Citation Nr: 21013469 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 13-29 297 DATE: March 9, 2021 REMANDED Entitlement to service connection for germ cell carcinoma, previously claimed as testicular cancer, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1962 to September 1964. This matter comes before the Board of Veterans’ Appeals (Board) from a February 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). This issue was previously remanded by the Board in May 2019 and has been returned for further adjudication. Although the Board regrets additional delay, remand is necessary to properly address the Veteran’s claim. In May 2019, the Board remanded this issue for a new VA examination with instructions for the VA examiner to consider and comment on the various medical articles submitted by the Veteran regarding the carcinogenic effect of diesel fuel, and number six fuel oil hazards. In May 2020, a VA medical opinion was provided. The examiner stated that exposure to asbestos, diesel fuel, or bunker oil has not been identified as a risk factor for germ cell carcinoma. The examiner explained that, for that reason as well as the fact that there are no records regarding if the Veteran has a history of cryptorchidism or undescended testis, it is less likely than not that his germ cell tumor and his time in-service are linked. As requested by the Veteran in a February 2021 Appellate Brief, the Board finds that a new VA opinion is necessary. The May 2020 VA examiner was asked to specifically comment on the various medical articles that the Veteran submitted. The examiner did not address these articles. The Board finds that the May 2020 VA opinion does not substantially comply with the May 2019 Board remand instructions and, as such, the claim must again be remanded. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Ask the Veteran to identify all outstanding treatment records relevant to treatment for germ cell carcinoma. All identified VA records should be added to the claims file. All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records. 2. After records development is completed, the claims file should be sent to an appropriate medical professional, preferably an oncologist, to offer an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the current germ cell carcinoma had onset in service or due to an event, or injury to service, to include in-service exposure to (i) asbestos, (ii) diesel fuel, and/or (iii) number six fuel oil (bunker oil). In offering the opinion, the examiner is asked to consider the medical literature that the Veteran has submitted on the possible harms of asbestos, diesel fuel, and number six fuel oil. The need for an examination is left to the discretion of the examiner. A rationale for all opinions offered is requested as the Board is precluded from making any medical findings. C.B. Iwanowski Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Hofmeister, Attorney Advisor 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.