Citation Nr: 21000802 Decision Date: 01/06/21 Archive Date: 01/06/21 DOCKET NO. 14-10 733 DATE: January 6, 2021 REMANDED Service connection for residuals of prostate cancer, to include as due to herbicide agent exposure, ionizing radiation exposure, and toxic chemical exposure is remanded. REASONS FOR REMAND The Veteran served honorably on active duty in the United States Army from April 1961 to April 1964. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2012 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this case for further development in December 2015, September 2017, and November 2018. The Veteran is contending that his prostate cancer is due to exposure to ionizing radiation. In November 2020, a radiation dose estimate was provided by the VA Under Secretary for Health and the claim was then referred to VA Under Secretary for Benefits for a determination as to whether it is at least as likely as not that the Veteran’s prostate cancer resulted from radiation exposure in service. In providing a dose estimate the VA Under Secretary for Health stated that in a March 2018 letter the Army Dosimetry Center was unable to locate any records of exposure to ionizing radiation. However, in a July 2018 letter the Army Dosimetry Center stated that its earlier letter was incorrect and was able to locate and provide the Veteran’s records for exposure to ionizing radiation. As such, a remand is necessary to obtain a new radiation dose estimate from the VA Under Secretary for Health using the Veteran’s records for exposure to ionizing radiation. In a November 2018 letter, the Veteran contends that his in-service records documenting his radiation exposure are not accurate. He argues that he was exposed to higher doses of radiation than what is reported. In support of this he refers to articles and websites that suggest Fort McClellan had radiation that exceeded acceptable limits. The Veteran’s in-service radiation dose was used by the VA Under Secretary for Health in providing a radiation dose estimate. As the Veteran is challenging a basis for the radiation dose estimate requested under 38 C.F.R. § 3.311, the Board is obligated to determine whether the radiation dose estimate constitutes sound medical and scientific evidence. See Skaar v. Wilkie, No. 17-2574, 2020 U.S. App. Vet. Claims LEXIS 2279, at *29–*30 (U.S. App. Vet. Claims Dec. 17, 2020). Accordingly, a remand is necessary to obtain an expert opinion as to whether the dose estimate constitutes sound medical and scientific evidence. In October 2019, a medical opinion was obtained as to whether the Veteran’s prostate cancer was due to exposure to herbicides, mustard gas, polychlorinated biphenyls (PCBs), and ionizing radiation. The VA physician provided an opinion for each type of exposure. The Veteran though is contending that his combined exposures are what caused his prostate cancer. As no VA physician has opined whether it is at least as likely as not that the Veteran’s combined exposure to chemical or biological agents and radiation caused his prostate cancer, a remand is necessary. In a July 2020 letter, the Veteran contends that the VA physician who provided the October 2019 opinions lacks the medical expertise necessary to provide such opinions. This satisfies the requirement to challenge the competency of the medical examiner, and a remand is necessary to obtain the curriculum vitae of the VA physician who provided the October 2019 opinions. See Francway v. Wilkie, 940 F.3d 1304, 1307 n. 1 (Fed. Cir. 2019).   The matter is REMANDED for the following actions: 1. Obtain the curriculum vitae of the VA physician who provided the October 2019 medical opinions. 2. Obtain an addendum opinion regarding whether the Veteran’s prostate cancer is at least as likely as not (50 percent or greater) related to the combined exposure to herbicides, mustard gas, PCBs, and ionizing radiation. The rational for the opinion must be provided. 3. In accordance with 38 C.F.R. § 3.11(b)(2), the case should be referred to the VA Under Secretary for Health, for preparation of a radiation dose estimate. The VA Under Secretary for Health is to note that the Veteran’s records of exposure to ionizing radiation were provided by the Army Dosimetry Center in a July 2018 letter. The VA Under Secretary for Health is also to provide the methodology used to determine the radiation dose estimate. 4. Forward the VA Under Secretary for Health’s radiation dose estimate to an expert to determine whether sound medical and scientific evidence was used in providing a radiation dose estimate. (Continued on the next page)   5. After a dose estimate has been provided by the VA Under Secretary for Health, the case should be forwarded to the VA Under Secretary for Benefits to obtain an advisory medical opinion as any relationship between the Veteran’s prostate cancer and in-service radiation exposure. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael Chandeck, 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.