Citation Nr: 18158988 Decision Date: 12/18/18 Archive Date: 12/18/18 DOCKET NO. 17-08 273 DATE: December 18, 2018 REMANDED Entitlement to service connection for colon cancer to include as secondary to asbestos exposure is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from July 1975 to May 1976. Entitlement to service connection for colon cancer to include as secondary to asbestos exposure is remanded. The Veteran has claimed that his colon cancer is secondary to exposure to asbestos while he was on active duty. There is no specific statutory guidance with regard to asbestos-related claims, nor has the Secretary of VA promulgated any regulations with regard to asbestos claims. VA has issued a circular on asbestos-related diseases. DVB Circular 21-88-8, Asbestos-Related Diseases (May 11, 1988) which provides guidelines for considering compensation claims based on exposure to asbestos. The DVB circular was subsumed verbatim as § 7.21 of Adjudication Procedure Manual, M21-1, Part VI, which has now been reclassified in a revision to the Manual at M21- 1, Part IV, Subpart ii, Chapter 2, Section C. VAOPGCPREC 4-00 (2000), 65 Fed. Reg. 33422 (2000). The adjudication of a claim for service connection for a disability resulting from asbestos exposure should include a determination as to whether or not: (1) service records demonstrate the Veteran was exposed to asbestos during service; (2) development has been accomplished sufficient to determine whether or not the Veteran was exposed to asbestos either before or after service; and (3) a relationship exists between exposure to asbestos and the claimed disease in light of the latency and exposure factors. M21-1, Part IV, Subpart ii, Chapter 2, Section C, Subsection (h). The M21-1 MR provides the following non-exclusive list of asbestos-related diseases/abnormalities: asbestosis, interstitial pulmonary fibrosis, tumors, effusions and fibrosis, pleural plaques, mesotheliomas of pleura and peritoneum, lung cancer, bronchial cancer, cancer of the larynx, cancer of the pharynx, cancer of the urogenital system (except the prostate), and cancers of the gastrointestinal tract. M21-1, part VI, Subpart ii, Chapter 2, Section C, 9 (b). The M21-1 also provides the following non-exclusive list of occupations that have higher incidents of asbestos exposure: mining, milling, work in shipyards, insulation work, demolition of old buildings, carpentry and construction, manufacture and servicing of friction products such as clutch facings and brake linings, and manufacture and installation of roofing and flooring materials, asbestos cement sheet and pipe products, and military equipment. M21-1, part VI, Subpart ii, Chapter 2, Section C, 9(f). The Veteran’s service personnel records show that his service duties were as an electrical repairman aboard the USS Hoist. Based upon the Veteran’s duties as an electrical repairman on board the USS hoist, his exposure to asbestos was probable. The Board finds that there is sufficient evidence to presume that the Veteran was exposed to asbestos in service. For service connection claims, VA must provide a VA medical examination where there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service; (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran’s service; and (4) insufficient competent medical evidence on file for VA to make a decision on the claim. 38 C.F.R. § 3.159 (c)(4) (2017); McLendon v. Nicholson, 20 Vet. App. 79 (2006). In light of the Veteran’s probable exposure to asbestos while on active duty coupled with an August 2016 VA treatment diagnosis of Colon Cancer, the Board finds that the Veteran should be scheduled for a VA examination for an etiology opinion regarding current colon cancer. The matter is REMANDED for the following action: 1. Contact the Veteran and request that he identify the names, addresses, and approximate dates of treatment for all VA and non-VA health care providers who have treated him for his disabilities. The Veteran should be requested to sign any necessary authorization for release of medical records to VA, and appropriate steps should be made to obtain any identified records. Regardless of the Veteran’s response, VA treatment records should be collected from the VA Long Beach Health Care System and all associated outpatient center and clinics. In particular, the AOJ should retrieve VA treatment records from August 2016 to present should be collected. Any archived records should be retrieved from storage. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. If the records are unavailable, notify the Veteran in accordance with 38 C.F.R. § 3.159. 2. The AOJ should also ensure that all service treatment records and service hospital records from all periods of verified active duty service have been associated with the claims file. In particular, a request should be made for the inpatient and outpatient records from Naval Medical Center Portsmouth, formerly Naval Hospital Portsmouth for the month of March 1974. All requests and responses should be documented and associated with the claims file. Any archived records should be retrieved from storage. 3. After considering the pertinent information in the record in its entirety, the VA examiner should identify any colon cancer. The examiner is asked to opine as to whether it is at least as likely as not i.e. 50 percent probability or greater, that any colon cancer identified, was incurred or aggravated by his active duty, to include his presumed exposure to asbestos. (i) In providing an opinion, the examiner should presume that the Veteran was exposed to asbestos during his active duty. (ii) In providing an opinion, the examiner should comment on the Veteran’s provided article, which speaks to a relationship between colon cancer and asbestos, attached to his August 20, 2016 statement. (iii) In providing an opinion, the examiner should be notified that the M21-1 MR provides the following non-exclusive list of asbestos-related diseases/abnormalities: asbestosis, interstitial pulmonary fibrosis, tumors, effusions and fibrosis, pleural plaques, mesotheliomas of pleura and peritoneum, lung cancer, bronchial cancer, cancer of the larynx, cancer of the pharynx, cancer of the urogenital system (except the prostate), and cancers of the gastrointestinal tract. M21-1, part VI, Subpart ii, Chapter 2, Section C, 9 (b). 4. Ensure that the examination report complies with this remand and the questions presented in this request. If the report is insufficient, it must be returned to the examiner for necessary corrective action, as appropriate. 5. After completing the requested actions and any additional notification and/or development deemed warranted, readjudicate the issues on appeal. If the benefit sought on appeal is not granted, the Veteran and his representative must be furnished a supplemental statement of the case and afforded the appropriate time period for response. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Acosta, Counsel