Citation Nr: 21004508 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 20-02 678 DATE: January 27, 2021 REMANDED Service connection for squamous cell carcinoma. Service connection for Waldenstrom macroglobulinemia.   REASONS FOR REMAND The Veteran served on active duty from September 1956 to June 1959. The case is on appeal from a July 2018 rating decision. In August 2020, the Veteran testified at a Board hearing. The record was held open for 60 days for the submission of additional evidence. Additional evidence was submitted by the Veteran’s representative. 1. Service connection for squamous cell carcinoma. The Veteran is seeking service connection for squamous cell carcinoma. At the August 2020 Board hearing, the Veteran asserted that his squamous cell carcinoma is due to in-service sun exposure. He contends that duties associated with training as a paratrooper and as a member of a baseball team while he was stationed at Ft. Campbell in Kentucky, required that he spend significant time outdoors. Initially, the Board notes that the Veteran’s service personnel records (SPRs) are absent from the claims file. As such, they should be obtained on remand. In addition, the Veteran has not been afforded a VA examination related to this condition. Private treatment records show he has treatment for this condition. Based on the Veteran’s testimony, and in light of the other evidence of record, the Board finds the evidence currently meets the low threshold for obtaining a VA examination as to this claim. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). 2. Service connection for Waldenstrom macroglobulinemia. Concerning his Waldenstrom macroglobulinemia, which is a form on non-Hodgkins lymphoma, the Veteran contends it is related to exposure to herbicides, such as “Roundup” and pesticides. He asserts he was exposed to herbicides and pesticides as the parade field where he trained and the baseball field where he played were well maintained, and he witnessed those areas being sprayed with what he asserts were herbicides and pesticides. As noted above, the Board notes that the Veteran’s SPRs are absent from the claims file. As such, they should be obtained on remand. In addition, the Board notes that if a veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases are presumed to be service connected if the requirements of 38 C.F.R. § 3.307(a)(6) are met, even though there is no record of the disease during service, provided that the rebuttable presumption provisions of 38 C.F.R. § 3.307(d) are also satisfied. 38 C.F.R. § 3.309(e). Non-Hodgkins lymphoma is listed as a disease associated with exposure to herbicide agents. 38 C.F.R. § 3.309(e). Private medical records reflect that the Veteran was diagnosed and treated for Waldenstrom macroglobulinemia. Thus, concerning the Veteran’s contention that herbicide agent exposure caused his Waldenstrom macroglobulinemia, the sole question before the Board is whether the Veteran was exposed to herbicide agents during his service. In this regard, evidence in the claims file reflects that the RO did not verify whether the Veteran was exposed to any herbicide agents. Thus, the Board finds remand is warranted to verify, to the extent possible, whether the Veteran was exposed to herbicide agents during his service. The Veteran alternatively contends that his Waldenstrom macroglobulinemia is due to his exposure to herbicides, such as “Roundup” and/or pesticides. As there is no indication in the claims file that the RO attempted to verify the Veteran’s exposure to other herbicides and/or pesticides, remand is also warranted to verify, to the extent possible, the Veteran’s exposure to such chemicals. In addition, the Veteran has not been afforded a VA examination related to this condition. Private treatment records show he has treatment for this condition. Based on the Veteran’s testimony, and in light of the other evidence of record, the Board finds the evidence currently meets the low threshold for obtaining a VA examination as to this claim. See McLendon, 20 Vet. App. at 81. The matters are REMANDED for the following action: 1. Obtain the Veteran’s SPRs. 2. Undertake all necessary development to attempt to verify the likelihood of the Veteran’s exposure to herbicide agents including Agent Orange, other herbicides, and pesticides. Document the efforts made to obtain verification along with any negative responses. 3. Also, schedule the Veteran for a VA examination (or telehealth interview, record review, etc., if an in-person examination is not feasible) by a qualified medical professional for an opinion to determine the nature and etiology of his squamous cell carcinoma. The entire claims file should be reviewed by the examiner. The examiner is to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that his squamous cell carcinoma had its onset during service or within one year of service separation, or is otherwise causally related to service. The examiner should consider the Veteran’s contentions with regard to spending a significant amount of time outdoors. A detailed rationale supporting the examiner’s opinion must be provided. 4. Then, if exposure to herbicide agents Agent Orange is not established, forward the claims file to a qualified medical professional for an opinion to determine the nature and etiology of the Veteran’s Waldenstrom macroglobulinemia. The entire claims file should be reviewed by the examiner. The examiner is to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s Waldenstrom macroglobulinemia had its onset during service or within one year of service, or is otherwise causally related to service, specifically including exposure to herbicides (other than herbicide agents), such as “Roundup” and pesticides. A detailed rationale supporting the examiner’s opinion must be provided. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Gray, 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.