Citation Nr: 18154640
Decision Date: 11/30/18	Archive Date: 11/30/18

DOCKET NO. 16-11 716
DATE:	November 30, 2018
REMANDED
Entitlement to service connection for psoriatic arthritis, to include as due to herbicide exposure is remanded.
Entitlement to service connection for a heart condition, to include as due to herbicide exposure is remanded.
REASONS FOR REMAND
The Veteran served on active duty from May 1968 to March 1970, to include active duty service in the Republic of Vietnam.
1. Entitlement to service connection for arthritis, to include psoriatic arthritis is remanded.
The Board cannot make a fully-informed decision on this issue because no VA examiner has opined whether the Veteran’s diagnosed psoriatic arthritis is etiologically due to actie duty service, to include conceded herbicide exposure.
The Veteran’s claim, to date, has been deneid partially due to a lack of any clinical diagnosis of arthritis.  However, review of the Veteran’s private treatment records reveal a diagnosis of psoriatic arthritis in September 2008.  Therefore on remand a VA examintion must be provided.  The Board is aware that the psoriatic arthritis is not a condition that is afforded presumptive service connection due to cocneded herbicide exposure but this does not preclude entitlement to service connection on a direct basis due to hericide exposure.
2. Entitlement to service connection for a heart condition, to include as due to herbicide exposure is remanded.
The Board cannot make a fully-informed decision on this claim because no VA examiner has opined whether the Veteran’s diagnosed heart condition is etiologically due to conceded herbicide exposure.
The Veteran’s private medical treatment records indicate that he has a diagnosis of hypertrophic cardiomyopathy with ventricular arrhythmias.  While the veteran’s original claim was characterized as one for service connection for ischemic heart disease, the Veteran changed this characterization on his August 2014 notice of disagreement to “heart disease” or “heart problems.”  Therefore, the Board finds that consideration of service connection for any diagnosed heart issue is necessary.  Brokowski v. Shinseki, 23 Vet. App. 79 (2009).
The matters are REMANDED for the following action:
1.  Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any psoriatic arthritis.  The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease.  
Additionally, the examiner must opine whether it is at least as likely as not related to in-service herbicide agent exposure.  The examiner is informed that the fact that psoriatic arthritis is not a condition entitled to presumptive service connection due to herbicide exposure is not adequate rationale. 
2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any heart condition, to include hypertrophic cardiomyopathy with ventricular arrhythmias.  The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease.  
Additionally, the examiner must opine whether it is at least as likely as not related to in-service herbicide agent exposure.  The examiner is informed that the fact that a diagnosed heart disability that is not among those conditions entitled to presumptive service connection due to herbicide exposure is not adequate rationale. 
 
M.E. Larkin
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	P.S. McLeod