Citation Nr: 21027848 Decision Date: 05/07/21 Archive Date: 05/07/21 DOCKET NO. 15-24 636 DATE: May 7, 2021 REMANDED Entitlement to service connection for malignant melanoma of the left iris with intermittent exotropia is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1971 to November 1971. In his May 2015 VA Form 9, the Veteran requested a hearing before a Veterans Law Judge. The hearing was scheduled in May 2019. However, the Veteran failed to report for the hearing and did not request that the hearing be rescheduled. As such, the Veteran's hearing request is deemed withdrawn. 38 C.F.R. § 20.704(d). In January 2020, the Board of Veterans' Appeals (Board) issued a decision that reopened the claim for service connection for a left eye disability and remanded the underlying service connection claim for additional development. Finally, it is noted that in October 2020, the Board invited the Veteran to request a virtual tele-hearing instead of waiting for a travel board hearing. However, it was later determined the letter was sent in error because, as noted, a hearing had already been scheduled and the Veteran failed to appear. See October 2021 Memorandum. Accordingly, the claim will be adjudicated based on the evidence of record. Entitlement to service connection for malignant melanoma of the left iris with intermittent exotropia is remanded. While the Board regrets further delay in the adjudication of this claim, the available medical evidence and argument of record has not resolved the question of whether the Veteran's malignant melanoma of the left iris pre-existed his military service. Therefore, another remand is required to obtain a medical addendum opinion prior to adjudication. Notably, the Veteran contends he suffers from malignant melanoma of the left iris with intermittent exotropia because of his military service. In support of his claim, the Veteran states he had an appointment with an optometrist in March 2015 and that an eye surgeon confirmed in April 2015 that "this type of melanoma [could] originate over a two-week timeframe or take 20 years to develop." The Veteran further noted that "[a]ll prior physical exams did not reveal a melanoma before service," and argued that while he had pre-existing exotropia before joining the Navy, he did not have a pre-existing melanoma. In support of that claim, the Veteran stated that "no doctor ever mentioned the melanoma prior to [his] initial visit at Great Lakes Naval Hospital". See May 2015 VA Form 9. Despite the Veteran's statements, the available service treatment records (STRs) provide conflicting evidence. In particular, while the Veteran's February 1970 Enlistment record does not show a diagnosis of the condition, a November 1971 treatment record from the Naval Hospital in Great Lakes, Illinois diagnosed malignant melanoma of the left iris and indicated that the condition existed prior to the Veteran's entry into service and was not aggravated by service. In January 2020, the Board remanded this claim to obtain a VA examination and medical opinion regarding the nature and etiology of the Veteran's malignant melanoma of the left iris with intermittent exotropia. A request to schedule the Veteran for a VA examination was made in March 2020, and a notice letter that same month informed the Veteran that the examination had been requested through a private medical facility and that he would be advised of the date, time, and place of the examination. The letter also explained to the Veteran that if he failed to report for an examination, the claim would be rated based on the evidence of record. See March 2020 Notice Letter. However, the records reflects that examination was later cancelled at the Veteran's request. See Exam Request Cancellation. Furthermore, the Veteran has not provided good cause for the cancellation of the examination. Wood v. Derwinski,1 Vet. App. 190 (1991). While the Board understands the Veteran's belief that the private medical treatment records included in the claims file provide clear evidence the condition did not pre-exist service and was instead incurred during service, the records cited by the Veteran do not clearly answer the question of whether the claimed condition pre-existed his military service. See June 2020 Appellate Brief. Accordingly, the claim is being remanded again for a VA examiner to review the claims file, including the available medical treatment records and STRs, and provide a medical opinion regarding the nature and etiology of the Veteran's malignant melanoma of the left iris with intermittent exotropia. The matter is REMANDED for the following action: Obtain a medical opinion from an appropriate clinician regarding whether the Veteran's malignant melanoma of the left iris with intermittent exotropia clearly and unmistakably (undebatable) preexisted the Veteran's military service. If the examiner finds it did clearly and unmistakably preexist service, was it clearly and unmistakably not aggravated beyond its normal course of progression by military service? (Continued on the next page) If the examiner finds that it either did not clearly and unmistakably preexist service, or was not clearly and unmistakably aggravated by service, the examiner must opine whether it is at least as likely as not related to service? The examiner is asked to specifically address the diagnosis of the condition during service. A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Churchwell, 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.