Citation Nr: 20037563 Decision Date: 06/02/20 Archive Date: 06/02/20 DOCKET NO. 18-29 285 DATE: June 2, 2020 REMANDED Entitlement to service connection for basal cell carcinoma, to include as due to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran had active duty service in the United States Army from October 1955 to October 1958, and January 1959 to January 1976. He served as a combat veteran of the Vietnam War and is in receipt of the Purple Heart Medal, Combat Infantryman Badge, Bronze Star Medal, Army Commendation Medal, Meritorious Service Medal, Republic of Vietnam Gallantry Cross with palm, Republic of Vietnam Service Campaign Medal, Armed Forces Expeditionary Medal, Vietnam Service Medal, and Presidential Unit Citation. This matter comes before the Board of Veterans Appeal (Board) from on appeal from a March 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). On his June 2018 Form 9, the Veteran requested a hearing at a local VA office. However, in a January 2020 submission, the Veteran requested to cancel his hearing. Under these circumstances, the regulations consider the hearing request to have been withdrawn. 38 C.F.R. § 20.704 (e) This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900 (c) (2016). Entitlement to service connection for basal cell carcinoma, to include as due to herbicide exposure is remanded. The Veteran contends that his basal cell carcinoma is related to service, to include as due to exposure to herbicides while serving in Vietnam. Because the Veteran served in Vietnam, he is presumed to have been exposed to Agent Orange during service. Although basal cell carcinoma is not listed in 38 C.F.R. § 3.309 (e) as diseases associated with exposure to herbicides, the Veteran may nonetheless substantiate his claims under that theory of entitlement by competent evidence that the skin cancers are related to such exposure. See Combee v. Principi, 4 Vet. App. 78 (1993). The Veteran’s military occupational specialty (MOS) was a vehicle mechanic. A January 1965 service treatment record (STR) notes skin damage. In June 2012, the Veteran had basal cell carcinoma excised from the right side of his neck. As such, the January 1965 STR and current basal cell carcinoma diagnosis indicate that the Veteran’s disability may be associated with service. The current record does not include an adequate medical opinion as to whether the Veteran’s basal cell carcinoma is related to service and/or exposure to herbicides in service. Accordingly, an examination to secure a medical opinion regarding the etiology of the Veteran’s basal cell carcinoma is necessary. See McLendon v. Nicholson, 20 Vet. App. 79,83 (2006). The Board also notes the Veteran’s report that he receives ongoing treatment for his cancer at the American Lake VAMC. See August 2017 Report of General Information. A review of the claims file reflects the most recent American Lake VAMC records associated with the record is August 2018. On remand, updated treatment records for his basal cell carcinoma should be obtained, if any.   The matters are REMANDED for the following actions: 1. With any necessary assistance from the Veteran, obtain all outstanding VA and/or private treatment records, to include American Lake VAMC, if any. All efforts to obtain additional evidence must be documented in the claims file. 2. Schedule the Veteran for a VA examination by a qualified clinician to address the nature and etiology of the Veteran’s basal cell carcinoma. The examiner must be provided access to the electronic claims file and indicate review of the file in the examination report. The examiner must address whether it is at least as likely as not (50 percent probability or more) that the Veteran’s basal cell carcinoma had its onset during service or is otherwise related to Veteran’s active service, to specifically include exposure to herbicides. The examiner should note that the Veteran submitted pictures regarding his claim and it is associated with the claims file. The examiner should also address the January 1956 STR noting skin damage. The examiner must provide a rationale in support of all opinions provided. If any opinion cannot be provided without resorting to speculation, the examiner must explain why this is so. 3. Readjudicate the claim. If the benefit sought on appeal is not granted to the Veteran’s satisfaction, provide the Veteran and his representative with a supplemental statement of the case and afford them the requisite opportunity to respond before the case is returned to the Board for further appellate action. L. CHU Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Y. Asfaw, 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.