Citation Nr: 1324020 Decision Date: 07/29/13 Archive Date: 08/07/13 DOCKET NO. 11-02 232 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUES 1. Entitlement to service connection for pituitary adenoma, to include as due to herbicide exposure. 2. Entitlement to service connection for headaches, to include as secondary to pituitary adenoma. 3. Entitlement to service connection for amyloidosis, to include as secondary to pituitary adenoma. 4. Entitlement to service connection for diabetes insipidus, to include as secondary to pituitary adenoma. 5. Entitlement to service connection for loss of visual acuity or peripheral vision, left eye, to include as secondary to pituitary adenoma. 6. Entitlement to service connection for hypothyroidism, to include as secondary to pituitary adenoma. REPRESENTATION Appellant represented by: Veterans of Foreign Wars WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD J. Juliano, Counsel INTRODUCTION The Veteran served on active duty from August 1969 to February 1972, followed by service in the Army Reserves until around June 2009. See DA Form 2-1; Board hearing transcript at 12; Notice of Waivers of VA Compensation to Receive Military Pay for 2008. These matters come before the Board of Veterans' Appeals (Board) on appeal from an August 2010 rating decision of the Department of Veterans Affairs (VA) regional office (RO) located in Nashville Tennessee. In May 2011, the Veteran testified at a videoconference Board hearing at the RO in Nashville, Tennessee before the undersigned Veterans Law Judge. A transcript of the proceeding has been associated with the claims file. The issues of entitlement to a total disability rating based on individual unemployability (TDIU), and entitlement to a nonservice-connected pension have been raised by the record but have not been adjudicated by the agency of original jurisdiction (AOJ). See Informal Claims, September 2010. Therefore, the Board does not have jurisdiction over these matters, and they are referred to the AOJ for adjudication. 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 The Veteran served on active duty from August 1969 to February 1972, followed by service in the Army Reserves until around June 2009. He claims that he has residuals of pituitary adenoma due to exposure to herbicides during his service in Vietnam. The Veteran testified at the Board hearing that he began to experience loss of vision and headaches in active service, which he attributes to the development of his pituitary adenoma. See Transcript at 9. He testified that his pituitary adenoma constitutes a slow advance or slow growth disease process that began during his active service in Vietnam. See Transcript at 9, 13. The Veteran's service personnel records confirm that he served in Vietnam from December 1970 to November 1971. See DA Form 2-1. Therefore, exposure to herbicides is presumed. See 38 U.S.C.A. § 1116(f) (West 2002); 38 C.F.R. § 3.307(a)(6)(iii) (2012). The Veteran's service treatment records reflect that by the time of the Veteran's December 1974 annual examination, his visual acuity was 20/200 in the right eye and 20/400 in the left eye. Prior thereto, his December 1971 separation examination report from his regular active duty reflects that his visual acuity was 20/20 in both eyes. A July 1983 Agent Orange registry examination records reflect that the Veteran's platelet count was 188. In June 2010, the Veteran listed certain private treatment providers relating to his claim, including Dr. M. Jenkins (primary care provider), and he also noted Humana Military Tri-Care Prime Insurance as a custodian of records relating to his claim. The Veteran also testified that he had environmental physicals with his employer, Kingsport Press. None of these records, however, have been requested by VA. Therefore, the Board finds that a remand is necessary so that any outstanding, relevant private medical records from these providers may be associated with the claims file. In addition, the Board notes that certain private treatment records appear to be outstanding. Specifically, in August 2010, the Veteran reported that he had appointments for treatment relating to his residuals of pituitary adenoma with Dr. K. Smith in September 2010 (for an MRI) and with Dr. L. Morris in November 2010. Also, at the Board hearing, the Veteran reported that he had an appointment scheduled with Dr. C. Bice in September 2011. See Transcript at 10. Also, the Veteran submitted CDs from the Wellmont Hospital relating to various MRIs of his brain, but the April 2009 and December 2009 discs do not include the MRI reports. Also, the February 29, 2008 MRI report makes a comparison to a November 12, 2007 MRI that is not included with the discs. In addition, a May 25, 2007 MRI report from Wellmont (associated with the claims file around August 2010) makes comparison