Citation Nr: A21019303 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 211122-200309 DATE: December 3, 2021 ORDER Entitlement to service connection for left neck squamous cell carcinoma secondary to presumed herbicide agent exposure is granted. FINDING OF FACTS 1. The Veteran is presumed to have been exposed to herbicide agents while serving in the Republic of Vietnam. 2. Left neck squamous cell carcinoma has been shown to have originated as the result of the Veteran's presumed herbicide agent exposure. CONCLUSION OF LAW The criteria for service connection for left neck squamous cell carcinoma associated with herbicide agent exposure have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from January 1966 to January 1969. He was awarded the Combat Infantryman Badge, the Purple Heart Medal, and the Air Medal. Service Connection for Left Neck Squamous Cell Carcinoma Service connection may be granted for recurrent disability arising from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110. Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). The Veteran is presumed to have been exposed to herbicide agents while serving in the Republic of Vietnam. Clinical documentation from North Fulton Regional Hospital dated in June 2001 states that the Veteran was diagnosed with left neck squamous cell carcinoma and underwent a left radical neck dissection, excision of the tumor, and radiation treatment. An April 2020 evaluation from T. Seiter, Jr., M.D., states that he had reviewed all relevant records including the claims file. The Veteran was diagnosed with squamous cell carcinoma of the left neck as "the soft tissues of the left side of this veteran's neck were involved in the cancer and surgically resected." Dr. Seiter concluded that, "in summary, after my own review of the record and the medical literature, and after personally conducting a medical history, it is my professional medical opinion that it is at least as likely as not that this veteran's squamous cell carcinoma of the neck is directly service connected due to herbicide exposure, by either a general or specific carcinogenic effect. The report of a January 2021 examination conducted for the Department of Veterans Affairs conveys that the Veteran was diagnosed with "throat cancer" in 2001. The Veteran was noted to have been "initially diagnosed with head and neck cancer in 2001 with nodules on the outside of the neck treated with surgery and radiation at North Fulton Hospital and Emory St Joes Hospital;" "in November 2020, he was seen for a dilation procedure and a new tumor was found endoscopically in the lower esophagus;" and "he has chemo weekly and daily proton therapy radiation x 27 last dose on 1/25." The examiner concluded that "the claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed inservice injury, event, or illness." The doctor commented that: "there is no record of pharyngeal mass, neoplasia or malignancy during active duty treatment records;" "the veteran has a history of service in Vietnam associated with Agent Orange exposure but that has not been associated with malignancy of the neck or esophagus;" and "as such, no nexus is established." (Continued on the next page) In a November 2021 the Veteran's attorney asserts that "we request a final decision from the Board on the merits of this case with specific attention to the sufficiency of the April 2020 private examiner opinion from retired Army doctor, Dr. T. Seiter, which supports this case." The evidence of record is in relative equipoise as to whether the diagnosed left neck squamous cell carcinoma originated secondary to the Veteran's presumed herbicide agent exposure in the Republic of Vietnam. Resolving all reasonable doubt in favor of the Veteran, the Board of Veterans' Appeals (Board) finds that the diagnosed left neck squamous cell carcinoma originated during active service. Therefore, the Board concludes that service connection for left neck squamous cell carcinoma secondary to presumed herbicide agent exposure is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Macek, M. A. 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.