Citation Nr: 18149196
Decision Date: 11/08/18	Archive Date: 11/08/18

DOCKET NO. 13-26 691
DATE:	November 8, 2018
REMANDED
Entitlement to service connection for esophageal cancer, to include as due to exposure to herbicides, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from June 1968 to March 1970.  He died in December 2011.  The Appellant, the Veteran’s surviving spouse, has been substituted for the Veteran for the pending claims on appeal.  In September 2017, the Board denied the claim.  The Appellant then appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court).  In an August 2018 Order, the Court granted a Joint Motion for Partial Remand (Joint Motion) which vacated the September 2017 Board decision with respect to this issue and remanded the matter for readjudication consistent with the motion.
Entitlement to service connection for esophageal cancer is remanded.
The parties to the Joint Motion agreed that the June 2016 VA medical opinion relied upon by the Board in the previous decision was inadequate; specifically, because the examiner’s rationale for finding that direct service connection was not warranted for esophageal cancer was that it was not presumed to be caused by in-service exposure to Agent Orange.  As noted by the parties, however, the examiner did not address the significant facts relevant to the Veteran’s death to reach the conclusions in the medical opinion.  In particular, the examiner did not comment on the Veteran’s amended death certificate, which provided that the immediate cause of the Veteran’s death was cancer of the esophagus, and it listed lung cancer and Agent Orange exposure as contributory causes of death.  The parties agreed that a new medical opinion was warranted to address the issue of whether the Veteran’s esophageal cancer was related to his in-service exposure to herbicide agents.
The matter is REMANDED for the following action:
Forward the claims file to an appropriate VA medical examiner to obtain a medical opinion regarding the likely etiology of his esophageal cancer.  The claims file and copies of all pertinent records should be made available to the examiner for review.  Based on a review of the record, the examiner should address the following question:
Is it as least as likely as not (50 percent or higher probability) that the Veteran’s esophageal cancer was causally related to his conceded in-service exposure to Agent Orange?  The examiner is asked to comment on the amended death certificate, dated September 26, 2013, which listed an immediate cause of death of cancer of the esophagus, with underlying causes listed as lung cancer and Agent Orange exposure.
A complete rationale must be provided.  If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made.
 
M. E. Larkin
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Jack S. Komperda, Counsel