Citation Nr: A21016536 Decision Date: 10/08/21 Archive Date: 10/08/21 DOCKET NO. 201009-120908 DATE: October 8, 2021 ORDER Service connection for squamous cell carcinoma is granted. FINDING OF FACT The Veteran's squamous cell carcinoma are a progression of his service-connected actinic keratosis. CONCLUSION OF LAW The criteria for service connection for squamous cell carcinoma are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1966 to January 1970. This matter comes before the Board of Veterans' Appeals (Board) on an appeal from a December 2019 rating decision by a Department of Veterans Affairs (VA) Regional Office, which is the Agency of Original Jurisdiction (AOJ). The Veteran elected the Board's evidence submission docket. September 2020 VA Form 10182. This restricts the Board's review to the evidence of record at the time of the December 2019 rating decision and evidence submitted with, or within 90 days of filing of, the Notice of Disagreement initiating appellate review. 38 C.F.R. § 20.303. Entitlement to service connection for squamous cell carcinoma. The Veteran contends his service-connected actinic keratosis caused his squamous cell carcinoma, and thus should be service connected. Upon review of the record, the Board agrees, and finds service connection for squamous cell carcinomas as secondary to and a progression of actinic keratosis is warranted. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Service connection may also be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). Turning to the evidence of record, the Board first notes that the Veteran has a current diagnosis of squamous cell carcinomas, as acknowledged in the December 2019 rating decision's finding of fact. See also January 2012 Lackawanna Valley Dermatology Records (noting squamous cell carcinoma on left temple); and see June 2017 Lackawanna Valley Dermatology Records (noting squamous cell carcinoma removal from left ear). Thus, as the Veteran argues that such is due to his service-connected actinic keratosis, the evidence must show that that actinic keratosis caused or aggravated the squamous cell carcinomas in order for service connection to be granted. In this regard, the medical treatment evidence of record reflects that the squamous cell carcinomas have progressed from actinic keratosis. Specifically, the first squamous cell carcinoma in December 2011 was noted as "arising within actinic keratosis." December 2011 Lackawanna Valley Dermatology Records. Later, in a November 2017 VA examination, the examiner noted in the diagnosis section that "some of the actinic keratosis has turned into squamous and basal cell carcinoma." In October 2020, the Veteran submitted a July 2020 private medical opinion from his treating dermatologist. In that correspondence, the dermatologist notes that he treated squamous cell carcinoma on the Veteran's left temple in 2012 and left ear in 2017. Continuing, he noted the Veteran has had numerous actinic keratoses which are the precursors of squamous cell carcinoma. Then, the dermatologist opined that the squamous cell carcinomas are also due to sun exposure in service, as the sun damage from service was the main cause of actinic keratosis, which in turn is the precursor for squamous cell carcinoma. Based on the above opinion, and the other foregoing evidence, the Board finds that squamous cell carcinoma was a progression of the service-connected actinic keratosis, and thus was secondary to the actinic keratosis. Consequently, service connection for squamous cell carcinoma is warranted. In reaching this decision, the Board finds the July 2020 private opinion highly probative as it considered all of the pertinent evidence of record, to include the Veteran's statements, and provided a complete rationale, relying on and citing to the records reviewed. Moreover, the examiner offered clear conclusions with supporting data as well as reasoned medical explanations connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion...must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). Further, the other evidence of record uniformly supports the opinion, with it noted in multiple records of different origin that the actinic keratosis turned into the squamous cell carcinoma. Accordingly, and resolving all reasonable doubt in his favor, the Board finds the criteria for service connection for squamous cell carcinoma as secondary to service-connected actinic keratosis. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Therefore, service connection for squamous cell carcinomas is granted. M. Mills Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jonathan M. Estes 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.