Citation Nr: 20007740 Decision Date: 01/30/20 Archive Date: 01/29/20 DOCKET NO. 16-19 654 DATE: January 30, 2020 REMANDED Entitlement to service connection for diabetes mellitus, type II, is remanded. Entitlement to service connection for a left lower leg disability is remanded. REASONS FOR REMAND The Veteran served on active naval service from May 1966 to December 1969. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Newark New Jersey. In July 2019, the Veteran testified before the undersigned Veterans Law Judge in regard to his current claims on appeal. A transcript of the hearing is included with the claims file. The Veteran asserts he was exposed to herbicide agents while serving aboard the USS Constellation (CVA-64) near the Republic of Vietnam, and therefore is entitled to the presumption of service connection for diabetes mellitus and possibly early onset peripheral neuropathy. See 38 C.F.R. § 3.309(e). The recent Blue Water Navy Vietnam Veterans Act of 2019 (Public Law 116-23) added 38 U.S.C. § 1116A which in pertinent part includes in the presumption of exposure to herbicide agents those veterans who served offshore of the Republic of Vietnam during the period from January 9, 1962 to May 7, 1975. “Offshore” is defined as a location not more than 12 nautical miles seaward of a line commencing on the southwestern demarcation line of the waters of Vietnam and Cambodia and intersecting at certain points. In this case, the Veteran testified that the USS Constellation was in Da Nang Harbor while he was aboard and he was therefore within 12 nautical miles of Vietnam and should be presumed exposed to herbicide agents. The record does not currently verify the USS Constellation was in Da Nang Harbor while the Veteran was aboard, and remand is necessary to determine if such was the case. The Veteran has also asserted that he has a left lower extremity disability as a result of another in-service event; specifically, injury to the left lower extremity when he lifted a missile that fell. At his July 2019 hearing before the Board, the Veteran testified that he experienced left lower extremity pain and numbness below his knee, and that his lower left leg first started bothering him after the accident with the missile. Service records show the Veteran complained of a sore and swollen left foot in December 1968, and also complained of knee problems on a few occasions. Post service records show a 2010 diagnosis of left and right lower extremity peripheral artery disease, and a 2010 stent placement for ischemic left lower extremity. The Veteran has also been diagnosed with peripheral vascular disease. See, e.g., August 29, 2019 VA Ambulatory Care Note. A medical opinion should be obtained regarding this issue. The matter is REMANDED for the following action: 1. Determine whether the USS Constellation (CVA-64) was within 12 nautical miles of Vietnam while the Veteran was aboard. 2. Ask the Veteran to identify all outstanding treatment records relevant to his diabetes and left lower extremity disability. All identified VA records should be added to the claims file. All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records. 3. After records development is completed, the Veteran should be afforded a VA examination to address the nature of any currently present left lower extremity disability and to obtain an opinion as to whether such is related to service. The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran the examiner should provide a fully reasoned explanation. Following review of the claims file and examination of the Veteran, the examiner should address the following: (a) Whether the Veteran has early-onset peripheral neuropathy; that is, peripheral neuropathy which manifested within a year of the Veteran’s (claimed but not yet verified) exposure to herbicide agents while serving aboard the USS Constellation. (b) Whether it is at least as likely as not (50 percent probability or greater) that any current left lower extremity disability – to include peripheral artery/vascular disease, and ischemia – is related to an in-service injury, event, or disease. The examiner should specifically consider the Veteran’s report that he injured his left lower extremity during an incident aboard the USS Constellation in which the Veteran was lifting a missile that fell. (c) Whether it is at least as likely as not that any current left lower extremity disability – to include peripheral artery/vascular disease, and ischemia – is (i) caused, or (ii) aggravated (worsened beyond natural progression) by the Veteran’s left knee disability. A rationale for all opinions expressed is requested as the Board is precluded from making any medical findings. Nathan Kroes Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Christopher O'Donnell 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.