Citation Nr: 21012172 Decision Date: 03/03/21 Archive Date: 03/03/21 DOCKET NO. 16-03 126 DATE: March 3, 2021 REMANDED Entitlement to service connection for esophageal cancer, to include as due to contaminated water at Camp Lejeune and/or to herbicide agent exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1969 to November 1971. He had documented service in both Camp Lejeune and the Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Louisville, Kentucky. As an initial matter, the Board offered the Veteran’s representative an opportunity to submit an Informal Hearing Presentation (IHP) but no response was received. See November 2020 BVA Letter. Accordingly, the Board is proceeding with the issuance of this remand. The Board finds no prejudice to the Veteran as he and his representative will be given an opportunity to submit additional argument prior to the Board’s review. In this case, the Board notes that both a private and VA opinion are of record that address the contaminated water at Camp Lejeune theory of entitlement. However, the Veteran has in fact asserted a second theory of entitlement in the form of asserting that his esophageal cancer originated from his documented exposure to herbicide agents while stationed in Vietnam. See e.g. February 2013 Correspondence. The Board notes that in April of 2013, a VA treatment provider recorded, “recommend[ing] that the veteran file a claim for esophageal cancer; however, no present link between this condition and Agent Orange exposure has been made.” The Board cannot make a fully-informed decision on the issue of the Veteran’s claimed esophageal cancer because no VA examiner has opined whether his documented in-service exposure to herbicide agents caused his esophageal cancer. Therefore, a remand for an addendum opinion is necessary. The matter is REMANDED for the following actions: 1. Obtain a medical opinion from an appropriate medical professional that addresses the nature and etiology of the Veteran’s esophageal cancer. The medical professional must be provided with and review the entire claims file, to include a copy of this remand AND the outstanding service records and it should be confirmed that such records were reviewed. Following a review of the evidence of record, to include the Veteran’s lay statements (the credibility of which is not yet determined), the medical professional should opine: Whether it is at least as likely as not (50 percent probability or higher) that the Veteran’s esophageal cancer condition began during or is etiologically related to his active duty service. In so opining, the medical professional is asked to reconcile, to the extent possible, the Veteran’s assertion that this condition was caused by his herbicide agent exposure while stationed in Vietnam. The clinician must provide a complete rationale for all opinions rendered, to include, as relevant, specific reasons in support of the opinion, why any statistical or medical studies are found to be persuasive or unpersuasive, whether there are other risk factors that might be the cause of the Veteran’s esophageal cancer, and whether the Veteran’s esophageal cancer has manifested itself in an unusual manner. The clinician may not base any opinion on the fact that esophageal cancer is not on the list of presumptive diseases associated with herbicide agent exposure. If the clinician is unable to provide this opinion without resorting to speculation, he or she must indicate why this is so. 2. Thereafter, readjudicate the claim. If the benefits sought on appeal remain denied, issue a supplemental statement of the case to the Veteran and his representative. Then return the appeal to the Board for further appellate review. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Smith, 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.