Citation Nr: 18142231
Decision Date: 10/15/18	Archive Date: 10/15/18

DOCKET NO. 16-12 820
DATE:	October 15, 2018
REMANDED
Entitlement to service connection for tongue cancer (claimed as throat cancer (larynx)) due to herbicide agent exposure is remanded.
REASONS FOR REMAND
The Veteran had active service from September 1967 to May 1971, to include service in the Republic of Vietnam. 
This matter comes before the Board of Veterans Appeals (Board) from an October 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Winston Salem, North Carolina.
Given his service in Vietnam during the Vietnam era, the Veteran is presumed to have been exposed to herbicide agents.  38 C.F.R. § 3.307.  Certain disabilities, such as respiratory cancers, are presumed to have been caused by exposure to herbicide agents.  38 C.F.R. § 3.309(e).  
A VA Compensation and Pension Examination Report (C&P Report) dated in January 2016 found that a prior VA diagnosis of larynx cancer in 2015 was based on the Veteran’s own recitation of his medical history to the VA examiner, and that the VA examiner in 2015 reviewed none of Veteran’s medical records.  Further, the C&P report pointed out that the Veteran’s other medical treatment records refer to treatment of tongue cancer only.  Notwithstanding, the examiner in the C&P Report acknowledged that other treatment records refer to a history of larynx cancer.  
Ultimately, the C&P report focused solely on the RO’s inquiry as to whether cancer of the tongue could be considered the same as cancer of the larynx.  The examiner stated that the tongue and larynx are anatomically different areas, and that no larynx cancer was diagnosed.  No medical opinion was sought as to a service connection to the Veteran’s tongue cancer, including whether it was caused by the Veteran’s exposure to an herbicide agent.  The Board finds that such an opinion should be obtained.  
Updated treatment records should also be sought on remand.  
The matter is REMANDED for the following action:
1. Ask the Veteran to identify all outstanding treatment records relevant to his claim.  All identified VA records should be added to the claims file.  All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran.  If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records.
2. After records development is completed, the claims file should be sent to an appropriate examiner to offer an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s tongue cancer is related to an in-service injury, event, or disease, to include the Veteran’s exposure to herbicide agents in the Republic of Vietnam.  
The need for an examination is left to the discretion of the examiner.  A rationale for all opinions offered is requested as the Board is precluded from making any medical findings.
 
Nathan Kroes
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Ruben D. Rudolph, Jr., Associate Counsel