Citation Nr: 21022269 Decision Date: 04/15/21 Archive Date: 04/15/21 DOCKET NO. 16-45 488 DATE: April 15, 2021 REMANDED Entitlement to service connection for malignant skin neoplasms is remanded. REASONS FOR REMAND The Veteran served in the United States Marine Corps from January 1971 to September 1998. He testified before the undersigned Veterans Law Judge in February 2021. A transcript of the hearing is of record. The Veteran’s service treatment records indicate care for cysts that required excision throughout his service. The Veteran testified that he had a significant sun exposure history during his nearly 28 years of service, specifically due to his assignment as a drill instructor, which required him to be outside in sunny conditions. While the Veteran was afforded a VA examination in 2014, the Board finds that remand is necessary to afford the Veteran another evaluation. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The 2014 examination appears to have been based on a limited review of the Veteran’s claims file. The opinion did not include a full accounting of the Veteran’s numerous skin cancer treatments, including the relevant dates of diagnoses, nor has a VA examiner or clinician acknowledged the Veteran’s lay statements or testimony as to his sun exposure in service. Specifically, the VA examination in April 2014 indicated that the Veteran was diagnosed with skin cancer ten years post-service. Records indicate that the Veteran was actually diagnosed with skin cancer in 2003, just five years after his retirement from active service, and further that he had excisions just before he retired from active service in 1998. While the examiner noted the in-service cyst excisions to be benign, the examiner did not indicate whether those excisions were early manifestations of skin cancer. Further, the April 2014 examiner provided an incomplete rationale for the opinion, stating “not treated in service. Diagnosed over 10 years post service. Veteran has risk factors of fair, light complexion.” As the examination does not appear to be based on a full reading of the Veteran’s claims file and does not provide a complete rationale for the opinion expressed, the Board finds the April 2014 skin examination has limited probative value. Thus, a new examination is necessary regarding the Veteran’s claim. The matters are REMANDED for the following action: 1. Provide the Veteran’s entire claims file to an appropriate clinician for an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s skin cancer (to include melanoma, basal cell carcinoma, and squamous cell carcinoma) had its onset in, or is otherwise due to, his military service, to include due to in-service sun exposure. If it is necessary to examine the Veteran to obtain the requested opinion, that should be arranged. (a.) The examiner should provide an opinion as to whether it is at least as likely as not that the Veteran’s cysts and growths, which began in service, are related to or otherwise were an early indicator/manifestation of the Veteran’s melanoma, basal cell carcinoma, and squamous cell carcinoma. (b.) The examiner should take into account the Veteran’s lay statements regarding his sun exposure and his in-service treatment for skin conditions. (c.) The examiner should specifically respond to the Veteran’s private treatment provider’s contentions that his over exposure to sun began in service, as over exposure takes 20-30 years to cause damaging effects. 2. A complete rationale for all opinions should be provided. The examiner must connect all opinions made to the evidence of record and any medical literature referenced. 3. If the examiner cannot provide a requested opinion without resorting to speculation, it should be so stated, and the examiner should provide the reasons why an opinion would require speculation. 4. After completing the above actions, to include any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran’s claim should be readjudicated based on the entirety of the evidence. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board V. Geer, 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.