Citation Nr: 21006937 Decision Date: 02/08/21 Archive Date: 02/08/21 DOCKET NO. 17-00 061 DATE: February 8, 2021 REMANDED Entitlement to service connection for a gastrointestinal disability, to include residuals of colorectal cancer, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from October 1966 to October 1968, including service in Vietnam. His decorations include a Combat Infantryman Badge, Vietnam Service Medal with three Bronze Service Stars, and a Republic of Vietnam Gallantry Cross with Palm. The Board remanded the issue in August 2019 for further development. 1. Entitlement to service connection for a gastrointestinal disability is remanded. The Veteran asserts that he was diagnosed with colorectal cancer and 12 inches of his colon was removed in 2001 due to the cancer. He contends that the cancer was due to his exposure to Agent Orange in Vietnam. See the January 2014 statement, May 2015 notice of disagreement, August 2018 statement. In August 2019, the Board remanded the issue to obtain outstanding private treatment records and afford the Veteran a VA examination. Subsequently, in November 2019, private treatment records dated from 2015 to 2019 were associated with the claims file and the Veteran had a VA intestinal surgery examination in January 2020. The VA examiner concluded that the Veteran’s claimed gastrointestinal condition, diagnosed as a bowel resection, was less likely than not incurred in or caused by military service, to include exposure to Agent Orange, because there was no evidence that the claimed condition manifested during service and it is not recognized as a presumptive disability due to Agent Orange exposure. The examiner indicated that of significant note, he was unable to locate any treatment records from the time of the Veteran’s claimed cancer diagnosis or colectomy in 2001; rather, the earliest dated treatment record associated with the claim file was a colonoscopy report from 2010. As such, it could not be definitively stated that cancer was the reason for the colectomy. The Board finds that VA examiner’s opinion is not a sufficient basis on which to determine whether any gastrointestinal disability is related to the Veteran’s active service, as the examiner did not have the opportunity to review the cancer diagnosis or colectomy treatment records and it is unclear whether review of such records would change the opinion. Moreover, although the examiner acknowledged the Veteran’s complaints of intermittent abdominal pain over the decades following his separation from service, the opinion was nevertheless based, in essence, on the fact that colorectal cancer is not eligible for presumptive service connection. See 38 C.F.R. § 3.309(e). Accordingly, remand is necessary to obtain treatment records containing the Veteran’s cancer diagnosis and colectomy procedure. Thereafter, a medical opinion addendum should be obtained. 38 U.S.C. § 5103A(d). The matter is REMANDED for the following action: 1. Contact the Veteran and request that he provide sufficient information, and if necessary, authorization to enable the AOJ to obtain any relevant outstanding non-VA treatment records, to include treatment records from the colorectal diagnosis and subsequent colectomy in 2001. The AOJ should make an attempt to obtain any treatment records identified by the Veteran that are not currently associated with the claims file. 2. After the above development is complete, obtain a medical opinion on the current nature and likely etiology of any diagnosed gastrointestinal disability, to include colorectal cancer and/or bowel resection. Following a review of the entire record, the examiner should opine on whether it is at least as likely as not (a 50 percent or greater probability) that any diagnosed gastrointestinal disability is related to the Veteran’s active service. A thorough rationale should be provided for all opinions expressed. If any requested medical opinion cannot be given, the examiner should state the reason(s) why. The examiner should note that it is inadequate to conclude that a diagnosis is not related to service simply because it is not on VA’s list of presumptive diseases associated with exposure to herbicides. (Continued on the next page)   If the examiner determines that further examination is necessary in order to render the requested medical opinion, the Veteran should be scheduled for such an examination. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Nelson 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.