Citation Nr: 18133003
Decision Date: 09/07/18	Archive Date: 09/07/18

DOCKET NO. 15-35 484
DATE:	September 7, 2018
REMANDED
Entitlement to service connection for coronary artery disease (claimed as ischemic heart disease) is remanded.
Entitlement to service connection for diabetes mellitus, type II is remanded.
REASONS FOR REMAND
The Veteran served in the United States Navy from February 1970 to October1973.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Portland, Oregon.
1. Entitlement to service connection for coronary artery disease (claimed as ischemic heart disease) is remanded.
The Veteran seeks service connection for coronary artery disease, which he asserts is related to service.  In November 2009, the Veteran stated that he was exposed to polychlorinated biphenyl (PCB’s) and other toxins while serving in the Navy during the Vietnam Era; and that exposure to the chemicals in service caused him to develop coronary artery disease.
VA is obliged to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with active service, and the record does not contain sufficient information to make a decision on the claims.  38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006).  The requirement that the evidence “indicates” that the Veteran’s disability “may” be associated with his service is a low threshold.  Id.  Thus, in light of the Veteran’s contentions and the record on appeal, a VA examination should be obtained to determine the probable etiology of the Veteran’s coronary artery disease, to include whether the Veteran’s coronary artery disease is related to service.  38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4)(i); McLendon, supra.
2. Entitlement to service connection for diabetes mellitus, type II is remanded.
The Veteran seeks service connection for diabetes mellitus, type II, which he asserts is related to service.  In November 2009, the Veteran stated that he was exposed to polychlorinated biphenyl (PCB’s) and other toxins while serving in the Navy during the Vietnam Era; and that exposure to the chemicals in service caused him to develop diabetes.
In light of the Veteran’s contentions and the record on appeal, a VA examination should be obtained to determine the probable etiology of the Veteran’s diabetes, to include whether the Veteran’s diabetes is related to service.  38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4)(i); McLendon, supra.
The matters are REMANDED for the following action:
1. The AOJ should contact the Joint Services Records Research Center (JSRRC) (or any other appropriate agency) to verify the Veteran’s alleged exposure to herbicides, Agent Orange, polychlorinated biphenyl (PCB’s), and related chemicals in service.  In particular, the agency should attempt to verify:
(a.) The Veteran’s allegations of exposure to various chemicals, including herbicides, Agent Orange, and PCB’s during his service in Davisville (Kingston), RI;
(b.) The Veteran’s allegations of exposure to various chemicals, including herbicides, Agent Orange, and PCB’s during his service in Marinette, WI.
2. Then, obtain an opinion, report, or other appropriate evidence from an appropriate examiner to determine the etiology of the Veteran’s coronary artery disease and diabetes mellitus.
The examiner should address:
(a.) whether it is at least as likely as not (50 percent or greater probability) that the Veteran was exposed to herbicides, to include Agent Orange during service.
(b.) whether it is at least as likely as not (50 percent or greater probability) that the Veteran was exposed to PCB’s during service.
Among the reports the RO should obtain to be associated with the record, should be a 1994 report by the Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides, Division of Health Promotion and Disease Prevention, Institute of Medicine, entitled Veterans and Agent Orange-Health Effects of Herbicides Used in Vietnam.  This report includes a discussion of a June 1959 experiment conducted at Fort Drum to determine the long-term effectiveness of aerially-dispensed herbicides in improving visibility of military operations.  As detailed by the 1994 Report, the 1959 experiment used a helicopter spray system to disperse a mixture of 2, 4-D and 2, 4, 5-T over a four-square-mile area at a quantity of one-half gallon per acre.  In addition, the 1994 Report discussed the risk assessment of herbicide exposure and the associated epidemiology of disease.
These findings must be discussed in the context of this Veteran and his assertions.
The examiner should also consider and discuss the following:
(a.) June 1972 service treatment record which reflects that the Veteran had been burned with gasoline while loading a fuel truck;
(b.) December 2009, December 2009, March 2011, March 2011, and November 2014 statements from the Veteran regarding his exposure to various chemicals in service;
(c.) August 2011 and September 2011 statements from the Veteran’s representative regarding the Veteran’s exposure to chemicals in service.
The examiner should consider and discuss statements from the Veteran’s fellow servicemembers, including:
(a.) January 2011 and March 2011 statements from C.M.;
(b.) March 2011 statement from D.K.;
(c.) March 2011 statement from P.C.;
(d.) March 2011 statement from D.C.;
(e.) March 2011 statement from L.M.;
(f.) March 2011 and March 2011 statements from S.J.
