Citation Nr: 18146176 Decision Date: 10/30/18 Archive Date: 10/30/18 DOCKET NO. 17-54 253 DATE: October 30, 2018 REMANDED Entitlement to service connection for liver cancer, due to exposure to herbicide agents, is remanded. Entitlement to service connection for skin cancer, due to exposure to herbicide agents, is remanded. Entitlement to service connection for colon cancer, due to exposure to herbicide agents, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Air Force from July 1965 to January 1969. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a July 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia. In March 2018, the Board remanded the instant matter to the agency of original jurisdiction (AOJ) with instructions to further develop the case prior to final appellate review. The case was then returned to the Board. Entitlement to service connection for liver cancer, colon cancer, and skin cancer is remanded. The Board remanded the claims for service connection for liver cancer, skin cancer and colon cancer for an etiology opinion in March 2018. Such etiology opinions were obtained in July 2018. The VA examiner opined that the Veteran’s claimed liver cancer, colon cancer and skin cancer were less likely than not incurred in or caused by the claimed in-service injury, event or illness. The examiner reasoned that the Veteran’s conditions were not on the presumptive conditions list as documented and listed in the Agent Orange Act of 1991 and that nexus was therefore not established. However, service connection for a disability claimed as due to exposure to herbicide agents may also be established by showing that a disability is, in fact, causally linked to such exposure. See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). On remand, addendum opinions addressing the etiology of the Veteran’s claimed liver cancer, colon cancer and skin cancer should be obtained. The Veteran should also be asked to furnish, or to furnish an authorization to enable VA to obtain, any additional private treatment records from providers who treated him for his claimed disorders. Accordingly, the matters are REMANDED for the following action: 1. The Veteran should be given an opportunity to identify any outstanding private or VA treatment records relevant to the claims on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and afford her an opportunity to submit any copies in his possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. After obtaining all outstanding records, return the claims file, to include a copy of this remand, to the July 2018 examiner for an addendum opinion. If the examiner who drafted the July 2018 report is unavailable, the opinion should be rendered by another appropriate medical professional. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. The examiner should offer an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the claimed liver cancer, colon cancer and/or skin cancer are related to the Veteran’s military service, specifically his presumed exposure to herbicide agents. The sole basis for a negative opinion cannot be that such disorder is not on the list of diseases subject to presumptive service connection based on exposure to herbicide agents. Any opinion expressed should be accompanied by a supporting rationale. KRISTY L. ZADORA Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Pierce, Associate Counsel