Citation Nr: 21008449 Decision Date: 02/17/21 Archive Date: 02/17/21 DOCKET NO. 16-01 130 DATE: February 17, 2021 REMANDED Entitlement to service connection for any stomach condition, to include renal cell carcinoma, to include as due to herbicide agent (Agent Orange) exposure, for accrual purposes, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from May 1969 to May 1972 with service in Vietnam. By way of background, the Veteran filed a claim for service connection for a stomach condition, a skin condition, and a bladder condition due to his Agent Orange exposure in June 2011, clarified in August 2011. An April 2013 rating decision denied all three claims for lack of nexus and/or lack of diagnosis. Unfortunately, in June 2013, the Veteran died. Subsequently, the Veteran’s spouse filed a timely Notice of Disagreement on all the issues and requested substitution of claimant. The Appellant’s request for substitution was granted in October 2016. A Statement of the Case was issued in October 2015, and the Appellant timely appealed with a VA Form 9 in December 2015, and selected to appeal only service connection for a stomach condition, asserting that the Veteran’s stomach and abdominal pain was ultimately diagnosed as renal cell carcinoma, which was the Veteran’s cause of death. The Appellant noted that although renal cell carcinoma is not a disease for which presumptive service connection may be granted, service connection may be warranted on a direct basis. To date, VA has not provided a medical opinion regarding any of the Appellant’s theories of entitlement. The Board finds that a medical opinion is necessary for the proper adjudication of this appeal. The matters are REMANDED for the following action: 1. Obtain an opinion from an appropriate examiner to offer an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s renal cell carcinoma was related to an in-service injury, event, or disease, to include his conceded exposure to herbicide agents (Agent Orange). The examiner is advised that a negative opinion cannot be based solely on the fact that the renal cell carcinoma is not on the list of diseases that are presumptively associated with exposure to herbicide agents. The examiner is asked to opine whether it is at least as likely as not that the Veteran’s renal cell carcinoma began as calculi of the kidney or bladder, a chronic disease under 38 C.F.R. § 3.303(b) and 3.309(a), (1) during active service, or (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service? In offering the opinion, the examiner is asked to consider the Veteran’s October 2011 statement that he was hospitalized in Columbia Hospital in November 1972 and has had bladder issues ever since his time in service. The Board observes that no patient records were found by Lancaster Hospital, formerly Columbia Hospital, for the Veteran for that period of time. Nonetheless, the Board finds that the Veteran’s statements are credible and must be addressed in any opinion offered. Finally, the examiner is asked to opine whether it is at least as likely as not that the Veteran’s metastasized renal carcinoma included a diagnosis of bladder cancer, now a presumptive disease under 3.309(e) for exposure to herbicide agents. In so opining, the examiner is asked to address the hospice notes of intermittent hematuria and bladder incontinence. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. 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.