Citation Nr: 21021448 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 16-25 361 DATE: April 13, 2021 REMANDED Entitlement to service connection for oral squamous cell carcinoma, to include as secondary to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran served in the United States Army from August 1966 to July 1968, with service in the Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2013 rating decision by the Department of Veteran Affairs (VA) Regional Office (RO). The Veteran requested a Board hearing in May 2013. In September 2019, the Veteran withdrew his hearing request. 38 C.F.R. § 20.704(e). This matter was previously remanded by the Board in October 2019 for further development. The matter returns for appellate consideration. Entitlement to service connection for oral squamous cell carcinoma, to include as secondary to herbicide exposure, is remanded. The Veteran contends that his oral squamous cell carcinoma is related to his herbicide exposure in service. Pursuant to the October 2019 Board remand, a January 2020 VA examination was obtained, from which the examiner diagnosed squamous cell carcinoma in the bilateral pharynx. The examiner opined the Veteran’s condition is less likely than not related to service because it is not a presumptive chronic disease recognized by the VA. The examiner also acknowledged that Agent Orange exposure is conceded. The Board finds the January 2020 opinion is inadequate. The examiner failed to provide a sufficient rationale in support of the conclusion. Furthermore, the examiner failed to discuss whether medical literature and science supports an association between squamous cell carcinoma and exposure to herbicides. The opinion was general in nature. Without an opinion that sufficiently provides a rationale for its conclusion, the Board cannot make a fully informed decision on the issue of entitlement to service connection for oral squamous cell carcinoma. See Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007) (“a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision as to what weight to assign to a doctor’s opinion”). As such, an addendum opinion is warranted to determine the nature and etiology of the Veteran’s squamous cell carcinoma. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from the January 2020 clinician, or another qualified clinician. The examiner providing the opinions must be provided access to the electronic claims file and indicate review of the file in the examination report. The claims folder and a copy of this remand in its entirety must be provided to the examiner in conjunction with the addendum opinion. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran’s service treatment records, post-service medical records, and lay statements; the examiner must indicate on the examination report that such review was undertaken. If examination of the Veteran is necessary, such should be arranged. The examiner is asked to determine the following: (a) Whether squamous cell carcinoma was caused by any in-service event, injury, disorder, or disease. (b) Whether squamous cell carcinoma was caused by in-service exposure to herbicide agents. In providing the opinions, the examiner must address the Veteran’s lay statements and any medical findings from the Veteran’s treatment records or any known medical studies/research that have found an association between squamous cell carcinoma and herbicide exposure. The examiner must provide a rationale in support of all opinions provided. If the examiner cannot provide the opinion without conducting an examination of the Veteran, then an examination must be scheduled. If any opinion cannot be provided without resorting to speculation, the examiner must explain why this is so. Signature on the next page DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Y. Asfaw, 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.