Citation Nr: 21063412 Decision Date: 10/14/21 Archive Date: 10/14/21 DOCKET NO. 17-16 188 DATE: October 14, 2021 REMANDED Issue of entitlement to service connection for prostate cancer is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1977 to October 1995. This appeal to the Board of Veterans' Appeals (Board) arose from a May 2015 rating decision issued by the Department of Veterans Affairs (VA). See May 2015 Notice of Disagreement (NOD); January 2017 Statement of the Case (SOC); March 2017 Substantive Appeal (VA Form 9). In February 2019, the Board remanded the claim for further development. February 2019 Board Decision. The agency of original jurisdiction (AOJ) developed the evidence and continued the denial of the Veteran's claim. See July 2021 Supplemental Statement of the Case (SSOC). The claim is now back before the Board. Issue of entitlement to service connection for prostate cancer is remanded. Unfortunately, the Board finds that a remand is warranted to obtain another opinion from a VA examiner. Two opinions VA examiner opinions were obtained after the February 2019 Board decision. The December 2019 VA examiner opined that the Veteran's prostate cancer is less likely than not incurred in or caused by service because the evidence did not specifically address any military activities as being causal of the Veteran's prostate cancer. December 2019 VA Examination for Prostate Cancer. The Board finds that it is unclear what evidence was considered, including how the VA examiner considered the medical literature submitted by the Veteran about prostate cancer and asbestos exposure. The November 2020 VA examiner, likewise, found the Veteran's prostate cancer as less likely than not incurred in or caused by service based on no medical literature evidence supporting asbestos exposure as a primary cause of prostate cancer, but provided no discussion on how the medical literature submitted by the Veteran was considered. In addition, neither VA examiner discussed whether the Veteran's prostate cancer is related to his asserted in-service exposure to paint and welding fumes, phosgene gas, and other chemicals. See April 2015 Correspondence; March 2017 Correspondence; October 2020 Correspondence. The matters are REMANDED for the following action: 1. Obtain addendum opinion(s) from appropriate medical professional(s) to determine the nature and cause of the Veteran's prostate cancer. The medical professional(s) should respond to the following: (a) Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's prostate cancer began in (or is otherwise related to) the Veteran's military service, including asbestos exposure and any evidence of radiation exposure? For the purposes of obtaining a medical opinion only, the medical professional(s) should presume as true the Veteran's report of in-service exposure to lead/zinc paint fumes, welding and brazing fumes, phosgene gas, hydrogen sulfide, carbon monoxide, halon 1311, potassium bicarbonate, hydrogen chloride, and cigarette smoke. See April 2015 Correspondence; October 2020 Correspondence; August 2021 Correspondence. The medical professional(s) should also specifically consider and discuss the medical literature submitted and cited by the Veteran, as well as the March 2017 opinion from the Veteran's private treatment provider that the Veteran's asbestos exposure was a "contributing factor" to the Veteran's prostate cancer based on several European epidemiologic studies. If the medical professional(s) determine that asbestos exposure is a supported risk factor for prostate cancer, a discussion about how that factor applies to the Veteran's medical and personal history is needed. In other words, does the Veteran have other risk factors that, in the medical professional(s)' opinion, more likely caused his prostate cancer to the point that it would render the Veteran's asbestos exposure to be less likely than not a cause. A detailed explanation (rationale) is requested. 2. Readjudicate the claim. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Lin 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.