Citation Nr: 20021877 Decision Date: 03/27/20 Archive Date: 03/27/20 DOCKET NO. 18-18 637 DATE: March 27, 2020 REMANDED Entitlement to service connection for soft tissue sarcoma, to include as secondary to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1969 to May 1971, to include service in the Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2018 rating decision of the Department of Veterans Affairs (VA) regional office (RO) in St. Louis, Missouri. In November 2018, the Veteran presented sworn testimony during a Travel Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the Veteran’s claims file. Soft Tissue Sarcoma At the outset, the Board notes that a veteran is presumed exposed to Agent Orange if he or she had active military, naval, or air service, in the Republic of Vietnam from January 9, 1962 through May 7, 1975, “unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service.” 38 U.S.C. § 1116 (f); 38 C.F.R. § 3.307 (a)(6)(iii). Such service must be either “foot-on-ground” service or service on the inland waterways in the interior of the Republic of Vietnam (“brown water service” versus “blue water service”). See 38 C.F.R. § 3.307(a)(6)(iii) (2016); Haas v. Peake, 525 F.3d 1168 (Fed. Cir. 2008; 66 Fed. Reg. 23,166 (May 8, 2001); VAOPGCPREC 27-97. In Procopio v. Wilkie, 913 F.3d 1371, 1380-81 (Fed. Cir. 2019), the U.S. Court of Appeals for the Federal Circuit held that veterans who “served in the 12 nautical mile territorial sea of the Republic of Vietnam” are entitled to presumptive service connection under 38 U.S.C. § 1116, so long as they meet the section’s other requirements. The Veteran’s military personnel records indicate that he had “foot-on-ground” service in the Republic of Vietnam during his time on active duty. Therefore, the Board will concede exposure to Agent Orange. The Veteran received a VA examination in December 2017 and the examiner noted diagnoses of squamous cell carcinoma from 2017 and basal cell carcinoma from 2015. The examiner, however, did not provide an opinion with regard to the etiology of the Veteran’s disabilities. Once VA undertakes the effort to provide an examination, it must obtain a fully adequate one. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); see also Bowling v. Principi, 15 Vet. App. 1, 12 (2001) (emphasizing the Board’s duty to return an inadequate examination report “if further evidence or clarification of the evidence... is essential for a proper appellate decision.”). Because the VA examiner here did not provide an opinion, this claim must be remanded for a new examination. The Board recognizes that Dr. T. M. submitted an opinion in August 2018, finding that Agent Orange exposure had not been confirmed as a cause of basal cell carcinoma, but it was possible that it was a factor. He does not, however, provide a rationale for his conclusions and the possibility of an association is not equivalent to the “at least as likely as not” standard required for VA benefits purposes. Without the appropriate rationale and standard, the Board must assign little probative value to Dr. T. M.’s opinion. The matters are REMANDED for the following action: Schedule the Veteran for a VA examination with an appropriate examiner to determine whether his soft tissue sarcoma is related to service, to include Agent Orange exposure. The examiner is requested to address whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s soft tissue sarcoma had its onset in service. The examiner is also requested to address whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s soft tissue sarcoma is related to herbicide exposure during his military service. In answering this question, the examiner is asked to disregard whether the disorder is one for which a “presumption” is established and, instead, to answer whether the medical condition is a result of herbicide exposure even though it is not on the list of “presumptive” diseases. The examiner should assume that the Veteran was exposed to herbicides during his service. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Daniels, 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.