Citation Nr: 18144095 Decision Date: 10/23/18 Archive Date: 10/23/18 DOCKET NO. 14-20 355A DATE: October 23, 2018 REMANDED Entitlement to service connection for prostate cancer, to include as due to exposure to herbicide agents and/or toxins is remanded. Entitlement to service connection for skin cancer, to include as due to exposure to herbicide agents and/or toxins is remanded. Entitlement to service connection for type II diabetes mellitus (“diabetes mellitus”), to include as due to exposure to herbicide agents and/or toxins is remanded. Entitlement to an initial compensable rating for hypertension is remanded. REASONS FORE REMAND The Veteran had active military service from April 1972 to May 1976. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from July 2012 (prostate cancer, skin cancer, and hypertension) and January 2014 (diabetes mellitus) rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO). In July 2016, the Veteran and his wife testified at a hearing. The transcript of the hearing is of record. The Board’s review of the claims file reveals that further action on the claims of entitlement to service connection for prostate cancer, skin cancer, and diabetes mellitus; as well as entitlement to an initial compensable rating for hypertension is needed. In the July 2016 hearing, the Veteran’s representative affirmed that the Veteran did not set foot in Vietnam during the Vietnam War but that he was on board the USS Racine LST 1191 twice for a total of 10 days. The representative stated that this ship carried Agent Orange and other hazardous chemicals. In addition, the representative argued that the Veteran was exposed to hazardous barrels while in Okinawa. The representative also contended that the Veteran frequently visited Kadena Air Base, an air base in which the Japanese News stated that there were hazardous chemicals. In the hearing, the Veteran stated that he was in the third tank battalion tank crew stationed in Camp Hansen in Okinawa. The Veteran alleged that he was exposed to herbicide agents in four different incidents. First, he alleged that he loaded empty barrels that he believed contained herbicide agents onto a truck. Second, the Veteran reported that they would use the barrels as a portable bathroom by cutting the barrel in half. The Veteran stated that he believed these barrels contained herbicide agents as they had poison stickers on top of the barrels. Third, the Veteran stated that the barrels were doused with diesel fuel and lit up and he was exposed to the smoke of herbicide agents. And lastly, the Veteran stated that he and his two buddies were walking down a sidewalk when one maintenance person was spraying herbicide agents on the edge of the sidewalk. A gust of wind redirected the spray and the Veteran and his buddies were directly hit with the herbicide agents. In addition to the testimony, the Veteran submitted several statements regarding his exposure to herbicide agents. The Veteran alleged that he slept in the northern jungle area where herbicide agents were used. See December 2016 VA 21-4138 Statement in Support of Claim. The Veteran submitted several articles, newspaper articles, case studies, past Board decisions, and third-party statements regarding herbicide agents in Okinawa. One undated article stated that insecticides, rodenticides, herbicides, inorganic and organic acids, alkalis, inorganic salts, organic solvents, and vapor degreasers were stored in Okinawa during the Vietnam War. See November 2015 SHARE Print Screens. However, there was no explicit affirmation that Agent Orange was found in Okinawa. Even the August 2013 newspaper article titled “Okinawa dump site may be proof of Agent Orange: experts” found that there were 22 barrels found in Okinawa which contained traces of 2, 4, 5 – trichlorophenoxyacetic acid and 2, 3, 7, 8- tetrachlorodizbenzo-p-dioxin, but not 2, 4-diclorophenoxyacetic acid, one of the other ingredients of Agent Orange. See August 2013 Web/HTML Documents. However, 2, 4-diclorophenoxyacetic acid is biodegradable and as such would have been broken down in the years since the barrels were buried. Id. Initially, the Board observes that it is not clear from the evidence of record whether the Veteran served in Okinawa. Further, it is not clear from the record whether the RO attempted to verify the potential herbicide and other chemical exposure the Veteran asserts he experienced. Based on the numerous articles submitted by the Veteran, the Board observes that the Veteran might have been exposed to some toxins, although not necessarily herbicide agents, if he was stationed in Okinawa. As such, the Board finds that the VA’s duty to assist has been triggered to attempt to verify such exposure. See M21-1, IV.ii.1.H.7.a. As for the hypertension, the Veteran alleged worsening since his May 2012 VA examination. Specifically, the Veteran stated that in 2014 he was hospitalized for his heart condition. The Veteran reported that his blood pressure medication dosage was increased. A review of the medical records shows that the Veteran’s blood pressure was at the highest in April 2014 with a reading of 164/84. See January 2015 CAPRI. The Veteran’s blood pressure gradually improved and was well managed with medication. His blood pressure was consistently between 118/71 to 137/79. Id. However, the Board notes that the blood pressure readings are sparse almost every four to six months. Based the Veteran’s assertions of worsening heart condition, the Board finds that further VA hypertension evaluation is needed to adequately determine the current nature and severity of the hypertension. The matters are REMANDED for the following action: 1. The RO should attempt to verify that the Veteran was exposed to herbicide and/or other toxic chemicals while serving in Okinawa. See M21-1, IV.ii.1.H.7.a. All efforts to verify such should be documented in the record. 2. Schedule the Veteran for a VA hypertension examination. The examiner must review the record and should note that review in the report. The examiner must make specific findings as to whether the Veteran requires continuous medication for control of blood pressure; whether any other hypertension-related symptoms are present; and the impact of hypertension on the Veteran’s vocational pursuits. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Noh, Associate Counsel