to a prior May 1, 2007 MRI that is not of record. Finally, the Veteran reported in an August 2010 Form 21-4142 that an April 2007 MRI of the brain was ordered by Dr. Bice (albeit it is not clear if he intended to refer to the May 2007 MRI). Therefore, in light of the above, the Board also finds that a remand is necessary to obtain copies of these outstanding private treatment records. The Board acknowledges VA treatment records from the Mountain Home system in the claims file dated through January 2010. Any outstanding VA treatment records dated since January 2010 to present should also be associated with the claims file. With regard to the Veteran's secondary service connection claims, the Board notes that the August 2010 rating decision on appeal herein denied service connection for headaches, amyloidosis, diabetes insipidus, hypothyroidism and loss of visual acuity or peripheral vision, left eye. The Veteran filed a September 2010 notice of disagreement, stating "I want to appeal the rating decision received on August 31, 2010" and noting that he was submitting evidence relating to the pituitary gland claim and all of the disorders of the pituitary gland. The Board finds, having read the Veteran's notice of disagreement liberally, that he intended to disagree with the denial of all of his secondary service connection claims. Therefore, as no statement of the case (SOC) has been issued to address these issues, the Board finds that a remand is required for the issuance of an SOC. In addition, his Army Reserve service treatment and personnel records should also be obtained. Accordingly, the case is REMANDED for the following action: (Please note, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). Expedited handling is requested.) 1. Obtain any relevant VA treatment records dated since January 2010. 2. Obtain copies of the following private medical records: a) Dr. M. Jenkins (primary care provider) dated since 2007; b) Humana Military Tri-Care Prime Insurance dated since 2007; c) Dr. C. Bice dated since March 2010, including any April 2007 MRI report and September 2011 treatment records cited by the Veteran; d) Dr. K. Smith dated since March 2010, including any September 2010 records cited by the Veteran (for an MRI); e) Dr. L. Morris dated since January 2010, including any November 2010 records; f) Environmental physicals from Kingsport Press; and g) MRI reports from Wellmont Hospital dated: - May 1, 2007 - November 12, 2007 - April 2009 (disc has no report) - December 2009 (disc has no report) 3. Obtain service treatment records from the Veteran's Army Reserve service which began in 1975 and ended in approximately June 2009. 4. Obtain service personnel records records from the Veteran's Army Reserve service which began in 1975 and ended in approximately June 2009. 5. If, after making reasonable efforts to obtain named non-VA records the AMC is unable to secure same, or if after continued efforts to obtain federal records it is concluded that it is reasonably certain they do not exist or further efforts to obtain them would be futile, the AMC must notify the Veteran and (a) identify the specific records the AMC is unable to obtain; (b) briefly explain the efforts that the AMC made to obtain those records; (c) describe any further action to be taken by the AMC with respect to the claim; and (d) inform the Veteran that he is ultimately responsible for providing the evidence. The Veteran must then be given an opportunity to respond. 6. Provide the appellant with an SOC addressing the issues of: a) Service connection for headaches, to include as secondary to pituitary adenoma; b) Service connection for amyloidosis, to include as secondary to pituitary adenoma; c) Service connection for diabetes insipidus, to include as secondary to pituitary adenoma; d) Service connection for loss of visual acuity or peripheral vision, left eye, to include as secondary to pituitary adenoma; and e) Service connection for hypothyroidism, to include as secondary to pituitary adenoma. The appellant should be informed that after the issuance of the SOC, he must file a timely and adequate substantive appeal in order to perfect an appeal of these issues to the Board. 7. Then, after taking any other development action that is warranted, readjudicate the claim. If the claim remains denied, the Veteran should be provided a Supplemental Statement of the Case (SSOC). After the Veteran and his representative have been given the applicable time to submit additional argument, the case should be returned to the Board for further review. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals 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). _________________________________________________ S.S. TOTH Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals 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).