Citation Nr: 23002425 Decision Date: 01/13/23 Archive Date: 01/13/23 DOCKET NO. 17-51 460 DATE: January 13, 2023 REMANDED Entitlement to service connection for prostate cancer including as due to herbicide exposure is remanded. Entitlement to service connection for ischemic heart disease (IHD) including as due to herbicide exposure is remanded. REASONS FOR REMAND The Veteran had active air service from August 1963 to August 1967. This matter comes before the Board of Veterans' Appeals (Board) on appeal from July 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In March 2021, the Board denied entitlement to service connection for prostate cancer and ischemic heart disease. The Veteran appealed to the United States Court of Appeals for Veterans Claims (Court). In a January 2022 joint motion for remand (JMR), the United States Court of Appeals for Veterans Claims vacated the March 2021 Board decision to deny entitlement to service connection for prostate cancer and ischemic heart disease and remanded the issues to the Board for additional development consistent with the JMR. Although the Board sincerely regrets a delay, a remand is necessary to ensure that there is a complete record upon which to decide the Veteran's claim and to afford him every possible consideration. 1. Entitlement to service connection for prostate cancer including as due to herbicide exposure is remanded. 2. Entitlement to service connection for ischemic heart disease (IHD) including as due to herbicide exposure is remanded. The Veteran was stationed at Eglin AFB, Florida from January 1967 through August 1967. The Veteran asserts that his prostate cancer and ischemic heart disease are related to exposure to herbicides. The Veteran's duties consisted of picking up supplies at various warehouses at Eglin. He made these runs daily and he was outside most of the time during testing and spraying of these herbicides. The Veteran asserted that he went to different areas of the compound including various fishing sites to sit on the ground and eat lunch. See VA Form 9 received on September 29, 2017. Tests were later conducted by the Air Force showing that most of the grounds he came in contact with were contaminated. As noted above, the Veteran appealed the March 2021 Board decision. Subsequently, the Court found that the Board erred when it failed to address potentially favorable evidence regarding the environmental effects from Eglin AFB. Specifically, an article by the Vietnam Veterans of America discussed the environmental effects of herbicide testing at Eglin AFB, ie. wind and water erosion from the contaminated testing sites brought dioxins, furans, and other contaminants into nearby areas used for fishing and swimming, as well as residential areas. This article and the information contained therein is particularly relevant considering the Veteran's assertions above. The Board did not address the Veteran's lay contentions considering the potentially favorable evidence regarding the effect that exposure to herbicides had on the environment surrounding Eglin AFB as discussed in the article. Accordingly, to more accurately assess whether the Veteran's prostate cancer and/or ischemic heart disease is related to service including due to herbicide exposure, an addendum medical nexus opinion must be obtained that is supported by a well-reasoned rationale. Barr v. Nicholson, 21 Vet. App. 303 (2007). The matters are REMANDED for the following action: 1. Forward the Veteran's claims file to a physician with sufficient expertise to provide an addendum medical opinion regarding the nature and etiology of the Veteran's prostate cancer and/or ischemic heart disease. The examiner must review the claims file and note that review in the report. Based on the record, whether there is at least an approximate balance of the positive and negative evidence (approximately 50 percent or better) that prostate cancer and/or ischemic heart disease is related to the Veteran's active service, to include due to exposure to herbicides. The physician must consider the Veteran's lay contentions with consideration of the article by the Vietnam Veterans of America that discusses the environmental effects of herbicide testing at Eglin AFB, ie. wind and water erosion from the contaminated testing sites brought dioxins, furans, and other contaminants into nearby areas used for fishing and swimming, as well as residential areas. See VA Form 9 and Correspondence received on September 29, 2017. The physician must also consider that a significant amount of the defoliants Agent Orange, Agent Purple, and Agent White were sprayed at Eglin AFB between 1982 and 1970. The spray rate for Agent Orange at Eglin was 876 kg per hectare (2 acres) versus 14.8 kg per hectare disseminated in a typical mission in the Republic of Vietnam. Each hectare at Eglin received at least 1300 times more dioxin than a hectare sprayed in Vietnam, which significantly increased the risk of contamination. A detailed rationale must be provided for all opinions expressed. A VA examination of the Veteran should only be conducted if deemed necessary by the examiner providing the requested medical opinions. 2. Confirm that the medical opinions provided comport with this remand, and undertake any other development found to be warranted. 3. Then, readjudicate the remaining issues on appeal. If a decision is averse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response and return the case to the Board. JIMMY L. BARDIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Ivan Franklin 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.