Citation Nr: 20008050 Decision Date: 01/30/20 Archive Date: 01/30/20 DOCKET NO. 17-00 391 DATE: January 30, 2020 REMANDED The issue of service connection for colon cancer is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from September 1964 to June 1967. This matter comes before the Board of Veterans’ Appeals (Board) from an August 2015 rating decision. In May 2019, the Veteran’s representative submitted a written statement on the Veteran’s behalf to withdraw the request for a hearing before the Board. Therefore, this appeal is now ready for adjudication. 38 C.F.R. § 20.704(e). Colon Cancer The Board finds that further development is necessary regarding the Veteran’s claim of service connection for colon cancer. First, the Veteran’s VA treatment records indicate a diagnosis of colon cancer in April 2014. Additionally, the Veteran’s service department records confirm that he served in the Republic of Vietnam, and he is therefore presumed to have been exposed to herbicide agents during service. Although the Veteran’s colon cancer is not a disability recognized as presumed related to exposure to herbicide agents, that fact, in and of itself, does not preclude the Veteran from establishing that this disability is related to herbicide agent exposure. See Combee v. Brown, 34 F.3d 1039, 1044 (Fed. Cir. 1994); see also Brock v. Brown, 10 Vet. App. 155 (1997). Notwithstanding the presumptive provisions, service connection for colon cancer based on exposure to herbicide agents may also be established by showing that a disease is, in fact, causally linked to such exposure. The Board notes that the Veteran has not been afforded a VA examination or medical opinion that addresses the nature and etiology of his colon cancer, including as due to exposure to herbicide agents during service. The Board also notes that the Veteran has submitted evidence supporting his contention that his colon cancer is caused by herbicide agent exposure, including a copy of the May 1990 Report to the Secretary of the Department of Veterans Affairs on the Association Between Adverse Health Effects and Exposure to Agent Orange (reported by Special Assistant Admiral E.R. Zumwalt, Jr.) (the “Zumwalt report”), which, in pertinent part, found that there was adequate evidence to reasonably conclude that it is at least as likely as not that there is a nexus relationship between exposure to herbicide agents and colon cancer. In this case, there is evidence suggesting an association between herbicide agent exposure and colon cancer, but there is no medical opinion as to whether this disability is related to the Veteran’s exposure to herbicide agents. Accordingly, the Board finds that a VA examination and opinion is necessary to determine whether the Veteran’s claimed disability is caused by or etiologically related to exposure to herbicide agents during service in the Republic of Vietnam. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The medical opinion should specifically address the findings contained in the May 1990 Zumwalt report. The matters are REMANDED for the following action: 1. Obtain all treatment records from any VA facility from which the Veteran has received treatment. If the Veteran has received additional private treatment, he should be afforded an appropriate opportunity to submit the medical records of such treatment. 2. Following the completion of the above, schedule the Veteran for an examination to determine the nature and etiology of his colon cancer. The claims folder must be made available to and be reviewed by the examiner. The examiner should address the following: a. Is it at least as likely as not (50 percent or greater probability) that the Veteran’s colon cancer is caused by or related to service, including to conceded exposure to herbicide agents? The examiner should consider the May 1990 Zumwalt report, which found a positive relationship between colon cancer and herbicide agent exposure. The examiner should also consider all lay statements submitted by the Veteran regarding his disorder. A rationale for all opinions is to be provided. If the examiner cannot provide any of the requested opinions without resorting to speculation, he or she should provide an explanation stating why this is so. In so doing, the examiner should explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). JAMES L. MARCH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Page-Nelson, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.