Citation Nr: 18157350 Decision Date: 12/12/18 Archive Date: 12/12/18 DOCKET NO. 16-11 355 DATE: December 12, 2018 REMANDED Service connection for lung cancer (left lung) to include as a result of asbestos, herbicide agents, and toxic hazards is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1970 to December 1973 and January 1974 to September 1996. The Veteran contends that he has lung cancer, or residuals of such, as a result of in-service exposures to asbestos, herbicide agents, and toxic hazards, such as: jet fuel, and corrosive chemicals in service. The Veteran’s DD-214 and multiple statements indicate that he served as a fire protection superintendent for over 22 years. The Veteran asserts that he did not have protective clothing or appropriate breathing apparatus while in service. A February 2012 private treatment record from Dr. John Nanfro noted that the Veteran had a history of lung carcinoma and underwent a left lower lobectomy in April 2010. Dr. Nanfro also noted that the Veteran has a history of smoking one and a half pack of cigarettes a day for 25 years, but no longer smokes. He also noted that the Veteran has been exposed to various noxious agents as a firefighter in the Air Force, but he did not specifically link the Veteran’s lung cancer to any exposures during his military service. The June 2013 VA examiner acknowledged the Veteran was diagnosed with adenocarcinoma and treated for lung cancer (surgery, radiation and chemotherapy) in 2010 and exposed to asbestos in service. He opined that it was less likely than not that the Veteran’s lung condition was related to exposure to asbestos during military service. He concluded that asbestos exposure alone has not been linked to the Veteran’s adenocarcinoma of the lung, because there is no objective evidence of asbestosis, including no related pathology on multiple radiographic studies including chest x-ray and CT scans to show asbestosis. He also found that smoking was a likely cause of the Veteran’s lung cancer. However, the examiner did not address whether the Veteran’s various in-service exposures, outside of asbestos, were at least as likely as not (50 percent or greater) to have resulted from an in-service exposure to include jet fuel, corrosive chemicals and/or smoke. The Veteran has also reported having had exposure to herbicide agents such as Agent Orange. The matter is REMANDED for the following action: 1. The Veteran claims he was assigned to two installations (Chanute and Anderson Airforce base in Guam) where agent orange was reportedly stored and used extensively. Attempt to verify the Veteran’s asserted in-service exposure to herbicide agents. If more details are needed, contact the Veteran to request the information. If there is still insufficient information to verify exposure to herbicide agents, issue a Formal Finding outlining the steps taken to assist the Veteran and notify the Veteran of VA's inability to verify the in-service herbicide agent exposure. 2. Obtain a medical opinion to determine the etiology of his lung condition. If an examination is needed to address the Board’s questions, one should be scheduled. If any examination is necessary, efforts should be made to schedule it close to the Veteran’s residence because he is unable to travel due to his lung condition. The examiner is asked to answer the following question: Is it at least as likely as not (50 percent or greater probability) that the Veteran’s lung disability was caused by his military service, specifically by any exposure to herbicide agents (if confirmed by the research directed in this examination), and/or toxic hazards, including jet fuel, corrosive chemicals and smoke. Why or why not? The examiner is asked to consider the Veteran’s multiple statements, to include his February 2016 Form 9; June 2013 Notice of Disagreement; and May 2013 statement regarding his exposure to herbicide agents, and toxic hazards, such as: jet fuel, corrosive chemicals and smoke while serving as a firefighter for over 22 years in the Air Force and without protective clothing and appropriate breathing apparatus. In so doing, the examiner should also consider the Veteran’s extensive smoking history. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Franklin, Associate Counsel