Citation Nr: 21014647 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 17-02 658 DATE: March 15, 2021 REMANDED Entitlement to service connection for squamous cell carcinoma of the nasopharynx is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from May 1969 to February 1971 and from May 1972 to May 1974. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2016 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). In February 2021, the Veteran testified at a virtual hearing before the undersigned Veteran’s Law Judge (VLJ). A transcript is of record. The Board acknowledges the Veteran’s citation to other Board opinions granting service connection for nasopharyngeal cancer. However, the Board notes that its decisions are not precedential. The facts and circumstances of each case differ and are specific to each case at hand. As such, the Board informs the Veteran that citations to other Board decisions in his arguments are not probative as they involve different Veterans with different facts and the decisions reached therein are non-binding on the Board. Remand To date, the Veteran has not been afforded a VA examination to address the etiology of his claimed squamous cell carcinoma of the nasopharynx. The Board notes that the Veteran has current diagnosis of squamous cell carcinoma of the nasopharynx. See Cleveland Clinic treatment records. The Veteran’s service treatment records (STRs) are silent for any complaints of, treatment for, or diagnosis of nasopharynx cancer. However, a February 2016 VA memo confirms that the Veteran does indeed have Vietnam service, and is presumptively exposed to Agent Orange while on active duty service. While squamous cell carcinoma of the nasopharynx is not a condition presumptively related to Agent Orange exposure, the Veteran can still prove service-connection on a direct basis. The Veteran submitted July 2015, September 2015, and August 2016 private medical opinions which indicate that there may be a relationship between the Veteran’s Agent Orange exposure and his current cancer. Based on the foregoing, the Board finds that an examination and medical opinion is necessary to determine whether the Veteran’s squamous cell carcinoma of the nasopharynx disability is etiologically related to, caused, or aggravated by his military service to include his conceded Agent Orange exposure. The matters are REMANDED for the following action: Afford the Veteran a VA examination by an oncologist with sufficient expertise to address the etiology of the Veteran’s claimed squamous cell carcinoma of the nasopharynx. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated studies should be performed. Following a review of the relevant records and lay statements, the examiner should state whether the Veteran’s claimed disability at least as likely as not (a 50 percent probability or greater): originated during his period of active service or is otherwise etiologically related to his active service. The examiner is specifically asked to opine whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s claimed disability is etiologically related to his conceded herbicide exposure. For purposes of these opinions, the examiner(s) should assume that the Veteran is a reliable historian, and must not ignore the Veteran’s competent reports of in-service injuries, or of symptoms experienced during active service and since. In this regard, the examiner must discuss and consider the Veteran’s competent lay statements. Additionally, the examiner must comment on the following evidence: (1) the July 2015 private medical opinion from Dr. B.B. which noted that the Veteran’s cancer is highly unusual for his age and demographic group; (2) the September 2015 private medical opinion from Dr. T.N. which noted that given the Veteran’s non-smoking history and exposure to Agent Orange his cancer “could have been, or could not have been” a result of Agent Orange; and (3) the August 2016 private medical opinion from Dr. S.K. which noted that the Veteran’s Agent Orange exposure could have contributed to his cancer, though it is unclear. The examiner must provide a complete rationale for all proffered opinions. If an examiner is unable to provide any required opinion, he or she should explain why. If an examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiners should identify the additional information that is needed. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Gresham 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.