Citation Nr: 22010595 Decision Date: 02/24/22 Archive Date: 02/24/22 DOCKET NO. 17-46 511A DATE: February 24, 2022 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran served on active duty in the Air Force from November 1965 to July 1973 and from June 1981 to May 1996. He died on July [REDACTED], 2016 and the appellant is his surviving spouse. This case comes before the Board of Veterans' Appeals (Board) on appeal from an April 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In October 2021, the appellant and her son testified before the undersigned Veterans Law Judge (VLJ) at a virtual hearing. A transcript of the hearing is of record. Regrettably, the Board finds that a remand is needed for additional development in accordance with VA's duty to assist, prior to adjudication of the claim. As an initial matter, the Board notes that the Veteran's death certificate lists his causes of death as multi organ system failure, advanced stage metastatic cancer and primary cancer of the esophagus. At the time of the Veteran's death, the Veteran had been awarded service connection for right knee residuals, ischemic optic neuropathy, bilateral hearing loss, and surgical scars on right knee. Significantly, these service-connected disabilities are not listed as a primary or contributory cause of death on the Veteran's death certificate. Furthermore, the appellant does not contend nor does the record show that the Veteran's service-connected disabilities caused, aggravated or contributed substantially or materially to the Veteran's death. There is no medical evidence of record showing that the Veteran's service-connected disabilities had increased in severity prior to his death, caused or contributed to the Veteran's multi organ system failure, advanced stage metastatic cancer, or primary cancer of the esophagus. Therefore, the Board finds there is no relationship between the Veteran's service-connected disabilities and the cause of his death. However, the appellant contends that the Veteran's listed causes of death on his death certificate was the result of the in-service exposure to herbicide agents and/or dioxins while serving in Vietnam, Guam, Okinawa, and/or Thailand, and therefore, service connection is warranted. Specifically, the appellant testified that the Veteran was stationed in Guam in 1968/69 where he served as a crew chief on B-52 bombers and was exposed to Agent Orange and dioxins; he served in Okinawa, Japan where he flew over demilitarized zones and received hazard duty pay; and that he was exposed while working in an area where they sprayed herbicides while serving in Thailand. See Hearing Transcript, October 2021. The Board notes that the Veteran's DD 214s reflects that he had over a year of foreign and/or sea service, and that he was a recipient of the Vietnam Service Medal. However, his service personnel records do not show that he served in the Republic of Vietnam or Thailand, but rather that he had service (temporary duty stations) in Guam and Okinawa, Japan for approximately 179 days beginning November 1972. To this end, the Board notes that there are only six pages of the Veteran's service personnel records in the claims file, and given the Veteran's 22-year career of military service, it appears that there are outstanding service personnel records that have not yet been associated with his claims file. As these personnel records are potentially relevant with respect to the appellant's assertions that the Veteran served in Vietnam and Thailand during an applicable period for presumed exposure to herbicides, the Board finds that it is incumbent on the RO to obtain such records for review. Additionally, the RO should conduct additional development as necessary to verify and specifically notate all periods of the Veteran's foreign service (to include actual dates and locations) and determine whether the Veteran was exposed to herbicides or other dioxins during any period of his foreign service. Lastly, if the evidence indicates the Veteran had verified in-service exposure to herbicides, the appellant should be provided a VA medical opinion to determine whether the Veteran's listed causes of death are related to his in-service exposure. Accordingly, a remand is necessary to address the matters discussed above. The matters are REMANDED for the following action: 1. Obtain outstanding service personnel records for the Veteran's 22-year military service. If these records are not available, the RO must explicitly state so, and provide a formal finding of unavailability. 2. Conduct evidentiary development, to include a listing of the precise dates and locations of the Veteran's service, and provide a determination verifying whether the Veteran was exposed to Agent Orange or other dioxins during any period of foreign service. Please refer to the October 2021 Board hearing testimony and contact the appropriate entities (to include the National Personnel Records Center (NPRC) and Department of Defense (DOD) in order to make this determination. All information obtained in this regard must be added to the record. If any such information and/or specific list of precise dates and/or locations cannot be obtained, the reasons therefore must be fully documented and associated with the Veteran's claims file. 3. If it is determined that the Veteran had verified in-service exposure to herbicides or other dioxins, the RO should obtain a VA medical opinion from an appropriate clinician to determine the etiology of the Veteran's causes of death. Following complete review of the record, the examiner must address the following: (a) Opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's cause of death by multi organ system failure, advanced stage metastatic cancer and/or primary cancer of the esophagus was related to his active duty service, to include in-service exposure to herbicides and/or dioxins. Please note: the examiner must discuss the two positive medical opinions (one undated and the other dated May 2017) submitted by the appellant in the requested opinion. (b) Any opinion should include a detailed rationale. The examiner should consider the entire claims file, and discuss the appellant's lay statements. The examiner is advised that the appellant is competent to report the Veteran's symptoms, and that her reports must be considered in formulating the requested opinion. (c) If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rational for the conclusion that an opinion could not be provided without resorting to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. See Jones v. Shinseki, 23 Vet. App. 382. (2010). DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Carter, 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.