BVA9504981 DOCKET NO. 91-49 245 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Des Moines, Iowa THE ISSUE Entitlement to service connection for skin cancer. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD William J. Jefferson, III Counsel INTRODUCTION The veteran had active service from February 1943 to November 1945. This case comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision of the Department of Veterans Affairs (VA) Des Moines, Iowa, Regional Office (RO). In a June 1991 rating decision, the RO denied the claim of entitlement to service connection for skin cancer. The veteran disagreed with the determination in September 1991 and a timely substantive appeal was filed. In March 1993 decision, the Board denied the claim of entitlement to service connection for skin cancer. The appellant appealed the Board's March 1993 decision to the United States Court of Veterans Appeals (Court). In an order entered November 1994, the Court vacated the Board's decision, and remanded the case in compliance with the agreement between the parties, in a Joint Motion For Remand And To Stay Proceedings. The motion requires the Board to address unsubstantiated medical conclusions, provide adequate reasons and bases, and fulfill the duty to assist. REMAND As indicated previously, the Court in its November 1994 order has directed the Board to comply with the Joint Motion For Remand And To Stay Proceedings. In pertinent part, with respect to the Board's duty to assist, the motion states that as a part of the duty to assist subsequent to finding a "well grounded" claim, the VA did not explore possible government means to determine the degree of exposure that the veteran received in service, including the make and model of the x-ray machines with which the veteran had daily contact and the conditions under which he worked. The motion also indicates that the veteran has not been informed that he can submit his own dose information from a "credible source," based upon his particular facts and circumstances. It is possible that the appropriate service department's central medical library or depository may have dose estimate information concerning the x-ray machines used and the surrounding circumstances of such use and the veteran's occupational radiation exposure while in World War II service. Such an investigation has not been attempted. If still no acceptable information is provided, the office of the VA Chief Medical Director may be able to suggest whether and where such information could be obtained in compliance with the Joint Motion For Remand And To Stay Proceedings. Furthermore, for specificity, information should be obtained from the veteran concerning daily sun exposure that he received during and after service. He reportedly served for 28 months with the 99th Station Hospital at Gaya, India. After service, he states that he was a farmer in Elliot, Iowa, for many years until his retirement in 1978. He developed skin cancers of the nose in 1989. Additionally, the Joint Motion For Remand And To Stay Proceedings refers to the May 1991 VA Chief Assistant Medical Director for Environmental Medicine opinion, in which it is stated that it was unlikely that the veteran received more than 25 rads to the face (during service), and that apart from military service he was exposed to more than usual actinic radiation as a farmer. If possible, the VA Chief Assistant Medical Director is requested to offer information to substantiate the aforementioned conclusions, specifically the dose data which was reported. The VA has a statutory duty to assist claimants with their claims under the provisions of 38 U.S.C.A. § 5107(a) (West 1991). In consideration of the foregoing, this case is REMANDED to the RO for the following: 1. The RO should contact the veteran to provide, as far as practicable, detailed information concerning the amount of exposure to the sun that he received during and after service, including that relating to his farming, and associate that information with the claims folder. 2. The RO should inform the veteran that he is entitled to submit his own dose estimate from a credible source 38 C.F.R. § 3.311(a)(3), regarding his exposure to radiation as an X-ray technician during service. 3. The RO should contact the United States Department of the Army so that they may ascertain if they have in their possession or in a medical depository or library (other than the U.S. Army Radiation Dosimetry Center which has already been contacted) any medical information or dosimetry data concerning occupational radiation exposure by soldiers from X-ray machines, particularly Picker and Waite 15MA and 30MA Portable Field Units, which were in use in the mid-1940's. Copies of those records should be associated with the claims folder. 4. The VA Assistant Chief Medical Director for Environmental Medicine is requested to offer any scientific or clarifying data to substantiate the conclusions from the May 1991 opinion that it was unlikely that the veteran received more than 25 rads to the face (during service), and that apart from military service he was exposed to more than usual actinic radiation as a farmer. If that information is unavailable, the RO should develop this claim under 38 C.F.R. § 3.311, so that the Chief Medical Director may provide a dose estimate, to the extent feasible, based on additional data and substantiated by any available scientific data. When the requested development has been accomplished, if the claim remains in a denied status, the appellant should be furnished with a supplemental statement of the case and afforded a reasonable opportunity to respond thereto. Thereafter, if necessary, the case and the requested evidentiary data should be returned to the Board of Veterans' Appeals for further appellate disposition. SAMUEL W. WARNER 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) (1994).