Citation Nr: 20031606 Decision Date: 05/05/20 Archive Date: 05/05/20 DOCKET NO. 16-36 927 DATE: May 5, 2020 REMANDED Entitlement to service connection for myasthenia gravis is remanded. Entitlement to service connection for systemic lupus erythematosus is remanded. Entitlement to service connection for peripheral neuropathy is remanded. Entitlement to service connection for the Veteran’s cause of death is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1967 to November 1969, to include service in the Republic of Vietnam. The appellant is the surviving spouse of the Veteran. These matters come before the Board of Veterans’ Appeals (Board) on appeal from February 2011 and August 2017 rating decisions by a Regional Office (RO) of the Department of Veterans Affairs (VA). The Appellant requested a Board video conference hearing. A review of the claims file notes that the March 2, 2020 hearing was cancelled. The Appellant has not submitted a request to reschedule her Board hearing. Entitlement to service connection for myasthenia gravis, systemic lupus erythematosus, peripheral neuropathy and the Veteran’s cause of death are remanded. The Veteran died on May [REDACTED], 2017. A death certificate on record listed the immediate cause of death as respiratory failure, due to or as a consequence of acute diastolic heart failure, which was due to pneumonia. The Appellant argued that the Veteran’s claimed disabilities and cause of death were a result of active service, specifically his exposure to herbicide agents while serving in Vietnam. Medical records submitted indicate the Veteran carried the diagnoses of systemic lupus erythematosus, peripheral neuropathy, and status-post myasthenia gravis. Military personnel records verify the Veteran served in the Republic of Vietnam from September 1967 to May 1969. Therefore, herbicide exposure is conceded. In November 2009, the Veteran submitted a medical report from Dr. R.S., M.D. who opined that the Veteran’s herbicide exposure “could have played a role in precipitating” the Veteran’s systemic lupus erythematosus disability. The Veteran was not afforded a VA examination during his lifetime nor has a medical opinion been obtained addressing the etiological relationship between the Veteran’s claimed disabilities, his cause of death, and his military service. Therefore, the Board finds that a VA medical opinion is needed. See 38 U.S.C. § 5103A (a); DeLaRosa v. Peake, 515 F.3d 1319, 1322 (Fed. Cir. 2008); Wood v. Peake, 520 F.3d 1345 (Fed. Cir. 2008). The matters are REMANDED for the following action: 1. The RO should refer the claims file to a suitable qualified VA examiner for a medical opinion to determine the nature and etiology of any myasthenia gravis, systemic lupus erythematosus, peripheral neuropathy and to address the cause of the Veteran’s death. (a.) The examiner must opine whether systemic lupus erythematosus, peripheral neuropathy, status-post myasthenia gravis is/are at least as likely as not related to an in-service injury, event, or disease, including conceded herbicide exposure during service in Vietnam. (b.) The examiner is requested to opine whether it is as likely as not that the Veteran’s death, was due to or the result of his in-service exposure to herbicide agents. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran’s service treatment records, post-service medical records, the Appellant’s assertions, and Dr. R.S., M.D.’s report. A clear rationale for all opinions must be provided and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. Jennifer White Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Mohammad Mahmoudi, 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.