Citation Nr: 18144118 Decision Date: 10/23/18 Archive Date: 10/23/18 DOCKET NO. 06-28 366A DATE: October 23, 2018 REMANDED Service connection for residuals of radiation exposure, to include skin cancer and thrombocytopenia, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1952 to February 1980. The case is on appeal from an April 2003 rating decision. In March 2008, the Veteran testified at a Board hearing. The Board notes that the Veterans Law Judge (VLJ) who conducted that hearing is no longer available to participate in the adjudication of the Veteran’s claim. In a January 2018 correspondence, the Veteran was notified of the situation and offered an opportunity to have another Board hearing, but he declined to do so in a February 2018 correspondence. The Board denied the claim on appeal in an April 2012 decision. The Veteran subsequently appealed this decision. Thereafter, the parties to the Veteran’s appeal entered into a January 2013 Joint Motion for Remand (Joint Motion), and, in an Order dated later in January 2013, the United States Court of Appeals for Veterans Claims (Court) granted the Joint Motion and remanded this claim back to the Board for further adjudication. Then, in a November 2013 decision, the Board again denied the claim. Subsequently, the parties entered into a July 2014 Joint Motion, and, in an Order dated later in July 2014, the Court granted the Joint Motion and remanded this claim back to the Board for further adjudication. The Board remanded the claim for additional development in December 2014. The Board also notes that, in January 2018, the Veteran’s representative requested a 60-day extension to submit additional evidence, which the Board granted in June 2018. Subsequently, the Veteran’s representative submitted additional argument in February 2018 and September 2018. Entitlement to service connection for residuals of radiation exposure, to include skin cancer and thrombocytopenia. In December 2007, the Chief Public Health and Environmental Hazards Officer, offered an opinion in response to the Director of Compensation Service November 2007 opinion request. The physician stated that based on the Veteran’s DD Form 1141, it is estimated that he was occupationally exposed to a dose of ionizing radiation during military service of 0.842 rep, rad or r. In an October 2013 correspondence, the Veteran challenged the accuracy of the ionizing radiation dose estimate. He stated that the records of occupational exposure to ionizing radiation are incomplete and do not reflect his actual exposure while in service. The Veteran reported that he was exposed to atomic/nuclear testing in 1954 and spent many years around nuclear reactors and aboard nuclear submarines between 1957 and 1978. He also reported that in December 1957 he was involved with dismantling portions of a nuclear reactor compartment that required he wear special clothing and undergo decontamination post exposure. The Veteran stated that showering was part of the decontamination process and that at times he was required to return to the showers to “scrub down again” before he would be cleared by a Safety Officer with a Geiger counter. He also stated that decontaminating his hair was a “major problem.” The Veteran further reported that the last radiation exposure is reflected in the estimate was September 1960, but that he continued to serve on nuclear submarines until 1978. Accordingly, the Veteran’s stated that his actual radiation exposure is unknown and the official estimate is of no value. In light of the Veteran’s contentions, the Board remanded this claim in December 2014 to obtain a revised dose estimate and an advisory opinion based on the Veteran’s competent reports of additional radiation exposure. In March 2016, a Defense Threat Reduction Agency (DTRA) representative responded that they were unable to verify that the Veteran participated in nuclear testing or in the occupation of Hiroshima or Nagasaki, Japan. He stated that occupational dosimetry data for radiation exposure during assignments at nuclear power training facilities and aboard nuclear-powered submarines should be obtained from the Naval Dosimetry Center (NDC). Thereafter, in July 2017, the NDC provided an updated estimate of 0.962 rem DDE-Photon was obtained. However, this estimate was based only on the Veteran’s solely official exposure record and accounted for radiation exposure from January 1, 1958 to December 31, 1961. As this estimate did not consider the Veteran’s reports of additional radiation exposure during service aboard nuclear submarines outside of this date range or explain why such reports do not establish additional radiation exposure, remand is required to obtain another estimate of the Veteran’s radiation exposure. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The matter is REMANDED for the following actions: 1. In accordance with 38 C.F.R. § 3.311(a), submit this case to the Under Secretary for Health for a dose estimate of this Veteran’s exposure to ionizing radiation from an appropriate source based on consideration of the DD Form 1141 of record, the service personnel records, and the Veteran’s reports of spending many years around nuclear reactors and aboard nuclear submarines between 1957 and 1978. The source providing such findings must include in the Veteran’s estimated radiation exposure through 1978 or explain why possible radiation exposure for any such years not included in such dose estimate. 2. After the dose estimate is obtained (step 1), submit this case to the Under Secretary for Benefits for an opinion, by the Under Secretary for Benefits, as to whether it is at least as likely as not that the Veteran’s skin cancer and/or thrombocytopenia resulted from radiation exposure in service. See 38 C.F.R. § 3.311(b)(1). In formulating the requested opinion, the Under Secretary for Benefits must review the claims file and consider the factors listed at 38 C.F.R. § 3.311(e) as well as the December 2007 opinion from the Chief Public Health and Environmental Hazards Officer; opinions from the Veteran’s private dermatologist, Dr. C. M.; and, the opinions of the VHA examiners. See 38 C.F.R. § 3.311(c)(1). The Under Secretary for Benefits may request an advisory medical opinion from the Under Secretary for Health. 38 C.F.R. § 3.311(c)(1). If the Under Secretary for Benefits, after considering any opinion of the Under Secretary for Health, is unable to conclude whether it is at least as likely as not, or that there is no reasonable possibility, this Veteran’s skin cancer and/or thrombocytopenia, the Under Secretary for Benefits shall refer the matter to an outside consultant in accordance with paragraph 38 C.F.R. § 3.311(d). In formulating the requested opinion, the outside consultant must review the claims file and consider the factors listed at 38 C.F.R. § 3.311(e) as well as the December 2007 opinion from the Chief Public Health and Environmental Hazards Officer; opinions from the Veteran’s private dermatologist, Dr. C. M.; and, the opinions of the VHA examiners. See 38 C.F.R. § 3.311(c)(1). Kristy L. Zadora Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Jimerfield, Associate Counsel