Citation Nr: 21012368 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 06-23 670 DATE: March 4, 2021 REMANDED Entitlement to service connection for thyroid cancer, status post thyroidectomy, to include as secondary to in-service exposure to ionizing radiation and asbestos is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1958 to February 1962. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2006 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In August 2010 the Board remanded the issue on appeal for additional development. In a June 2017 decision, the Board denied the claim and the Veteran appealed that decision to the Court of Appeals for Veterans Claims (Court). In an April 2018 Joint Motion for Remand (Joint Motion), the parties agreed that the Department of Veterans Affairs (VA) failed to consider the Veteran’s contention that his thyroid cancer was due to possible asbestos exposure during military service. In an April 2018 Order the Court granted the Joint Motion and remanded the claim for action consistent with the terms of the Joint Motion. In August 2019, consistent with the Joint Motion, the Board remanded the Veteran’s claim for further development. In February 2020, the Veteran requested a Board hearing prior to a decision being made. In November 2020, the Veteran testified at a Board video hearing. Following his Board hearing, the Veteran submitted numerous additional documents detailing potential exposure to hazardous levels of radiation during his service. In this regard, the Board notes that the September 2016 Radiation Review document used in the Veteran’s case indicated that power supply tubes for the Hawk radar system were the only ionizing radiation hazard on the Hawk system. In addition, it was determined cumulative average doses rarely exceeded 10 REM for individual radar soldiers stationed for up to 15 years on the Hawk prior to 1980. The veteran appears to contend, however, that he served prior to the technical advancements of the 1960s and 1970s, that brought the exposure levels down to the point VA used in calculating his exposure. In other words, he appears to believe that VA used data from the time period after the Veteran served, to calculate the amount of radiation to which he was exposed, and that this underestimated the amount of his exposure. His reasoning appears to be that as time passed, the amount of exposure considered safe was revised downward, and that greater protections were devised to ensure the safety of those working on this equipment. Because he served prior to these safety enhancements, his exposure was necessarily greater than for those who came after him. He appears to believe the 10 REM cumulative average dose used in the calculation of his exposure is artificially low because it contemplates all the technical advancements that occurred after he served through 1980. From a layman’s perspective, this appears to be a reasonable contention. As such, clarification of the level of the Veteran’s ionizing radiation exposure will be sought. In this regard, the Veteran’s representative discusses radiation present in the Hawk radar system, while the September 2016 radiation report estimates actual radiation exposure. On remand, the request also will seek to ascertain the levels of radiation present in the Hawk system and how that may or may not differ from the actual levels to which the Veteran may have been exposed. Lastly, the Board notes the prior examiner was asked to discuss whether the Veteran’s exposure to asbestos was at least as likely as not the cause of the Veteran’s thyroid cancer. While the examiner offered a negative opinion, all of the evidence discussed was on particular causes of thyroid cancer other than asbestos exposure. On remand, the requested opinion should address if asbestos exposure is a known cause of thyroid cancer and if so, whether the Veteran’s cancer was as likely as not due to his asbestos exposure during service. . The matters are REMANDED for the following action: 1. Attempt to ascertain from the appropriate entity as set out in 38 C.F.R. 3.311(a)(2)(iii), whether the calculations used to determine the Veteran’s ionizing radiation dose estimate included data when greater safety or other precautions were in place than when the Veteran served, which would have tended to reduce the estimate of his exposure. In communicating this request, the responding party also should be asked to discuss the levels of radiation present in the Hawk missile system at the time the Veteran served, and how that may or may not differ from the actual levels to which the Veteran may have been exposed. If in responding to this development the Veteran’s dose estimate changes, an opinion should be obtained pursuant to 38 C.F.R. 3.311(c) as to whether it is as likely as not the Veteran’s disease resulted from exposure to radiation in service. 2. Provide the claims file to an appropriate person for an addendum opinion as to whether the Veteran’s thyroid cancer is as likely as not related to in-service asbestos exposure. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. In addressing this, the reviewer should indicate whether asbestos exposure is a known cause of thyroid cancer and to reference any medical literature which discusses that question. All findings should be reported in detail and all opinions must be accompanied by a clear rationale. 3. Readjudicate the issue on appeal. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Uller, 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.