Citation Nr: 18158970
Decision Date: 12/18/18	Archive Date: 12/18/18

DOCKET NO. 17-03 045
DATE:	December 18, 2018
REMANDED
Entitlement to service connection for lymph node cancer, to include as due to herbicide agent exposure, is remanded.
Entitlement to service connection for skin cancer, to include as due to herbicide agent exposure, is remanded.
Entitlement to service connection for an acquired psychiatric disorder, to include as secondary to a service connected disability, is remanded.
REASONS FOR REMAND
The Veteran had active service in the Air Force from January 1970 to January 1974.
The Veteran asserts that his lymph node cancer and skin cancer are due to herbicide agent exposure.  The Veteran’s service personnel records show that his occupation was material facilities specialist.  One of his assignments was to inspect, inventory, and rewarehouse herbicide agents in Gulfport, Mississippi.  The Veteran submitted multiple articles and buddy statements regarding herbicide agent exposure in Gulfport, Mississippi.  As such, herbicide agent exposure is conceded.
Regarding the Veteran’s service connection claims for lymph node cancer and skin cancer due to herbicide agent exposure, the Veteran’s VA physician wrote in September 2015 that the Veteran’s cancers were “potentially” related to herbicide agent exposure.  As such, a medical opinion is necessary to adjudicate the service connection claims for lymph node cancer and skin cancer.
Regarding the Veteran’s service connection claims for an acquired psychiatric disorder, his treatment records show that he had mental health symptoms due to treatment for his cancer.  As such, a medical opinion is necessary to adjudicate the service connection claim for an acquired psychiatric disorder.
The matters are REMANDED for the following action:
1. Schedule the Veteran for a VA examination to determine the nature and etiology of his lymph node cancer and skin cancer, to include as due to herbicide exposure.
The examiner then should opine whether it is at least as likely as not (50 percent or greater) that the Veteran’s lymph node cancer and/or skin cancer began during or was otherwise caused by the Veteran’s active service, to include as a result of his presumed herbicide agent exposure.  Why or why not?  The examiner should address the September 2015 statement of the Veteran’s physician (contained in 11/30/2015 CAPRI records). 
2. Then, if the examiner links the Veteran’s cancer to his presumed exposure to herbicide agents, schedule the Veteran for a VA examination by a VA psychiatrist or psychologist to determine the nature and likely etiology of any acquired psychiatric disorder.  The examiner should provide opinions responding to the following:
a.	What is (are) the diagnosis(es) for the Veteran’s current psychiatric disorder(s), if any?
b.	For each psychiatric disorder diagnosed, please provide an opinion as to whether such at least as likely as not (50 percent or better probability) either began in or was otherwise caused by the Veteran’s active service.  Why or why not? 
c.	For each psychiatric disorder diagnosed, please provide an opinion whether it is as at least as likely as not (50 percent or greater) that such psychiatric disorder was caused by either his lymph node cancer and/or his skin cancer?  Why or why not?
d.	For each psychiatric disorder diagnosed, please provide an opinion whether it is as at least as likely as not (50 percent or greater) that such acquired psychiatric disorder was aggravated (made worse) by either his lymph node cancer and/or his skin cancer?  Why or why not?
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If aggravation is found, the examiner should attempt to establish the baseline level of severity of the acquired psychiatric disability by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the acquired psychiatric disability.
 
MATTHEW W. BLACKWELDER
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	T. Berryman, Counsel