Citation Nr: 21068184 Decision Date: 11/09/21 Archive Date: 11/09/21 DOCKET NO. 10-34 641 DATE: November 9, 2021 REMANDED Entitlement to service connection for larynx cancer, to include due to exposure to chemical or environmental hazards, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from July 1990 to September 2000 and January 2004 to April 2005. This matter is on appeal from a July 2009 rating decision. In August 2012, the Veteran testified at a Travel Board hearing with the undersigned Veterans Law Judge of the Board. A transcript of the hearing is associated with the record. A November 2019 Board decision denied service connection for larynx cancer. The Veteran appealed the decision to the U.S. Court of Appeals for Veterans Claims (Court). In September 2020, the Court issued an order that vacated the Board's decision and remanded the matter on appeal for adjudication consistent with the Joint Motion for Remand (JMR) by the parties. Accordingly, in a July 2021 remand, the Board noted that the September 2020 JMR instructed the RO obtain an adequate medical opinion as to whether the Veteran's larynx cancer is related to exposure to chemical and environmental hazards during his Gulf War service. The Veteran contends exposure to burn pits in Afghanistan. He also contends his duties as a helicopter repairer exposed him to chemicals, to include "MEK," "P-D-680," and diesel fuel. See August 2012 Board hearing testimony. A May 2021 VA medical opinion found the Veteran's laryngeal cancer was less likely than not caused by exposure to chemical/environmental hazards during the Gulf War because laryngeal cancer is not on the presumptive list of Gulf War related conditions. However, the Board requested an opinion that addresses direct causation, to include specifically discussing the chemical and environmental hazards identified by the Veteran. Pursuant to the Board's remand, in an August 2021 addendum the May 2021 examiner opined that the claimed disability is not related to the Veteran's service. The rationale was that medical literature shows, "No association was observed between jobs that entail exposure to diesel fumes, such as automobile mechanics, and the risk of laryngeal cancer. These results show that diesel engine exhaust is unrelated to laryngeal cancer risk." However, in an October 2021 Brief the Veteran stated that the August 2021 addendum was inadequate because the examiner failed to provide an assessment regarding the Veteran's claimed exposure to "MEK" or "P-D-680. As it remains unclear whether the Veteran has laryngeal cancer that is related to his service, on remand an appropriate addendum should be obtained. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007); Stegall v. West, 11 Vet. App. 268 (1998). The matter is REMANDED for the following action: Obtain addendum by an appropriate examiner, other than the August 2021 VA examiner, regarding the nature and etiology of the Veteran's laryngeal cancer. Unless the examiner finds that a new examination is required, the Veteran need not be examined again. The claims file, including a copy of this remand, must be made available to the examiner for review who should indicate that the claims file was reviewed. The examiner should provide the following opinion(s): Is it at least as likely as not (50 percent probability or more) that the Veteran's laryngeal cancer is related to exposure to chemical or environmental hazards during Gulf War service? The examiner is asked to consider and discuss as necessary the pertinent evidence of record to include the Veteran's lay statements, including those made to medical providers and the contentions of exposure to burn pits and exposure to chemicals during his duties as a helicopter repairer, to include "MEK," "P-D-680," and diesel fuel; August 2012 Board testimony; and October 2021 Brief. The Board, by this remand, makes no determination, expressed or implied, concerning the credibility of any statements on file. The addendum should include the complete rationale for all opinions expressed. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Adams, 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.