Citation Nr: 0814572 Decision Date: 05/02/08 Archive Date: 05/12/08 DOCKET NO. 05-30 744 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Boise, Idaho THE ISSUES 1. Entitlement to service connection for the cause of the veteran's death. 2. Entitlement to Dependency and Indemnity Compensation (DIC) under 38 U.S.C.A. § 1318. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD Jennifer Margulies, Associate Counsel INTRODUCTION The veteran served in the Marine Corps from September 1967 to April 1967. He also had unconfirmed service in the Army from March 1977 to July 1977. He died on August [redacted], 2002. The appellant is the widow of the veteran. This matter is before the Board of Veterans' Appeals (Board) on appeal from a December 2002 rating decision of the Department of Veterans Affairs (VA) in Salt Lake City, Utah, which denied the claims of entitlement to service connection for the cause of the veteran's death and entitlement to DIC pursuant to 38 U.S.C.A. § 1318. 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 appellant asserts that her husband's death was the result of pulmonary lung disease. The available service medical records show on enlistment in September 1967, the veteran's Report of Medical History noted a skin graft left eye, 2 years earlier. Discharge examination in March 1969 was normal, although skin graft of the lower left eye was noted. VA outpatient treatment reports dated in June 2002 note the veteran's history of being diagnosed with a stage IV melanoma over 13 years earlier, although he had not received treatment since. Another June 2002 clinical entry records a past medical history of excess sun exposure with sunburns as a child and hairy nevus removal over left eye at the age of 18 months. The entry also notes a diagnosis of metastatic carcinoma likely. At that time, the entry also reiterated the veteran's stage IV melanoma of the right foot 13 years earlier (treatment with surgery, patient refused chemotherapy) and hairy nevus. Metastatic melanoma is the most likely cancer. It was also noted that other causes could be lung cancer (history of smoking), colon cancer (bowel symptoms), or prostate cancer although pancreatic cancer can also have late abdominal symptoms. Tests were orders and it was noted that hematology/oncology would be contacted if cancer was confirmed. A June 2002 discharge summary note confirmed the presence of cancer in the liver, lung, mediastinum and subcutaneous. It was noted that the source was likely melanoma given the history. The Board notes that the reports associated with the "treatment with surgery, patient refused chemotherapy" are not of record. Thus, additional action in this regard is warranted. The death certificate shows that the cause of the veteran's death was attributed to "widely metastatic melanoma." An autopsy was not performed. Also of record is a statement from Dr. C.P. In the statement, Dr. C.P. concludes that the veteran died from metastatic melanoma. Dr. C.P. then states that "pulmonary lung involvement was assumed based on abnormal imaging studies." He went on to say, "The probability is extremely high that the abnormalities were the result of lung involvement by metastatic melanoma. As a biopsy was not performed I cannot conclude without absolute certainty that the veteran did not have lung cancer." Although the VA medical reports show multiple metastatic melanoma, and note cancer of the liver and lungs, the Board finds that additional development is needed. A VA medical opinion is needed to determine the origin of the veteran's metastatic melanoma and lung cancer; that is, whether it initially began as a skin disorder of his feet and metastasized therefrom, or whether the cancer began in his lungs, liver or in any other location. Additionally, there are some indications within the record noting that the veteran had two periods of service. There is no DD-214 to show the period of service from March 1977 to July 1977. In addition, there is no evidence of record showing that the RO attempted to locate the veteran's service medical records for the above referenced period of service. Accordingly, the case is REMANDED for the following action: 1. Attempt to obtain any outstanding private medical records, nursing care records, or VA treatment records, which address treatment for the veteran's metastatic melanoma and/or lung cancer, to include any medical reports associated with the veteran's surgical treatment approximately 13 years prior to his death. If no additional records are available, documentation of such should be noted in the claims file and the appellant should be afforded an opportunity to submit evidence in support of her claim. 2. Thereafter, transfer the claims folder to an appropriate examiner to determine the likely origination point of the veteran's metastatic melanoma and lung cancer, and to determine whether the veteran's cause of death was related to his active service. The examiner should provide an opinion as to whether there is a 50 percent probability or greater that the veteran's cause of death was related to his period of active service, manifested to a compensable degree within a year after service, or is related to any in- service herbicide exposure. The examiner should specifically address Dr. C.P.'s opinion and provide a rationale for any conclusion reached. 3. An attempt to verify the veteran's second period of service and locate his service medical records from that time should be accomplished as well. All correspondence should be incorporated into the claims file. 4. Thereafter, readjudicate the issues on appeal. If the desired benefits are not granted, a supplemental statement of the case should be furnished to the veteran and his representative. The case should then be returned to the Board, if otherwise in order. The appellant has 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. 2007). _________________________________________________ C. CRAWFORD 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) (2007).