Citation Nr: 20041884 Decision Date: 06/19/20 Archive Date: 06/19/20 DOCKET NO. 15-27 064 DATE: June 19, 2020 REMANDED Entitlement to service connection for prostate cancer, to include as due to pesticide exposure is remanded. REASON FOR REMAND The Veteran served on active duty from May 1962 to April 1965.  This case comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO).  This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900 (c). Entitlement to service connection for prostate cancer, to include as due to pesticide exposure is remanded. The Veteran seeks service connection for prostate cancer and contends that while stationed at Fort Bliss, Texas, he moved barrels of what he thought contained pesticides. The Board initially remanded this issue for a nexus opinion in May 2018. In a November 2018 a VA examiner opined, in pertinent part, that the Veteran’s prostate cancer less likely than not, had onset in service or is otherwise related to service. The rationale was that the Veteran was not exposed to pesticides in service. After receiving this opinion, it was determined that an addendum was needed. In the June 2019 Remand, the Board explained that it did not dispute the Veteran’s lack of pesticide exposure in service, and in turn a lack of causation between any alleged pesticide exposure and the Veteran’s prostate cancer. However, the Board explained that the November 2018 opinion, as written, did not sufficiently explain why the examiner determined prostate cancer had no etiological relationship to service, notwithstanding the lack of pesticide exposure. The addendum opinion received in April 2020 does not address this either. The April 2020 examiner opined that the prostate cancer did not onset in service but rather over 30 years later. The Board acknowledges that this opinion is responsive to the question in the June 2019 Remand directive. Unfortunately, the broader nexus inquiry included in the Remand text, was not specifically included in the Remand directive section. The addendum opinion also discussed Agent Orange exposure, however, which was not included in the Board’s Remand and is not relevant to this appeal. The Veteran does not assert, and there is no other competent and credible indication, of herbicide agent exposure in service. On remand, the examiner is asked to opine as to whether it is at least as likely as not that the Veteran’s prostate cancer (which was first diagnosed many years after service) is related to service, exclusive of any alleged pesticide exposure. The examiner must provide a fully-explained rationale that discusses the underpinning for the opinion. The matter is REMANDED for the following action: Obtain an addendum opinion by an appropriate medical professional to determine whether the Veteran’s prostate cancer is etiologically related service, exclusive of the alleged pesticide exposure therein. [The examiner is advised that the Veteran is not found to have been exposed to pesticides in service.] A complete rationale must be provided. For instance, are there generally accepted medical principles regarding the nature and course of prostate cancer and/or any evidence in the file relevant to this individual Veteran and his circumstances, which support the conclusion reached? If so, this should be explained. If the examiner cannot provide the requested opinion without resorting to speculation, he or she must explain why this is so. A copy of the entire Remand must be provided to the examiner. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Telamour, 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.