Citation Nr: 18159418
Decision Date: 12/19/18	Archive Date: 12/19/18

DOCKET NO. 15-30 564
DATE:	December 19, 2018
REMANDED
The claim of entitlement to service connection for lung cancer, to include as due to herbicide agent exposure or asbestos exposure, is remanded. 
The claim of entitlement to service connection for pancreatic cancer, to include as due to herbicide agent exposure or asbestos exposure, is remanded. 
The claim of entitlement to service connection for the cause of the Veteran’s death, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from September 1968 to October 1972.  He passed away in March 2014.  The appellant is his surviving spouse. 
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2014 rating decision by the St. Paul Pension Center and Regional Office (RO) of the United States Department of Veterans Affairs (VA).  In August 2018, the Board remanded this matter for medical inquiry.  
The claims on appeal must again be remanded.  
Pursuant to the August 2018 remand, an October 2018 VA medical opinion was included in the claims file.  The opinion is responsive to the Board’s inquiries, with one exception.  The examiner did not provide a specific answer, with a supporting rationale, to the question regarding whether pancreatic cancer is related to service.  The examiner stated that medical evidence did not indicate a medical nexus between herbicide and asbestos exposure and the development of pancreatic cancer.  And the examiner listed several risk factors associated with pancreatic cancer.  But the examiner did not answer the question of whether the disorder related to service.  The also examiner did not discuss whether the cited risk factors applied in this case.  For example, the examiner cited African-American racial background, diabetes mellitus, and a history of pancreatitis as risk factors but none of these apply to this Veteran.    
The matters are REMANDED for the following action:
Return the case to the VA examiner who issued the October 2018 medical opinion (or to a suitable substitute).  After again reviewing the claims file, the examiner should answer the following question.
Is it likely, at least as likely as not (i.e., probability of 50 percent), or not likely that pancreatic cancer is related to a disease, event or injury during service?
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Please explain in detail any opinion provided.  In particular, discuss the risk factors noted in the October 2018 opinion, and explain which apply in this matter and why or how they may have contributed to the development of pancreatic cancer here.
 
G. A. WASIK
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Christopher McEntee, Counsel