Citation Nr: 20004601 Decision Date: 01/21/20 Archive Date: 01/21/20 DOCKET NO. 19-20 216 DATE: January 21, 2020 ORDER Service connection for B-cell lymphoma, secondary to herbicide agent exposure, is granted. Service connection for diabetes mellitus, Type II (diabetes), secondary to herbicide agent exposure, is granted. FINDINGS OF FACT 1. The evidence of record establishes the Veteran has a current diagnosis of B-cell lymphoma in remission. 2. The evidence of record establishes the Veteran has a current diagnosis of diabetes. 3. The evidence of record establishes the Veteran’s duties as a medic while stationed at Camp Samae San, Thailand, during the Vietnam Era, required him to serve near the base perimeter at the U-Tapao Royal Thai Air Force Base (RTAFB). CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for B-cell lymphoma, secondary to herbicide agent exposure, have been met. 38 U.S.C. §§ 1110, 1111, 1112, 1113 (2012); 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309 (2018). 2. The criteria for entitlement to service connection for diabetes, secondary to herbicide agent exposure have been met. 38 U.S.C. §§ 1110, 1111, 1112, 1113; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from September 1969 to April 1971, during the Vietnam Era. Since the Regional Office issued its May 2019 Statement of the Case, new, pertinent VA treatment records have been associated with the claims file. To date, the Regional Office has not issued a Supplemental Statement of the Case addressing these new VA treatment records. See 38 C.F.R. § 19.31 (2018). Notwithstanding, the Board may proceed with the adjudication of the claims herein without any prejudice to the Veteran given the favorable findings below. See Bernard v. Brown, 4 Vet. App. 384 (1993). 1. The issues of entitlement to service connection for B-cell lymphoma, to include as secondary to herbicide agent exposure; and service connection for diabetes, to include as secondary to herbicide agent exposure. Laws and Regulations Generally, service connection may be established if the evidence demonstrates that a current disability resulted from a disease or injury incurred in or aggravated by active duty service. 38 C.F.R. § 3.303. In that regard, service connection may be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to the period of service, establishes the disease was incurred during active duty service. 38 C.F.R. § 3.303(d). In order to prove service connection, there must be competent and credible evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus or link between the current disability and the in-service disease or injury. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Further, a veteran who served on active duty in the Republic of Vietnam during the Vietnam Era is presumed to have been exposed to an herbicide agent during such service, absent affirmative evidence establishing that he was not. 38 C.F.R. § 3.307(a)(6), (d). If a veteran exposed to an herbicide agent pursuant to 38 C.F.R. § 3.307(a)(6) develops a disease delineated in 38 C.F.R. § 3.309(e), it shall be service connected on a presumptive basis even though there is no record of such disease during service. 38 C.F.R. § 3.309(e) provides an exhaustive list of the diseases that may be service connected on a presumptive basis and it includes Non-Hodgkin’s lymphoma and diabetes. For service in Thailand during the Vietnam Era, there is no similar statutory or regulatory presumption of exposure to an herbicide agent during such service. Nonetheless, pursuant to VA policy, special consideration will be accorded, and exposure herbicide agents will be acknowledged if the veteran served at the RTAFBs at U-Tapao, Ubon, Nakhom Phanom, Udorn, Takhli, Korat, or Don Muang; and served as a security policeman, security patrol dog handler, member of a security police squadron, or otherwise served near the base perimeters. Service near a base perimeter may be shown by a veteran’s military occupational specialty (MOS), daily work duties, performance evaluations or other credible evidence. Analysis The Veteran contends that his diagnoses of B-cell lymphoma and diabetes stem from his service. More specifically, he asserts these diagnoses are due to herbicide agent exposure in-service. See, e.g., February 2015 Statement in Support of Claim. Throughout the pendency of this appeal, the Veteran has described multiple instances in which he may have been exposed to herbicide agents in service. Among them, he believes he was exposed to herbicide agents while stationed at Camp Samae San in Thailand with the 162nd Medical Detachment, which was located a mile or two west of the U-Tapao RTAFB. While stationed at Camp Samae San, his MOS was as a medic. During his first few weeks there, he spent time gathering palm leaves to build a shelter for the medical dispensary. This activity occurred in the areas between Camp Samae San and the U-Tapao RTAFB. He was also occasionally assigned to duties at a firing range in the area between Camp Samae San and the U-Tapao RTAFB. Additionally, his duties as a medic required him to provide medical care to servicemembers and civilians near the perimeter of the U-Tapao RTAFB. A review of the medical evidence of record leaves no doubt the Veteran has a current diagnosis of B-cell lymphoma, a type of Non-Hodgkin’s lymphoma, which is in remission, as well as diabetes. See January 2013 Progress Note from Dr. P.D.B.; October 2013 A.R.C.N.Y Radiation Oncology Completion Note; February 2019 VA Primary Care Evaluation and Management Note. The Veteran’s service personnel records (SPRs) confirms he was stationed in Thailand from March 1970 to April 1971. While his SPRs do not explicitly identify he was stationed at Camp Samae San, his service treatment records (STRs) corroborate his lay statement that he was stationed there. Notably, a review of the Veteran’s STRs indicates that he was seen at the 162nd Medical Detachment’s Samae San Dispensary in March 1970. His STRs disclose he received medical attention at Camp Samae San again in August 1970 and was referred for a subsequent surgical appointment at the U-Tapao RTAFB in September 1970. In fact, his STRs suggest that he received medical attention at the U-Tapao RTAFB on several occasions. See August 1970 Consultation Sheet (noting the Veteran was scheduled for an appointment at the surgical clinic at the U-Tapao RTAFB in September 1970); February 1971 Operation Report (noting the Veteran underwent a surgical procedure performed at the 11th United States Hospital at the U-Tapao RTAFB). Further, his STRs appear to indicate medical services were coordinated between Camp Samae San and the U-Tapao RTAFB suggesting they were in close proximity to each other. See August 1980 Miscellaneous (noting a sample was collected from the Veteran and was sent to the 11th United States Hospital at the U-Tapao RTAFB for testing). As another matter, the Veteran’s DD Form 214 confirms his MOS in-service was a medic. Considering the above, the Board finds the Veteran’s claim that his duties as a medic required him to provide medical care to servicemembers and civilians near the perimeter of the U-Tapao RTAFB is consistent with the other credible evidence of record. Therefore, the Board finds the preponderance of the evidence demonstrates his MOS as a medic required him to occasionally serve near the U-Tapao base perimeter while stationed at Camp Samae San, Thailand. Accordingly, the Board acknowledges he was exposed to herbicide agents in service. As B-cell lymphoma and diabetes have been recognized as diseases associated with exposure to herbicide agents, the Board finds service connection for B-cell lymphoma and diabetes, secondary to herbicide agent exposure is warranted. M. Donohue Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Suh, 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.