Citation Nr: 18139910
Decision Date: 10/01/18	Archive Date: 10/01/18

DOCKET NO. 16-20 069
DATE:	October 1, 2018
REMANDED
Entitlement to service connection for bladder cancer, to include as due to herbicide agent and/or diesel fuel exposure, is remanded.
REASONS FOR REMAND
The Veteran had active naval service from, October 1966 to August 1970, and from December 1980 to April 1987, to include service in the Republic of Vietnam. 
This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a May 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri.
Service Connection – Bladder Cancer
The Board notes that the Veteran has consistently asserted that he has bladder cancer as due to active service.  In that regard, he asserts that he had herbicide exposure and/or diesel fuel exposure, to include exposure to benzene, during active service that caused his bladder cancer.  
The Veteran’s DD Form 214 shows that the Veteran had active service in the Republic of Vietnam.  Moreover, the Veteran asserts exposure to herbicides and diesel fuel while performing his duties as a boat coxswain while stationed in the Republic of Vietnam.  In light of the Veteran’s statements and his current diagnosis of bladder cancer, the Board concludes that the Veteran should be afforded a VA examination to determine the nature and etiology of any current bladder cancer disability.  McLendon v. Nicholson, 20 Vet. App. 79 (2006).
Additionally, current treatment records should be identified and obtained before a decision is made in this case.
The matter is REMANDED for the following action:
1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file.
2. Then, schedule the Veteran for a VA examination by an examiner with sufficient expertise to determine the nature and etiology of the Veteran’s bladder cancer.  The examiner should review the claims file and indicate that review in the report.  Any indicated studies should be performed.  
Based upon the examination results and a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any bladder cancer is etiologically related to service, to include as due to herbicide agent exposure and/or diesel fuel exposure, to include benzene.
The examiner should specifically address the November 2013 letter from the Veteran’s treatment provider, S.M., RNCSFNP, indicating that Agent Orange exposure has been linked with causing bladder cancer.  
The examiner must note that the fact that bladder cancer is not a disability that is presumed to be related to herbicide exposure is not a sufficient rationale upon which to base a finding that bladder cancer is not related to exposure to herbicides.
The rationale for all opinions expressed must be provided.
3. Confirm that the VA examination report and all opinions provided comport with this remand, and undertake any other development found to be warranted.
4. Then, readjudicate the issue on appeal.  If the decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response.  Then, return the case to the Board.
 
Kristin Haddock
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Mariah N. Sim, Associate Counsel