BVA9501005 DOCKET NO. 91-13 615 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to service connection for the cause of the veteran's death. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant and A.R.J. ATTORNEY FOR THE BOARD Harold A. Beach, Counsel INTRODUCTION The veteran, who died in February 1990, served on active duty from May 1954 to December 1957 and from January 1958 to June 1976. This matter comes to the Board of Veterans' Appeals (Board) on appeal of an April 1990 decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. During the course of the appeal, the appellant raised contentions to the effect that the veteran's death was due, in part, to his exposure to Agent Orange while serving in the Republic of Vietnam. In May 1991, the Board noted that claims related to Agent Orange were being held in abeyance pending the issuance of new regulations regarding the residuals of such exposure. Accordingly, the Board remanded the case pending the issuance of those regulations. In July 1994, following the issuance of the new regulations applicable to Agent Orange claims, the RO confirmed and continued the denial of service connection for the cause of the veteran's death. Thereafter, the case was returned to the Board for further appellate review. REMAND The death certificate shows that the veteran died in February 1990, as a result of cholangiocarcinoma. The appellant maintains that the fatal cancer was caused by the veteran's extensive exposure to carbon tetrachloride during service. She asserts that a VA physician who followed the veteran for this cancer is of the opinion that carbon tetrachloride exposure was a possible cause of the veteran's cholangiocarcinoma. The Board notes that documentation of this opinion is not of record. The Board further notes that cholangiocarcinoma is a disease subject to presumptive service connection, based on a veteran's participation in a "radiation-risk" activity and that the record reflects that the veteran was monitored for radiation exposure at Kadena Air Base in September 1962. The circumstances of that exposure, including the type of exposure and radiation dose, are not described in the service personnel records. In light of the foregoing, the Board is of the opinion that further development is warranted prior to final appellate consideration. Accordingly, the case is REMANDED for the following actions: 1. The RO should request that the service department provide copies of the veteran's medical records from his first period of service. It should also request the personnel records from his entire time in service, including, but not limited to, any job descriptions, enlisted efficiency reports, or records of exposure to hazardous substances. All records so obtained should be associated with the claims folder. Negative responses or failures to reply to any request should be noted in writing and associated with the claims folder. 2. The RO should request the appellant to provide the names, addresses and approximate dates of treatment for all health care providers who treated the veteran for cholangiocarcinoma. After the requested information and any necessary authorization have been received, the RO should obtain copies of all indicated records. In any event, the RO should obtain a copy of the September 1989 report of the veteran's hospitalization at the Cochran VA Hospital in St. Louis, Missouri. 3. The RO should request the appellant to provide as much information as possible concerning the circumstances of the veteran's possible exposure to radiation during service. Any information provided by the appellant and copies of the veteran's service personnel records to include the September 1962 DD Form 1141 should be forwarded to the Defense Nuclear Agency (DNA) for preparation of a radiation dose estimate and verification of the veteran's participation in a "radiation risk" activity. 4. If the evidence received in response to the above development fails to establish the veteran's participation in a "radiation- risk" activity, the appellant should be afforded an opportunity to submit medical evidence to show that a plausible basis exists for attributing the veteran's fatal cancer to service radiation exposure. 5. The RO should arrange for the claims folder to be reviewed by a board-certified oncologist, if available. The oncologist should provide an opinion, with complete rationale, as to the etiology of the veteran's cholangiocarcinoma, to include whether it is at least as likely as not that the cancer was etiologically related to the veteran's exposure to carbon tetrachloride in service. 6. Thereafter, the RO should undertake any other indicated development and readjudicate the appellant's claim for service connection for the cause of the veteran's death. In readjudicating the radiation aspect of the claim, the RO should give due consideration to Combee v. Brown, No. 93-7107 (Fed.Cir. September 1, 1994) reversing in part Combee v. Principi, 4 Vet.App. 78 (1993). If the decision remains adverse to the appellant, she and her representative must be furnished a Supplemental Statement of the Case and afforded an opportunity to respond. 38 C.F.R. § 20.302(c) (1993). Thereafter, if otherwise in order, the claims folder should be returned to the Board for further appellate consideration. By this REMAND, the Board intimates no opinion as to the final disposition warranted. The appellant need take no action until she is otherwise notified. SHANE A. DURKIN Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1993).