Citation Nr: 1323079 Decision Date: 07/19/13 Archive Date: 07/24/13 DOCKET NO. 10-11 238 ) DATE ) ) Received from the Department of Veterans Affairs Regional Office in Houston, Texas THE ISSUES 1. Entitlement to service connection for type 2 diabetes mellitus. 2. Entitlement to service connection for hypertension including on a secondary basis. 3. Entitlement to secondary service connection for peripheral neuropathy of the right leg and left leg. 4. Entitlement to secondary service connection for erectile dysfunction. REPRESENTATION Appellant represented by: Texas Veterans Commission WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD N. T. Werner, Counsel INTRODUCTION The Veteran served on active duty from October 1960 to April 1965. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a January 2008 decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Chicago, Illinois. The Veteran thereafter moved to Texas and jurisdiction over the appeal was transferred to the RO in Houston, Texas. In March 2013 the Veteran testified at a video hearing before the undersigned Veterans' Law Judge. A transcript of that hearing has been associated with the record. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND As to all the issues on appeal, in writings to VA as well as at his hearing the Veteran reported that in May 1962, while stationed on the U.S.S. Bennington as a hydraulics technician he was part of a team of mechanics that worked exclusively on the ships anti-submarine aircraft and there was an occasion when they had to fly to DaNang, the Republic of Vietnam, to repair the brakes on an S2-F3 anti-submarine aircraft in order for the aircraft to return to the ship. He also reported that the repair took eight to ten hours and then he flew back to the U.S.S. Bennington. Accordingly, because the Veteran's service personnel records confirm his service on the U.S.S. Bennington in May 1962 as a mechanic with an anti-submarine aircraft division, the Board finds that a remand is required for VA to request that a search of the ship logs for the U.S.S. Bennington be undertaken for May 1962 to see if they document the above incident. See 38 U.S.C.A. § 5103A(b) (West 2002). As to the claim of service connection for hypertension, at the March 2013 hearing the Veteran notified VA for the first time that within the first three or four years after his separation from military service he was turned down for life insurance from the National Life Insurance Company because of his hypertension. He also reported that he received treatment in the late 1960's for his hypertension from the Carbondale Clinic as well as Carbondale Hospital. However, while the record shows that the Veteran's post-January 1996 treatment records from Carbondale Clinic were requested and obtained by the RO, it does not show that his records for the 1960's were requested from the Carbondale Clinic or any of his records were requested from Carbondale Hospital or the National Life Insurance Company. Therefore, the Board finds that a remand is also required to request these records. See 38 U.S.C.A. § 5103A(b). As to all the issues on appeal, while the RO was notified in July 2008 and December 2008 that the St. Louis University Hospital needed a properly executed authorization to provide VA with a copy of the Veteran's records, the record does not show that the RO thereafter obtained such an authorization from the claimant and resubmitted it to the hospital. Therefore, the Board finds that a remand is also required to once again request these records. See 38 U.S.C.A. § 5103A(b). As to the claim of service connection for type 2 diabetes mellitus, the Board also finds that a remand is required to obtain a medical opinion as to whether the Veteran's described herbicide exposure would be sufficient to cause his current disorder. See 38 U.S.C.A. § 5103A(d) (West 2002); 38 C.F.R. § 3.307 (2012). As to the claim of service connection for hypertension, the Board finds that a remand is required to obtain a medical opinion as to whether the Veteran's current disability is related to military service including the documented elevated blood pressure readings seen in service treatment records dated in March 1963, September 1964, and December 1964 as well as at the March 1965 separation examination. See 38 U.S.C.A. § 5103A(d) (West 2002); 38 C.F.R. § 3.303 (2012); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992) (establishing service connection requires finding a relationship between a current disability and events in service or an injury or disease incurred therein). As to the claims of secondary service connection for hypertension, peripheral neuropathy of the right leg and left leg, and erectile dysfunction, the Board finds that a remand is also required to obtain a medical opinion as to whether any of these problems were caused or aggravated by the Veteran's type 2 diabetes mellitus. See 38 U.S.C.A. § 5103A(d) (West 2002); 38 C.F.R. § 3.310 (2012); Allen v. Brown, 7 Vet. App. 439 (1994) (en banc) (holding that where service connection is sought on a secondary basis, service connection could be granted for a disability which was not only proximately due to or the result of a service-connected condition, but could also be granted where a service-connected disability had aggravated a nonservice-connected disability, with compensation being paid for the amount of disability which exceeded "the degree of disability existing prior to the aggravation."). Accordingly, the appeal is REMANDED to the RO/AMC for the following actions: 1. The RO/AMC, after obtaining authorizations from the Veteran, should seek to obtain and associate with the record, copies of all of his medical records from the National Life Insurance Company, Carbondale Clinic, Carbondale Hospital, and St. Louis University Hospital from 1965 to the present. All actions to obtain the requested records should be documented fully in the claims file. If any of the records cannot be located or do not exist, the Veteran should be notified that the records are not available. 