Citation Nr: 21023735 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 16-29 313 DATE: April 21, 2021 REMANDED Entitlement to service connection for hypertension is remanded. Entitlement to service connection for bladder cancer is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from August 1969 to February 1975. The Veteran also had service with the National Guard, with various periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA). For his meritorious service, the Veteran was awarded (among other decorations) the Vietnam Service Medal and Republic of Vietnam Campaign Medal. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a March 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for hypertension is remanded. 2. Entitlement to service connection for bladder cancer is remanded. These matters were before the Board in October 2018, at which time the Board remanded the claim for further development. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives regarding the issue on appeal. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). Specifically, the October 2018 Board remand directives instructed the examiner to opine on whether the Veteran’s hypertension and bladder cancer were at least as likely as not related to service, including exposure to fuel, oil, and demineralized water while serving aircraft. The Veteran underwent a VA examination in July 2019, but the VA examiner did not comply with the Board’s remand directives. The VA examiner concluded the Veteran’s hypertension was diagnosed in the 1990s and bladder cancer was diagnosed in 2013 to 2014; the examiner stated that with the long duration of time since his discharge from service, it is less likely that his disabilities happened during active duty. This VA examination is inadequate as the rationale did not consider the Board’s prior directives. Veterans, as a matter of law, are entitled to compliance with Board instructions. Stegall v. West, 11 Vet. App. 268 (1998). The claim will be remanded for development and documented compliance with the Board’s prior directives. Additionally, the Board is aware the Veteran contends his hypertension and bladder cancer are due to exposure to herbicide agents. The Veteran’s contention he had exposure to herbicide agents in-service has not been conceded by the VA, therefore that theory of entitlement will not be further addressed. The matters are REMANDED for the following actions: 1. Obtain an addendum opinion from an appropriate examiner to determine the nature and etiology of the Veteran’s claimed hypertension. It is up to the discretion of the examiner if a new examination is necessary. The examiner must opine whether it is at least as likely as not related to service, including exposure to fuel, oil, and demineralized water while servicing aircraft. Also, indicate whether it at least as likely as not (1) began during active service, (2) manifested within one year after discharge from service. 2. Obtain an addendum opinion from an appropriate examiner to determine the nature and etiology of bladder cancer. It is up to the discretion of the examiner if a new examination is necessary. The examiner must opine whether it is at least as likely as not that the Veteran’s claimed bladder cancer is related to service, including exposure to fuel, oil, and demineralized water while servicing aircraft. For both requested opinions, if an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Mouzakis, 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.