The examiner should consider and discuss articles and documents submitted in support of the Veteran’s claim, including:
(a.) November 2009 document titled “Waste Site Cleanup and Reuse in New England;”
(b.) April 2010 document titled “Agent Orange:  Herbicide Tests and Storage in the U.S.;”
(c.) March 2011 document titled “ABC Dry Chemical;”
(d.) August 2011 documents submitted by the Veteran’s representative;
(e.) August 2011 documents submitted by the Veteran.
3. Then, schedule the Veteran for a VA examination to ascertain the nature and etiology of the Veteran’s coronary artery disease.  All necessary tests should be conducted.  The claims file should be made available to and be reviewed by the examiner in conjunction with the examination.
The examiner should address whether it is at least as likely as not (50 percent or greater likelihood) that coronary artery disease manifested during service, that coronary artery disease was manifest to a compensable degree within one year of service, or that it, is otherwise causally or etiologically related to a period of active duty service.
The examiner should consider and discuss the following:
(a.) June 1972 service treatment record which reflects that the Veteran had been burned with gasoline while loading a fuel truck;
(b.) December 2009, December 2009, March 2011, March 2011, and November 2014 statements from the Veteran regarding his exposure to various chemicals in service;
(c.) August 2011 and September 2011 statements from the Veteran’s representative regarding the Veteran’s exposure to chemicals in service.
The examiner should consider and discuss statements from the Veteran’s fellow servicemembers, including:
(a.) January 2011 and March 2011 statements from C.M.;
(b.) March 2011 statement from D.K.;
(c.) March 2011 statement from P.C.;
(d.) March 2011 statement from D.C.;
(e.) March 2011 statement from L.M.;
(f.) March 2011 and March 2011 statements from S.J.
The examiner should consider and discuss articles and documents submitted in support of the Veteran’s claim, including:
(a.) November 2009 document titled “Waste Site Cleanup and Reuse in New England;”
(b.) April 2010 document titled “Agent Orange:  Herbicide Tests and Storage in the U.S.;”
(c.) March 2011 document titled “ABC Dry Chemical;”
(d.) August 2011 documents submitted by the Veteran’s representative;
(e.) August 2011 documents submitted by the Veteran.
The examiner should discuss and consider the toxicologist’s report regarding exposure to herbicides, Agent Orange, PCB’s, and other related chemicals.
The examiner should provide a complete rationale for all opinions expressed and conclusions reached.
4. Schedule the Veteran for a VA examination to ascertain the nature and etiology of the Veteran’s diabetes mellitus, type II.  All necessary tests should be conducted.  The claims file should be made available to and be reviewed by the examiner in conjunction with the examination.
The examiner should address whether it is at least as likely as not (50 percent or greater likelihood) that diabetes manifested during service, that diabetes was manifest to a compensable degree within one year of service, or that it, is otherwise causally or etiologically related to a period of active duty service.
The examiner should consider and discuss the following:
(a.) June 1972 service treatment record which reflects that the Veteran had been burned with gasoline while loading a fuel truck;
(b.) December 2009, December 2009, March 2011, March 2011, and November 2014 statements from the Veteran regarding his exposure to various chemicals in service;
(c.) August 2011 and September 2011 statements from the Veteran’s representative regarding the Veteran’s exposure to chemicals in service.
The examiner should consider and discuss statements from the Veteran’s fellow servicemembers, including:
(a.) January 2011 and March 2011 statements from C.M.;
(b.) March 2011 statement from D.K.;
(c.) March 2011 statement from P.C.;
(d.) March 2011 statement from D.C.;
(e.) March 2011 statement from L.M.;
(f.) March 2011 and March 2011 statements from S.J.;
The examiner should consider and discuss articles and documents submitted in support of the Veteran’s claim, including:
(a.) November 2009 document titled “Waste Site Cleanup and Reuse in New England;”
(b.) April 2010 document titled “Agent Orange:  Herbicide Tests and Storage in the U.S.;”
(c.) March 2011 document titled “ABC Dry Chemical;”
(d.) August 2011 documents submitted by the Veteran’s representative;
(e.) August 2011 documents submitted by the Veteran.
The examiner should discuss and consider the toxicologist’s report regarding exposure to herbicides, Agent Orange, PCB’s, and other related chemicals.
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The examiner should provide a complete rationale for all opinions expressed and conclusions reached.
 
J. CONNOLLY
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	G. Johnson, Associate Counsel