Citation Nr: 22016504
Decision Date: 03/22/22	Archive Date: 03/22/22

DOCKET NO. 18-34 794
DATE: March 22, 2022

REMANDED

Service connection for colon cancer is remanded.

REASONS FOR REMAND

The Veteran served on active duty from October 1988 to June 1998.  He died in August 2016.  The appellant has been substituted for him.  

This matter comes to the Board of Veterans' Appeals (Board) on appeal from a June 2016 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA).  The appellant testified before the undersigned Veterans Law Judge at a hearing held in November 2020. A copy of the transcript is of record.

1. Entitlement to service connection for colon cancer is remanded.

The appellant has asserted, in pertinent part, that the Veteran's colon cancer may have occurred as a result of his exposure to burn pits while in Southwest Asia. 

In September 2021, the Board remanded the appeal so the AOJ could obtain an opinion that addressed, in pertinent part, whether the Veteran's colon cancer developed as a result of such exposure. The RO obtained a VA medical opinion in October 2021.  The examiner opined that it was less likely than not that the Veteran's colon cancer was due to exposure to burn pits.  

Unfortunately, the Board is not able to determine from this opinion, or other competent medical evidence in the claims file, whether the Veteran's colon cancer constitutes a medically unexplained chronic multisymptom illness (MUCMI) as defined under 38 C.F.R. § 3.317(a)(2)(ii). The opinion and rationale appear to reflect that at least the etiology of the Veteran's colon cancer is partially understood. However, the holding in Stewart v. Wilkie, 30 Vet. App. 383 (2018) is clear that the Board must address whether both the etiology and the pathophysiology are at least partially understood in its analysis of whether a claimed diagnosed disorder may constitute a MUCMI.  Thus, it is necessary to remand the appeal for an addendum to the October 2021 opinion that explicitly discusses whether both the etiology and pathophysiology of colon cancer are at least partially understood in the context of the Veteran's unique circumstances. The Board sincerely regrets the delay.

The matter is  REMANDED for the following action:

Obtain an addendum opinion regarding the Veteran's colon cancer. The examiner is to provide responses to the following:

A) Is the etiology of the Veteran's colon cancer (1) inconclusive, (2) partially understood, or (3) fully understood? This determination must be based on the Veteran's specific case and cannot be based on the etiology of the disease or disability population as a whole.

B) Is the pathophysiology of the Veteran's colon cancer (1) inconclusive, (2) partially understood, or (3) fully understood? This determination must be based on the Veteran's specific case and cannot be based on the pathophysiology of the disease or disability population as a whole.

A rationale must be provided. 

 

 

D. JOHNSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	M. Prem, 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.