Citation Nr: 21067857 Decision Date: 11/05/21 Archive Date: 11/05/21 DOCKET NO. 17-23 886 DATE: November 5, 2021 REMANDED Service connection for chronic lymphocytic leukemia (hereinafter CLL), to include as due to alleged asbestos exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1967 to September 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). The Board issued a decision on this matter in June 2020, denying the claim. The Veteran appealed the decision to the U.S. Court of Appeals for Veterans Claims (Court). Pursuant to a joint motion for remand (JMR) granted by the Court in June 2021, the June 2020 decision was vacated, and the matter was remanded to obtain an adequate VA examination and for the Board to provide an adequate statement of reasons and bases. Pursuant to the JMR, the Board finds that remand is necessary. The Board finds the March 2017 VA opinion inadequate, as the examiner did not include medical analysis addressing why the Veteran's CLL was less likely than not caused by asbestos exposure and did not explain how his colleague, Dr. M.C., determined that there was no credible evidence that asbestos exposure causes CLL. Rather, the examiner merely stated that he reviewed the relevant expert literature and discussed the issue with Dr. M.C., and then referenced Dr. M.C.'s conclusion with no discussion of the evidence or how this conclusion was reached. Because the examiner did not provide a reasoned medical explanation explaining his and Dr. M.C.'s conclusion, the March 2017 opinion lacks adequate rationale, and the Board may not rely on it. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008) (noting that an examiner must provide "not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two"); see also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (holding that "a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision as to what weight to assign to the doctor's opinion"). On remand, the VA examiner must opine, with clear conclusions, supporting data, and a reasoned medical explanation, whether the Veteran's CLL is related to an in-service event, injury, or disease, to include alleged asbestos exposure. In making this opinion, the examiner must ensure he or she addresses specific circumstances relating to the Veteran's condition and discusses the leukemia article submitted by the Veteran in June 2014. See Bailey v. O'Rourke, 30 Vet. App. 54, 60 (2018) (stating that a medical rationale based solely on general medical literature without discussing the specific facts pertaining to a veteran's condition or individual circumstances is inadequate). The matter is REMANDED for the following action: Forward the claims file to an appropriate examiner, preferably a hematologist or oncologist, to obtain an opinion that complies with the following directives. The examiner should review the claims file, specifically including this remand as to why the prior opinion was inadequate, and articles submitted by the Veteran, and respond to the following: Is it at least as likely as not (50 percent or greater probability) that the Veteran's CLL is caused by an in-service event, injury, or disease, to include alleged asbestos exposure? All opinions must be accompanied by a rationale consistent with the evidence of record that explicitly considers the Veteran's specific circumstances and the June 2014 article submitted by the Veteran. A discussion of the pertinent evidence, relevant medical treatises, and generally accepted medical principles is required. MICHELLE L. KANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Tierno 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.