Citation Nr: 21042698 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 18-42 403 DATE: July 13, 2021 REMANDED Entitlement to service connection for non-Hodgkins lymphoma is remanded. REASONS FOR REMAND The Veteran had active duty service from September 1954 to February 1958. This matter comes to the Board of Veterans' Appeals (Board) from a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) rating decision dated in September 2015. The AOJ had previously denied this claim in a July 2012 rating decision that was not appealed. Although normally new and material evidence would be required to reopen the service connection claim for non-Hodgkins lymphoma, in this case relevant service treatment records were added to the file after the July 2012 rating decision. Specifically, the separation examination report was added to the file, which is relevant to any claim for service connection. Any time after VA issues a decision on a claim, if VA receives or associates with the claims file relevant official service department records that existed when VA first decided the claim, VA will reconsider the claim. 38 C.F.R. § 3.156(c). Thus, the issue is correct as noted on the first page of this decision. The Veteran and his spouse testified before the undersigned Veterans Law Judge at a virtual Board hearing in May 2021. A transcript of the testimony is of record. 1. Entitlement to service connection for non-Hodgkins lymphoma is remanded. The Veteran contends that his non-Hodgkin's lymphoma is due to exposure to radiation in service. He testified at the Board hearing that during on-the-job training in the radiology department at the hospital at Sampson Air Base he was exposed to radiation from a transverse axial tomography (precursor to the CT scan). See May 2021 Board hearing transcript, pp. 2-3. The Veteran stated that he, along with four other service members, were asked to volunteer for preliminary exposures to see if they could get an image that was diagnostic. Id. at 3. He recalled about 15 to 20 exposures lasting 45 seconds to 90 seconds. Id. He noted that they could never get an image that was diagnostic, and the program was abandoned. Id. He later became aware that two of the other individuals testing the transverse axial tomography died from lymphoma. Id. at 3-4. He testified that his second exposure happened when he was serving in Pittsburg and was checking in people coming in for x-rays. Id. at 3. He recalled that the x-ray equipment was pointed directly at the partition that he and the other civilian he was working with were sitting behind for logging in the pre-inductees. Id. He stated that they did not have film badges or anything and the wall was lead but that this did not completely stop the radiation from leaking through. Id. He also was aware that the civilian he worked with in Pittsburgh later died from lymphoma, but he did not know if it was non-Hodgkins. He stated that he was first diagnosed with lymphoma in July 1995 at Lincoln Hospital in the South Bronx; but his wife recalled that the Veteran's lymph nodes were swollen on a regular basis and he was running low grade temperatures while in the military. Id. at 13, 15. The record shows treatment records from 2002 at the Lincoln Medical Center but no earlier. VA treatment records also note a history of lymphoma treatment in 1995 with a recurrence in 2002. See, e.g., February 27, 2015 VA primary care visit. Additional efforts should be made to find records dating back to 1995 from the Lincoln Medical Center in the Bronx on remand. The U.S. Air Force radiation inquiry response noted in May 2018 that there was no external or internal radiation exposure data for the Veteran. However, this is consistent with the Veteran's testimony that he did not wear a dosimetry badge in service. The Veteran's personnel records show that his military occupational specialty (MOS) in service was Radiology Specialist. The Veteran's testimony is consistent with the circumstances of his service. Given the Veteran's competent and credible statements concerning his radiation exposure in service, his MOS in service being consistent with radiation exposure, and medical evidence showing the Veteran has a history of lymphoma diagnosed in 1995, a medical opinion is warranted to resolve this claim. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for Lincoln Medical Center in the South Bronx for treatment records dated in 1995. Make two requests for the authorized records from Lincoln Medical Center unless it is clear after the first request that a second request would be futile. 2. Obtain the Veteran's VA treatment records for the period from March 2018 to present. 3. After undertaking any other indicated development of the Veteran's radiation claim, the Veteran for a VA examination for his non-Hodgkin's lymphoma. The examiner must review the claims file. The examiner is asked to provide a response to whether the Veteran's non-Hodgkins lymphoma is at least as likely as not related to service, including radiation exposure from his duties as a Radiology Specialist. The examiner must consider the Veteran's lay statements and testimony that he was exposed to radiation from a transverse axial tomography (precursor to the CT scan) at the hospital at Sampson Air Base, as a volunteer for preliminary exposures to see if they could get an image that was diagnostic. He recalled about 15 to 20 exposures lasting 45 seconds to 90 seconds. He also testified that his second exposure happened when he was serving in Pittsburg and was checking in people coming in for x-rays. He recalled that the x-ray equipment was pointed directly at the partition that they were sitting behind for logging in the pre-inductees. He stated that they did not have film badges or anything and the wall was lead but that this did not completely stop the radiation from leaking through. He stated that he was first diagnosed with lymphoma in July 1995 at Lincoln Hospital in the South Bronx; but his wife recalled that the Veteran's lymph nodes were swollen on a regular basis and he was running low grade temperatures while in the military. Please provide a rationale to support the opinion. (Continued on the next page) In providing the requested opinion, consider the Veteran's description of his in-service exposure and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported exposure and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? S. L. Kennedy Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sarah B. Richmond, 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.