Citation Nr: 21027739 Decision Date: 05/06/21 Archive Date: 05/06/21 DOCKET NO. 14-24 728 DATE: May 6, 2021 REMANDED Entitlement to service connection for colon cancer is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from September 1960 to January 1974. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a June 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Manila Philippines. This case was previously before the Board in March 2016, when the service connection claim was reopened and remanded to the agency of original jurisdiction (AOJ) for additional development. After taking further action, the AOJ confirmed and continued the prior denial and returned the case to the Board. Although the Board sincerely regrets the additional delay, a remand is necessary to ensure that there is a complete and adequate record upon which to decide the Veteran's claim and to afford him every possible consideration. The Board's prior remand required development of the evidence to establish the Veteran's exposure to herbicides in service. If his herbicide exposure was confirmed, the AOJ was to afford him a VA examination and obtain a nexus opinion. Following the Board's remand, the AOJ conceded the Veteran's in-service exposure to herbicides. The Veteran was then afforded a VA examination in connection with his claim in January 2021. The examiner stated that the Veteran had a soft tissue cancer that was presumptive for Agent Orange. However, colon cancer is not a type of cancer presumed connected to herbicides under 38 C.F.R. § 3.309(e). Nonetheless, the Board recognizes the examiner seems to be suggesting there is perhaps an actual direct connection between the Veteran's cancer and the now conceded herbicide exposure. It is unclear, however, as the examiner seems to discuss this as a presumptive condition. The Board finds remand is necessary in order to obtain a clarifying opinion. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's colon cancer is at least as likely as not related to his now conceded in-service exposure to herbicide agents. To the extent possible, make arrangements to provide the record on appeal to the VA examiner who previously offered an opinion with respect to the etiology of the Veteran's colon cancer in January 2021. The Board leaves it up to the clinician providing this opinion as to whether additional physical examination is necessary. The clinician providing this opinion is advised that a negative opinion cannot be based solely on the fact that colon cancer is not on the list of diseases that are presumptively associated with exposure to herbicide agents. In the discussion, the examiner should discuss the statements in the January 2021 report suggesting a causal connection may exist. A rationale should be provided for any opinion requested. 2. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraph, the Veteran's claim should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. A. ADAMSON Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Smith, 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.