Citation Nr: 18147129 Decision Date: 11/02/18 Archive Date: 11/02/18 DOCKET NO. 16-23 415 DATE: November 2, 2018 REMANDED Entitlement to service connection for asthma, to include allergies, to include as due to herbicide exposure, is remanded. Entitlement to service connection for neuropathy in the left foot, to include as due to herbicide exposure, is remanded. Entitlement to service connection for neuropathy in the right foot, to include as due to herbicide exposure, is remanded. Entitlement to a compensable rating for erectile dysfunction associated with residuals of prostate cancer is remanded. Entitlement to a rating greater than 10 percent for residuals of prostate cancer, to include voiding dysfunction, is remanded. REASONS FOR REMAND Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration. See 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2017). As an initial matter, the Board notes that the Veteran’s military personnel records reflect that the Veteran had service in Vietnam, therefore exposure to herbicides in conceded. 1. Entitlement to service connection for asthma, to include allergies, to include as due to herbicide exposure is remanded. The Veteran contends that his asthma and allergies are related to his military service and specifically related to his service in Vietnam and herbicide exposure. In August 2014, the Veteran underwent a VA respiratory examination. The examiner noted that the Veteran is currently diagnosed with asthma. However, the examiner ultimately opined that the Veteran’s asthma is less likely than not related to the Veteran’s military service. The examiner based this opinion on the fact that the Veteran does not have any in-service records stating that he had asthma or allergies. Additionally, the examiner stated that the Veteran mentioned an event in 1968, however, the examiner noted that the records do not support that event. The Board finds the August 2014 examination inadequate for several reasons. First, an examiner cannot base a negative nexus opinion solely on the absence of service treatment records. Second, the Veteran’s service treatment records note an August 1968 treatment record for sinusitis. Finally, a March 2013 statement from the Veteran’s primary physician states that the Veteran’s asthma could be related to the Veteran’s herbicide exposure. However, the August 2014 examiner did not discuss this statement. Additionally, the evidence does not reflect that the Veteran’s contention that his asthma and allergies are a result of his conceded herbicide exposure has been explored. Even though the Veteran is not entitled to service connection on the basis of the presumption in 38 C.F.R. § 3.309, VA must still consider whether the Veteran’s asthma and allergies are causally linked to service on a direct basis, to include herbicide exposure. Combee v. Brown, 34 F.3d 1039, 1044 (Fed. Cir. 1994), citing 38 U.S.C. §§ 1113 (b),1116; 38 C.F.R. § 3.303. Upon remand, VA should obtain an examination and opinion to consider whether the Veteran’s asthma and allergies are related to herbicide exposure. Therefore, a remand is warranted for the Veteran to undergo a new VA examination to determine the etiology of the Veteran’s asthma and allergies. 2. Entitlement to service connection for left and right foot neuropathy, to include as due to herbicide exposure is remanded. The Veteran contends that his left and right foot neuropathy are related to his military service and herbicide exposure in Vietnam. A March 2013 statement from the Veteran’s primary physician states that the Veteran’s left and right foot neuropathy could be related to the Veteran’s herbicide exposure. However, the physician stated that this contention must be investigated further. Additionally, the Veteran submitted several correspondences attempting to reschedule his VA neuropathy examination. To date, the Veteran has not been afforded a new VA examination to determine the etiology of his neuropathy. Therefore, a remand is warranted for an examination to be scheduled. Even though the Veteran is not entitled to service connection on the basis of the presumption in 38 C.F.R. § 3.309 (as it has not been found to be early onset peripheral neuropathy), VA must still consider whether the Veteran’s left and right foot neuropathy are causally linked to service on a direct basis, to include herbicide exposure. Combee v. Brown, 34 F.3d 1039, 1044 (Fed. Cir. 1994), citing 38 U.S.C. §§ 1113 (b),1116; 38 C.F.R. § 3.303. Upon remand, VA should obtain an examination and opinion to consider whether the Veteran’s left and right foot neuropathy are related to herbicide exposure. 3. Entitlement to a compensable rating for erectile dysfunction associated with residuals of prostate cancer is remanded. The Veteran contends that his service connected erectile dysfunction warrants a compensable rating. The Veteran’s most recent VA examination to evaluate his erectile dysfunction was conducted in August 2014. Since then, in his May 2016 Formal Appeal to the Board, the Veteran stated that his erectile dysfunction has worsened. Therefore, the Board finds that a new VA examination is warranted to determine the current severity of his erectile dysfunction. 4. Entitlement to a rating greater than 10 percent for residuals of prostate cancer, to include voiding dysfunction is remanded. The Veteran contends that his service connected residuals of prostate cancer warrants a compensable rating. The Veteran’s most recent VA examination to evaluate his residuals of prostate cancer was conducted in August 2014. Since then, in his May 2016 Formal Appeal to the Board, the Veteran stated that his residuals of prostate cancer have worsened. Therefore, the Board finds that a new VA examination is warranted to determine the current severity of his residuals of prostate cancer Since the claims file is being remanded, it should be updated to include any outstanding VA treatment records. See 38 C.F.R. § 3.159(c)(2); see also Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate those documents with the Veteran’s claims file. 2. Schedule the Veteran for an examination to provide an opinion as to the nature and etiology of the Veteran’s asthma and/or allergies, left foot neuropathy, and right foot neuropathy that have been present during the period on appeal. After reviewing the record, to include the Veteran’s lay testimony, the examiner is asked to address the following: a) Is it at least as likely as not (a 50 percent probability or greater), that the Veteran’s asthma and/or allergies, were caused by service, or are otherwise related to the Veteran’s military service, to include herbicide exposure? b) Is it at least as likely as not (a 50 percent probability or greater), that the Veteran’s left foot neuropathy, was caused by service, or is otherwise related to the Veteran’s military service, to include herbicide exposure? c) Is it at least as likely as not (a 50 percent probability or greater), that the Veteran’s right foot neuropathy, was caused by service, or is otherwise related to the Veteran’s military service, to include herbicide exposure? All opinions provided must be thoroughly explained and an adequate rationale for any conclusions reached must be provided. If any requested opinion cannot be provided without resort to speculation, the medical professional should state and explain why an opinion cannot be provided without resort to speculation. 3. Schedule the Veteran for a VA examination to determine the current nature and severity of his service connected erectile dysfunction. The examination should include all studies, tests, and evaluations deemed necessary by the examiner. The examiner should report all manifestations related to the service connected disability. All opinions provided must be thoroughly explained and an adequate rationale for any conclusions reached must be provided. If any requested opinion cannot be provided without resort to speculation, the medical professional should state and explain why an opinion cannot be provided without resort to speculation. 4. Schedule the Veteran for a VA examination to determine the current nature and severity of his service connected residuals of prostate cancer, to include voiding dysfunction. The examination should include all studies, tests, and evaluations deemed necessary by the examiner. The examiner should report all manifestations related to the service connected disability. All opinions provided must be thoroughly explained and an adequate rationale for any conclusions reached must be provided. If any requested opinion cannot be provided without resort to speculation, the medical professional should state and explain why an opinion cannot be provided without resort to speculation. (Continued on the next page)   5. Following completion of the above, and a review of any additional evidence received, the RO should also undertake any other development it deems to be necessary, to include, if warranted, an addendum medical opinion which considers any newly received evidence. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Mountford, Associate Counsel