Citation Nr: 20022019 Decision Date: 03/30/20 Archive Date: 03/30/20 DOCKET NO. 17-52 821 DATE: March 30, 2020 ORDER Entitlement to service connection for skin cancer, to include malignant melanoma in situ, is granted. FINDING OF FACT Resolving all reasonable doubt in favor of the Veteran, his current skin cancer is due to his active duty service. CONCLUSION OF LAW The criteria for service connection for skin cancer are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1982 to March 1986. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts. The Veteran testified at a videoconference hearing before the undersigned in February 2020. A transcript is of record. Pursuant to the Veterans Claims Assistance Act (VCAA), VA has duties to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C. §§ 5102, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.156(a), 3.159. Given the Board’s favorable disposition of the claim, the Board finds that all notification and development action needed to fairly adjudicate the appeal has been accomplished. 1. Entitlement to service connection for skin cancer, to include malignant melanoma in situ, is granted. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Generally, service connection requires: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. See Shedden v. Principi, 381 F.3d 1163, 1166 67 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Based on a careful review of all the subjective and clinical evidence, the Board finds that resolving all reasonable doubt in favor of the Veteran, his service connection claim for skin cancer is warranted. The evidence, including the September 2016 VA examination, shows that the Veteran was diagnosed with skin cancer, specifically malignant melanoma in situ, which was excised in July 2016. In September 2016, the Veteran reported that this skin melanoma on his left cheek had been present for two years. Service treatment and military personnel records show that the Veteran was placed on limited duty for twelve months beginning in January 1985. The Veteran has consistently reported that he was transferred to gate watch in Kauai, for four-hour afternoon shifts, for a month on and a month off. He testified that he endured prolonged sun exposure without any shade or sunblock and was in his dress whites. He got multiple sunburns and skin peeling. also testified that he got multiple sunburns. Post service he worked in an office and used sun protection. The Veteran testified that his primary care doctor is adamant that his skin cancer was mostly likely from his time in Kauai. In a September 2016 VA examination, the Veteran was diagnosed with malignant melanoma in situ. The examiner opined that it was less likely than not that the Veteran’s skin cancer was due to his service. To support his opinion, the examiner cited a medical study indicating that the risk factors of malignant melanoma in situ included fair skin and a history of sunburns. He found that the Veteran’s contentions that simple exposure to increased levels of sunlight caused his skin cancer to be unsupported by medical research. In a February 2020 private opinion, Dr. K. A. Creamer, the Veteran’s primary care physician at the Boston VA medical center, opined that it was at least as likely as not that the Veteran’s malignant melanoma was due to his chronic intense sun exposure at Pearl Harbor. Dr. Creamer based his opinion on his review of the Veteran’s service treatment records, post-service treatment records, and lay statements. (Continued on the next page)   The Board finds that the medical opinion evidence is at least in equipoise. Therefore, resolving all reasonable doubt in favor of the Veteran, his diagnosed skin cancer is at least as likely as not due to his active duty service, specifically his prolonged exposure to the sun. Accordingly, his claim for service connection for skin cancer, to include malignant melanoma in situ, is granted. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Ko, 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.