Citation Nr: 18144584 Decision Date: 10/24/18 Archive Date: 10/24/18 DOCKET NO. 17-47 977 DATE: October 24, 2018 REMANDED Entitlement to service connection for the cause of the Veteran’s death is remanded. REFERRED The issue of entitlement to nonservice-connected death pension was raised in the Appellant’s December 2016 Application for DIC, Death Pension, and/or Accrued Benefits. VA has not rendered a rating decision concerning this issue. Therefore, the issue is referred to the Agency of Original Jurisdiction (AOJ) for adjudication. REASONS FOR REMAND The Veteran served on active duty from December 1975 to December 1978. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2017 rating decision. The Appellant is the surviving spouse of the Veteran. The Appellant seeks service connection for the cause of the Veteran’s death. During the Veteran’s lifetime, service connection was established for residuals of a left leg gunshot wound. According to the Veteran’s Certificate of Deathh, the immediate cause of his death was invasive squamous cancer of the tongue. For the following reasons, the Appellant’s claim must be remanded. 1. Entitlement to service connection for the cause of the Veteran’s death is remanded. When a Veteran dies of a service-connected disability, the Veteran’s surviving spouse is eligible for dependency and indemnity compensation (DIC) benefits for the cause of death. 38 U.S.C. § 1310; 38 C.F.R. §§ 3.5(a), 3.312. To establish service connection for the cause of death, the evidence must show that a disability incurred in or aggravated by service was either the principal cause of death or contributed substantially and materially to the Veteran’s death. 38 C.F.R. § 3.312. The Appellant maintains that the Veteran’s death is due to his service-connected residuals of a left leg gunshot wound. The Veteran’s VA treatment records from May 1994 demonstrate that biopsies of the left tongue and left medial lingual surface of the tongue showed invasive squamous carcinoma and a biopsy of the left posterior lateral pharynx showed squamous carcinoma in the situ. At that time, the Veteran’s brief clinical history was noted as 40-year-old black male with acute rapid bleeding from the oropharynx and that the Veteran advised of heavy alcohol abuse. During an April 1992 VA examination, the examiner noted that the Veteran has chronic alcoholism related to his service-connected residuals of a left leg gunshot wound. Based on the Appellant’s assertions and the Veteran’s medical records, the Board finds that a medical opinion should be obtained to determine whether the Veteran’s cause of death is related to his active service, including his service-connected residuals of a left leg gunshot wound. See 38 U.S.C.§ 5103A(a); see also Kowalski v. Nicholson, 19 Vet. App. 171 (2005) (VA has discretion to arrange for a medical examination or opinion when necessary to make an informed decision); Wood v. Peake, 520 F.3d 1345, 1348-49 (Fed. Cir. 2008) (holding that the provisions of § 5103A(a) rather than 5103A(d) apply to cause-of-death claims with regard to obtaining a medical examination or opinion); DeLaRosa v. Peake, 515 F.3d 1319, 1321-22 (Fed. Cir. 2008). The matter is REMANDED for the following action: 1. Obtain a medical opinion from an appropriate clinician regarding: (a.) Whether it is at least as likely as not (at least a 50 percent probability) that the Veteran’s service-connected residuals of a left leg gunshot wound either: (i) caused; or (ii) aggravated (i.e., worsened) his invasive squamous cell cancer of the tongue. (b.) Whether it is at least as likely as not (at least a 50 percent probability) that the Veteran’s service-connected residuals of a left leg gunshot wound proximately caused the Veteran’s alcohol use disorder or aggravated beyond its natural progression the Veteran’s alcohol use disorder, which as a result either: (i) caused; or (ii) aggravated (i.e., worsened) his invasive squamous cell cancer of the tongue. (c.) Whether it is at least as likely as not (at least a 50 percent probability) that the Veteran’s service-connected residuals of a left leg gunshot wound resulted in alcohol use disorder to an extent that it rendered him materially less capable of resisting the effects of the invasive squamous cell cancer of the tongue that that primarily caused his death. All examination findings, along with the complete rationale for all opinions expressed, must be set forth in the examination report. J. CONNOLLY Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Mussey, Associate Counsel