Citation Nr: 21003853 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 20-18 740 DATE: January 25, 2021 REMANDED The issue of entitlement to service connection for non-Hodgkin's lymphoma is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1989 to December 1993. This matter is before the Board following his appeal of an October 2018 rating decision. In November 2020, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. The issue of entitlement to service connection for non-Hodgkin's lymphoma is remanded. Unfortunately, the Board finds that remand of the Veteran’s claim of entitlement to service connection for non-Hodgkin’s lymphoma (NHL) is necessary in order to obtain an adequate medical opinion. In this regard, the Veteran contends that his diagnosed NHL is the result of various exposures while serving in Southeast Asia or, alternatively, the result of his father’s Agent Orange exposure in Vietnam. While a March 2020 VA examiner indicated that an opinion as to whether the Veteran’s NHL was related to exposures in service, to include oil well fires and burn pits, would be speculative, the examiner appears to have relied on the fact that VA and Department of Defense have not conceded such an association, which is insufficient rationale. Additionally, the examiner did not address the theory, raised by a February 2019 private medical statement, that the Veteran was at an increased risk for NHL due to his father’s herbicide exposure in Vietnam. Additionally, following the March 2020 VA opinion, the Veteran submitted literature discussing the health risks associated with oil well fires. Given the new evidence, as well as the deficiencies in the March 2020 opinion discussed above, the Board finds that a new opinion is necessary. The matters are REMANDED for the following action: Forward the Veteran's claims file to an environmental or occupational exposure specialist or another qualified medical expert in the field of hazardous exposures. The entire claims file, including a copy of this Remand, must be made available to and must be reviewed by the expert. Thereafter, the expert should address the following: (a) Please state whether it is at least as likely as not (50 percent probability or more) that the Veteran's non-Hodgkin’s (follicular) lymphoma was incurred in, caused by, or otherwise related to service. Please specifically address whether the Veteran's condition was caused by his exposure to oil well fires, burn pits, or other chemical exposures during service in Southwest Asia. Please note that an opinion based on the fact that a particular disorder is not one for which VA grants presumptive service connection for exposures in Southwest Asia is inadequate. The opinion must be based on this particular Veteran's exposures, to include oil well fires and burn pits, and whether those exposures caused his diagnosed disorder, regardless of whether the diagnosed disorder appears on the list of diseases for which VA grants presumptive service connection. (b) If not related to service, please state whether it is at least as likely as not (50 percent probability or more) that the Veteran’s non-Hodgkin’s (follicular) lymphoma was caused or contributed to by his father’s exposure to herbicide agents, including Agent Orange, during service in the Republic of Vietnam. In providing the foregoing opinions, the specialist should consider medical and lay evidence dated both prior to and since the filing of the claim, including: (1) the literature submitted by the Veteran discussing the health risks associated with oil well fires; and (2) the Veteran’s November 2020 testimony regarding positive readings for chemical exposure in service; and, (3) the February 2019 private opinion discussing the potentially increased likelihood of the Veteran developing NHL based on his father’s exposure to herbicides in Vietnam; and, The specialist must provide a complete rationale for any opinion rendered. If the specialist cannot provide an opinion without resorting to speculation, he or she should explain why an opinion cannot be provided (e.g., lack of sufficient information/evidence, the limits of medical knowledge, etc.). S. C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Fagan, Aileen 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.