Citation Nr: 21028641 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 14-31 260 DATE: May 11, 2021 REMANDED Entitlement to service connection for a prostate disability, to include as due to herbicide agent exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1966 to October 1968. This matter comes to the Board of Veterans' Appeals (Board) on appeal from October 2012 and March 2021 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. While on appeal, a March 2021 rating decision established service connection for status post, intestinal neoplasm, malignant colon polyp. As that is a full grant of the benefit sought on appeal, that issue is no longer before the Board. Entitlement to service connection for a prostate disability, to include as due to herbicide agent exposure, is remanded. The Veteran claims that a prostate disability is the result of herbicide agent exposure while in service, or alternatively, is related to adenocarcinoma, to include surgery and treatment for colon cancer. Specifically, the Veteran stated in August 2014 correspondence that a doctor indicated that a colon cancer diagnosis at the age of 33 was unusual. During the June 2017 Board hearing, the Veteran stated that prostate issues began in the 1980s or 1990s. The Veteran's representative stated that "research through the Cancer Treatment Centers of America" indicates that "adenocarcinoma, is a 99 percent gland that is an onset of prostate cancer." During a December 2019 VA examination, the VA examiner noted a history of "adenocarcinoma colon polyp" in 1975. The Veteran underwent VA examination in December 2019. The Board remanded the claim in April 2020 for an opinion as to whether the Veteran's prostate disability was directly related to service, related to herbicide agent exposure, or related to the service-connected colon polyp. In March 2021, a VA examiner concluded that the Veteran "has been seen for benign prostate hypertrophy (BPH) and is elderly, which puts him at greater risk for BPH. There is no evidence that herbicide exposure causes BPH and it is likely his age that is the contributing factor." The Board finds that opinion inadequate as it does not use the appropriate legal standard (at least as likely as not) or address all relevant theories of entitlement to service connection. Moreover, the examiner did not consider the Veteran's age at onset of the prostate disability; address the Veteran's contention that prostate enlargement was the result of residuals of adenocarcinoma of the colon; or explain why an age-related etiology was more likely than exposure to herbicide agents or residuals of adenocarcinoma of the colon. A remand by the Board confers on the Veteran, as a matter of law, the right to compliance with the remand. Stegall v. West, 11 Vet. App. 268 (1998). Because of the cited deficiencies in the March 2021 VA examination report, the Board is again remanding the case for compliance with the April 2020 Remand requests. The matters are REMANDED for the following action: 1. Obtain updated VA and private treatment records. 2. Then, schedule the Veteran for a VA examination, with a medical doctor who has not previously examined the Veteran, to determine the etiology of any prostate disability. The examiner must review the claims file and should note that review in the report. All opinions provided must be thoroughly explained, and an adequate rationale for any conclusions reached must be provided. The examiner should offer an opinion as to the following questions: (a.) Diagnose all prostate disabilities found or shown by the record and specifically state whether or not a diagnosis of prostate cancer is warranted. (b.) Opine whether it is at least as likely as not (50 percent probability or greater) that any prostate disability is causally or etiologically related to service, to include, but not limited to, conceded exposure to herbicide agents. If a prostate disability is attributed to another etiology, the examiner must explain why the other etiology is more likely than conceded exposure to herbicide agents in service. The examiner is advised that a mere assertion that a prostate disability is not one of the presumptive diseases recognized as due to herbicide agent exposure recognized by VA is insufficient rationale. (c.) Opine whether it is at least as likely as not (50 percent probability or greater) that any prostate disability is etiologically related to, caused by, or aggravated (increased in severity beyond the natural progress of the disorder) by a malignant colon polyp, to include surgery and treatment for a malignant colon polyp. The examiner must consider and discuss all pertinent medical evidence and lay statements, including the Veteran's age at onset of the colon and prostate disabilities and the Veteran's contention that a prostate disability is related to a history of adenocarcinoma of the colon. If an age-related etiology is found more likely, the examiner should clearly explain the reasons for the opinion. Harvey P. Roberts Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Duke, 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.