Citation Nr: 21066237
Decision Date: 10/29/21	Archive Date: 10/29/21

DOCKET NO. 18-00 611
DATE: October 29, 2021

REMANDED

Entitlement to service connection for a skin disability, to include as due to herbicide exposure is remanded.

REASONS FOR REMAND

The Veteran served on active duty from July 1969 to April 1971.  This matter comes before the Board of Veteran's Appeals (Board) on appeal from January 2016 and January 2017 decisions.  The Veteran presented testimony before the Board in October 2021. 

The Veteran contends his skin disability is the result of exposure to herbicides during his service in the Republic of Vietnam.  He alternatively contends that as someone with fair skin and of Scandinavian descent, he was at an increased risk for skin cancer, which he developed as a result of excessive sun exposure in Vietnam, to include sustaining three or four sunburns with peeling.  The Veteran has been variously diagnosed with squamous cell carcinoma, basal cell carcinoma, and actinic keratosis

The Veteran's qualifying service in Vietnam during the Vietnam Era and consequent presumed exposure to an herbicide agent are already established from the evidence of record.  See 38 C.F.R. §§ 3.307 (a)(6); 3.309(e). The fact that presumptive service connection may not be established for a disability claimed to be caused by herbicide exposure does not preclude a claimant from establishing direct service connection based on such exposure. See Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007).  The Veteran has not been afforded a VA medical examination in connection with his claim.  On remand, a medical opinion should be obtained as to whether any current skin disability was caused by the Veteran's in-service exposure to sun and/or herbicide agents. 

The matter is REMANDED for the following action:

 1. Schedule the Veteran for a VA examination for his skin disability.  The examiner must review the claim file. The examiner must provide a response to the following: 

(a) is it at least as likely as not that the Veteran's skin disability, variously diagnosed as squamous cell carcinoma, basal cell carcinoma, and actinic keratosis, is related to conceded in-service exposure to herbicide agents?  The examiner is advised that a negative opinion cannot be based solely on the fact that the Veteran's skin disability, including cancer, is not on the list of diseases that are presumptively associated with exposure to herbicide agents.

(b) if no, is it at least as likely as not that the Veteran's skin disability, variously diagnosed as squamous cell carcinoma, basal cell carcinoma, and actinic keratosis began during active service, manifested within a year after discharge from service, or was noted during service with continuity of the same symptomatology since service? In answering this question, the examiner must address the Veteran's contentions that because he has fair skin and is of Scandinavian descent, he was at an increased risk for skin cancer, which he developed as a result of excessive sun exposure in Vietnam, to include sustaining three or four sunburns with peeling.  The examiner must provide the complete rationale for all opinions expressed. 

2.  If upon completion of the above action the claim remains denied, the matter must be returned to the Board after compliance with appellate procedures. 

 

 

 

E. I. VELEZ

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	K. L. Wallin, 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.