Citation Nr: 18150553
Decision Date: 11/15/18	Archive Date: 11/15/18

DOCKET NO. 16-44 946
DATE:	November 15, 2018
REMANDED
Service connection for multiple sclerosis (MS) is remanded.
 
REASONS FOR REMAND
The Veteran served on active duty from March 1969 to November 1970.  
The case is on appeal from an August 2012 rating decision.  
Service connection for multiple sclerosis is remanded.
The Veteran contends that his MS is related to his presumed exposure to herbicide agents, such as Agent Orange, from when he served in Vietnam.  MS is not among the diseases associated with presumptive service connection based on exposure to herbicide agents.  See 38 C.F.R. § 3.309(e).  Additionally, the Health and Medicine Division (HMD) (previously the Institute of Medicine (IOM)) of the National Academy of Sciences (NAD) has not included MS in its reports as no studies have provided enough substance to justify developing a section for this health outcome.  See Veterans and Agent Orange: Update 2014 (March 10, 2016).  However, service connection may still be warranted on a direct basis.  See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994).  The Veteran asserts that MS should be treated similarly to Parkinson’s disease, which is on the presumptive list.  He has also submitted internet research on the matter.  The Veteran should be afforded a VA examination on remand as the low threshold for obtaining an examination has been met.  See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006).
In addition, unlike other chronic diseases, if MS becomes manifest to a degree of 10 percent within seven years from the date of the Veteran’s separation from service, it is presumed to be service connected.  38 C.F.R. §§ 3.307(a)(3), 3.309(a).  This theory should also be addressed by the VA examination.  
In light of the remand, updated VA treatment records should be obtained.
The matter is REMANDED for the following action:
1. Obtain and associate with the file all VA treatment records dated since January 2018.
2. Schedule the Veteran for a VA examination by an appropriate medical professional to determine the nature and etiology of the Veteran’s MS.  The entire claims file must be reviewed by the examiner.  
The examiner should provide an opinion as to whether it as least a likely as not (a 50 percent or greater probability) that the Veteran’s MS (i) had its onset during service, (ii) became manifest within seven years of separation from service; or (iii) is otherwise related to service, including his presumed exposure to herbicide agents such as Agent Orange.
A complete rationale should be provided for all opinions reached.

 
RYAN T. KESSEL
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	E. Gray