Citation Nr: 21000149 Decision Date: 01/04/21 Archive Date: 01/04/21 DOCKET NO. 19-25 591 DATE: January 4, 2021 REMANDED Service connection for eye cancer and any residuals is remanded. Service connection for skin cancer and any residuals is remanded. Service connection for prostate cancer and any residuals is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1952 to June 1959. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a June 2018 rating decision by the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). A September 2020 Board hearing was held before the undersigned, and a transcript has been associated with the record. 1. Service connection for eye cancer and any residuals therefrom is remanded. 2. Service connection for skin cancer and any residuals therefrom is remanded. 3. Service connection for prostate cancer and any residuals therefrom is remanded. The three claims listed above are closely related and are being remanded for the same reason, thus, the Board will address them together here. The Veteran has not been afforded a VA examination for any of the above claimed disabilities. The Veteran submitted October 2020 correspondence that included a VA Public Health Bulletin. The first section of the bulletin includes a section titled “LORAN Radiation.” The Bulletin indicated that U.S. Coast Guard Veterans who worked at LORAN (Long Range Navigation) stations from 1942 to 2010 may have been exposed to X-ray radiation from high voltage vacuum tubes. The report indicated that 10,000 USCG members were stations at LORAN transmitters during the exposure period and most received only minimal occupational exposures. Further down in the report, it was indicated that body-surface diseases such as skin cancer and cataracts were more likely linked to this type of exposure. The Veteran’s military personnel records indicate he worked on the U.S. Navy Mobile Construction Battalion (NMCB) Seven. This vessel may have been used in the construction of Coast Guard LORAN Stations between 1957 and 1959, a period during which the Veteran served onboard. The Veteran also indicated he was exposed to significant amounts of sunlight during his service. Because the Veteran has current diagnoses or potential residuals from his cancers, served on an MCB with exposure to sun and potentially other forms of radiation, and there is some indication (in the form of the VA Public Health Bulletin) that the Veteran’s cancers may be related to his military service and those exposures, a remand is required to obtain VA examinations and medical opinions as to each claimed disability. The matters are REMANDED for the following action: 1. Please note that this Veteran’s case has been advanced on the docket and, by law, ALL remanded claims must be processed expeditiously. 2. Obtain all updated records (i.e., those not already of record) of VA and adequately identified private treatment the Veteran has received for the disabilities remaining on appeal. The AOJ should obtain, if possible, records of relevant private evaluations and treatment the Veteran has received. The Veteran must assist in the matter by identifying his private healthcare providers and by submitting releases for VA to obtain any private records identified. 3. The AOJ should make inquiries to all appropriate sources, including the Joint Services Records Research Center Division (JSRRC), to verify the mission and projects completed by the NMCB Seven while the Veteran was serving onboard. The inquiries should encompass the period from November 1956 to June 1959. Successive requests must be made to JSRRC (or other source) until the entire relevant time period has been considered. If the JSRRC responds that it is unable to comply with the request or that NMCB 7’s mission and ship logs cannot be corroborated, the AOJ should issue a formal finding documenting the scope of the inquiry, the steps taken, and the ultimate findings. In addition to the above, attempt to verify whether the Veteran served in or around any Coast Guard LORAN stations during his time serving in the U.S. Navy and what, if any his exposure to X-ray radiation may have been. 4. After the above development is completed, the AOJ should arrange for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) of the Veteran to determine the nature and likely cause of any eye cancer disability. The examiner should review the claim file (including this remand) and note such review was conducted. Based on review of the record and examination of the Veteran, the examiner should provide an opinion with detailed rationale that responds to the following: (a.) Please identify, by diagnosis, all eye cancer disabilities present during the appeal period (from November 2017). (b.) For each eye cancer disability diagnosed, is it AT LEAST AS LIKELY AS NOT (50% OR GREATER PROBABILITY) that such disability was either incurred in or otherwise related to the Veteran’s military service? Please explain why. Specifically, the examiner MUST address the Veteran’s potential