Citation Nr: 21013804 Decision Date: 03/10/21 Archive Date: 03/10/21 DOCKET NO. 17-03 426 DATE: March 10, 2021 REMANDED Entitlement to service connection for skin cancer is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from July 1964 to July 1968. He had subsequent service in the Navy Reserve until December 1987. This matter comes before the Board of Veteran’s Appeals (Board) on appeal from a November 2016 rating decision by the Regional Office (RO). In December 2018, the Board remanded the claim for further development. This matter is now returned to the Board for further appellate review. Entitlement to service connection for skin cancer The Veteran claims that he has skin cancer due to his active service. As an initial matter, the Board acknowledges the Veteran’s assertion that he had temporary duty in the Republic of Vietnam to repair an aircraft, and that herbicide exposure should be presumed. See 38 C.F.R. § 3.307(a)(6) (2019). The Board acknowledges records recently submitted by the Veteran in support of this assertion. However, even if herbicide exposure could be presumed in this case, basal cell carcinoma and squamous cell carcinoma are not among those diseases listed in 38 C.F.R. § 3.309(e) for which service connection may be presumed based on herbicide exposure. The Veteran may nonetheless prove actual causation due to herbicide exposure, although here, there is no medical evidence tending to indicate any etiological link between his claimed skin cancer and herbicide exposure. The Veteran served on active duty in the U.S. Navy from July 1964 to July 1968. His service treatment records from his active duty service show no treatment for skin trouble or skin cancer. The Veteran had subsequent service in the Naval Reserve from August 1977 to August 1979, and from December 1982 to December 1987. See Personnel records, received September 2015 at p.18, 33, 54, 59-61, 77, 109 of 137. During his last year of Reserve service, a June 1987 report of medical history shows the physician noted the Veteran had been diagnosed with basal cell carcinoma on his nose. See Service treatment records, received September 2015 at p.13; see also CAPRI, received April 2016 at p.104 (May 2000 noting a history of basal cell carcinoma). The Board takes notice that the Veteran’s private dermatology records from University Dermatology indicate that his skin cancer was caused by sun damage or photodamage. A dermatologist cited the Veteran’s duties in Cuba and aboard the aircraft carrier as sources of sun exposure. See Records, received June 2015 at p.22; see also p.11, 13, 18, 25. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated during active service. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. §§ 3.303, 3.304 (2019). This includes injuries or diseases incurred during active duty for training (ADT), or injuries suffered during inactive duty training (IDT). See 38 U.S.C. §§ 101(24), 106 (2012). Recently, the Board remanded the claim for a VA medical opinion to address whether the Veteran’s skin cancer was caused by his active service or subsequent Reserve service, including whether it was caused by sun exposure. A September 2019 VA examination was performed, and a June 2020 addendum opinion were provided. The examiner opined, taken together, that the Veteran’s skin cancer was not caused by his active duty service from 1964 to 1968, but it is at least as likely as not that his skin cancer was incurred during his Reserve service. The examiner reasoned it part that the Veteran “has clear documentation of basal cell carcinoma during Navy Reserve service on June 13, 1987,” and intense intermittent sun exposure is the most important risk factor for basal cell carcinoma. The examiner also noted in the report that the Veteran’s duties in the Naval Reserve involved working on P3 Orion aircraft, whereas his civilian occupation was as a facilities engineer involving mostly inside work. Although this indicates that the onset of cancer was prior to June 1987, it does not address the relative nature and frequency of sun exposure during Reserve training as compared to occupational and recreational exposure in civilian life. During this period, the Veteran was an aviation electrician whose duties would likely be inside aircraft located in Massachusetts. Regrettably, before a decision can be made on the claim, the Board finds that this matter should be remanded for further development. The Veteran’s personnel records in the claims file include Records of Naval Reserve Service from August 1977 to December 1985, which show his retirement points earned for drill duty, active duty, and ADT. The records show that through December 1985, the Veteran’s Reserve duty was all drill time except for a few periods of ADT in 1978. See Personnel records at p.54 and 59 of 137. Drill time constitutes IDT, and there can be no service connection for diseases incurred due to IDT. However, as noted above, it was not until June 1987 that the Veteran is shown to have been diagnosed with skin cancer, and a record of his active duty and ADT service, if any, from December 1985 to December 1987 is not in the file. The weight of medical evidence is that basal cell skin cancer is caused by intense sun exposure over a period of time. The examiner ruled out exposure during active duty. The notation in the final examination report in 1987 indicates that there was a history of skin cancer onset at an earlier date but not necessarily that it was caused by some aspect of training duty as opposed to exposure in civilian life. To determine the relative time of exposure (Reserve duty vs. civilian) from 1977 to 1987 records of his tempo of training from December 1985 to December 1987 are necessary. Therefore, the Board finds the claim should be remanded so that a record of his periods of active duty and ADT in the Naval Reserve from December 1985 to December 1987 may be associated with the claims file. The matter is REMANDED for the following action: Associate with the claims file a record of the Veteran’s active duty and active duty for training service in the Naval Reserve from December 1985 to December 1987. Note that his personnel records in the file indicate that he was assigned to the Ready Reserve unit VP-92 in South Weymouth, Massachusetts. See, e.g., Personnel records, received September 2015 at p.18 and 83 of 137. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Juliano, 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.