Citation Nr: 21023306 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 17-13 667 DATE: April 20, 2021 REMANDED Entitlement to service connection for colon cancer is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1967 to February 1971, to include service in the Republic of Vietnam. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision. In January 2019, the Board issued a decision denying entitlement to service connection for colon cancer. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In a September 2019 Order, the Court granted a September 2019 Joint Motion for Remand (JMR) of the parties and remanded the case to the Board for action consistent with the JMR. In April 2020, the Board remanded this matter for development consistent with the JMR. 1. Entitlement to service connection for colon cancer is remanded. Review of the VA treatment records added following the April 2020 Board remand shows that there are outstanding potentially relevant treatment records. A February 2019 VA treatment record shows that the Veteran is treated by a private physician for follow up relating to his colon cancer with intermittent colonoscopies, the last which was performed in November 2018. The Veteran’s claims file only contains records from the private physician to March 2014. An October 2017 VA treatment record also notes continued treatment for the Veteran’s bladder cancer by his private physician. The Veteran’s claims file only contains records from the private physician treating the Veteran’s bladder cancer to May 2014 and the Veteran asserts that his colon cancer is secondary to his bladder cancer. The October 2017 VA treatment record also notes that the Veteran is treated by a private primary care physician. The Veteran’s claims file does not contain treatment records from the private primary care physician referenced in the October 2017 VA treatment record. As it appears that there are outstanding treatment records potentially relevant to the Veteran’s claim, remand is warranted to obtain these records. In an April 2021 brief, the Veteran’s representative asserted that VA should address the issue of whether the Veteran’s colon cancer is secondary to his now service-connected bladder cancer. While this matter is on remand, VA medical opinion should be obtained regarding whether the Veteran’s colon cancer was caused by or aggravated by his service-connected bladder cancer. The matters are REMANDED for the following action: 1. After securing any necessary authorization, obtain any private treatment records as the Veteran may identify relevant to his claims, including records from Dr. Thompson since March 2014, from Dr. Milne since May 2014, and from Dr. Wiley. If the Veteran provides a signed authorization form, make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 2. Obtain any additional VA treatment records, to include VA treatment records from September 2020 to the present. 3. After outstanding records are obtained to the extent possible, ask the appropriate examiner to review the Veteran’s file. The necessity of an in-person examination is left to the discretion of the examiner. The examiner should opine regarding whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s colon cancer is caused by or aggravated by his service-connected bladder cancer disability. Note that aggravation means any incremental increase in disability in non-service-connected disabilities (i.e., any additional impairment of earning capacity) resulting from service-connected condition. The examiner should consider all medical and lay evidence of record. The examiner is asked to explain the reasons behind any opinions expressed. The examiner is reminded that the term “as likely as not” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that, in the examiner’s expert opinion, it is as medically sound to find in favor of the proposition as it is to find against it. (Continued on the next page)   4. After the above development, and any additionally indicated development, has been completed, readjudicate the issue on appeal. Shereen M. Marcus Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Purcell 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.