Citation Nr: 21042232 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 14-23 046 DATE: July 12, 2021 REMANDED Entitlement to service connection for colon cancer, to include as due to exposure to contaminated water at Camp Lejeune and due to exposure to herbicide agents in Vietnam is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1966 to February 1969. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2011 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this claim in November 2019 for additional development. In July 2020, the Board denied this issue which was appealed to the Court of Appeals for Veterans Claims (CAVC). Pursuant to a Joint Motion, the CAVC issued a March 2021 Order to vacate the July 2020 denial and remanded the underlying claim to the Board for readjudication. See March 2021, Order granting Joint Motion for Remand (JMR). 1. Entitlement to service connection for colon cancer, to include as due to exposure to contaminated water at Camp Lejeune and due to exposure to herbicide agents in Vietnam is remanded. The Veteran contends that service connection is warranted for his colon cancer. The Veteran asserts that his colon cancer is the result of either herbicide or contaminated water exposure during active service. The Veteran specifically asserts the September 2016 and September 2019 examinations were inadequate in that the September 2016 examiner noted that he lacked information "critical to forming a forensic opinion" regarding the Veteran's health and lifestyle, potential exposure to second-hand smoke, his work history and his potential exposure to chemicals while employed. The September 2019 examiner failed to provide an adequate rationale as the opinion provided was wholly conclusory. The Veteran's personnel records confirm he served at Camp Lejeune from July to August 1966. Thus, exposure to contaminated water is conceded. The Veteran's personnel records also confirm he served in Vietnam from February 1968 to February 1969. Thus, exposure to an herbicide agent is conceded. The parties to the JMR agreed that remand is warranted for the Board to obtain a medical opinion that provides an adequate rationale to support any conclusions reached. Accordingly, a remand is warranted pursuant to the terms of the JMR. The matter is REMANDED for the following action: 1. Schedule the Veteran for an appropriate VA examination to ascertain the nature and etiology of his colon cancer. The file must be provided to the examiner for review. The examiner must do the following: (a) Pursuant to the direction of the September 2016 VA examiner in regard to information deemed critical to forming a forensic opinion regarding whether or not there is a nexus between the Veteran's colon cancer and his exposure to Camp Lejeune contaminated water, the Veteran must be asked the following questions: (1) family history of relevant chronic diseases; (2) his lifestyle and diet; (3) potential exposures to secondhand tobacco smoke; and (4) description of any chemical exposures he may have had at work. (b) Opine as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's colon cancer had its onset during the Veteran's service or is causally or etiologically due to service, to include exposure to herbicides OR exposure to Camp Lejeune contaminated water. In regard to herbicide exposure, the Board is cognizant that colon cancer is not a presumptive disease associated with herbicide exposure. The Board seeks a medical opinion on the likelihood that this Veteran's colon cancer is related to his herbicide exposure given his medical history, family history, existence of or absence of other risk factors, and any other additional factors deemed relevant by the examiner. A complete rationale should be given for all opinions and conclusions expressed. In the event the examiner cannot provide an opinion without resorting to speculation, it is essential that the examiner provide a rationale for this conclusion (e.g., lack of sufficient information/evidence, the limits of medical knowledge, etc.). (continued on next page) TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Edwin B. Esmenda, 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.