Citation Nr: 18148154 Decision Date: 11/08/18 Archive Date: 11/06/18 DOCKET NO. 18-37 217 DATE: November 8, 2018 ORDER Entitlement to service connection for a heart disability is granted. Entitlement to service connection for diabetes mellitus type II is granted. Entitlement to service connection for peripheral neuropathy, left lower extremity is granted. Entitlement to service connection for peripheral neuropathy, left upper extremity is granted. Entitlement to service connection for peripheral neuropathy, right lower extremity is granted. Entitlement to service connection for peripheral neuropathy, right upper extremity is granted. Entitlement to service connection for anxiety is denied. FINDINGS OF FACT 1. Exposure to an herbicide agent is found based on competent and credible evidence of the Veteran’s service near the air base perimeter of Korat Royal Thai Air Force Base in Thailand during the Vietnam era. 2. The Veteran has coronary artery disease. 3. The Veteran has diabetes mellitus type II. 4. The Veteran has peripheral neuropathy of the left lower extremity. 5. The Veteran has peripheral neuropathy of the left upper extremity. 6. The Veteran has peripheral neuropathy of the right lower extremity. 7. The Veteran has peripheral neuropathy of the right upper extremity. 8. An anxiety disorder was not manifest during service and is not attributable to service. CONCLUSIONS OF LAW 1. The criteria for service connection for coronary artery disease have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.303, 3.307, 3.309. 2. The criteria for service connection for diabetes mellitus type II have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.303, 3.307, 3.309. 3. The criteria for service connection for peripheral neuropathy of the left lower extremity have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.303, 3.307, 3.309. 4. The criteria for service connection for peripheral neuropathy of the left upper extremity have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.303, 3.307, 3.309. 5. The criteria for service connection for peripheral neuropathy of the right lower extremity have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.303, 3.307, 3.309. 6. The criteria for service connection for peripheral neuropathy of the right upper extremity have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.303, 3.307, 3.309. 7. The criteria for service connection for an anxiety disorder have not been met. 38 U.S.C. §§ 1101, 1110; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1972 to August 1975. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2017 rating decision. Service Connection Service connection will be granted for a current disability that resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Shedden v. Principi, 381 F. 3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). A veteran who, during active military, naval, or air service, served in the Republic of Vietnam between January 9, 1962 and May 7, 1975 is presumed to have been exposed to an herbicide agent if a listed chronic disease becomes manifest to a degree of 10 percent disabling or more, unless there is affirmative evidence to the contrary. 38 C.F.R. § 3.307(a). If a veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases are presumed to be service-connected if the requirements of 38 C.F.R. § 3.307(a)(6) are met, even though there is no record of the disease during service. These diseases include type II diabetes mellitus, coronary artery disease, and early-onset peripheral neuropathy. 38 U.S.C. § 1116(a); 38 C.F.R. § 3.309(e). VA has also conceded herbicide exposure for veterans who served in units that operated in or near the Korean demilitarized zone (DMZ) between April 1, 1968, and August 31, 1971. 38 C.F.R. § 3.307(a)(6)(iv). Notwithstanding any evidentiary presumption relating to service connection, a claimant may establish service connection for a disability based upon adequate evidence of actual causation. 38 U.S.C. § 1113(b); Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). 1. Entitlement to service connection for a heart disability. 2. Entitlement to service connection for diabetes mellitus type II. 3. Entitlement to service connection for peripheral neuropathy, left lower extremity. 4. Entitlement to service connection for peripheral neuropathy, left upper extremity. 5. Entitlement to service connection for peripheral neuropathy, right lower extremity. 6. Entitlement to service connection for peripheral neuropathy, right upper extremity. The Veteran has coronary artery disease and type 2 diabetes mellitus with diabetic polyneuropathy. See May 2017 private treatment record. He was diagnosed with diabetes mellitus in 1996 and with peripheral neuropathy in 1997. The DD Form 214 indicates a military occupational specialty of aircraft maintenance specialist. Service treatment records show that the Veteran served at the Korat Royal Thai Air Force Base (RTAFB)in Thailand in 1973 and at the Osan Air Base in Korea in 1974. The Veteran argues that, while stationed at the Korat RTAFB in 1973, his duties as an aircraft maintenance specialist included repairing and refueling aircraft on the flight line and regularly going to aircraft storage locations for supplies. He maintains that both the flight line and the storage were in close proximity to the perimeter of the air base. See Veteran’s affidavit of June 2017; appellate brief of July 2018. Exposure to an herbicide agent may be considered on a direct/facts-found basis if a veteran served with the U.S. Air Force in Thailand during the Vietnam era at one of the RTAFBs as an Air Force security policeman, security patrol dog handler, member of the security police squadron, or otherwise near the air base perimeter as shown by evidence of daily work duties, performance evaluation reports, or other credible evidence. Korat is among the identified RTAFBs in Thailand. See VA Adjudication Manual, M21-1, Part IV, Subpart ii, Chapter 1, Section H.5.b. M21-1 provisions are not substantive rules and are not binding on the Board. See DAV v. Sec’y of Veterans Affairs, 859 F.3d 1072, 1074 (Fed. Cir. 2017). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. §§ 1154(a), 7104(a); Baldwin v. West, 13 Vet. App. 1, 8 (1999). Reasonable doubt concerning any issue material to the determination of a matter will be resolved in a claimant’s favor. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The Veteran’s credible competent and credible statements indicate (and no evidence contradicts) that his duties placed him on or near the perimeters of his base in Thailand, where herbicide agents are known to have been used. Therefore, exposure to an herbicide agent is found. Because the Veteran’s coronary artery disease, diabetes mellitus type 2, and upper and lower bilateral peripheral neuropathy are listed as diseases for which service connection may be presumed based on exposure to an herbicide agent, service connection for these disabilities will be granted. 38 U.S.C. §§ 1101, 1110, 1113, 1116; 38 C.F.R. §§ 3.303, 3.307, 3.309. With all three elements of service connection having been met, there is no need to consider whether herbicide exposure during the Veteran’s service in Korea in 1974 may be found on a presumed or factual basis. 7. Entitlement to service connection for an acquired psychiatric disability, to include anxiety. The Veteran seeks service connection for anxiety. See Veteran’s claim of June 2017. The claim includes any acquired psychiatric disability indicated by the record. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). The Veteran has been diagnosed with anxiety. See private treatment record of May 2017. The service treatment records note no psychiatric symptoms. On the separation examination report of July 1975, the Veteran was found to be normal as to “psychiatric.” He also expressly denied having psychiatric symptoms, including depression or excessive worry. The Veteran is competent to report his experienced symptoms during and following service. 38 C.F.R. § 3.159(a); Layno v. Brown, 6 Vet. App. 465, 470 (1994). A psychiatric disability is not the type of disability, however, that the Veteran, as a layperson, may diagnose or relate to service. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007); Kahana v. Shinseki, 24 Vet. App. 428 (2011). The Veteran has provided no evidence or argument linking his current anxiety to service or to a service-connected disability. See notice of disagreement of September 2017; appellate brief of July 2018. No competent opinion of record indicates that the Veteran’s anxiety may be related to service or a service-connected disability. Furthermore, anxiety is not listed among the chronic diseases for which service connection may be presumed. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. Because the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for an acquired psychiatric disorder, the benefit-of-the- doubt doctrine is not applicable. 38 U.S.C. § 5107(b); 38 C.F.R. § 102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Steven D. Najarian, Counsel