Citation Nr: 18145754 Decision Date: 10/30/18 Archive Date: 10/30/18 DOCKET NO. 14-38 079A DATE: October 30, 2018 REMANDED Entitlement to service connection for ischemic heart disease is remanded. Entitlement to service connection for erectile dysfunction is remanded. Entitlement to service connection for diabetes mellitus is remanded. Entitlement to service connection for left upper extremity peripheral neuropathy is remanded. Entitlement to service connection for right upper extremity peripheral neuropathy is remanded. Entitlement to service connection for left lower extremity peripheral neuropathy is remanded. Entitlement to service connection for right lower extremity peripheral neuropathy is remanded. Entitlement to service connection for front teeth injury is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1968 to March 1970. The Veteran testified before the undersigned during a Board videoconference hearing held in May 2018. A copy of the hearing transcript is of record. 1. Entitlement to service connection for ischemic heart disease is remanded. 2. Entitlement to service connection for erectile dysfunction is remanded. 3. Entitlement to service connection for diabetes mellitus is remanded. 4. Entitlement to service connection for left upper extremity peripheral neuropathy is remanded. 5. Entitlement to service connection for right upper extremity peripheral neuropathy is remanded. 6. Entitlement to service connection for left lower extremity peripheral neuropathy is remanded. 7. Entitlement to service connection for right lower extremity peripheral neuropathy is remanded. The Veteran contends that service connection is warranted for ischemic heart disease as well as diabetes mellitus, Type II, erectile dysfunction, and peripheral neuropathy of the upper and lower extremities as a result of herbicide exposure. Specifically, he contends that he served along the demilitarized zone (DMZ) in Korea and was exposed to herbicides at that time. See e.g. May 2014 Notice of Disagreement. The United States Department of Defense (DOD) has also confirmed that Agent Orange was used from April 1968 through July 1969 along the DMZ in Korea. If it is determined that a Veteran who served in Korea belonged to one of the units identified by DOD, then it is presumed that he was exposed to herbicides containing Agent Orange, and the presumptions outlined in 38 C.F.R. § 3.309(e) will apply. See MR21- 1, Part VI, Chapter 2, Section B. VA’s Adjudication Manual contains a list of service units that have been recognized by the Department of Defense (DoD) as having served in areas along the Korean DMZ. Exposure to herbicides is to be conceded for Veterans who allege service along the DMZ in Korea and were assigned to certain units between April 1968 and August 1971. See M21-1 IV.ii.1.H.4.b. If a veteran’s unit is not listed, the Manual instructs that a request must be made to the Joint Services Records Research Center (JSRRC) for verification of exposure to herbicides. See M21-1 IV.ii.1.H.4.c. In May 2018, the Veteran testified before the undersigned VLJ that he was exposed to herbicides while conducting patrols in Korea. The Veteran further testified that he was in the DMZ on more than one occasion. Also, in June 2018, the Veteran provided a buddy statement from J. L. noting that, “military intelligence personnel would travel as needed to the DMZ.” J. L. also stated that Military Police also accompanied travel through portions of Korea. Military personnel records show that the Veteran was assigned to company A, 512th MP PLT (Military Police Platoon) 502nd BN in Korea. However, the Veteran’s unit is not listed in block in M21-1 IV.ii.1.H.4.b. as a unit that operated in or near the Korean DMZ area. Thus, on remand a request should be sent to the JSRRC for verification of exposure to herbicides. 8. Entitlement to service connection for front teeth injury is remanded. Remand is warranted to determine whether the Veteran has a compensable disability and for adjudication of entitlement to service connection for a dental disability for treatment purposes following adjudication by the VBA. Service connection may be awarded for dental conditions for (1) compensation benefits and/or (2) outpatient dental treatment purposes. Pursuant to Veterans Benefits Administration (VBA) Fast Letter 12-18 (July 10, 2012), claims for outpatient dental treatment submitted to VBA should be referred to the Veterans Health Administration (VHA) for preparation of a dental treatment rating. See also 38 C.F.R. § 3.381. VBA Will adjudicate a claim for service connection of a dental condition for treatment purposes after VHA determines that a veteran meets the basic eligibility