Citation Nr: 18151659 Decision Date: 11/20/18 Archive Date: 11/19/18 DOCKET NO. 16-39 026 DATE: November 20, 2018 ORDER Service connection for coronary artery disease is granted. Service connection for diabetes is granted. Service connection for bilateral lower extremity diabetic peripheral neuropathy is granted. Service connection for a right eye disability is granted. REMANDED Entitlement to a compensable rating for bilateral hearing loss is remanded. FINDINGS OF FACT 1. The evidence of record establishes that the Veteran was presumptively exposed to herbicide agents during his active service. 2. The Veteran’s diagnosed coronary artery disease (CAD) is presumed to have been caused by his presumed herbicide agent exposure in service. 3. The Veteran’s diagnosed diabetes is presumed to have been caused by his presumed herbicide agent exposure in service. 4. Resolving all doubt in favor of the Veteran, his bilateral lower extremity diabetic peripheral neuropathy is the result of his service connected diabetes. 5. Resolving all doubt in favor of the Veteran, his right eye disability is the result of his active service. CONCLUSIONS OF LAW 1. The criteria for service connection for CAD have been met. 38 U.S.C. §§ 1110, 1112, 1116; 38 C.F.R. §§ 3.303, 3.307, 3.309. 2. The criteria for service connection for diabetes have been met. 38 U.S.C. §§ 1110, 1112, 1116; 38 C.F.R. §§ 3.303, 3.307, 3.309. 3. The criteria for service connection for bilateral lower extremity diabetic peripheral neuropathy have been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.310. 4. The criteria for service connection for a right eye disability have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the Air Force from October 1961 to October 1965 and October 1966 to October 1970. In August 2016, the Veteran requested a hearing before a Veterans Law Judge. A hearing was scheduled for March 27, 2019. A review of the file indicates that the Veteran submitted a request to withdraw the hearing on October 8, 2018. Thus, the hearing request is deemed withdrawn. 38 C.F.R. § 20.704(d). Service Connection In order to establish entitlement to service connection, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) a causal connection between the claimed in-service disease of injury and the current disability. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may be granted on a presumptive basis for certain diseases that are associated with exposure to certain herbicide agents, including diabetes, even though there is no record of such disease during service, if they manifest to a compensable degree any time after service, in a veteran who had active military, naval, or air service for at least 90 days, during the period beginning on January 9, 1962 and ending on May 7, 1975, in the Republic of Vietnam, including the waters offshore, and other locations if the conditions of service involved duty or visitation in Vietnam. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307, 3.309(e), 3.313. This presumption may be rebutted by affirmative evidence to the contrary. 38 U.S.C. § 1113; 38 C.F.R. §§ 3.307, 3.309. In addition, recent findings indicate that herbicides were also used in Thailand. In May 2010, VA published a “Compensation & Pension (C&P) Service Bulletin” which establishes “New Procedures for Claims Based on Herbicide Exposure in Thailand and Korea.” In explaining the need for the new procedures, the bulletin noted that there was significant use of herbicides on the fenced-in perimeters of military bases in Thailand intended to eliminate vegetation and ground cover for base security purposes. VA has determined that a special consideration of herbicide exposure on facts found or direct basis should be extended to those veterans whose duties placed them on or near the perimeters of Thailand military bases. It was noted that the majority of troops in Thailand during the Vietnam era were stationed at the Royal Thai Air Force Bases of U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang. It was also noted that if a US Air Force Veteran served on one of these air bases as a security policeman, security patrol dog handler, member of a security police squadron, or otherwise served near the air base perimeter, as shown by MOS (military occupational specialty), performance evaluations, or other credible evidence, then herbicides exposure should be acknowledged on a facts found or direct basis. This applies only during the Vietnam Era, from February 28, 1961, to May 7, 1975. In December 2013, the Veteran filed his service connection claims for CAD and diabetes, arguing that they were the result of exposure to herbicide agents during service. The Veteran’s personnel records show that he was stationed at Udorn Royal Thai Air Force Base. His military occupational specialty was an aircraft maintenance specialist. The Veteran submitted the statement of veteran N.A., who reported that was assigned to make an inspection trip to Thailand and personally confirmed that herbicide agents were being used inside the base perimeter at Udorn Royal Air Force Base for vegetation control. In addition, the Veteran was required to service aircraft. The aircraft were likely parked adjacent to the base perimeter and that the staging area for the aircraft was devoid of any vegetation. The Board has no reason to doubt the veracity of the lay statements. Accordingly, the evidence is judged to be sufficient to establish that the Veteran was presumptively exposed to herbicide agents during his active service. Coronary Artery Disease and Diabetes As noted, when a veteran is diagnosed with CAD and diabetes and is presumed to have been exposed to herbicide agents during service, service connection will be granted unless there is clear evidence to the contrary, which is not present here. As such, the criteria for service connection for CAD and diabetes have been met, and the Veteran’s claims are granted. Bilateral Lower Extremity Diabetic Peripheral Neuropathy Secondary service connection may be granted for a disability which is proximately due to, the result of, or aggravated by an established service-connected disorder. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995). In December 2013, the Veteran filed his service connection claim for bilateral lower extremity diabetic peripheral neuropathy, which he asserts is secondary to his diabetes. As discussed above, the Veteran is now service connected for his diabetes. His medical records show he was diagnosed with diabetes with bilateral lower extremity diabetic peripheral neuropathy. The September 2014 VA examiner indicated that the Veteran had complications from his diabetes that included bilateral lower extremity diabetic peripheral neuropathy. Having reviewed the evidence of record, the Board finds that the evidence for and against the Veteran’s claim is in at least relative equipoise. In such circumstances, the regulations dictate that reasonable doubt is to be resolved in the Veteran’s favor. Accordingly, the Veteran’s service connection claims for bilateral lower extremity diabetic peripheral neuropathy is granted. Right Eye Disability The Veteran is seeking service connection for a right eye disability, which he asserts is due an eye injury during his active service. The Veteran’s STRs show that in March 1969, he was stuck in the right eye with a baseball. In July 2016, Dr. Francis C. Skilling, Jr., a Board Certified ophthalmologist reviewed the Veteran’s claims file. Dr. Skilling reported that the Veteran experienced ecchymoses of the orbital area. Dr. Skilling diagnosed the Veteran with advanced stage traumatic glaucoma. Dr. Skilling opined that the Veteran’s advanced stage traumatic glaucoma was at least as likely as not the result of the facial injury he experienced during his active service. As such, when weighing the evidence of record, the Board finds that at most the evidence for and against the Veteran’s claim is in relative equipoise. In such circumstances, the regulations dictate that reasonable doubt is to be resolved in the Veteran’s favor. Accordingly, the Veteran’s claim for service connection for a right eye disability is granted. REASONS FOR REMAND The Veteran filed a service connection claim for his bilateral hearing loss in December 2013, which was granted by a May 2014 rating decision. He was last afforded a VA examination in May 2014. In his August 2016 substantive appeal, he asserted that his hearing had worsened and he was entitled to a higher rating. A new examination is required to evaluate the current severity of the hearing loss. The matter is REMANDED for the following action: Schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected left ear hearing loss. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Berryman, Counsel