Citation Nr: 21064832 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 20-02 890 DATE: October 21, 2021 REMANDED Entitlement to service connection for bladder cancer is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1961 to June 1965. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a Board hearing before the undersigned in September 2020. A transcript is of record. The Board remanded this case in January and June 2021 for further development. While the Board regrets further delay, the Veteran's appeal must once again be remanded as review of the claims file reveals there was not substantial compliance with the Board's prior remand instructions. Stegall v. West, 11 Vet. App. 268 (1998) (a remand by the Board confers on the Veteran, as a matter of law, the right to compliance with the remand). 1. Entitlement to service connection for bladder cancer is remanded. In its January and June 2021 remand directives, the Board requested a VA examiner to determine the nature and etiology of the Veteran's bladder cancer. In doing so, the examiner was to specifically address an April 2017 private opinion that "on a more probable benign basis, the patient's bladder tumors are related to his exposure to radiation fuel and chemicals," a July 2017 private opinion that the Veteran's bladder cancer was due to "exposure to aviation fuel and chemical during military career," and a February 2020 medical articles purporting to show a link between aviation fuels and the development of cancers. However, the March and June 2021 VA examiner did not do so. Further, the examiners cited one article providing that there was a weak association between exposure to military fuels and bladder without applying it to the specific facts of the Veteran's case. As such, an additional remand is warranted. See Barr v. Nicholson, 21 Vet. App. 303, 311 (once the VA undertakes the effort to provide an examination, it must provide an adequate one). The matters are REMANDED for the following action: Obtain a supplemental VA opinion from an appropriately qualified examiner who has not yet provided an opinion in this case regarding the nature and etiology of the Veteran's bladder cancer. Only if deemed necessary to provide an opinion, should the Veteran be scheduled for a new VA examination. Provide the claims file, including a copy of this REMAND, to the examiner for review. The examiner must address whether it is at least as likely as not (approximately 50 percent probability or greater) that the Veteran's bladder cancer began in service, within a year of separation from service, or is otherwise related to the Veteran's active service, to include any exposure to aviation fuels and other chemicals. The VA examiner MUST specifically address the April 2017 private opinion that "on a more probable benign basis, the patient's bladder tumors are related to his exposure to radiation fuel and chemicals," the July 2017 private opinion that the Veteran's bladder cancer was due to "exposure to aviation fuel and chemical during military career," and the February 2020 medical articles purporting to show a link between aviation fuels and the development of cancers. A complete rationale must be given for all opinions and conclusions expressed. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Ko, 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.