Citation Nr: 20008313 Decision Date: 01/31/20 Archive Date: 01/31/20 DOCKET NO. 16-41 742 DATE: January 31, 2020 REMANDED Entitlement to service connection for a psychiatric disorder, to include depression, is remanded is remanded. Entitlement to service connection for residuals of a cerebrovascular accident is remanded. Entitlement to service connection for an acute venous embolism and thrombosis of the deep vessels of the right lower extremity is remanded. REASONS FOR REMAND The Veteran served on active duty in the Navy from October 1971 to August 1975. This matter is before the Board of Veterans’ Appeals (Board) on appeal of a December 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). As there are multiple other psychiatric diagnoses of record, the Board finds that it is more appropriate to characterize the claim broadly as one of entitlement to service connection for a psychiatric disorder, to include depression. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). In September 2019, the Veteran appeared at a Board videoconference hearing before the undersigned Veterans Law Judge. On July 1, 2019, the Secretary of Veterans Affairs directed the Board of Veterans’ Appeals (Board) to stay adjudication of all cases which may be affected by the Blue Water Navy Vietnam Veterans Act of 2019 (the Act), until the effective date of the Act, January 1, 2020. The Act creates new statutory requirements for the adjudications of certain claims based on veterans’ herbicide agent exposure in the offshore waters of the Republic of Vietnam during the period from January 9, 1962, to May 7, 1975, in or near the Korean Demilitarized Zone during the period from September 1, 1967, to August 31, 1971, and in Thailand during the period from January 9, 1962, to May 7, 1975. The stay has now been lifted. The Veteran contends that he has a psychiatric disorder, to include depression; residuals of a cerebrovascular accident; and an acute venous embolism and thrombosis of the deep vessels of the right lower extremity, that are related to service, to include as due to Agent Orange exposure. He specifically maintains that he was exposed to Agent Orange while serving aboard the USS Dubuque. He reports that the USS Dubuque anchored in Haiphong Harbor in Saigon, which he believes is in within 12 nautical miles of the shores of the Republic of Vietnam. The Veteran also indicates that his psychiatric disorder, to include depression, began during his period of service. He reports that a fellow serviceman, and friend of his, was cut in half by a helicopter. He states that the circumstances of his discharge may have caused his psychiatric problems because he wanted to make a career out of being in the military. The Veteran further asserts that his psychiatric disorder may be related to his residuals of a cerebrovascular accident and an acute venous embolism and thrombosis of the deep vessels of the right lower extremity. As noted above, the Veteran served on active duty in the Navy from October 1971 to August 1975. His DD Form 2014 indicates that he had two years, eleven months, and twenty-one days of foreign and/or sea service. The Veteran’s discharge was under honorable conditions. His service personnel records show that he served on the USS Dubuque from September 1972 to November 1974. A November 2012 response from the National Personnel Records Center (NPRC) indicates that it was unable to determine whether the Veteran served in the Republic of Vietnam. The NPRC indicated that the Veteran served aboard the USS Dubuque, which was in the official waters of the Republic of Vietnam from December 13, 1972, to December 20, 1972; from January 7, 1973, to January 18, 1973; and from February 2, 1973, to February 28, 1973. The NPRC stated that the record provided no conclusive proof of in-country service. It is not clear from the record what the NPRC meant by “official” water of Vietnam. The Veteran’s service treatment records do not show treatment for psychiatric problems, to include depression; a cerebrovascular accident; or for an acute venous embolism and thrombosis of the deep vessels of the right lower extremity. Significantly, the service treatment records show that in October 1972 the Veteran was seen for complaints of headaches, lightheadedness and persistent episodes of blurred vision and his blood pressure was recorded as 140/105, 140/105 and 140/100. These records show that on October 11, 1972 and that he was diagnosed with hypertension. Post-service VA treatment records show treatment for variously diagnosed psychiatric disorders, including a depressive disorder, not elsewhere classified; a depressive disorder, not otherwise specified; rule out a generalized anxiety disorder; rule out posttraumatic stress disorder (PTSD); and a history of depression/anxiety. Such records also indicate that the Veteran was treated for residuals of a cerebrovascular accident and for a transient ischemic attack, as well as for deep vein thrombosis; pedal edema; and for an acute venous embolism and thrombosis of unspecified deep vessels of the lower extremities. The Board observes that updated guidance provides that, for the purposes of determining whether a veteran may be presumed to have been exposed to herbicide agents (Agent Orange), the term “Service in the Republic of Vietnam” includes not only service on the landmass and inland waterways, but also service in the territorial sea extending 12 nautical miles from the shores of that nation. Procopio v. Wilkie, 913 F.3d 1371 (2019). The Board notes, however, that there is no indication