Citation Nr: 18144554 Decision Date: 10/24/18 Archive Date: 10/24/18 DOCKET NO. 11-27 326 DATE: October 24, 2018 ORDER Entitlement to service connection for diabetes mellitus, type 2 is granted. REMANDED Entitlement to service connection for a brain condition, to include dementia, as secondary to service-connected disabilities is remanded. FINDINGS OF FACT 1. The Veteran as likely as not visited Vietnam while performing duties during active service. 2. Exposure to herbicide agents is conceded and diabetes is presumed to be due to this exposure. CONCLUSION OF LAW The criteria for establishing service connection for diabetes mellitus have been met. 38 U.S.C. §§ 1110, 1116, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran had active military service from January 1966 to June 1970 and from April 1972 to March 1974. The Veteran was in receipt of the National Defense Service Medial, Vietnam Service Medal with two bronze stars, and the Republic of Vietnam Campaign Medal. The Veteran died in March 2010. The Appellant in is his surviving spouse, who has been substituted as claimant. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of an October 2009 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In the September 2016 Board Decision, this matter was remanded for a Board video hearing. However, in a December 2017 statement, the Appellant withdrew her request for a hearing. Entitlement to service connection for diabetes mellitus Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110 (2012). Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Additionally, VA regulations provide that veterans who, during active military, naval, or air service, served in the Republic of Vietnam from February 28, 1961 to May 7, 1975, shall be presumed to have been exposed to an herbicide agent, including Agent Orange, unless there is affirmative evidence to establish that the Veteran was not exposed to any such agent during that service. 38 C.F.R. §3.307(a)(6)(iii) (2017). "Service in the Republic of Vietnam" includes service in the waters offshore and service in other locations if the conditions of service involved duty or visitation in the Republic of Vietnam, that is, within the land borders, including the inland waters, of Vietnam. 38 C.F.R. § 3.307 (a)(6)(iii); Haas v. Peake, 525 F. 3d 1168, 1193-95 (Fed. Cir. 2008). If a veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases shall be service-connected if the requirements of section 3.307(a)(6) are met, even though there is no record of such disease during service, provided that the rebuttable presumption provisions of 38 C.F.R. § 3.307(d) are also satisfied. 38 C.F.R. § 3.309(e). Type II diabetes mellitus is included in the list of presumptive disabilities. Id. The Veteran contends that diabetes mellitus manifested as a result of exposure to herbicide agents at bases in Vietnam. The Veteran’s private treatment records at the time of his death reveal a diagnosis of diabetes mellitus. Consequently, the determinative issue is whether the condition is attributable to the Veteran’s military service. The Veteran’s service treatment records (STRs) are silent for treatment, diagnosis or symptoms of diabetes during service. At the Veteran’s May 1970 separation examination from his first period of active duty, the Veteran’s clinical evaluation was noted to be normal. The decision on appeal denied service connection for diabetes in an October 2009 rating decision due ot lack of proof that the Veteran’s military service involved duty or visitation in the Republic of Vietnam. The Veteran’s Form DD 214 indicates that his military occupational specialty (MOS) was Communications Yeoman and that, in addition to the above- noted commendations, that he received the Navy Unit Commendation for his contributions to the Fleet Air Wing (FAW) 10. An article in the record indicates that the 2nd Fleet Air Wing 10 served alongside Fleet Air Wing 8 in alternating six-month rotations “to better support efforts in the Vietnam War.” A PIES response to an RO request indicated that they were unable to verify whether the Veteran had Vietnam service. The response stated the Veteran was attached to a Navy unit that could have been assigned to a ship or to shore. The response further noted that for Department of Defense purposes. the unit was credited with Vietnam service from July 14, 1966 to November 1, 1968, but there was no conclusive proof of the Veteran having physically served in Vietnam. In a written statement, the Veteran has submitted a detailed statement indicating that the FAW 10, to which he was assigned, consisted of four patrol squadrons which were deployed to bases in the Philippines every six months. He further stated that these squadrons had detachments assigned to bases in both Saigon and Cam Rahn Bay in Vietnam. He stated that he flew missions over, as well as landed at both of these bases in Vietnam for periods of 1-7 days, for which he received hazardous duty pay. In a June 2009 statement, the Appellant indicated that when she attempted to contact the Veteran at the base in the Philippines after the birth of their child, the Veteran responded 9 days later that he had been in-country in Vietnam, and the message had not been forwarded from the Philippines to Vietnam. Upon review of the record and after resolving all doubt in the favor of the Veteran, the Board finds that it is at least as likely as not that the Veteran had duty or visitation in Vietnam during his military service. As such, the Veteran is presumed to have been exposed to Agent Orange, and his diagnosed diabetes will be presumed to have resulted from that exposure. Thus, service connection for diabetes mellitus is established. REASONS FOR REMAND Entitlement to service connection for a brain condition Prior to his death, the Veteran asserted that his diagnosed dementia (claimed as a brain condition) was due to or aggravated by his diabetes, including more specifically, chronically reduced blood flow. In light of the above grant of service connection for diabetes, the Board finds an opinion is warranted on the claim for entitlement to service connection for a brain condition. The matter is REMANDED for the following action: 1. Send the claims file to an appropriate VA examiner to obtain an opinion as to whether the Veteran suffered from dementia that was related to his service-connected diabetes mellitus. After review of the claims file, the examiner should respond to the following questions: a. Please provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran had dementia that was caused by the service-connected diabetes mellitus. The examiner should explain why or why not. b. If not caused by the service-connected diabetes, is it at least as likely as not that the Veteran’s dementia was worsened beyond its natural progression (aggravated) by his service-connected diabetes? The examiner should explain why or why not. c. If the examiner finds that the Veteran's dementia was aggravated by his service-connected diabetes, the examiner should attempt to quantify the level of aggravation beyond the baseline level of the dementia. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Rachel Mamis