Citation Nr: 1320159 Decision Date: 06/21/13 Archive Date: 07/02/13 DOCKET NO. 05-40 228 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Waco, Texas THE ISSUE Entitlement to service connection for skin cancer, to include basal cell and squamous cell carcinomas. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL The Veteran ATTORNEY FOR THE BOARD J. W. Loeb INTRODUCTION The Veteran had active service from February 1960 to April 1968, September 1968 to June 1970, and July 1970 to May 1980. This matter originally came to the Board of Veterans' Appeals (Board) on appeal from an August 2005 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. In September 2012, the Board granted service connection for an acquired psychiatric disorder diagnosed as depression and for a low back disorder, denied service connection for posttraumatic stress disorder (PTSD), and remanded the issues of entitlement to service connection for skin cancer, for hypertension, and for a lung disorder to the RO for additional development. A March 2013 rating decision granted service connection for hypertension and for chronic obstructive pulmonary disease (COPD) with bronchitis. As service connection has been granted for hypertension and COPD with bronchitis, these issues are no longer part of the Veteran's appeal. The issue of entitlement to service connection for skin cancer, to include basal cell and squamous cell carcinomas, is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the Veteran if further action is required. REMAND In response to the September 2012 Board remand, a VA skin evaluation was obtained in December 2012 in which the examiner determined that the Veteran had basal cell and squamous cell carcinomas and concluded that it was less likely than not that the Veteran's basal cell and squamous cell carcinomas are related to military service. Although the examiner cited from a medical text that cumulative exposure to sunlight is the most significant factor in the cause of basal cell and squamous cell carcinomas, the opinion did not discuss whether the Veteran's exposure to sunlight during his approximately 20 years in the military was causally related to these skin disorders, as contended on behalf of the Veteran in May 2013. Consequently, the Board finds that additional development is warranted prior to final Board adjudication. Accordingly, the case is REMANDED for the following actions: 1. The RO/AMC must send the claims file to the VA examiner who evaluated the Veteran for skin disease in December 2012 and ask him to review the claims file and provide an additional opinion on whether the Veteran's basal cell carcinoma and/or his squamous cell carcinoma is at least as likely as not (50 percent probability or more) related to service to include his service exposure to sunlight. If the examiner who evaluated the Veteran in December 2012 is not available, the RO will obtain an opinion from another appropriate medical professional. If the reviewer determines that an additional examination of the Veteran is necessary to provide a reliable opinion, such examination should be scheduled and the Veteran informed as to the consequences for failure to report for a VA examination without good cause in accordance with 38 C.F.R. § 3.158, 3.655 (2012). However, the Veteran should not be required to report for another examination as a matter of course, if it is not found to be necessary. The claims file, including a copy of this remand, must be made available to the examiner in conjunction with the examination. The rationale for all opinions expressed must be explained. The Board notes that the Veteran spent much of his time in service stationed in California, Texas, or Florida and that he was stationed on a ship in the waters off the coast of Vietnam and that history must be considered by the examiner when offering an opinion. 2. Thereafter, the AMC/RO will consider all of the evidence of record and re-adjudicate the Veteran's claim for entitlement to service connection for skin cancer, to include basal cell and squamous cell carcinomas. If the benefit sought on appeal remains denied, the Veteran will be provided a supplemental statement of the case ("SSOC"). The SSOC must contain notice of all relevant actions taken on the claim for benefits, to include a summary of the evidence and applicable law and regulations considered pertinent to the issue currently on appeal. An appropriate period of time will be allowed for response. The Veteran has the right to submit additional evidence and argument on the matter 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 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. 2012). _________________________________________________ ROBERT C. SCHARNBERGER Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board 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) (2012).