Citation Nr: 18157640 Decision Date: 12/13/18 Archive Date: 12/13/18 DOCKET NO. 15-04 199A DATE: December 13, 2018 ORDER Entitlement to service connection for ischemic heart disease is granted. FINDING OF FACT 1. The Veteran has a current diagnoses of ischemic heart disease. 2. The Veteran set foot in the Republic of Vietnam (Vietnam) during service, and as a result, is presumed to have been exposed to herbicide agents. CONCLUSION OF LAW The criteria to establish service connection for ischemic heart disease have been met. 38 U.S.C. §§ 1110, 1116, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served from June 1966 until December 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for Ischemic heart disease is granted Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110 (2012); 38 C.F.R. § 3.303 (2017). To establish a right to compensation for a present disability, a veteran must show: “(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service”-the so-called “nexus” requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). With regard to herbicide exposure, VA laws and regulations provide that a Veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the Vietnam war (i.e., January 9, 1962, to May 7, 1975), shall be presumed to have been exposed to an herbicide agent, unless there is affirmative evidence to the contrary. 38 U.S.C. § 1116 (a) (3) (2012); 38 C.F.R. § 3.307 (a)(6)(iii) (2017). The list of diseases associated with exposure to certain herbicide agents includes ischemic heart disease (including, but not limited to, acute, subacute, and old myocardial infarction; atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass surgery; and stable, unstable and Prinzmetal’s angina). 38 C.F.R. § 3.309 (e) (2017). Certain chronic diseases, including ischemic heart disease, are subject to presumptive service connection if manifest to a compensable degree within one year from separation from service even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1112, 1113 (2012); 38 C.F.R. §§ 3.307 (a) (3), 3.309(a) 2017. Even though a disease is not included on the list of presumptive diseases, a nexus between the disease and service may nevertheless be established on the basis of direct service connection. Stefl v. Nicholson, 21 Vet. App. 120 (2007). When a claimed disorder is not included as a presumptive disorder, direct service connection may nevertheless be established by evidence demonstrating that the disease was in fact incurred during service. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). It has been established that the Veteran is currently diagnosed with ischemic heart disease. This diagnosis is reflected in both VA and private treatment records. The dispositive issue is whether the Veteran set foot in Vietnam, which would entitle him to the presumption of exposure to herbicide agents, and an award of service connection for ischemic heart disease on a presumptive basis. The Veteran’s service records indicate that he was stationed in New Mexico, Colorado, and Okinawa, but the records do not specifically reference service on the ground in Vietnam. However, the Veteran has asserted through a lay statement dated July 2014 that while he was stationed in Okinawa he flew to Vietnam on a C-130 military aircraft for a temporary assignment. He further stated that he visited his brother while in Vietnam and the two attended a USO show together. The Veteran’s brother (a Vietnam Veteran himself) also provided a notarized dated statement, also dated July 2014, confirming that the Veteran visited him while on temporary assignment in December 1968 and the two attended the above referenced USO show together. In addition, the Veteran also provided a statement, dated February 2017, indicating that his unit was awarded the Presidential Unit Citation (PUC) for Vietnam service. He further provided an article confirming this. The PUC was also referenced on his DD-214 and his service personnel records but does not indicate if it was awarded for Vietnam Service. The Board has reviewed the evidence of record, including his lay statements and the statement of his brother. Resolving any doubt in favor of the evidence, the Board finds that he had sufficient service in Vietnam, to include boots on the ground Vietnam service, from which he should be presumed as having been exposed to herbicides. Taking the above documentation into account the Board finds that the Veteran is competent to give an account of where he was during service. He is credible given that his account has not been questioned. Further, given the corroboration and detail the Veteran’s account has significant probative value. While there are no service department records on file that expressly confirm that the Veteran set foot on the ground in Vietnam, when considering the totality of circumstances surrounding the nature of the Veteran’s service and resolving all doubt in his favor, the Board finds that that the Veteran set foot on land in Vietnam in the course of his service. 38 C.F.R. § 3.102 (2017). Thus, the Veteran’s herbicide exposure is presumed. 38 C.F.R. § 3.307(a)(6)(iii). In sum, in light of the Veteran’s current diagnosis of ischemic heart disease and his presumed exposure to herbicides during service, the Board finds that service connection for ischemic heart disease on a presumptive basis is warranted. 38 C.F.R. § 3.309(e); see also 38 C.F.R. § 3.307(a)(6). K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Luby, Associate Counsel