Citation Nr: 18141672 Decision Date: 10/11/18 Archive Date: 10/11/18 DOCKET NO. 14-07 032A DATE: October 11, 2018 ORDER Entitlement to service connection for skin cancer, diagnosed as squamous cell carcinoma, is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has squamous cell carcinoma due to a disease or injury in service, to include as a result of exposure to sunlight and herbicide agents. CONCLUSION OF LAW The criteria for service connection for skin cancer, diagnosed as squamous cell carcinoma, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from June 1959 to May 1963 and the United States Air Force from April 1965 to April 1969. By correspondence received May 2017, the Veteran withdrew his prior request for a hearing. In August 2017, the RO remanded the Veteran’s claim to schedule a VA examination and obtain a medical opinion regarding whether the Veteran’s skin cancer is related to in-service exposure to sunlight or herbicide agents. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease initially diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In the August 2017 Board decision, the Board held the Veteran was exposed to herbicide agents during service. If a Veteran is exposed to an herbicide agent during active service and one of the listed diseases manifests any time after service, the disability is presumed related to the exposure. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6), 3.309(e). 1. Entitlement to service connection for skin cancer, diagnosed as squamous cell carcinoma Regarding direct service connection, the first element is satisfied, in that the Veteran’s March 2018 VA skin examination indicates a prior diagnosis of squamous cell carcinoma on the Veteran’s right hand in April 2010 and the Veteran’s right shin in April 2017. As squamous cell carcinoma is not one of the presumptive diseases associated with exposure to herbicide agents, service connection for squamous cell carcinoma is not presumptively available based on the Veteran’s in-service exposure to herbicide agents. The second element of direct service connection is also satisfied, in that the Veteran argues that squamous cell carcinoma is the result of in-service exposure to sunlight and herbicide agents. Unfortunately, service connection must be denied because the nexus element is not satisfied. A March 2018 VA examiner states that “the Veteran’s Report of Medical Examinations with physical assessments during active duty noted moles to the Veteran’s nose, right cheek[,] and several on chest (noted on entrance exam) and the Veteran was treated for tinea corporis to the left mid abdomen in 1968.” Furthermore, the Veteran was “discharged in 1969 with no medical evidence of skin conditions other than the moles documented on entrance exam and tinea corporis in 1968.” The examiner acknowledges that the Veteran was exposed to sunlight and herbicide agents during service. Because the Veteran showed none of the signs of squamous cell carcinoma on his body upon discharge and was not diagnosed with skin cancer until 2010, the examiner concludes that the Veteran’s squamous cell carcinoma is less likely than not related to service. This medical opinion is probative because it is based on a review of the record and contains clear conclusions with supporting data connected by a reasoned medical explanation. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301–02 (2008). Because the preponderance of the evidence is against the existence of a nexus between squamous cell carcinoma and in-service exposure to sunlight and herbicide agents, the Veteran’s claim for service connection for skin cancer, diagnosed as squamous cell carcinoma, must be denied. Finally, the Board would like to point out that in its remand, the Board requested an appropriate examination that fully addressed the Veteran’s claims, and while the examination was conducted by a nurse practitioner, the Board finds that the examination and opinions provided were responsive to the Board’s requests and there is no medical opinion that contradicts the opinions and findings of the March 2018 VA examiner. Consequently, the Board finds that the Board’s examination request was substantially complied with and that remand for an additional medical opinion under these circumstances is not warranted. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Cannon, Associate Counsel