Citation Nr: 21066210 Decision Date: 10/29/21 Archive Date: 10/29/21 DOCKET NO. 16-16 502 DATE: October 29, 2021 REMANDED Entitlement to service connection for residuals of skin cancer, to include basosquamous cell carcinoma right forearm and nodular basal cell carcinoma of scalp, is remanded. REASONS FOR REMAND The Veteran had active duty in the United States Marine Corps from March 1966 to April 1968, including service in the Republic of Vietnam from September 1967 to April 1968. In March 2019, the Veteran testified during a hearing before the undersigned Veterans Law Judge; a transcript is associated with the claims file. In August 2020, the Board denied the Veteran's claim. The Veteran appealed the denial to the United States Court of Appeals for Veterans Claims (Court) and in a June 2021 Order the Court granted a June 2021 Joint Motion for Remand (JMR) that vacated an August 2020 Board decision and remanded the appeal to the Board for further development. 1. Entitlement to service connection for residuals of skin cancer, to include basosquamous cell carcinoma right forearm and nodular basal cell carcinoma of scalp The June 2021 JMR concluded that the August 2020 Board decision relied on an inadequate November 2019 VA examination report. Specifically, the JMR concluded that the November 2019 report, "failed to adequately address whether the condition was at least as likely as not related to service... [as] the examiner explained that 'a greater than 50% nexus cannot be established between claimed condition and in-service event(s),' which is a higher standard than that required to establish service connection." In addition, the November 2019 report "failed to provide a clear rationale addressing [the Veteran's] specific theory of sun exposure" and did not explain why a temporal relationship between service and the current disorder would be expected in this case. There are two shortcomings in the analysis by the parties to the JMR. First, in two places in the report, the examiner either checked a box or spelled out in capital letters: "THE CLAIMED RESIDUALS OF BASAL CELL CARCINOMA OF THE LEFT SCALP IN AUGUST 2007 LESS LIKELY THAN NOT (less than 50 percent probability) INCURRED IN OR CAUSED BY THE CLAIMED IN-SERVICE INJURY, EVENT, OR ILLNESS." The parties selectively quoted another sentence in the analysis that does not contradict his finding nor is the examiner expected to apply legal standards. The Board found that the explanation was clear. There is no requirement that a medical opinion use the precise language of a statute or regulation. Dyment v. West, 13 Vet. App. 141 (1999) (holding medical examiner's word choice is not error where opinion is unambiguous). Second, the Board addressed the issue of sun exposure, acknowledging that the examiner did not address it. Rather, the Board made a finding that there was no sun injury in service such that a medical opinion on this issue was not required. Nevertheless, the Board must comply with the instructions in the JMR. In light of the foregoing, the claim is remanded for an additional VA examination. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination for skin disability. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: Is any diagnosed skin disability, specifically to include any residuals of basosquamous cell carcinoma right forearm and nodular basal cell carcinoma of scalp, at least as likely as not incurred in or caused by service? Provide a rationale to support the opinion(s). The rationale must consider and discuss the Veteran's contention that the skin cancer was the result of in-service sun exposure during service in Vietnam. In providing the requested opinion, consider the Veteran's description of his/her in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of his/her current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? If the examiner places weight on the absence of medical attention or treatment in or after service for many years, the examiner must explain why this lack of a temporal relationship is important to any finding for or against causation by service. J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. J. Houbeck, 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.