Citation Nr: 22015187
Decision Date: 03/16/22	Archive Date: 03/16/22

DOCKET NO. 18-35 692
DATE: March 16, 2022

REMANDED

Entitlement to service connection for prostate cancer and residuals is remanded.

REASONS FOR REMAND

The Veteran had active duty service from March 1952 to March 1954.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2018 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). 

The Board most recently remanded the issue for further development in September 2021. The Board previously remanded the claim in February 2019 and January 2021. The claims have been returned to the Board for appellate review. 

Entitlement to service connection for prostate cancer and residuals is remanded.

Unfortunately, there has not been substantial compliance with the Board's previous remand directive regarding service connection for prostate cancer and residuals. Stegall v. West, 11 Vet. App. 268, 271 (1998). The September 2021 Board remand required that the Veteran be afforded an in-person examination, which was not provided. Another remand is required.

In addition, the Veteran's representative submitted a January 2022 informal hearing presentation. Therein, the representative argued that the examinations of record are insufficient. The representative argues that, amongst other arguments, with regard to service-connection as secondary to bladder cancer, the medical literature cited by the examiner supports the grant, rather than denial, of secondary service connection.  Such must be considered on remand.

The matters are REMANDED for the following action:

1. Obtain updated private and VA treatment records, with any assistance required from the Veteran.

2.  Schedule the Veteran for an in-person VA examination for prostate cancer and residuals, with a physician. Following a complete review of the evidence of record and with consideration of the Veteran's lay statements, assuming the statements are credible for the limited purpose of the request herein, the physician is requested to provide the following opinion: 

(a.) Are the Veteran's prostate cancer and residuals related to service, to include exposure to contaminants in the water at Camp Lejeune?  Why or why not?

The examiner is advised that a negative opinion cannot be based solely on the fact that prostate cancer and residuals are not on the list of diseases that are presumptively associated with exposure to contaminants in the water supply at Camp Lejeune.

(b.) Are the Veteran's prostate cancer and residuals proximately due to or aggravated beyond its natural progression by already service-connected bladder cancer?  Why or why not?

The examiner must address the medical literature relied on in the October 2021 examinations regarding the association between bladder cancer and prostate cancer and whether this evidence supports service connection as secondary to bladder cancer.

The examiner is informed that a positive opinion indicating a nexus to service does not require certainty.  Rather, if the weight of the evidence is in approximate balance for and against a nexus to service, the examiner should make a determination favorable to the Veteran.

A complete rationale must be provided for all opinions offered. If any opinion cannot be offered without resort to mere speculation, the examiner must fully explain why this is the case and identify what, if any, additional evidence would potentially allow for a more definitive opinion. 

 

Jennifer White

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Mookim, Hope P.

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.