Citation Nr: 21003159 Decision Date: 01/19/21 Archive Date: 01/19/21 DOCKET NO. 20-05 874 DATE: January 19, 2021 ISSUE Entitlement to service connection for Parkinson's disease. REMANDED Entitlement to service connection for Parkinson's disease is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from December 1955 to August 1957. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In December 2020 the Veteran testified before the undersigned Veterans Law Judge in a video teleconference hearing. A transcript of the testimony offered at the hearing has been associated with the record. The Board finds that additional evidentiary development is required before the claim on appeal is adjudicated. This matter has been advanced on the docket pursuant to 38 C.F.R. § 20.900. 1. Entitlement to service connection for Parkinson's disease is remanded. The Veteran contends that his Parkinson’s disease is related to his active service through exposure to various paint thinners and chemicals, including trichloroethylene, while in service. In March 2018 the Veteran submitted medical treatise evidence which discusses the positive nexus relationship between trichloroethylene and Parkinson’s disease. With regard to medical treatise evidence, the United States Court of Appeals for Veterans Claims (Veterans Court) has held that a medical article or treatise "can provide important support when combined with an opinion of a medical professional" if the medical article or treatise evidence discussed generic relationships with a degree of certainty such that, under the facts of a specific case, there is at least "plausible causality" based upon objective facts rather than on an unsubstantiated lay medical opinion. Sacks v. West, 11 Vet. App. 314 (1998); see also Wallin v. West, 11 Vet. App. 509. In this case, however, the medical treatise evidence submitted by the Veteran is not accompanied by the opinion of a medical professional and lacks the specificity to constitute competent evidence of the claimed medical nexus. See Sacks, 11 Vet. App. at 317; see Libertine v. Brown, 9 Vet. App. 521, 523 (1996). The record also contains a July 2018 private medical opinion from Dr. G.S.B that notes a diagnosis of Parkinson’s disease. Dr. G.S.B. opined that the Veteran’s current disability is more likely than not related to his exposure to trichloroethylene during service. In offering this opinion the examiner provided a conclusionary statement with no rationale. The examination failed to provide not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Therefore, the Board finds the July 2018 private examiner’s opinion to be inadequate for adjudication purposes. In his December 2020 Board hearing the Veteran testified that his MOS while in service was a yeoman. He testified that during his time in service he worked on a repair ship, the U.S.S. Ajax, and part of his duties included taking items that needed to be repaired to various locations on the ship. While in different parts of the ship he was exposed to the various cleaners and paint thinners which were being used throughout the ship. The Board notes that the Veteran has not been provided with a VA examination for his Parkinson’s disease nor has he been provided with a medical opinion to address the issue of etiology. VA must provide a medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service, or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006); see also 38 U.S.C. § 5103A (d)(2), 38 C.F.R. § 3.159 (c)(4)(i) (2017). The third prong, which requires that the evidence of record "indicate" that the claimed disability or symptoms "may be" associated with the established event, is a low threshold. McLendon, 20 Vet. App. at 83. Here, the Board finds that the McLendon criteria have been satisfied. Specifically, there is competent evidence that the Veteran has Parkinson’s disease which may be associated with his active service, including his exposure to various paint thinners and chemicals, including trichloroethylene, but there is insufficient competent medical evidence on file for the Board to make a decision on the claim. As such, remand for an examination and medical opinion is necessary. The matters are REMANDED for the following action: 1. Make appropriate efforts to obtain and associate with the claims file any updated VA medical records of the Veteran not previously obtained. 2. Once the development has been completed, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his Parkinson’s disease. Following a complete review of the Veteran's claims file, the examiner must opine whether the Parkinson’s disease is at least as likely as not related to an in-service injury, event, or disease, to include exposure to paint thinners and chemicals, including trichloroethylene while in service. When considering this question, the examiner is to consider all lay statements of record carefully, VA treatment records, private treatment records and evaluations and medical treatise evidence. The examiner’s attention is directed to the Veteran’s statements that he was exposed to the various cleaners and paint thinners while aboard the U.S.S Ajax. The examiner should view the Veteran as a reliable historian as to his service and his report of his activities in service. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The examiner is also asked to consider and discuss the July 2018 medical opinion from Dr. G.S.B. who opined that the Veteran’s current disability is more likely than not related to his exposure to trichloroethylene during service. A detailed rationale must be provided for any opinion offered. After completing the requested actions, readjudicate the claim in light of all pertinent evidence and legal authority. If the benefit sought remains denied, furnish to the Veteran and his representative with a Supplemental Statement of the Case and afford them the appropriate time period for response before the claims file is returned to the Board for further appellate consideration. Michael A. Pappas Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Nettey, 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.