Citation Nr: 21064170 Decision Date: 10/19/21 Archive Date: 10/19/21 DOCKET NO. 15-30 914 DATE: October 19, 2021 REMANDED Entitlement to service connection for prostate cancer, claimed as secondary to hazardous environmental exposure at Camp Lejeune, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from December 1972 to September 1978, including service at Camp Lejeune. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge in an April 2018 hearing. In November 2018, the Board requested the opinion of a medical specialist from the Veterans Health Administration (VHA). The requested opinion was received in February 2019. In a July 2019 decision, the Board denied service connection for prostate cancer. The Veteran appealed the Board's July 2019 decision to the United States Court of Appeals for Veterans Claims (Court). Pursuant to a March 2021 Court Memorandum Decision, the Court vacated the Board's July 2019 decision, and remanded the matter to the Board for further action. 1. Entitlement to service connection for prostate cancer is remanded. After a review of the evidence of record, the Board finds that this matter must be remanded for additional development. As highlighted by the Court in the March 2021 Memorandum Decision, a March 2015 VA examination indicated that past genitourinary infections and benign prostatic hypertrophy are two known risk factors for prostate cancer. Notably, the Veteran's service treatment records reflect treatment for urethritis and recurrence of prostatitis. See, e.g., August 1974, January 1975, March 1977 service treatment records. However, the March 2015 examiner did not adequately address whether the Veteran's treatment during his active service was related to his currently diagnosed prostate cancer. In addition, a March 2017 medical opinion opined that it was at least as likely as not the Veteran's prostate cancer was linked to contaminated water exposure at Camp Lejeune. As noted by the Court, this opinion was not addressed by the Board in its July 2019 decision. However, the opinion was not supported by any rationale for such opinion. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (holding that a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision as to what weight to assign to the doctor's opinion). Accordingly, the Board finds the March 2017 medical opinion is not probative in this matter. More recently, in a February 2019 VHA medical opinion, it was opined that the Veteran's prostate cancer was more likely than not, not a result of toxin exposure at Camp Lejeune. While it was conceded the Veteran had significant exposure at Camp Lejeune, the medical expert indicated that studies have not linked prostate cancer to Camp Lejeune drinking water conclusively. It was also noted that the Veteran has two male siblings, both of which prostate cancer, so there is a very strong family history of prostate cancer in the family. As the Veteran testified in his April 2018 hearing, and as highlighted by the Court in the March 2021 Memorandum Decision, it is unclear if the February 2019 medical expert was aware one of the male siblings that has been diagnosed with prostate cancer also served in Camp Lejeune, and during the same time as the appellant, and for which the appellant's brother has apparently been awarded service connection. In light of the evidence above and the inadequacies of the opinions of record, the Board finds that this matter must be remanded again for an addendum opinion as to the etiology of the Veteran's diagnosed prostate cancer. The matters are REMANDED for the following action: Obtain an addendum opinion regarding the onset and etiology of the Veteran's prostate cancer. After a review of the claims file, the examiner should opine as to whether it is at least as likely as not the Veteran's prostate cancer had its onset in service, or is otherwise related to service, to include his conceded exposure to toxins, including through contaminated water, while serving at Camp Lejeune. In offering this opinion, the examiner must acknowledge and discuss the Veteran's treatment for urethritis and recurrence of prostatitis during his active service. The examiner must also acknowledge and discuss that the Veteran has a male sibling that has prostate cancer that served with the Veteran at Camp Lejeune. The examiner should give a reasoned explanation for all opinions provided. If the examiner is unable to provide a medical opinion, then he or she should provide a statement as to whether there is any additional evidence that could enable an opinion to be provided or whether the inability to provide the opinion is based on the limits of medical knowledge. STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Marley, 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.