2. The RO/AMC should request that a search of the appropriate logs for the U.S.S. Bennington be undertaken for May 1962 to see if they document the Veteran's claims regarding aviation mechanics from the U.S.S. Bennington having to fly to DaNang in May 1962 to repair anti-submarine aircraft. All actions to obtain the requested information should be documented fully in the claims file. Because these are Federal records, efforts to obtain the information should be ended only if it is concluded that the information sought does not exist or that further efforts to obtain the information would be futile. If they cannot be located or no such records exist, a memorandum of unavailability should be associated with the claims files and the Veteran should be notified that the information is not available. 3. After undertaking the above development to the extent possible, the RO/AMC should make arrangements with an appropriate VA medical facility for the Veteran to be examined and the questions set out below addressed. The claims file should be provided to the examiner for review in connection with the examination. All indicated tests and studies deemed appropriate by the examiner should be accomplished and all clinical findings should be reported in detail. The examiner should address the following questions. a. Considering sound medical reasoning and all the evidence of record, would exposure to herbicides as may have been present in DaNang, Vietnam in May 1962 for a period of 8 to 10 hours, caused the Veteran to develop his diabetes. b. Is it at least as likely as not (50 percent probability or more) that the Veteran's current hypertension was caused by his military service or has continued since that time? c. Is it at least as likely as not (50 percent probability or more) that the Veteran's current for hypertension, peripheral neuropathy of the right leg and left leg, and/or erectile dysfunction were caused by or aggravated by his type 2 diabetes mellitus? In providing answers to the above questions, the examiner should comment on, among other things, the documented elevated blood pressure readings seen in service treatment records dated in March 1963, September 1964, and December 1964 as well as at the March 1965 separation examination. If the examiner cannot provide answers to any of the above questions, the examiner is advised that he/she should explain why the requested opinion cannot be provided (e.g., because the limits of medical knowledge had been exhausted or because further information to assist in making the determination is needed such as additional records and/or diagnostic studies). If further information to assist in making the determination is needed, that information should be identified, and follow-up efforts taken to obtain it, in order to obtain the requested opinion. In providing answers to the above questions, the examiner is advised that the term "as likely as not" does not mean within the realm of possibility. Rather, it means that the weight of medical evidence both for and against a conclusion is so evenly divided that it is medically sound to find in favor of causation as to find against causation. "More likely" and "as likely" support the contended causal relationship; "less likely" weighs against the claim. In providing answers to the above questions, the examiner is advised that "aggravation" is defined for these purposes as a chronic worsening of the underlying condition, as opposed to a temporary flare-up of symptoms. If aggravation is found, the examiner should also provide an opinion as to the base line of the hypertension, peripheral neuropathy of the right leg and left leg, and/or erectile dysfunction before being aggravated. A complete rationale with citation to relevant evidence found in the claims file should be provided for each opinion offered. 4. The RO/AMC should readjudicate the claims. If any of the benefits sought on appeal remain denied, the Veteran and his representative should be provided a supplemental statement of the case (SSOC). The SSOC should contain notice of all relevant actions taken on the claims for benefits, to include a summary of the evidence received since the February 2010 statement of the case including the Viet Nam Bonus receipt, and all applicable laws and regulations considered pertinent to the issues currently on appeal. A reasonable period of time should be allowed for response before the appeal is returned to the Board. The appellant has the right to submit additional evidence and argument on the matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). These claims must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ MICHAEL E. KILCOYNE Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board is appealable to the United States Court of Appeals for Veterans Claims. 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) (2012).