Citation Nr: 21006535 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 19-10 754 DATE: February 4, 2021 ORDER Entitlement to service connection for bladder cancer, as due to herbicide agent exposure, is granted. REMANDED Entitlement to service connection for a right lower extremity neurological disability (claimed as peripheral neuropathy,) to include as due to herbicide agent exposure, is remanded. FINDING OF FACT The Veteran’s bladder cancer is presumptively related to his in-service herbicide agent exposure. CONCLUSION OF LAW The criteria for entitlement to service connection for bladder cancer are met. 38 U.S.C. §§ 1110, 1112, 1113, 1116(a)(2), 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(e). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1966 to May 1969, with service in the Republic of Vietnam and additional service in the Army Reserve. These issues were previously before the Board in August 2020, at which time they were remanded for further development Entitlement to service connection for bladder cancer, as due to herbicide agent exposure. The Veteran contends that he developed bladder cancer as a result of his active duty service. The Veteran had active service in the Republic of Vietnam, and exposure to herbicide agents is conceded. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may also be granted on a presumptive basis for certain diseases associated with exposure to certain herbicide agents even though there is no record of such disease during service, if they manifest to a compensable degree after service, in a veteran who had active military, naval, or air service for at least 90 days, during the period beginning on January 9, 1962 and ending on May 7, 1975, in the Republic of Vietnam. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307, 3.309(e), 3.313. Of note, the disease of bladder cancer was recently added to the list of diseases subject to presumptive service connection, via the National Defense Authorization Act for Fiscal Year 2021, effective January 1, 2021. See Pub.L. 116-283; 38 U.S.C. § 1116(a)(2) (January 1, 2021). There is no dispute that the Veteran had a diagnosis of bladder cancer during the pendency of the claim. See October 2015 Dr. S.W. Operation Report; September 2017 Prostate Cancer Disability Benefits Questionnaire; September 2020 VA Examination. VA has also already established that the Veteran served in Vietnam, and is presumed to have been exposed to herbicide agents. As noted above, the disease of cancer of the bladder was recently added to the list of diseases subject to presumptive service connection under 38 U.S.C. § 1116(a)(2) (January 1, 2021). Moreover, in the present case, the Board finds that the Veteran’s bladder cancer became manifest to a compensable degree under 38 C.F.R. § 4.115A, as he has associated voiding dysfunction. See September 2020 VA Examination. As such, the Board finds that service connection for bladder cancer may be presumed. The benefit sought on appeal is granted. REASONS FOR REMAND Entitlement to service connection for right lower extremity neurological disability (claimed as peripheral neuropathy), to include as due to herbicide agent exposure. The Veteran asserts that he has right lower extremity peripheral neuropathy due to exposure to herbicide agents while serving in the Republic of Vietnam. In its August 2020 decision, the Board directed the agency of original jurisdiction (AOJ) to obtain an opinion addressing the etiology of the Veteran’s right lower extremity neurological disability. The clinician was asked to opine whether it was at least as likely as not that the Veteran’s right lower extremity neurological disability was related to his period of active duty service, to specifically include in-service herbicide exposure. In a September 2020 VA medical opinion, the examiner opined that it was less likely than not that the Veteran’s peripheral neuropathy was incurred in or was caused by his period of active duty. She stated that EMG results dated June 1993 stated that the Veteran’s right lower extremity neuropathy was due to right L5 radiculopathy from a lumbar spine condition; and therefore, there was no medical nexus to herbicide exposure. While the examiner concluded that the Veteran’s right lower extremity peripheral neuropathy was not due to his in-service herbicide agent exposure, she failed to address the Veteran’s November 1967 in-service reports of pain radiating down the lateral aspects of both legs, and whether this in-service report had any relation to the Veteran’s current right lower extremity neurological disability. Once VA undertakes to provide an opinion/examination, it must provide an adequate one. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Therefore, remand is warranted so that an additional opinion may be obtained addressing the etiology of the Veteran’s right lower extremity neurological disability. The matters are REMANDED for the following action: 1. Obtain a medical opinion addressing the etiology of the Veteran’s right lower extremity neurological disability (claimed as peripheral neuropathy). The claims folder must be made available to and reviewed by the examiner. Upon review of the file, the reviewing clinician is asked to respond to the following: (a.) Identify all right lower extremity neurological disabilities. (b.) For each identified disability, is it at least as likely as not (i.e. 50 percent or greater probability) that the disability had onset in, or is otherwise related to the Veteran’s period of active duty service, to specifically include in-service treatment for radiating leg pain in 1967, and/or herbicide exposure? All opinions should be supported by a medical explanation or rationale. If the reviewing clinician cannot provide an opinion without an in-person or virtual examination or interview, such should be scheduled. 2. After the above development has been completed, readjudicate the issue on appeal. V. Chiappetta Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Bristow Williams, 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.