Citation Nr: 21067196 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 18-02 872 DATE: November 3, 2021 REMANDED Entitlement to service connection for bladder cancer as cause of death, as due to herbicide agent exposure is remanded. REASONS FOR REMAND The Veteran had active service from March 1968 to March 1970 with service in the Republic of Vietnam. The Veteran is deceased, and the appellant is his surviving spouse. This matter comes before the Board of Veterans' Appeals (Board) from rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO) in July 2016. The appellant testified at a hearing before the undersigned in May 2020. Entitlement to service connection for bladder cancer, as due to herbicide exposure is remanded. The Veteran had service in Vietnam during the period between January 9, 1962 and May 7, 1975 and exposure to certain herbicide agents (Agent Orange) is presumed. 38 C.F.R. § 3.307(a)(6). The Veteran was diagnosed with bladder cancer (CA) prior to his death and his death certificate lists metastatic urothelial cell carcinoma as a contributing condition. See November 2015 Death Certificate. The appellant submitted argument and evidence regarding a relationship between bladder CA and herbicide agent exposure. See May 2016 Article; see also February 2020 Correspondence. Specifically, the appellant has submitted an internet article indicating a relationship between bladder CA and herbicide agents and congressional correspondence regarding the current determination of "limited or suggestive" evidence of a relationship between bladder CA and herbicide agents from the National Academy of Medicine in a March 2016 update. The RO did not obtain an opinion with respect to the issue of entitlement to service connection for the cause of the Veteran's death; however, in order to comply with its duty to assist, VA must obtain a medical opinion when such opinion is "necessary to substantiate the claimant's claim for a benefit." DeLaRosa v. Peake, 515 F.3d 1319, 1322 (Fed. Cir. 2008). As such, a remand is required to obtain an opinion to address the contention of relationship between bladder CA and exposure to herbicide agents. The matter is REMANDED for the following action: Obtain an opinion from a qualified examiner regarding the Veteran's metastatic urothelial cell carcinoma. A complete copy of the claims file must be provided to the examiner, including a copy of this remand. The examiner must review the entire claims folder. The examiner must also review the March 2016 NAS Agent Orange Update previously referenced regarding "limited or suggestive" evidence of a relationship between bladder CA and herbicide agents. After a thorough review of the medical and lay evidence of record, the examiner should opine as to the following: Is it at least as likely as not (i.e., a probability of 50 percent or more) that the Veteran's bladder cancer resulted from active military service, to include as due to exposure to herbicide agents? The examiner may not state that it is less likely as not that the Veteran's bladder cancer is related to active service because it is not a presumptive condition of exposure to herbicide agents. The examination report should specifically state that a review of the record was conducted. The examiner should provide a complete rationale for all opinions provided. If an opinion cannot be provided without to resorting to mere speculation, the examiner should identify all medical and lay evidence considered in this conclusion, fully explain why this is the case and identify what additional evidence (if any) would allow for a more definitive opinion. J. B. FREEMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Trickey 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.