Citation Nr: 21003624 Decision Date: 01/22/21 Archive Date: 01/22/21 DOCKET NO. 17-24 671 DATE: January 22, 2021 REMANDED Entitlement to service connection for a respiratory condition is remanded. Entitlement to service connection for hypertension (HTN) is remanded. Entitlement to service connection for neuropathy of the bilateral upper and lower extremities is remanded. REASONS FOR REMAND The Veteran had active duty service with the U.S. Navy from August 1968 to March 1970. This case comes before the Board of Veteran’s Appeals (Board) on appeal from a September 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In July 2020, the Veteran had a Board hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that hearing is of record. Respiratory Condition/ Hypertension The Veteran contends that this respiratory condition and HTN was related to his military service. Specifically, he contends that his conditions were related to his Agent Orange (AO) exposure. Service personnel records documented that the Veteran was in the Republic of Vietnam from June 1969 to September 1969. Therefore, his exposure to AO (herbicide agents) is conceded. The Veteran has not been afforded a VA examination with respect to his claimed conditions. In July 2020, the Veteran testified that he was diagnosed with a respiratory condition around 2010 and HTN over 25 years ago. He indicated that his condition was related to the AO exposure he had when he was in Vietnam. VA treatment records documented that that the Veteran was diagnosed with several respiratory disabilities, to include chronic obstructive pulmonary disease (COPD), chronic respiratory insufficiency, chronic hypoxemic respiratory failure, and an acute respiratory infection. Also, treatment records documented that the Veteran was diagnose with HTN. There is no medical opinion as to whether the Veteran’s claimed conditions are related to his military service, including presumed exposure to herbicide agents. Where there is evidence of a current disability or persistent or current symptoms of a disability and an in-service incident or injury, and the possibility of a nexus between them, remand is required to obtain an examination and medical opinion. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159 (c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006). Bilateral Upper and Lower Extremities The Veteran contends that his bilateral upper and lower extremities neuropathy was related to his military service. Specifically, he contends that his conditions were related to his Agent Orange (AO) exposure. The Veteran has not been afforded a VA examination with respect to his claimed conditions. VA treatment records documented that the Veteran was diagnosed with chronic neuropathy and cellulitis. In July 2020, he testified that he was wounded the first week of September during an attack at night while in Vietnam. He stated that an RPG was fired very close to him and a flare was fired very close to him. He indicated that after the attack he had a burning sensation on his arms and had a lot of white scars on his arms. He indicated that some shrapnel was taken out of his arm and it was just superficial wounds. There is no medical opinion as to whether the Veteran’s claimed conditions are related to his military service, including presumed exposure to herbicide agents and an RPG attack. Where there is evidence of a current disability or persistent or current symptoms of a disability and an in-service incident or injury, and the possibility of a nexus between them, remand is required to obtain an examination and medical opinion. 38 U.S.C. § 5103A(d); 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. Obtain updated VA treatment records. 2. When scheduling the Veteran’s VA examination please contact the Veteran to schedule his VA examinations. He needs at least a month advance notice due to his mobility. 3. Schedule the Veteran for a VA respiratory conditions examination; the claims file must be reviewed in conjunction with the examination. The examiner must identify all current respiratory conditions; chronic obstructive pulmonary disease (COPD), chronic respiratory insufficiency, chronic hypoxemic respiratory failure, and acute respiratory infection should be specifically discussed. For each diagnosed condition, the examiner must provide an opinion as to whether such is at least as likely as not caused or aggravated by service, to include exposure to herbicides. 4. Schedule the Veteran for a VA hypertension examination. The claims file must be reviewed in conjunction with the examination. The examiner must opine as to whether currently diagnosed hypertension is at least as likely as not caused or aggravated by service, to include exposure to herbicides in Vietnam. The examiner must discuss recent National Academy of Sciences (NAS) updates indicating a potential causal link between herbicide exposure and hypertension. 5. Schedule the Veteran for a VA peripheral nerves examination. The claims folder must be reviewed in conjunction with the examination. The examiner should conduct all necessary testing, to include nerve conduction studies or EMG studies and should clearly identify any neurological disability of the upper and lower extremities. The examiner must opine as to whether it is at least as likely as not any currently diagnosed condition is caused or aggravated by service, to include exposure to herbicides in Vietnam and/or an RPG attack. 6. Thereafter, readjudicate the remanded issues. If any benefit sought remains denied, issue a supplemental statement of the case. The case should then be returned to the Board for appellate review if otherwise in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Baxter 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.