Citation Nr: 18142070 Decision Date: 10/16/18 Archive Date: 10/12/18 DOCKET NO. 14-12 657 DATE: October 16, 2018 REMANDED Entitlement to service connection for testicular cancer, to include as due to exposure to ionizing radiation is remanded. Entitlement to service connection for lymphatic cancer, to include as due to exposure to ionizing radiation is remanded. Entitlement to service connection for lung cancer, to include as due to exposure to ionizing radiation is remanded. Entitlement to service connection for erectile dysfunction (ED), to include as due to exposure to ionizing radiation is remanded. Entitlement to service connection for lung damage, to include as secondary to chemotherapy treatment is remanded. Entitlement to service connection for right bundle branch block, to include as secondary to chemotherapy treatment is remanded. Entitlement to service connection for acid reflux, to include as secondary to chemotherapy treatment is remanded. Entitlement to service connection for low testosterone, to include as secondary to chemotherapy treatment is remanded. Entitlement to special monthly compensation (SMC) based on loss of use of creative organ is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1976 to February 1980. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an October 2009 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) in Jackson, Mississippi. The Veteran requested a hearing in October 2014. The record reflects the Veteran withdrew his hearing request in April 2015. Thus, the request is deemed withdrawn. 1. Entitlement to service connection for testicular cancer, lymphatic cancer, and lung cancer to include as due to exposure to ionizing radiation is remanded. The Veteran was diagnosed with testicular cancer, lymphatic cancer, and lung cancer in 1992. See Medical Treatment Record – Non-Government Facility received August 20, 2008. He has alleged that these cancers are related to in-service exposure to ionizing radiation. The Veteran worked on active duty as a weather equipment specialist. See DD Form 214. He states that he was exposed to ionizing radiation while performing his duties as a special equipment operator while serving overseas at the Shemya Air Force Base, Alaska where atmospheric nuclear testing was being conducted in 1979. While the Veteran does not qualify as a “radiation-exposed veteran” under 38 C.F.R. § 3.309 (d)(3), he may still benefit from the special development procedures provided in 38 C.F.R. § 3.311. “Radiogenic diseases,” may be service-connected pursuant to 38 C.F.R. § 3.311. The regulation does not provide presumptive service connection for radiogenic diseases but provides special procedures to help a Veteran prove his or her claim on a direct basis. Ramey v. Gober, 120 F.3d 1239 (Fed. Cir. 1997). Pursuant to these special development procedures, 38 C.F.R. § 3.311 (a) requires that a request be made for any available records concerning a Veteran’s exposure to radiation. These records normally include but may not be limited to the Veteran’s Record of Occupational Exposure to Ionizing Radiation (DD Form 1141), if maintained, service treatment records, and other records which may contain information pertaining to the Veteran’s radiation dose in service. All such records will be forwarded to the Under Secretary for Health, who will be responsible for preparation of a dose estimate, to the extent feasible, based on available methodologies. 38 C.F.R. § 3.311 (a)(2)(iii). The Agency of Original Jurisdiction (AOJ) did not complete the appropriate procedures under § 3.311 to develop the Veteran’s claim. As the Veteran has the above listed cancers, which are radiogenic diseases, development to determine the level, if any, of in-service radiation exposure must be completed on remand. 2. Entitlement to service connection for ED, lung damage, right bundle branch block, acid reflux, low testosterone and SMC based on loss of use of creative organ is remanded. Finally, because a decision on the remanded issues of testicular, lymphatic and lung cancers could significantly impact a decision on the issues listed here, the issues are inextricably intertwined. A remand of these claims is required. The matters are REMANDED for the following action: 1. Request from the appropriate record repositories all records relating to the Veteran’s claimed in-service exposure to radiation, including, but not limited to, DD Form 1141, if available, military treatment records, and military personnel records not otherwise associated with the evidentiary record. 2. All obtained records should be associated with the evidentiary record. If any identified records are not obtainable (or none exist), the Veteran and his representative should be notified and the record clearly documented. 3. Forward any records secured in response to the remand directive above and any other evidence regarding the Veteran’s in-service exposure to ionizing radiation to the Under Secretary of Health and request preparation of a dose estimate, to the extent feasible, based on available methodologies and in accordance with 38 C.F.R. § 3.311 (a). 4. After obtaining the dose estimate, and if it is determined that the Veteran was exposed to ionizing radiation, forward the claims file to the Under Secretary of Benefits for an opinion pursuant to 38 C.F.R. § 3.311 (c). 5. After the above development, if feasible, obtain an addendum opinion from an appropriate clinician to determine the etiology of the Veteran’s ED, lung damage, right bundle branch block, acid reflux and low testosterone. After a review of the record, the examiner should provide the following opinions: Whether it is at least as likely as not (50/50 probability or greater) that the Veteran’s ED is due to his military service, to include exposure to ionizing radiation? Whether the Veteran’s lung damage, right bundle branch block, acid reflux and low testosterone are at least as likely as not (1) proximately due to chemotherapy treatments received for his cancers, or (2) aggravated beyond its natural progression by chemotherapy treatments received for his cancers. The examiner must provide an explanation of all opinions expressed. 6. After the above is complete, readjudicate the Veteran’s claims. If the claims remain denied, issue a supplemental statement of the case (SSOC). The Veteran and his representative should be given an opportunity to respond, before the case is returned to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. McDuffie, Associate Counsel