Citation Nr: 21062210 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 16-49 938 DATE: October 6, 2021 REMANDED The issue of service connection for cause of death is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1969 to December 1970. The Veteran died in July 1996. The Appellant is the surviving spouse. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office. This matter is before the Board on a December 2020 joint motion for partial remand (JMPR) from the Court of Appeals for Veterans Claims (Court), which vacated the September 2019 Board decision that denied the Appellant's claim of service connection for the Veteran's cause of death and remanded the issue for further development and readjudication in compliance with the JMPR. Continued on Next Page The matter is REMANDED for the following action: 1. BACKGROUND FOR THE ADJUDICATOR: The Board finds that a medical opinion is required to properly adjudicate the claim. The remand directives follow. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's cause of death is related to service. The entire claims file, including a copy of this Remand, should be made available to, and be reviewed by, the VA examiner. An explanation should be given for all opinions and conclusions rendered. Based upon a review of the relevant evidence of record and sound medical principles, the VA examiner should provide the following opinions: (a.) Identify whether any of the Veteran's causes of death, including cardio-respiratory failure and adenocarcinoma of the liver, were incurred in service, or caused by an in-service injury, event, or illness to include conceded exposure to herbicide agents. (b.) Whether the Veteran's cardio-respiratory failure could have preceded his adenocarcinoma of the liver. The examiner is advised that a negative opinion cannot be based solely on the fact that liver cancer is not on the list of diseases that are presumptively associated with exposure to herbicide agents. The examiner must fully explain the opinion. A summary conclusion is not sufficient under the law and the opinion will be returned for further clarification. The examiner must review the entire record in conjunction with making the requested opinions. IN ADDITION TO ANY RECORDS THAT ARE GENERATED BECAUSE OF THIS REMAND, the VA examiner's attention is drawn to the following: *The Veteran had conceded exposure to herbicide agents during service. *Service treatments records from 1969 to 1970 note the Veteran's complaints affecting the respiratory system to include, chest pain, shortness of breath and coughing. *A July 1996 VA radiology report notes the Veteran was diagnosed with metastatic lung disease. The examiner noted the metastatic lung disease was probably from the Veteran's liver cancer. *A 2003 Iris analysis drafted by Dr. E. L. notes the Veteran was "destined to suffer from a cardio-bronchial-pulmonary disease process." Dr. E. L. also noted that the Veteran had liver and pancreas dysfunction 10 or 12 years prior to his death. *A private medical opinion from Dr. M. C. notes the Veteran liver cancer is most likely caused by Agent Orange exposure. *A web article submitted in July 2021 entitled "Misclassification of Metastatic Cancers as Primary Liver Cancer." Continued on Next Page 3. After the above development, readjudicate the issue on appeal. If the benefit sought on appeal is denied, the Appellant and her representative should be supplied a supplemental statement of the case. An appropriate period should be allowed for response before the case is returned to the Board. K.A. KENNERLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. McDuffie, 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.