requirements of 38 C.F.R. § 17.161 and requests that VBA make a determination on relevant questions. In the present case, the record reflects that the Veteran has raised the issue of entitlement to service connection for a dental disorder for outpatient dental treatment purposes. See also Mays v. Brown, 5 Vet. App. 302 (1993) (any claim for service connection for a dental condition is also a claim for VA outpatient dental treatment). Review of the file reveals, however, that the AOJ (i.e., VBA) has only adjudicated the issue of entitlement to service connection for a dental disorder for VA compensation purposes. The Board notes that in an October 2014 Deferred Rating Decision, the RO indicated such matter should be referred to the VAMC. However, the record contains no further evidence that this referral was made, or that the VAMC adjudicated the matter. Therefore, as it is unclear whether any claim for outpatient dental treatment has yet been considered and/or referred to VHA, it is remanded to the AOJ (which, in this case, is VHA) for appropriate action. The Board notes that under current legal authority, compensation is only available for certain types of dental and oral conditions, such as impairment of the mandible, loss of a portion of the ramus, and loss of a portion of the maxilla. See 38 C.F.R. § 4.150 (setting for the schedule of ratings for dental and oral conditions). It appears that teeth #8 and #9 were service connected for purposes of VA outpatient treatment in November 1970. According to a May 2014 treatment report from E. H., D.D.S., it was noted that the Veteran’s teeth were clinically sound but that the appearance would further deteriorate over time. The nature and extent of the Veteran’s current dental disorder is unclear. During the May 2018 Board hearing, the Veteran indicated that his teeth have cause him problems when eating and cosmetically. As such, the Board finds that the Veteran should be provided an opportunity to report for VA examination with respect to whether he has a current dental disability related to service. Thus, remand is warranted to determine whether the Veteran has a compensable disability and for adjudication of entitlement to service connection for a dental disability for treatment purposes following adjudication by the VBA. The matters are REMANDED for the following actions: 1. Associate with the record all updated VA treatment records dated since April 2015. 2. Send the Veteran a VCAA notice letter in connection with his service connection claim for a noncompensable dental disorder for the purpose of obtaining VA outpatient dental treatment under 38 C.F.R. § 17.161. This letter should discuss the various classes of eligibility for VA outpatient dental treatment listed under 38 C.F.R. § 17.161. The letter should (1) inform him of the information and evidence that is necessary to substantiate the claim; (2) inform him about the information and evidence that VA will seek to provide; and, (3) inform him about the information and evidence he is expected to provide. Refer the claim for entitlement to service connection for a dental disorder, to include teeth #8 and #9, for purposes of VA outpatient dental treatment, to the appropriate VA Medical Center (VAMC) to determine if the Veteran meets the basic eligibility requirements of 38 C.F.R. § 17.161. If the VAMC determines that the Veteran meets the basic eligibility requirements of 38 C.F.R. § 17.161 and requests VBA make a determination, adjudicate the claim. 3. Send the June 2018 buddy statement along with the other statements made by the Veteran regarding his service in Korea, to the US Joint Service Records Retention Center (JSRRC), as well as the to the National Personnel Records Center (NPRC), if appropriate, to determine whether the military unit(s) identified by the Veteran can confirm the presence of the Veteran in the DMZ. Any supplied and/or obtained evidence should be included in the electronic claims file for future review. The JSRRC, or any other appropriate service department agency, should consider (and provide supported comment upon) the Veteran’s depiction of trips to the DMZ. 4. Then, schedule the Veteran for a VA dental examination by an appropriate medical professional. The entire file must be reviewed by the examiner. The examiner is to conduct all indicated tests. The examiner is to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that a current dental disability is related to the Veteran’s active service, to include the reported dental trauma. (Continued on the next page)   A complete rationale for the opinion expressed should be provided. K. PARAKKAL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Williams, Counsel