Citation Nr: 18147644
Decision Date: 11/06/18	Archive Date: 11/05/18

DOCKET NO. 18-23 484
DATE:	November 6, 2018
REMANDED
Entitlement to service connection for kidney cancer with partial nephrectomy is remanded.
REASONS FOR REMAND
The Veteran had active service from September 1969 to July 1971 and from October 1971 to January 1990.  
1. Entitlement to service connection for kidney cancer with partial nephrectomy is remanded.
The Veteran’s service treatment records show numerous complaints of and treatment for genitourinary symptoms such as hematuria (e.g. June 1980, July 1987), urinary frequency (e.g. March 1980) and lower back pain (e.g. March 1980.)  The Veteran submitted a medical letter from Dr. S who espouses the likelihood of a relationship between dioxins such as Agent Orange and the development of renal cell carcinoma.  The Veteran’s more recent medical treatment records show complaints of hematuria and urinary frequency, e.g. December 2013 and April 2013 respectively.  The Veteran was diagnosed with renal cell carcinoma and underwent a partial nephrectomy in September 2015.  The Veteran has confirmed service in the Republic of Vietnam during the Vietnam era.  The Board notes that renal cancer is not a presumptive disability under the Agent Orange regulations, however, the Veteran is able to assert a direct causation theory between his condition and Agent Orange.  The Veteran has not been afforded a VA examination.  
The matter is REMANDED for the following action:
1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any residuals of renal cancer or other genitourinary conditions.  The examiner is asked to response to the following inquiries:
(a.) whether it is at least as likely as not related to an in-service injury, event, or disease, including numerous complaints of hematuria, urinary frequency, and lower back pain.  
(b.) whether it at least as likely as not (1) began during active service, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service.
(c.) Whether the Veteran’s renal cancer was more likely than not related to Agent Orange or other herbicide exposure.  The examiner is asked to reference the letter in the Veteran’s file from Dr. S as well as the letter dated May 2011 from the 
 
American Urological Association regarding Agent Orange and renal cancer.  

 
DAVID L. WIGHT
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Miller, Associate Counsel