Entitlement to service connection for thyroid cancer, claimed as the result of ionizing radiation exposure, is remanded.
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Citation Nr: 22027423 Decision Date: 05/10/22 Archive Date: 05/10/22 DOCKET NO. 17-63 906 DATE: May 10, 2022 REMANDED Entitlement to service connection for thyroid cancer, claimed as the result of ionizing radiation exposure, is remanded. Entitlement to service connection for pituitary adenoma, claimed as the result of ionizing radiation exposure, is remanded. REASONS FOR REMAND The Veteran had active service from January 1974 to August 1977; from March 1983 to December 1992; and from September 2001 to April 2003. He additionally had duty with the Air Force Reserve. Entitlement to service connection for both thyroid cancer and pituitary adenoma, claimed as the result of ionizing radiation exposure, is remanded. The Veteran contends that service connection for thyroid cancer is warranted as the claimed disability was incurred as the result of in service ionizing radiation exposure while patrolling the Nellis Air Force Base's South Range during active service. He asserts that service connection for pituitary adenoma is warranted as the result of in service ionizing radiation exposure and/or secondary to the thyroid cancer. The service personnel records reflect that the Veteran was stationed at Indian Springs Air Force Base. Private treatment records show that in August 2013, the Veteran was diagnosed with both thyroid cancer and pituitary adenoma. In an April 2015 written statement, the Air Force indicated that a review of occupational radiation exposure monitoring records in the USAF Master Radiation Exposure Registry found no external or internal radiation exposure data for the Veteran. An April 2016 written statement from the Chief of the Air Force Safety Center's Nuclear Weapons Safety Branch notes that the Veteran's duties while assigned to Creech (Indian Springs) Air Force Base included duties in the southern part of the Nellis Air Force Range, which bordered the eastern boundary of the Nevada Test Site. He observed that: "[d]uring the Veteran's time at the air force base, 33 underground tests were conducted at the Nevada Test Site;" "[a]s the tests were underground and had engineered containment, radiological releases to the atmosphere were negligible;" and while "the Veteran may have received more radiation dose than some or all of the off-site locations that were monitored," it was found that such "levels would have remained negligible in comparison to the established exposure limit for members of the public and those already naturally part of background." He concluded that the "Veteran's concern of radiation exposures from underground nuclear weapons tests while he was at Indian Spring Air Force Base cannot be validated with historical monitoring data conducted by the Environmental Protection Agency at off-site locations and data collected by the Energy Research and Development Admin at Nevada Test Site locations" and "[a]s such, we have no dose recommendation for the Veteran." In a January 2017 written statement, the National Nuclear Security Administration indicated that a search of dosimetry records revealed no entries for the Veteran. In a May 2017 written statement, the Air Force stated that the Air Force Safety Center had reviewed the Veteran's records. The unit did not find evidence that the Veteran's duties would have involved working directly with nuclear weapon systems or components and/or required prolonged and close proximity to nuclear weapons. No dose estimate or other radiation dose information for the Veteran was provided. A March 2017 evaluation from C. Bash, M.D., states that the Veteran "had exposure to radiation at Indian Springs, AFB-Nevada." The doctor concluded that the "time lag between radiation dose exposures in service and current thyroid cancer pathology is consistent with known medical principles and the natural history of this disease" and the diagnosed thyroid cancer "is due to military service." The Department of Veterans Affairs' (VA) duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124 (1991). The Veteran has not been afforded a VA examination which addresses thyroid cancer and pituitary adenoma. The matters are REMANDED for the following action: Schedule the Veteran for a VA an oncology examination conducted by a medical doctor to assist in determining the relationship between thyroid cancer, pituitary adenoma, and active service, to include exposure to include the claimed ionizing radiation exposure. The examiner must review the record, including the April 2016 written statement from the Chief of the Air Force Safety Center's Nuclear Weapons Safety Branch, the March 2017 evaluation from C. Bash, M.D., and the medical references submitted by the Veteran, and should note that review in the report. A rationale for all opinions should be provided. The examiner should: (a) Identify all thyroid and pituitary disabilities found. (b) Opine whether it is at least as likely as not (50 percent probability or greater) that any identified thyroid and pituitary disabilities had their onset during active service or is related to any incident of service, including the claimed in service ionizing radiation exposure. The examiner must specifically address the April 2016 written statement from the Chief of the Air Force Safety Center's Nuclear Weapons Safety Branch, the March 2017 evaluation from C. Bash, M.D., and the medical references submitted by the Veteran. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Casula 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.