Citation Nr: 21008981 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 19-17 903 DATE: February 18, 2021 REMANDED Entitlement to service connection for glioblastoma multiforme, to include as due to environmental exposures during service in Southwest Asia is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from February 1984 to October 2004. This appeal comes before the Board of Veterans’ Appeals (Board) from a December 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for glioblastoma multiforme, to include as due to environmental exposures during service in Southwest Asia is remanded. The Veteran contends his glioblastoma multiforme is due to his service in Southwest Asia, to include exposure to oil fires while in the Northern Arabian Sea and Persian Gulf. See October 2018 VA Form 21-4138. After a review of the record, the Board finds further development is required before it may reach a decision on this claim. The Veteran underwent a VA examination by a neurologist in November 2018. The VA examiner noted the Veteran had a current diagnosis of glioblastoma multiforme. The VA examiner further stated that a glioblastoma multiforme is a clear disease-malignant brain tumor with poor long-term survival. For most of the cases, the etiology is not clear. The examiner concluded that there is insufficient evidence to support that the Veteran’s glioblastoma multiforme is secondary to his Gulf War service. The Veteran also underwent a Gulf War General VA examination in November 2018. The VA examiner indicated the Veteran had a current diagnosis with a clear and specific etiology and diagnosis. He opined it was less likely than not that the disability pattern or diagnosed disease is related to a specific exposure event experienced by the Veteran during his service in Southwest Asia. The Board finds the two VA examinations of records are inadequate for adjudicatory purposes. Neither VA examiners provided any rationale or sufficient explanation for their conclusion that it was less likely than not that the Veteran’s glioblastoma multiforme was due to his service. Barr v. Nicholson, 21 Vet. App. 303, 310-11 (2007); 38 U.S.C. § 5103A(d)(1). As the record does not contain an adequate examination, one must be obtained upon remand. Additionally, further development is needed to ascertain that the Veteran had qualifying service in Southwest Asia in accordance with 38 C.F.R. § 3.317(e). Therefore, a remand for further development is required. The matters are REMANDED for the following action: 1. Conduct any necessary development to ascertain that the Veteran had qualifying service in Southwest Asia in accordance with 38 C.F.R. § 3.317(e). 2. Once the first directive is completed, schedule the Veteran for an examination (or a telehealth interview, a review of the record, or other appropriate substitute for an in-person examination, if deemed sufficient in the event that an in-person examination is not feasible) to determine the nature and etiology of his glioblastoma multiforme. The examiner must review the entire claims file, including a copy of this remand. The examiner is asked to provide responses to the following: A) Is the etiology of the Veteran’s glioblastoma multiforme (1) inconclusive, (2) partially understood, or (3) fully understood? This determination must be based on the Veteran’s specific case and cannot be based on the etiology of the disease or disability population as a whole. B) Is the pathophysiology of the Veteran’s glioblastoma multiforme (1) inconclusive, (2) partially understood, or (3) fully understood? This determination must be based on the Veteran’s specific case and cannot be based on the pathophysiology of the disease or disability population as a whole. C) If both the etiology and pathophysiology are partially understood or fully understood, then is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s glioblastoma multiforme was incurred in, or is otherwise related to, his active service? A complete rationale must be provided for all opinions expressed. The examiner’s attention is invited to the lay statement by the Veteran that his service, to include exposure to oil fires while in the Northern Arabian Sea and Persian Gulf caused his glioblastoma multiforme. See October 2018 VA Form 21-4138. M. Mills Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Holcombe, Associate 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.