the decision of the RO, and if otherwise appropriate, the RO should issue a supplemental statement of the case which includes reference to the applicable law and regulations pertaining to the appellant's claim. After the appellant and her representative have been provided an opportunity to respond, the case should be returned to the Board for further consideration, if otherwise in order. By this REMAND, the Board intimates no opinion as to the final outcome warranted. No action is required of the appellant until she is notified by the RO. BOARD OF VETERANS' APPEALS WASHINGTON, D.C. 20420 * JOHN J. CASTELLOT, SR., M.D. ROBERT E. SULLIVAN * 38 U.S.C.A. § 7102(a)(2)(A) (West 1991) permits a Board of Veterans' Appeals Section, upon direction of the Chairman of the Board, to proceed with the transaction of business without awaiting assignment of an additional Member to the Section when the Section is composed of fewer than three Members due to absence of a Member, vacancy on the Board or (CONTINUED ON NEXT PAGE) inability of the Member assigned to the Section to serve on the panel. The Chairman has directed that the Section proceed with the transaction of business, including the issuance of decisions, without awaiting the assignment of a third Member. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. 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. 57 Fed. Reg. 4126 (1992) (to be codified as 38 C.F.R. § 20.1100(b)).