Citation Nr: 19190879 Decision Date: 12/03/19 Archive Date: 12/03/19 DOCKET NO. 16-43 077 DATE: December 3, 2019 REMANDED Service connection for scleroderma due to environmental exposure is remanded. Service connection for rheumatoid arthritis to include as secondary to scleroderma and due to environmental exposure is remanded. Service connection for lupus to include as secondary to scleroderma and due to environmental exposure is remanded. Service connection for pulmonary fibrosis to include as secondary to scleroderma and due to environmental exposure is remanded. Service connection for Raynaud's disease to include as secondary to scleroderma and due to environmental exposure is remanded. REASONS FOR REMAND The Veteran served in the United States Army from September 1972 to September 1992. The issues are on appeal from a June 2015 rating decision. All Issues The Veteran testified in his October 2019 hearing that he used trichloroethylene (TCE) as part of his military occupational specialty (MOS) duties. The Board of Veterans’ Appeals (Board) notes that the Veteran’s DD Form 214 shows his MOS was as a Communications Operator. Within his military education section, the DD Form 214 states his training included duties as a Maintenance Management Operator. Therefore, the Board finds the Veteran’s testimony on his MOS and MOS duties as credible. In his hearing, the Veteran testified that his MOS duties required him to maintain generators and vehicles within the motor pool of his communications unit. TCE was used to clean the equipment and pass inspection. Upon remand, an attempt should be made to verify whether exposure to TCE is consistent with the Veteran’s work as a communications operator. If so, examinations should be scheduled to determine whether the Veteran’s scleroderma, rheumatoid arthritis, lupus, pulmonary fibrosis, and Raynaud’s disease are at least as likely as not related to that exposure. Finally, if examinations are conducted, secondary service connection opinions based on causation, or aggravation, of scleroderma should also be provided. “Aggravation” is defined as a permanent worsening of the pre-existing or underlying condition, as contrasted to temporary or intermittent flare-ups of symptoms which resolve with return to the previous baseline level of disability. The matters are REMANDED for the following action: 1. Attempt to verify the Veteran’s asserted in-service exposure to TCE based upon his hearing testimony. In this regard, the Veteran provided details that TCE was used to clean and maintain the generators and vehicles within the motor pool. If more details are needed, contact the Veteran to request the information. If there is still insufficient information to verify exposure to TCE, issue a Formal Finding outlining the steps taken to assist the Veteran and notify the Veteran of VA’s inability to verify the in-service TCE exposure. 2. If the Veteran was exposed to TCE during service, schedule an examination to determine whether the Veteran’s claimed disabilities are at least as likely as not (i.e. 50 percent or greater probability) related to that TCE exposure. The examiner should take into account the Veteran’s testimony that TCE was used to clean and maintain generators and vehicles. The examiner should also provide an opinion on whether it is at least as likely as not (i.e. 50 percent or greater) that his rheumatoid arthritis, lupus, pulmonary fibrosis, or Raynaud’s disease was caused or aggravated by his scleroderma. “Aggravation” is defined as a permanent worsening of the pre-existing or underlying condition, as contrasted to temporary or intermittent flare-ups of symptoms which resolve with return to the previous baseline level of disability. Rationales for the requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, the examiner shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that the examiner has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). 3. Readjudicate the appeals. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Lee, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.