Citation Nr: 18142821 Decision Date: 10/17/18 Archive Date: 10/16/18 DOCKET NO. 12-27 774 DATE: October 17, 2018 REMANDED Entitlement to service connection for diabetes mellitus, type II, to include as due to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1967 to October 1970. This matter comes to the Board of Veterans' Appeals (Board) on appeal from an April 2011 rating decision issued by a Department of Veterans Affairs (VA) Regional Office. In August 2013, the Veteran testified at a Board hearing before a Veterans Law Judge. A transcript of the hearing is of record. While the Veterans Law Judge who conducted the hearing has since retired, the Veteran, through his representative, indicated that he did not desire another hearing before a different Veterans Law Judge in August 2018. In January 2015 and March 2016, the Board remanded the case for additional development and, in October 2017, denied the Veteran's claim. He subsequently appealed this decision to the Court of Appeals for Veterans Claims (Court). In June 2018, the Court issued an Order vacating the October 2017 decision and returning the case to the Board for action consistent with the Joint Motion for Partial Remand (JMPR). Entitlement to service connection for diabetes mellitus, type II, to include as due to herbicide exposure. The Veteran seeks service connection for diabetes mellitus, type II, which he claims is the result of exposure to herbicides, including Agent Orange, or other contaminants while he was stationed at Andersen Air Force Base in Guam from May 1969 to April 1970. In this regard, a May 2016 VA examiner opined that a nexus was unlikely because, as the Board noted in its January 2015 remand, exposure to Agent Orange in Guam was unlikely as there was no record of storage or use of Agent Orange in Guam during the Veteran’s period of service. The VA examiner further opined that there was also no evidence of any other potential exposures in Guam. However, in June 2018, the Court remanded the Veteran’s claim based on the JMPR’s finding that the May 2016 VA examination is inadequate. Specifically, the JMPR stated that there was a disconnect between the VA examiner’s opinion and articles submitted by the Veteran that identified the presence of potentially qualifying contaminants in Guam during the Veteran’s period of service. The JMPR noted that Congress has recognized dioxin as a contaminant or herbicide agent eligible to warrant service connection due to exposure, and the Veteran submitted articles, including an October 1992 article from the Environmental Protection Agency (EPA), that identified the presence of dioxin in Guam. In order to ensure compliance with the JMPR, the Board finds that a remand is necessary in order for the Agency of Original Jurisdiction to contact any appropriate entity so as to verify the presence of contaminants as included in the articles submitted by the Veteran’s representative on Andersen Air Force Base in Guam between May 1969 and April 1970. Furthermore, in accordance with the JMPR, a remand is also necessary in order to obtain an addendum opinion to address whether exposure to contaminants other than Agent Orange caused the Veteran’s diabetes mellitus, type II. In this regard, the Board acknowledges that, in her September 2018 brief, the Veteran’s representative referenced a seven-page independent medical opinion from Dr. J.D. Bagdade that it was more likely than not that the Veteran’s diabetes mellitus, type II, was causally related to his exposure to herbicidal agents such as TCDD, lead, PCB, and organopesticides such as DDT and DDE while he was at Andersen Air Force Base. However, this opinion has not been submitted for inclusion in the file. Therefore, the Veteran and/or his representative should be asked to submit this evidence on remand. The matter is REMANDED for the following action: 1. Request that the Veteran and/or his representative submit the opinion from Dr. J.D. Bagdade referenced in the September 2018 brief submitted by his representative. 2. Contact any appropriate entity so as to verify the presence of contaminants as included in the articles submitted by the Veteran’s representative on Andersen Air Force Base in Guam between May 1969 and April 1970. All requests and responses should be associated with the record. 3. Thereafter, return the record to the VA examiner who offered the opinion as to the etiology of the Veteran’s diabetes mellitus, type II, in May 2016. The record and a copy of this Remand must be made available to the examiner. If the May 2016 VA examiner is not available, the record should be provided to an appropriate medical professional so as to render the requested opinion. Following a full review of the record, please offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s currently diagnosed diabetes mellitus, type II, is related to exposure to contaminants, other than Agent Orange, at Anderson Air Force Base on Guam from May 1969 to April 1970. In this regard, the examiner should consider the articles submitted by the Veteran, including the October 1992 EPA article, and the Veteran’s contention that he has type II diabetes mellitus as a result of exposure to other contaminants in the soil and water including dioxins (TCDD), solvents, DDT metabolites, pesticides, lead, and PCBs. A rationale for any opinion offered should be provided. If it is not possible to provide an opinion without resort to speculation, the reason that is so should explained, indicating whether there is additional evidence that could enable an opinion to be provided or whether the inability to provide an opinion is based on the limits of medical knowledge. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Smith-Jennings, Associate Counsel