Citation Nr: 18149077 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 16-47 010 DATE: November 8, 2018 REMANDED Entitlement to service connection for a left kidney disability manifested by a renal mass, to include as due to exposure to herbicides and secondary to service-connected hypertension (HTN) (also claimed as left kidney cancer), is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1970 to December 1990. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2015 rating decision by the Department of Veterans Affairs (VA). Entitlement to a left kidney disability is remanded. The Board finds that further development and adjudication is necessary to comply with VA’s duty to assist the Veteran to obtain evidence needed to substantiate his claim. The Veteran contends that his left kidney disability is related to his active service. Specifically, he asserts his kidney disability is due to exposure to Agent Orange (AO) and secondary to his service-connected HTN. See November 2016 Statement of Accredited Representative. In this regard, the Board notes that while service treatment records (STRs) are silent for symptoms or treatment of a left kidney disability, multiple diagnoses of a renal mass that providers have characterized as “likely cancer,” “concerning for renal cell carcinoma,” and “suspicious for malignancy” (with elevated creatine levels, hematuria, and poor renal function) are of record. See VA treatment records dated May 2015, July 2015, August 2015, February 2016, September 2016, March 2017. There is no opinion of record regarding any relationship between the diagnose kidney disability and the service connected HTN; therefore, an examination is warranted. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). In the alternative, the Veteran asserts that that his kidney disability is related to exposure to herbicides during active service in the Navy. The Veteran’s DD 214 shows two years and eight months of foreign and/or sea service during the Vietnam era. However, a complete copy of the Veteran’s service personnel records (SPRs) have not been associated with the file and it is unclear whether he has either service in Vietnam during the Vietnam era or exposure to herbicides through some other military experiences. As such, remand is necessary to obtain the Veteran’s SPRs and clarify the extent of the Veteran’s military service during the Vietnam era and his exposure to herbicides. The matter is REMANDED for the following action: 1. The Agency of Original Jurisdiction (AOJ) should obtain SPRs pertaining to the Veteran's service. All records and/or responses received should be associated with the claim file. The non-existence or unavailability of the information and/or records must be verified by each Federal department or agency from which they are sought. Such verification should be documented for the record and the Veteran should be provided notice of that fact. 2. The AOJ should contact the Veteran to obtain additional information regarding his service during the Vietnam era. Specifically, obtain from the Veteran the approximate dates, location, and nature of the alleged exposure to AO; use the information obtained to attempt to verify his exposure. Attempts to verify exposure should include, efforts to determine if the Veteran served in Vietnam. All attempts to verify exposure must be documented in the claim file. 3. The AOJ should obtain copies of VA treatment records for the Veteran’s disabilities from March 2017 to the present. 4. After the development in the first two instructions is completed, the AOJ should arrange for a VA examination of the Veteran to determine the nature and likely cause of any left kidney disability. The examiner should review the claim file (including this remand) and note such review was conducted. Based on review of the record and examination of the Veteran, the examiner should provide an opinion with detailed rationale that responds to the following: (a.) Please identify all left kidney disorders present during the appeal period (from August 2015). In doing so, it should be noted that the record contains a diagnosis of a left renal mass characterized as “concerning for renal cell carcinoma.” (b.) For each left kidney disability diagnosed, is it at least as likely as not (50% or greater probability) that the disability was either caused or aggravated by the Veteran’s service-connected hypertension? Please explain why. The opinion must address whether the disability increased in severity beyond its natural progression (i.e., was aggravated). If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation. For each left kidney disability diagnosed, is it at least as likely as not (50% or greater probability) that the disability was either incurred in or otherwise related to the Veteran’s active duty service, specifically by exposure to herbicide agents, if such exposure is confirmed? Please explain why. The examiner may not solely rely on an absence of a VA presumption for a diagnosed disability and must discuss the Veteran’s specific background. 5. If upon completion of the above action the issues remain denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Roe, Associate Counsel