Citation Nr: 21003847 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 19-06 326A DATE: January 25, 2021 ISSUE Entitlement to service connection for skin cancer. REMANDED Entitlement to service connection for skin cancer is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from October 1960 to October 1964. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In December 2020 the Veteran testified before the undersigned Veterans Law Judge in a video teleconference hearing. A transcript of the testimony offered at the hearing has been associated with the record. The Board finds that additional evidentiary development is required before the claim on appeal is adjudicated. This matter has been advanced on the docket pursuant to 38 C.F.R. § 20.900. Entitlement to service connection for skin cancer is remanded. The Veteran contends that his skin cancer is related to his active service through exposure to ionizing radiation during active service. The record contains private treatment records received by VA in August 2016 which reflect a diagnosis of basal cell carcinoma (BCC) of the right forearm, in 2003, right thigh 2006,left nose 2007, right temple 2011, and right eyebrow 2014; and Squamous cell carcinoma (SCC) of the left proximal forearm in 2013 and SCC of the left upper limb, shoulder and wrist. The examiner however provided no medical opinion on the etiology of the Veteran’s diagnosed skin cancer. At the December 2020 Board hearing the Veteran credibly testified that while on active service he was assigned to the 56 Weather Squadron in Tokyo, Japan. While there he was mainly assigned on the flight line. There were times where he would be assigned to the decontamination crew where he was required to get readings of the radiation levels of aircrafts which were used in nuclear tests. He further testified that he was not provided with any equipment or hazmat suit while performing these duties. The Veteran stated that he has no family history of skin cancer and has not had sun exposure since discharge. He has stated that he believes that his skin cancer is directly related to his exposure to ionizing radiation while in active service. The Board notes that the Veteran has not been provided with a VA examination for his skin cancer nor has he been provided with a medical opinion to address the issue of etiology. VA must provide a medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service, or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006); see also 38 U.S.C. § 5103A (d)(2), 38 C.F.R. § 3.159 (c)(4)(i) (2017). The third prong, which requires that the evidence of record "indicate" that the claimed disability or symptoms "may be" associated with the established event, is a low threshold. McLendon, 20 Vet. App. at 83. Here, the Board finds that the McLendon criteria have been satisfied. Specifically, there is competent evidence that the Veteran has skin cancer which may be associated with his active service, including his exposure to ionizing radiation, but there is insufficient competent medical evidence on file for the Board to make a decision on the claim. As such, remand for an examination and medical opinion is necessary. The matters are REMANDED for the following action: 1. Make appropriate efforts to obtain and associate with the claims file any updated VA medical records of the Veteran not previously obtained. 2. Once the development has been completed, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his skin cancer. Following a complete review of the Veteran's claims file, the examiner must opine whether the skin cancer is at least as likely as not related to an in-service injury, event, or disease, to include exposure to ionizing radiation while in service. When considering this question, the examiner is to consider all lay statements of record carefully, VA treatment records and private treatment records and evaluations. The examiner’s attention is directed to the Veteran’s statements that he was assigned to the decontamination crew where he would have to get readings of the radiation levels of nuclear aircrafts which is where he believes he was exposed to ionizing radiation. The examiner should view the Veteran as a reliable historian as to his service and his report of his activities in service. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). A detailed rationale must be provided for any opinion offered. 3. After completing the requested actions, readjudicate the claim in light of all pertinent evidence and legal authority. If the benefit sought remains denied, furnish to the Veteran and his representative with a Supplemental Statement of the Case and afford them the appropriate time period for response before the claims file is returned to the Board for further appellate consideration. Michael A. Pappas Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Nettey, 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.