Citation Nr: 21024210 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 13-25 173A DATE: April 22, 2021 REMANDED Service connection for a back disorder, to include osteoporosis, including as due to herbicide exposure, is remanded. Service connection for a stomach condition, to include gastroesophageal reflux disease (GERD), including as due to herbicide exposure, is remanded. Service connection for basal cell carcinoma, including as due to herbicide exposure, is remanded. Service connection for a thyroid disorder, including as due to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran, who is the appellant, had active service from December 1967 to July 1969. In August 2020, the Board, in pertinent part, remanded the issues on appeal to the Agency of Original Jurisdiction (AOJ) for additional development. Further discussion of the AOJ compliance with the August 2020 Board remand directives as to the service connection issues are included in the Remand section below. See Stegall v. West, 11 Vet. App. 268 (1998). 1. Service Connection for Back Disorder 2. Service Connection for Stomach Condition 3. Service Connection for Basal Cell Carcinoma 4. Service Connection for a Thyroid Disorder The Veteran served in Vietnam during the Vietnam War and, therefore, is presumed to have been exposed to herbicides during service. In August 2020, the Board remanded this matter, in pertinent part, to obtain medical opinions regarding the etiology of the claimed back, stomach, basal cell, and thyroid disorders, to the include the question of whether the claimed disorders are related to the presumed herbicide exposure during service. Subsequently, in a November 2020 VA medical opinion, the VA physician opined that the claimed disorders were unrelated to service, and even provided a list of risk factors for the claimed disorders; however, the November 2020 VA opinion did not specifically address whether the back, stomach, basal cell, and/or thyroid disorders were related to the herbicide exposure in service, as specifically directed by the August 2020 Board remand and noted in the instructions to the VA examiner. See Stegall v. West, 11 Vet. App. 268 (1998). For the above reasons, the Board finds that another remand for either an addendum or a new VA medical opinion from file review is necessary to assist in determining whether the back, stomach, basal cell, and thyroid disorders are related to herbicide exposure in service. The matters are REMANDED for the following action: Send the claims file for an addendum or new medical opinion. Examination of the Veteran is not required unless the examiner determines that an examination is necessary to provide a reliable opinion. A rationale for all opinions and a discussion of the facts and medical principles involved should be provided. The VA examiner should offer the following opinions with supporting rationale: Is it at least as likely as not (50 percent probability or greater) that the currently diagnosed back disorder was caused by the in-service herbicide exposure? Is it at least as likely as not (50 percent probability or greater) that the currently diagnosed stomach disorder was caused by the in-service herbicide exposure? Is it at least as likely as not (50 percent probability or greater) that the currently diagnosed basal cell disorder was caused by the in-service herbicide exposure? Is it at least as likely as not (50 percent probability or greater) that the currently diagnosed thyroid disorder was caused by the in-service herbicide exposure? In rendering the direct service connection opinions requested, the VA examiner should assume, as fact, that the Veteran was exposed to herbicides during service. J. PARKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Tenney, 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.