exposure to radiation in service via Coast Guard LORAN (Long Range Navigation) stations or any other source, including long periods of sun exposure. The examiner’s attention is drawn to the following records (the following is a brief factual background and not intended to be a substitute for your review of the claims folder): (c.) A June 1959 notation on the Veteran’s separation examination that indicated some form of mark, scar, or tattoo to the Veteran’s left eyebrow. (d.) The Veteran’s July 2019 Radiation Risk Activity worksheet. (e.) October 2020 correspondence submitted by the Veteran referencing a VA public health bulletin found at: https://www.publichealth.va.gov/exposures/radiation/sources/loran.asp A detailed explanation (rationale) is required for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification request.) 5. The AOJ should arrange for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) of the Veteran to determine the nature and likely cause of any skin cancer disability. The examiner should review the claim file (including this remand) and note such review was conducted. Based on record review and examination of the Veteran, the examiner should provide an opinion with detailed rationale that responds to the following: (a.) Please identify, by diagnosis, all skin cancer disabilities present during the appeal period (from November 2017). (b.) For each skin cancer disability diagnosed, is it AT LEAST AS LIKELY AS NOT (50% OR GREATER PROBABILITY) that such disability was either incurred in or otherwise related to the Veteran’s military service? Please explain why. Specifically, the examiner MUST address the Veteran’s potential exposure to radiation in service via Coast Guard LORAN (Long Range Navigation) stations or any other source, including long periods of sun exposure. The examiner’s attention is drawn to the following records (the following is a brief factual background and not intended to be a substitute for your review of the claims folder): (c.) A June 1959 separation examination noted identifying body marks, scars or tattoos to the Veteran’s right lower quadrant, penis, left arm, left knee, and left eyebrow. It is not apparent to the Board what the designations “OPS,” “VS,” “PS,” and “S” indicate in this record. (d.) The Veteran’s July 2019 Radiation Risk Activity worksheet. (e.) October 2020 correspondence submitted by the Veteran referencing a VA public health bulletin found at: https://www.publichealth.va.gov/exposures/radiation/sources/loran.asp A detailed explanation (rationale) is required for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification request.) 6. The AOJ should arrange for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) of the Veteran to determine the nature and likely cause of any prostate cancer disability. The examiner should review the claim file (including this remand) and note such review was conducted. Based on review of the record and examination of the Veteran, the examiner should provide an opinion with detailed rationale that responds to the following: (a.) Please identify, by diagnosis, all prostate cancer disabilities present during the appeal period (from November 2017). (b.) For each prostate cancer disability diagnosed, is it AT LEAST AS LIKELY AS NOT (50% OR GREATER PROBABILITY) that such disability was either incurred in or otherwise related to the Veteran’s military service? Please explain why. Specifically, the examiner MUST address the Veteran’s potential exposure to radiation in service via Coast Guard LORAN (Long Range Navigation) stations or any other source, including long periods of sun exposure. The examiner’s attention is drawn to the following records (the following is a brief factual background and not intended to be a substitute for your review of the claims folder): (c.) A June 1959 separation examination noted identifying body marks, scars or tattoos to the Veteran’s right lower quadrant, penis, left arm, left knee, and left eyebrow. It is not apparent to the Board what the designations “OPS,” “VS,” “PS,” and “S” indicate in this record. (d.) The Veteran’s July 2019 Radiation Risk Activity worksheet. (e.) October 2020 correspondence submitted by the Veteran referencing a VA public health bulletin found at: https://www.publichealth.va.gov/exposures/radiation/sources/loran.asp The examiners are reminded that the Veteran is competent to provide information about observable symptoms and events. The examiner should assume, for the purposes of the opinions, that the Veteran’s reports are both accurate and credible. A detailed explanation (rationale) is required for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification request.) 7. If any of the Veteran’s cancers are deemed to be related to service, the AOJ should also obtain secondary service connection opinions for any remaining cancer disabilities not service connected. VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Williams, 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.