Citation Nr: 20053131 Decision Date: 08/11/20 Archive Date: 08/11/20 DOCKET NO. 17-39 578 DATE: August 11, 2020 REMANDED Entitlement to service connection for prostate cancer is remanded. REASONS FOR REMAND The Veteran had active service from July 1972 to August 1974. As an initial matter, the Board of Veterans’ Appeals (the Board) notes that its July 2018 decision stylized the issue as a petition to reopen a claim of entitlement to service connection for prostate cancer. There is, however, no need to reopen the Veteran’s claim. The Agency of Original Jurisdiction (AOJ) denied the Veteran’s claim in a June 2015 rating decision. The Veteran did not file a notice of disagreement with that decision; however, in February 2016 he submitted a prostate disability benefits questionnaire (DBQ) completed by his treating physician. While the DBQ did not include an opinion regarding any etiological association between the Veteran’s prostate cancer and his active service or his service-connected disabilities, it was new evidence received within one year of the June 2015 rating decision. As a result, the June 2015 rating decision did not become final. The Veteran’s claim for service connection for prostate cancer was therefore still pending when he submitted his January 2017 petition to reopen. Following the January 2017 claim, the AOJ denied service connection for prostate cancer in a May 2017 rating decision. The Veteran perfected his appeal to the Board, which remanded his claim in July 2018 to afford him a VA addendum opinion regarding the etiology of his prostate cancer. That opinion was proffered in February 2019, and the Veteran’s claim is once again before the Board. 1. Entitlement to Service Connection for Prostate Cancer The Veteran contends that he is entitled to service connection for prostate cancer. In a July 2017 statement accompanying his substantive appeal, the Veteran contends that he was exposed to herbicide agents while serving in Germany. The Veteran contends further that he is entitled to service connection for prostate cancer on a secondary basis. Specifically, he relates his prostate cancer to medications he takes to treat his service connected hepatitis C. He emphasizes that he take Ribavirin, which he contends is a known carcinogen. In a February 2020 statement, the Veteran contends that prostate cancer is due to Zantac (Ranitidine). The Veteran’s VA treatment records establish that he has taken ranitidine to treat his service-connected gastroesophageal reflux disease (GERD). In its previous remand directive, the Board requested a VA opinion regarding whether Ribavirin caused or aggravated the Veteran’s prostate cancer; however, no opinion has been provided regarding Ranitidine. Accordingly, the Veteran’s claim must again be remanded to afford him an addendum opinion regarding whether his prostate cancer is etiologically related to the use of Ranitidine to treat service-connected GERD. In remanding the Veteran’s claim, the Board notes that his personnel records establish that he served in Germany from February 1973 to July 1974. The Veteran does not have active service in the Republic of Vietnam, and his is not, therefore, presumed to have been exposed to herbicide agents. However, the Veteran is welcome to submit additional evidence showing actual exposure—as opposed to presumed exposure—to herbicide agents such as Agent Orange. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician to determine the nature and etiology of prostate cancer. After reviewing the claims file, the examiner should provide an opinion as to whether prostate cancer is at least likely as not: (a.) proximately due to the use of Ranitidine in treating the Veteran’s service-connected GERD, or (b.) underwent any incremental increase in disability, regardless of its permanence, due to the use of Ranitidine in treating the Veteran’s service-connected GERD. The term “incremental increase in disability” means additional impairment of earning capacity. Objective measurement, or numerical quantification, is not required to ascertain an increase in disability. Moreover, any “incremental increase in disability” need not be permanent. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Douglas M. Humphrey, 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.