Citation Nr: 21000172 Decision Date: 01/04/21 Archive Date: 01/04/21 DOCKET NO. 16-18 218 DATE: January 4, 2021 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1960 to May 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The appeal was remanded in May 2020 for additional development. It has since been returned to the Board for further appellate consideration. 1. Entitlement to service connection for the cause of the Veteran's death is remanded. Regarding each of the claims on appeal, remand is again necessary because the RO has not complied with the prior remand directives. The Board is obligated by law to ensure that the RO complies with its directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). RO compliance with remand directives is not optional or discretionary and the Board errs as a matter of law when it fails to ensure remand compliance. Stegall, 11 Vet. App. at 271. The May 2020 remand directed the RO to obtain an addendum opinion. The Board instructed that the examiner address the August 2015 internet articles submitted and the appellant’s March 2019 testimony. A July 2020 VA addendum opinion was obtained. The examiner opined that the Veteran’s service-connected prostate cancer less likely than not contributed substantially or materially to the cause of the Veteran’s death, listed as hepatocellular carcinoma, combined to cause the Veteran's death, or aided or lent assistance to producing the Veteran's death. The examiner noted a review of the Veteran’s claims file, including service treatment records, VA treatment records, and medical records. The examiner however failed to address the medical literature submitted in August 2015 that discusses metastatic liver cancer in relation to cancer located elsewhere, including the prostate. Also, the examiner did not address the appellant’s March 2019 Board hearing testimony. The matters are REMANDED for the following action: Obtain an addendum opinion regarding the etiology of the cause of the Veteran’s death from a VA examiner. The entire claims file must be made available to and be reviewed by the examiner. An explanation for all opinions expressed must be provided. The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s service-connected prostate cancer contributed substantially or materially to the cause of the Veteran’s death, listed as hepatocellular carcinoma, combined to cause the Veteran’s death, or aided or lent assistance to producing the Veteran’s death. The examiner must address the following: 1) internet articles submitted in August 2015 discussing liver metastases, prostate cancer, and metastatic liver cancer that could develop from prostate cancer; 2) the appellant’s March 2019 testimony; and 3) the July 2020 addendum opinion. K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Braxton, 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.