Citation Nr: 25004063 Decision Date: 03/26/25 Archive Date: 03/26/25 DOCKET NO. 18-25 491 DATE: March 26, 2025 REMANDED Entitlement to service connection for a colon disability, to include colon resection, colon cancer, and benign neoplasm of the colon is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1971 to February 1973. This matter came before the Board of Veterans Appeals (Board) on appeal from a January 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veteran's Law Judge during February 2020 and September 2023 hearings. The transcripts of the hearings are of record. The Board remanded the issues on appeal for further development in June 2020, October 2021, June 2022, December 2023, and December 2024. The Board also denied entitlement to service connection for bilateral sinus, hypertension, respiratory, and bilateral eye disabilities in the June 2022 decision. The Board notes that the Veteran's February 2016 Notice of Disagreement (NOD) included the issues of entitlement service connection for arthritis of the left hip, left knee, and left foot, as well as service connection for a prostate disability. However, a September 2024 rating decision granted service connection for left hip arthritis, left knee arthritis, left foot arthritis, and benign prostate hypertrophy. As this constituted a full grant of the issues on appeal, they therefore are not before the Board. See Harper v. Wilkie, 30 Vet. App. 356 (2018). Entitlement to service connection for a colon disability, to include colon resection, colon cancer, and benign neoplasm of the colon Pursuant to the December 2024 Board remand, the AOJ obtained a new VA etiology opinion in January 2025 which found that the Veteran's colon polyps were less likely than not related to his in-service toxic exposure. The examiner found that medical literature did not support such a relationship and that it was "not objectively possible." However, a medical opinion cannot be based solely on medical literature without a discussion of the facts pertaining to the Veteran's condition or individual circumstance, and the statement that a nexus was not objectively possible is conclusory without any further rationale or citation to the record. See Bailey?v. O'Rourke, 30 Vet. App. 54, 60-61 (2018). The only discussion regarding the Veteran's specific disease progression addressed the presence and likelihood of other potential risk factors, but it is not clear how this necessarily supported a finding that the Veteran's toxic exposure was not among them. As the January 2025 etiology opinion lacks sufficient supporting rationale based on the Veteran's specific disability picture, it is inadequate. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Remand is necessary to obtain an adequate etiology opinion. The matters are REMANDED for the following action: 1. Obtain a VA opinion, from an appropriate clinician who has yet to provide an opinion on this matter, to determine the etiology of any current colon disability, including a history of benign neoplasms and colon resection. The examiner should review the file and provide a complete rationale for all opinions expressed. For any current colon disability diagnosed, the examiner should provide an opinion as to whether it is at least as likely as not (likelihood is at least in approximate balance or nearly equal in the Veteran's favor, if not higher) that any such disability is related to the Veteran's toxic exposure during service, to include his conceded asbestos exposure. The examiner must consider the Veteran's total potential exposure through all applicable military deployments, as well as the synergistic combined effect of all toxic exposure risk activities. In providing the opinion, the examiner should consider and discuss any lay statements of record, to include the Veteran's statements regarding the onset and persistence of his symptoms. 2. If upon completion of the above action the appeal remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Bock 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.