Citation Nr: 21026718
Decision Date: 05/03/21	Archive Date: 05/03/21

DOCKET NO. 11-24 856
DATE: May 3, 2021

REMANDED

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

REASONS FOR REMAND

The Veteran served on active duty from February 1963 to February 1967. He died in March 2008 and the appellant is his surviving spouse.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2008 rating decision issued by a Department of Veterans Affairs (VA) Regional Office. 

In July 2016, and August 2020 the Board remanded the case for additional development. 

In November 2020 a VA examiner issued a medical opinion.

In the March 2021 Written Brief Presentation, the appellant's representative cited new medical articles and research that had not been reviewed by the November 2020 VA examiner.

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

The Veteran's death certificate reflects that the immediate cause of death was rectal cancer, with ventilator dependence and wound infection as underlying causes. At the time of the Veteran's death, he was service-connected for posttraumatic stress disorder, bilateral pes planus, tinnitus, and bilateral hearing loss. The appellant asserts that his fatal rectal cancer is the result of his acknowledged in-service exposure to contaminated water while stationed at Camp Lejeune and/or herbicide agents while serving in the Republic of Vietnam.

The Board finds that an additional remand is necessary in order to obtain an addendum opinion that adequately addresses the matters at issue, due to newly submitted evidence. In her March 2021 Written Brief Presentation, the appellant's representative cited medical articles comparing the mortality of Marine Corps personnel, Navy personnel, and civilian workers exposed to contaminated drinking water at Camp Lejeune with that of Marine Corps personnel, Navy personnel, and civilian workers stationed at Camp Pendleton. The representative also included research about colon-rectum cancer among individuals residentially exposed to high cumulative levels of PCE-contaminated drinking water. Therefore, on remand, the examiner should address the findings in the aforementioned medical articles/research in offering an opinion. 

The matters are REMANDED for the following action:

Forward the record, to include a copy of this Remand, to an appropriate clinician in order to obtain an addendum opinion addressing the newly submitted evidence.

In offering such opinion, the examiner should consider the medical articles/research cited by the appellant's representative in her March 2021 Written Brief Presentation. 

Is it at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's fatal rectal cancer was related to his acknowledged in-service exposure to contaminated water and/or herbicide agents?

The examiner is advised that an unfavorable opinion may not be based solely on the fact that rectal cancer is not included in the list of diseases VA acknowledges to be presumptively related to exposure to herbicide agents.

All opinions must be supported with explanation. The examiner is asked to research the medical literature prior to opining.

 

 

Nathaniel J. Doan

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S. Ottley III

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.