Citation Nr: 21064329 Decision Date: 10/19/21 Archive Date: 10/19/21 DOCKET NO. 14-24 060 DATE: October 19, 2021 REMANDED Entitlement to service connection for a back condition is remanded. Entitlement to service connection for esophageal cancer, to include as due to radiation exposure is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1994 to February 2004. This matter comes before the Board of Veterans' Appeals (Board) on appeal from August 2009 and August 2013 rating decisions issued by the Department of Veterans Affairs (VA) Regional Office (RO) in New Orleans, Louisiana. The Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge in August 2017. A transcript of the hearing is of record. The Board remanded this matter in March 2018. 1. Entitlement to service connection for a back condition is remanded. Pursuant to the March 2018 Board remand, additional records were obtained from the Veteran's physicians. In the August 2010 VA examination, the examiner determined that the Veteran did not have a current back condition and therefore it was not caused by the back strain noted during service. The examiner stated that the Veteran's service medical record documented soft tissue injury (lumbar sprain) socin 1987. The 1989 and 2002 episodes did not involve trauma and were related to prolonged sitting. The 1990 episode was likely renal stones. The electronic records indicated the Veteran attributed his August 2010 back pain to working on his wife's car. The physical exam and x-rays of August 2010 were essentially normal. Therefore, the Veteran did not have a current back condition. The Board finds that based on the additional evidence of record finding a back condition diagnosis and the examiner's failure to consider the Veteran's lay statements regarding continuity of symptomatology, an additional VA examination and opinion are needed. Specifically, the Veteran has consistently testified that he has had continued back pain since the aircraft explosion in service; he said that he has continued to obtain treatment for this back pain. Additionally, an August 2017 private treatment record noted the following diagnoses: post-trauma chronic pain; injury of lumbar nerve roots; lumbosacral radiculitis; lumbar disc herniation without cord compression; lumbosacral spondylosis without myelopathy; and spondylolisthesis, lumbar region. Therefore, on remand, an additional VA examination and opinion should be obtained regarding the etiology of the Veteran's back disability. 2. Entitlement to service connection for esophageal cancer, to include as due to radiation exposure is remanded. Pursuant to the March 2018 Board remand, the RO requested the Veteran's radiation dose information from the relevant service department. In an October 2020 memorandum, it was determined that there was no external or internal occupational radiation exposure data for the Veteran. However, it was also noted that the Veteran's initial request, which the Board notes was in May 2014, contained limited information. It was determined that a more complete investigation could be accomplished if the Veteran provided additional information. Therefore, it was requested that the Veteran fill out the Radiation Risk Activity Information Sheet. This was not required by the RO following this recommending. The Board therefore finds that an additional Radiation Risk Activity Information Sheet should be completed by the Veteran to give him the opportunity to provide more information to determine his dose estimate. The matters are REMANDED for the following actions: 1. Obtain any outstanding VA or private treatment records. Request that the Veteran assist with locating these records, if possible. Associate these records with the claims file. 2. Then, obtain a VA examination with an appropriate examiner to determine the etiology of the Veteran's back condition. The claims file and a copy of this remand must be made available for review. Following review of the pertinent evidence, the examiner must determine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's back condition is related to service. A clear rationale must be provided for all opinions expressed. The examiner must consider and discuss the Veteran's statements regarding continued pain in service and after service following the aircraft explosion. The examiner must also discuss the Veteran's in-service treatment for his back condition and his statements that he did not seek medical treatment frequently due to the culture of not seeking treatment in the military at that time. If the examiner is unable to provide an opinion without resorting to mere speculation, then the examiner must state this and provide any information needed to make an opinion. 3. Also, regarding the Veteran's esophageal cancer, obtain an updated radiation risk activity information sheet (RRAIS) and/or dose estimate for the Veteran based on his service and activities in Fort Bliss, Texas, performing desert warfare training. 38 C.F.R. § 3.311 (a)(2)(iii). After this is obtained, then forward the records of the Veteran's alleged in-service radiation exposure to the Undersecretary for Health for preparation of a dose socestimate. A copy of any letter sent to the Undersecretary for Health requesting a radiation dose estimate for the Veteran, and any reply, should be included in the claims file. After the Undersecretary for Health responds with a radiation dose estimate for the Veteran, the RO should review that estimate and determine whether any additional development of this claim is required, to include whether it should be sent to the Undersecretary for Benefits. A copy of any determination that additional development is required, to include any letter sent to the Undersecretary for Benefits requesting additional review of this claim, should be included in the claims file. 4. Thereafter, readjudicate the claim on appeal. If the benefit sought remains denied, issue the Veteran and his representative a supplemental statement of the case and provide a reasonable opportunity to respond before returning the matter to the Board for further appellate review. MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Brown, Saudiee 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.