Citation Nr: 21072559 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 17-39 985A DATE: December 3, 2021 REMANDED Entitlement to service connection for cause of death is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1969 to December 1980. The appellant is his surviving spouse. This matter is before the Board of Veterans' Appeals (Board) on appeal from a December 2015 Department of Veterans Affairs (VA) rating decision. In May 2020, a videoconference hearing was held before a Veterans Law Judge (VLJ) who is no longer with the Board; a transcript is in the Veteran's record. In August 2020 and July 2021, this matter was remanded for further development [to obtain addendum medical opinions]. In April 2021 correspondence, the appellant declined an additional Board hearing before a VLJ who would decide her appeal, and requested that the case be adjudicated on the evidence of record. [In March 2021, the appellant filed a supplemental claim for entitlement to service connection for cause of death. The agency of original jurisdiction (AOJ) did not adjudicate that claim under the appeals modernization act (AMA) framework, as entitlement to service connection for cause of death remains pending on appeal in the legacy system.] Entitlement to service connection for cause of death. The previous [July 2021] Board remand requested an addendum VA medical opinion by the provider of the February 2021 VA examination regarding the likely etiology of the Veteran's doudenal adenocarcinoma. In pertinent part, the Board instructed that the examiner must specifically address the appellant's contention that the Veteran's exposure to herbicide agents in Vietnam caused his duodenal cancer. On August 2021 VA examination, the consulting provider noted the Veteran's diagnosis of doudenal adenocarcinoma and opined that the U.S. Department of Veterans Affairs does not include doudenal adenocarcinoma and/or small bowel adenocarcinoma in their list of cancers caused by herbicide exposure and noted that environmental exposure may lead to an increased risk for small bowel doudenal carcinogenesis. The examiner did not directly address whether the Veteran's conceded herbicide exposure in Vietnam caused his doudenal adenocarcinoma. The appellant has submitted a copy of a prior Board decision that granted service connection for duodenal cancer in support of the claim. While prior Board decisions have no precedential effect on subsequent Board decisions in a similar matter, the analysis provided therein may be considered for applicability in a later case Notably, the appellant has also submitted textual evidence which should be review and considered for applicability. A remand for an addendum medical opinion is necessary. See Stegall v. West, 11 Vet. App. 268 (1998). The matter is REMANDED for the following: Arrange for the Veteran's record to be forwarded to an appropriate clinician (e.g., in oncology) for review and an addendum medical advisory opinion regarding the likely etiology of the Veteran's cancer disability. The consulting provider should review the prior Board decision allowing a service connection for duodenal cancer for any persuasiveness of the analysis provided therein in the circumstances of the instant case, as well as the textual evidence submitted by the appellant. The consulting provider should : Identify the likely etiology for the duodenal cancer underlying the Veteran's death. Specifically, is it at least as likely as not (a 50 percent or greater probability) that the disability is etiologically related to the Veteran's service (to include as due to his presumed exposure to herbicides in Vietnam, his exposures in service to trichloroethylene (TCE) and tricresyl phosphate (TCP) as a cryogenics equipment operator, and treatment in service treatment for gastrointestinal complaints in 1972, Bell's Palsy in 1975 or 1976, and treatment for Bell's Palsy after service.) [The consulting provider is advised that the record contains articles submitted by the appellant regarding TCE and TCP exposure on July 24, 2015, December 2, 2016, August 18, 2020, and March 16, 2021.] The consulting provider is advised that an opinion that in explaining rationale merely indicates that the Veteran's death-causing duodenal cancer is not listed in 38 C.F.R. §3.309(e) as a disease presumed to be related to exposure to herbicide agents would be considered inadequate. All opinions must include a complete explanation of rationale, with citation to supporting factual data and medical principles, as deemed appropriate. GEORGE R. SENYK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Lederman, Michael 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.