Citation Nr: 21010463 Decision Date: 02/24/21 Archive Date: 02/24/21 DOCKET NO. 10-34 641 DATE: February 24, 2021 REMANDED Entitlement to service connection for larynx cancer, to include as due to chemical exposure/environmental hazards, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1990 to September 2000 and from January 2004 to April 2005. The Veteran testified at a Board hearing in August 2012; a transcript of the hearing has been associated with the record. In June 2014, June 2016, June 2017 and November 2019, the Board remanded the matter for additional development. In November 2019, the Board denied the Veteran’s claim for service connection for larynx cancer, to include as due to chemical exposure/environmental hazards. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (CAVC). In a September 2020 Order, the CAVC granted a Joint Motion for Remand (JMR), which vacated and remanded the November 2019 Board decision. The case has been returned to the Board for further adjudication.   Entitlement to service connection for larynx cancer, to include as due to chemical exposure/environmental hazards, is remanded. In accordance with the Board’s June 2017 remand, the Veteran was afforded a VA examination in August 2019. The examiner opined that the Veteran’s larynx cancer is not related to service because during service, the Veteran had no complaints of a laryngeal condition. The examiner also noted that the Veteran was a known smoker for years prior to his diagnosis of laryngeal cancer in 2008. However, the August 2019 examiner did not address the Veteran’s in-service exposure to chemicals and environmental hazards as a potential cause of his larynx cancer. As such, the parties to the Joint Motion agree that this portion of the August 2019 examiner’s opinion is inadequate for evaluation purposes. The examiner, in a separate report, also opined that the larynx cancer was less likely than not incurred in or caused by service, including exposure to chemicals/environmental hazards during the Gulf War because there was no evidence in the medical records of the claimed laryngeal cancer or problems due to exposure to chemicals. The Board finds this opinion confusing. In this regard, the fact that there is no evidence in the service treatment records of “problems” due to chemical exposure does not explain why the Veteran’s larynx cancer is not related to chemical exposure in service. Service connection is possible for disabilities first identified after service, and the lack of evidence of a disorder in the service treatment records is not fatal to a claim for service connection. 38 C.F.R. § 3.303 (d) (2019). Accordingly, the Board finds that this portion of the August 2019 VA opinion is also inadequate for evaluation purposes. Therefore, the Board finds that a remand for a new examination and medical opinion as to the etiology of the Veteran's larynx cancer is necessary. 38 C.F.R. § 4.2 (2019). Barr v. Nicholson, 21 Vet. App. 303 (2007). The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all outstanding records of VA and private treatment for the Veteran’s claimed larynx cancer. Ensure the Veteran is provided the necessary authorization and release forms (VA Form 214142) to allow VA to obtain all confidential private treatment records. Specifically, seek to procure all outstanding private treatment records, including those from the offices of Dr. Malone, and the Ear, Nose, and Throat specialist mentioned at the August 2012 Travel Board hearing. When requesting records not in the custody of a Federal department or agency, such as private treatment records, the appropriate authority must make an initial request for the records and at least one follow-up request if the records are not received or a response that records do not exist if not received. All attempts to secure this evidence should be documented in the claims file. If, after making reasonable efforts, such records cannot be obtained, notify the Veteran and (a) identify the specific records which cannot be obtained; (b) briefly explain the efforts made to obtain those records; (c) describe any further action to be taken with respect to the claim; and (d) that he is ultimately responsible for providing the evidence. The Veteran and his representative should then be given an opportunity to respond 2. After the above development is completed, the AOJ should schedule the Veteran for an examination to determine the etiology of his larynx cancer. The Veteran's record should be provided to the examiner for review in conjunction with the examination. After examination and review of the record, the examiner should opine as to whether it is at least as likely as not that the Veteran's larynx cancer had its onset during active service. If not, the examiner should also provide an opinion, with supporting explanation, as to whether the larynx cancer is causally related to active service or any incident therein, including any exposure to chemicals/environmental hazards during the Gulf War. 3. After completing the above actions, and any other development as may be indicated, the AOJ should readjudicate the claim. If the claim remains denied, a supplemental statement of the case must be provided to the Veteran and his representative. After the Veteran and his representative have had an adequate opportunity to respond, the appeal must be returned to the Board for appellate review. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Fatima Yankey 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.