Citation Nr: 21064460
Decision Date: 10/20/21	Archive Date: 10/20/21

DOCKET NO. 16-50 776
DATE: October 20, 2021

REMANDED

Entitlement to service connection for hepatocellular carcinoma is remanded.

REASONS FOR REMAND

The Veteran served on active duty from April 1966 to February 1970.

This appeal was previously before the Board in February 2020, at which time it was remanded to the agency of original jurisdiction (AOJ) so that a medical opinion could be obtained that addressed the Veteran's theory of entitlement that his currently-diagnosed hepatocellular carcinoma was related to his presumed exposure to herbicide agents as a result of his service in the Republic of Vietnam.

Although an opinion was provided in December 2020, the Veteran's representative subsequently raised a new theory of entitlement.  In the October 2021 appellate brief, the Veteran's representative argued that, as an airplane mechanic, the Veteran was likely exposed to hazardous toxins, such as trichloroethylene (TCE), through his use of cleaning solvents and degreasers.  The representative then quoted and cited two publications from the Internet that suggest a higher risk of liver cancer in persons who were exposed to TCE.

The Board notes that the Veteran's DD Form 214 confirms that his military occupational specialty was as an airplane mechanic.

To ensure an adequate record upon which to decide the appeal, the Board finds that another VA medical is necessary that considers all pertinent evidence of record as well as all theories of entitlement. See McLendon v. Nicholson, 20 Vet. App. 79 (2006).

On remand, any outstanding VA treatment records should be associated with the claims file. Additionally, the Veteran should be given the opportunity to identify or submit any outstanding evidence pertinent to the appeal, to include the articles referenced in the October 2021 appellate brief.

The matters are REMANDED for the following action:

1. Associate any VA treatment records dated after April 1, 2021, with the Veteran's claims file.

2. Give the Veteran the opportunity to identify any outstanding pertinent evidence that has not already been associated with the claims file. The AOJ should then attempt to obtain those records if he provides the appropriate authorization.

3. Ask the Veteran's representative to submit printed or electronic copies of all medical treatise evidence and/or Internet research articles he wishes VA to consider in support of the Veteran's claim, as identified in the October 2021 appellate Brief.

4. After all available records have been associated with the claims file, return the claims file to the VA examiner who provided the December 2020 VA medical opinion. If the December 2020 opinion provider is not available, the claims file should be provided to another medical professional to render the requested opinion. The need for an additional examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion.

Following a review of the record, the examiner should respond to the following:

Is it at least as likely as not (approximately 50 percent probability) that the Veteran's hepatocellular carcinoma is related to his active duty service, to specifically include exposure to hazardous materials, such as TCE, through his use of cleaning solvents and degreasers as an airplane mechanic?

In offering any opinion, the examiner must consider the full record, to include the medical evidence quoted in the October 2021 appellate brief.  

A clearly-stated rationale for any opinion offered should be provided.

5. Thereafter, readjudicate the appeal.

 

 

V. Chiappetta

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	James R. Springer, 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.