Citation Nr: 21062830 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 17-23 013 DATE: October 12, 2021 REMANDED Entitlement to service connection for squamous cell carcinoma, claimed as soft-tissue sarcoma due to exposure to herbicide agents, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1966 to June 1968. This matter is on appeal from an October 2014 decision of a Department of Veterans Affairs (VA) Regional Office (RO). In July 2021, a videoconference hearing was held before the undersigned. A transcript of the hearing is in the record. Entitlement to service connection for squamous cell carcinoma, claimed as soft tissue sarcoma due to exposure to herbicide agents, is remanded. The Veteran contends that he is entitled to service connection for soft tissue sarcoma due to exposure to herbicide agents. However, upon review of the record, the Board finds that further development is necessary to clarify the nature of the Veteran's condition. Soft-tissue sarcoma is a condition recognized as being presumptively associated with exposure to herbicide agents, which indicates that presumptive service connection may be warranted in this case. 38 C.F.R. § 3.309(e). On the other hand, squamous cell carcinoma is a not a condition which is presumptively associated with exposure to herbicide agents. Id. In this case, the Veteran was provided with a VA examination in September 2014 in which the clinician noted a diagnosis of soft-tissue sarcoma. However, upon review of the record, the Board finds that it is not clear whether this diagnosis was rendered based upon the examiner's independent review of the evidence in this case or merely the Veteran's self-reported medical history. Specifically, the record reflects that the Veteran's private treatment clinicians, Dr. H.S. and Dr. T.F., described the Veteran's condition as squamous cell cancer, and these private treatment records do not describe the condition as soft-tissue sarcoma. Further, VA treatment records note no such diagnosis of soft-tissue sarcoma. The September 2014 VA examiner did not provide an explanation for this discrepancy in the diagnoses. As the September 2014 VA opinion does not describe the disability in sufficient detail so that the Board's evaluation of the claimed disability is fully informed, an addendum opinion must be obtained to clarify the Veteran's diagnosis. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). The Veteran has also submitted a copy of another Board decision in which service connection was awarded for squamous cell cancer as due to herbicide agent exposure. Board decisions are not precedential, meaning that outcome is binding only in the case for which the decision is issued. 38 C.F.R. § 20.1303. It does, however, indicate that the Veteran's disability may be related to service. Thus, an opinion whether, in the facts of this case, the Veteran's squamous cell cancer is due to herbicide agent exposure is warranted if it is not a soft-tissue sarcoma. 38 C.F.R. § 3.159(c)(4). The record also reflects the Veteran receives VA treatment; thus, updated VA treatment records should be associated with the claims file. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from June 2018 to the present. 2. After completing the development requested in item 1, return the claims file to the September 2014 VA examiner, or another appropriate clinician if that examiner is not available, for review and an addendum medical opinion. An in-person (or telehealth) examination is only necessary if deemed so by the clinician. The reviewing clinician should be requested to provide opinions (based on a review of the record) to answer the following: a. Clarify whether the Veteran's squamous cell cancer diagnosis is soft-tissue sarcoma. If so, no further opinions are necessary. In providing an opinion, the examiner is asked to specifically discuss the diagnosis noted in the September 2014 VA examination report and the diagnoses provided by Dr. H.S. and Dr. T.F. b. If Veteran's condition is not soft-tissue sarcoma, is it at least as likely as not (a 50 percent or greater probability) that the Veteran's condition is related to his presumed exposure to herbicide agents? A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. J. B. FREEMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. H. White, 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.