Citation Nr: 21004275 Decision Date: 01/26/21 Archive Date: 01/26/21 DOCKET NO. 13-05 766 DATE: January 26, 2021 REMANDED Entitlement to service connection for colon or colorectal cancer, to include as due to exposure to asbestos or herbicide agents, based on substitution of the appellant, is remanded. Entitlement to service connection for liver cancer, to include as due to exposure to asbestos or herbicide agents, based on substitution of the appellant, is remanded. Entitlement to service connection for a seizure disability, to include as due to exposure to asbestos or herbicide agents, based on substitution of the appellant, is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1968 to October 1969. He died in November 2013, and the appellant is his surviving spouse and the substitute-claimant in this appeal. The appellant’s claims were most recently before the Board of Veterans’ Appeals (Board) in June 2019 wherein they were remanded to the agency of original jurisdiction (AOJ) for additional development. As noted by the appellant’s representative, the development was not in substantial compliance with the Board’s remand instructions. See Stegall v. West, 11 Vet. App. 268 (1998). Unfortunately, another remand is required. 1. Entitlement to service connection for colon or colorectal cancer, to include as due to exposure to asbestos or herbicide agents, based on substitution of the appellant, is remanded. 2. Entitlement to service connection for liver cancer, to include as due to exposure to asbestos or herbicide agents, based on substitution of the appellant, is remanded. The Board directed the AOJ to perform the following development, in pertinent part: “arrange for the claims file, and a copy of this remand, to be made available to the oncologist who wrote the September 2017 medical opinion regarding the etiology of the Veteran’s colon cancer. If that examiner is unable to provide the requested opinions, the claims file should be provided to another VA oncologist to provide the requested opinions.” Instead of providing the claims file to a VA oncologist, opinions were returned by medical doctors who specialized in family practice and orthopedics. A medical opinion from an oncologist is needed because of their specialized training and medical expertise. If such specialist is not available, that must be noted in the record prior to returning the appeal. Thus, a remand is required. 3. Entitlement to service connection for a seizure disability, to include as due to exposure to asbestos or herbicide agents, based on substitution of the appellant, is remanded. Similarly to the issues above, the Board directed the AOJ to perform the following development on the claim of service connection for a seizure disability, in pertinent part: “arrange for the claims file, and a copy of this remand, to be made available to a neurologist who has not previously reviewed the file.” Instead of providing the claims file to a VA neurologist, opinions were returned by medical doctors who specialized in family practice, as well as a physician’s assistant. A medical opinion from a neurologist is needed because of their specialized training and medical expertise. If such specialist is not available, that must be noted in the record prior to returning the appeal. Thus, a remand is required. The matters are REMANDED for the following action: 1. Arrange for the claims file, and a copy of this remand, to be made available to the oncologist who wrote the September 2017 medical opinion regarding the etiology of the Veteran’s colon cancer. If that examiner is unable to provide the requested opinions, the claims file should be provided to another VA oncologist to provide the requested opinions. Every effort to have an oncologist to render the requested opinions is necessary. If such specialist is not available, that must be explained in the record prior to returning the appeal. In writing the required opinions, the oncologist is asked to please refer to the Veteran’s clinical history in addition to treatise or other general medical evidence. After examining the file, oncologist is requested to address the following: (a) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s colon cancer is related to herbicide agent exposure during service?; (b) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s colon cancer is related to asbestos exposure during service?; (c) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s liver cancer is related to herbicide agent exposure during service?; (d) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s liver cancer is related to asbestos exposure during service? Arrange for the claims file, and a copy of this remand, to be made available to a neurologist who has not previously reviewed the file. Every effort to have a neurologist to render the requested opinions is necessary. If such specialist is not available, that must be explained in the record prior to returning the appeal. In reviewing the file, the neurologist is requested to specifically note the Veteran’s post-service medical records; the September 1980 VA medical examination report, in which an examiner diagnosed seizures possibly due to chemical exposure; the appellant’s lay statements indicating onset of the Veteran’s seizures in June 1970; and the VA medical opinions on file. The neurologist should specifically note this evidence in any subsequent report. The neurologist is also advised that the Veteran is presumed to have been exposed to herbicide agents and asbestos during his service. After examining the file, neurologist is requested to address the following: (a) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s seizure disorder had its onset in service or within one year of separation from service?; (b) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s seizure disorder is related to herbicide agent exposure during service?; (c) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s seizure disorder is related to asbestos exposure during service? Bethany L. Buck Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board I. M. Hitchcock 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.