Citation Nr: 18140021 Decision Date: 10/02/18 Archive Date: 10/02/18 DOCKET NO. 16-07 054 DATE: October 2, 2018 REMANDED Service connection for Raynaud's syndrome of the left upper extremity is remanded. Service connection for Raynaud's syndrome of the right upper extremity is remanded. Service connection for Raynaud's syndrome of the left lower extremity is remanded. Service connection for Raynaud's syndrome of the right lower extremity is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1982 to March 1985. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The claims for service connection for Raynaud's syndrome of the bilateral upper and lower extremities are remanded. An April 2017 VA treatment record reflects that a psychiatrist stated that the Veteran’s Raynaud’s syndrome started in active service due to chemical exposure. This evidence is pertinent and has not been reviewed by the AOJ. The AOJ must review this evidence in the first instance. 38 C.F.R. § 20.1304(c). The Veteran states that his Raynaud’s syndrome was caused by exposure to chemicals in jet fuel during active service. VA treatment records show the Veteran was initially diagnosed with Raynaud’s phenomenon in November 2013 after he reported a history of poor circulation in the hands and feet for the past four to five years. His DD 214 and service treatment records show that he served as an aviation electrician’s mate (“AE”) and in aviation maintenance. In June 1984, the Veteran was examined for the purpose of being qualified to paint, and was found so qualified. In a December 2014 VA treatment record, the Veteran’s treating physician indicated that there is an association between Raynaud’s and chemicals such as benzene. The Veteran has submitted treatise evidence reflecting that there can be isopropylbenzene exposure through absorption of aromatic hydrocarbons from jet fuel. The Veteran also submitted a study stating that arsenic exposure can cause Raynaud’s disease. Based on the above evidence, the AOJ should conduct further development to try to assess the extent and nature of the Veteran’s chemical exposure from jet fuel or paint in connection with his duties in aviation maintenance. Then, if warranted based on the information obtained regarding such exposure, a VA medical opinion should be obtained as to the likelihood that the Veteran’s Raynaud’s phenomenon is linked to in-service chemical exposure. The matters are REMANDED for the following action: 1. Review the April 2017 VA treatment record in which a psychiatrist stated that the Veteran’s Raynaud’s syndrome started in active service due to chemical exposure. Also review the VA Problem List from the VA treatment records in which it is noted under the diagnosis of Raynaud’s phenomenon that the Veteran had contact with chemicals in the military. This evidence must be considered on readjudication of the claim. 2. Contact the appropriate entity to try to assess the nature and extent of any chemical exposure the Veteran may have had from jet fuel or paint, including to benzene and arsenic, in connection with his duties in aviation maintenance. One possible source is the U.S. Navy and Marine Corps Public Health Center (NMCPHC). The following information (and any additional information that the AOJ may deem pertinent) should be furnished to the NMCPHC (or other appropriate entity as determined by the AOJ): The Veteran served as an aviation electrician’s mate (AE) with an MOS specialty number of AE-8379 H-46, System Organizational Maintenance. He was assigned to HC-3 (Helicopter Sea Combat Squadron, also known as HSC-3) at Naval Air Station North Island in San Diego. His rating was AE3 at separation. He also may have performed painting duties. See June 1984 Service Examination Report. Based on the Veteran’s MOS and duty assignment, the NMCPHC (or other appropriate entity) should be asked to provide an opinion as to the nature and extent of any chemical exposure the Veteran may have had from jet fuel or paint, including to benzene and arsenic. 3. If sufficient information is gathered regarding the Veteran’s in-service chemical exposure (as discussed in the preceding directive), obtain a VA medical opinion as to whether it is at least as likely as not (50% probability or more) that the Veteran’s Raynaud’s phenomenon is linked to such exposure. The opinion must be supported by a complete explanation. P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Rutkin, Counsel