Citation Nr: 21024913
Decision Date: 04/26/21	Archive Date: 04/26/21

DOCKET NO. 14-34 705A
DATE: April 26, 2021

REMANDED

Entitlement to service connection for the cause of the Veteran’s death is remanded.

REASONS FOR REMAND

The Veteran had active military service from April 1969 to April 1971. He died in December 2001. The appellant is his surviving spouse, so widow.

Entitlement to service connection for the cause of the Veteran’s death is remanded.

Additional medical comment is needed to assist in deciding this claim. The Board has reviewed both the June 2020 VA opinion and the January 2020/March 2021 private opinions but finds that it is still unclear whether the medical literature supports a link between colon cancer and exposure to herbicides in Vietnam. While the June 2020 VA examiner stated that there was no objective medical evidence in the available research that Agent Orange exposure causes colon cancer, the March 2021 private examiner conversely stated that there is adequate published laboratory science and epidemiologic data linking Agent Orange or dioxins to colorectal cancer. It is unclear to the Board whether the studies cited by the private physician provide an adequate link between the Veteran’s herbicide exposure and the development of his colon cancer.  For example, while the private physician cites to two studies to support the conclusion that in non-familial cases malignant transformation takes place over at least 15-20 years, a review of these studies does not necessarily uncover this statistic.  Due to such questions raised, on remand, the Board requests that the VA examiner review each of the studies cited by the private physician and determine whether they support this posited association. 

Accordingly, this claim is REMANDED for the following action:

Forward the file to an appropriate VA physician with the requisite education and experience to comment on the studies that have been cited concerning the Veteran’s terminal colon cancer. To this end, the VA examiner is specifically requested to review all the studies cited by the January 2020/March 2021 private physician - listed as References on the last page of each opinion - and to discuss whether these studies are sufficient to provide an etiological link (at least as likely as not probability) between the Veteran’s terminal colon cancer and his exposure to Agent Orange/herbicides as outlined in 38 C.F.R. § 3.307(a)(6).

In providing this needed additional comment, the VA examiner also should discuss the Veteran’s risk factors for colon cancer (if he had any), the timing of diagnosis in relation to his time in service, and clinical history. 

(Continued on the next page)

 

The examiner should also discuss the findings in relation to the Veteran’s specific type of colon cancer, if pertinent.

 

 

KEITH W. ALLEN

Veterans Law Judge

Board of Veterans’ Appeals

R. Erdheim, Attorney for the Board	Department of Veterans Affairs

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.