that the NPRC, or any other appropriate official source, have addressed whether the Veteran served on any ships in the territorial sea extending 12 nautical miles from the shores of that nation, to include any service on the USS Dubuque. Given the foregoing, the Board finds that a remand is necessary to determine if the Veteran had service on any ships, to include the USS Dubuque, in the territorial sea extending 12 nautical miles from the shores of the Republic of Vietnam, and to obtain copies of deck logs, ship logs, or any other documents, detailing the movements and operations of the USS Dubuque during the Veteran’s service period. The Board also observes that the Veteran has not been afforded VA examinations, as to his claimed psychiatric disorder, to include depression; residuals of a cerebrovascular accident; and an acute venous embolism and thrombosis of the deep vessels of the right lower extremity. In light of the above, the Board finds that the Veteran must be afforded VA examinations with the opportunity to obtain responsive etiological opinions, following a thorough review of the entire claims file, as to his claims for service connection for a psychiatric disorder, to include depression; residuals of a cerebrovascular accident; and an acute venous embolisms and thrombosis of the deep vessels of the right lower extremity. Such examinations must be accomplished on remand. 38 C.F.R. § 3.159 (c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. Contact all appropriate official sources, to include the National Personnel Records Center (NPRC), and/or the Joint Services Records Research Center (JSRRC), to determine if the Veteran served within in the territorial sea extending 12 nautical miles from the shores of the Republic of Vietnam while serving in the Navy from October 1971 to August 1975. The deck logs, ship logs, or any other documents, detailing the movements of the USS Dubuque, aboard which the Veteran served from September 1972 to November 1974, should also be obtained. If more detailed information is needed for this research, the appellant should be given an opportunity to provide it. 2. Ask the Veteran to identify all medical providers who have treated him for psychiatric problems; residuals of a cerebrovascular accident; and for an acute venous embolism and thrombosis of the deep vessels of the right lower extremities, since October 2014. After receiving this information and any necessary releases, obtain copies of the related medical records which are not already in the claims folder. Document any unsuccessful efforts to obtain the records, inform the Veteran of such, and advise him that he may obtain and submit those records himself. 3. Notify the Veteran that he may submit lay statements from himself and from other individuals who have first-hand knowledge, and/or were contemporaneously informed of his in-service and post-service psychiatric problems, to include depression as well as for residuals of a cerebrovascular accident; and acute venous embolism and thrombosis of the deep vessels of the right lower extremity. The Veteran should be provided an appropriate amount of time to submit this lay evidence. 4. Schedule the Veteran for an appropriate VA examination to determine if he suffers from PTSD or from any other psychiatric disorders related to service. The claims file must be reviewed by the examiner. The examiner must identify each psychiatric disability found to be present (to include a depressive disorder, not elsewhere classified; a depressive disorder, not otherwise specified; and depression/anxiety, etc.), and a diagnosis of PTSD must be ruled in or excluded. The examiner must opine as to whether it is at least as likely as not that any currently diagnosed psychiatric disorders (to include to include a depressive disorder, not elsewhere classified; a depressive disorder, not otherwise specified; and depression/anxiety, etc.), are etiologically related or had their onset in service. The examiner must specifically acknowledge and discuss any reports by the Veteran that he suffered from psychiatric problems during service and since service. 5. Schedule the Veteran for a VA examination to determine the onset and etiology of his claimed residuals of a cerebrovascular accident and an acute venous embolism and thrombosis of the deep vessels of the right lower extremity. The entire claims file must be reviewed by the examiner. The examiner must specifically indicate if the Veteran has currently diagnosed residuals of a cerebrovascular accident and an acute venous embolism and thrombosis of the deep vessels of the right lower extremity. The examiner must specifically acknowledge and discuss the Veteran’s October 1972 in-service diagnosis of hypertension. The examiner must opine as to whether it is as at least as likely as not that any currently diagnosed residuals of a cerebrovascular accident and an acute venous embolism and thrombosis of the deep vessels of the right lower extremity, are related to and/or had their onset during his period of service. The examiner must also specifically acknowledge and discuss the Veteran’s treatment for dizziness and fainting spells, as well as the diagnosis of hypertension during service, and discuss any reports by the Veteran of symptoms he thought were due to a cerebrovascular accident and an acute venous embolisms and thrombosis of the deep vessels of the right lower extremity, during and since service. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. D. Regan, 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.