Citation Nr: 21004596 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 12-18 642 DATE: January 27, 2021 REMANDED Entitlement to service connection for a blood disorder to include as due to ionizing radiation exposure, also claimed as a blood condition to include leukemia, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1979 to November 1983 with additional service in the Virginia Army National Guard from October 1984 to October 1986. This case initially came before the Board of Veterans' Appeals (Board) on appeal from a September 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO), which denied service connection for the above issue. In March 2017, the Veteran testified at a Board Central Office hearing before the undersigned Veterans Law Judge. A hearing transcript is of record. In June 2017, the Board remanded the appeal. In June 2019, the Board denied service connection for this claim. The Veteran appealed the Board’s denial to the United States Court of Appeals for Veterans Claims (Court). Before the Court issued a decision, the parties filed a joint motion for partial remand (joint motion). The Court granted the joint motion in August 2020, which vacated the portion of the June 2019 Board decision that denied service connection for a blood disorder and remanded it to the Board for review consistent with the joint motion instructions. Entitlement to service connection for a blood disorder to include as due to ionizing radiation exposure, also claimed as a blood condition to include leukemia, is remanded. Additional development is needed for this claim. The June 2017 Board remand instructed that if any symptom or impairment related to any blood abnormality, including leukopenia, was shown, then additional development was required. It included verifying the nature and extent of reported ionizing radiation in accordance with 38 C.F.R. § 3.311(a)(2)(iii) and then furnishing a VA examination and medical opinion. As noted in the August 2020 joint motion, the Veteran identified fatigue as a symptom possibly associated with a blood disorder. (See March 2017 Board hearing transcript, pp.18-19). Notably, the current disability element is broad and encompasses any manifestation resulting in functional impairment of earning capacity. Saunders v. Wilkie, 886 F.3d 1356, 1367-68 (Fed. Cir. 2018). The Board finds that the Veteran’s March 2017 symptom report satisfies the current disability element for purposes of triggering the additional development action outlined in the June 2017 Board remand. With the above indication of a current disability, the following development is required to comply with the June 2017 Board remand. First, the agency of original jurisdiction (AOJ) must obtain all VA treatment records since September 2018 and request that the Veteran identify any relevant private medical records. Second, the AOJ must also request a dose estimate from the Under Secretary for Health be created for the Veteran based upon his service as a Pershing Missile Crewmember for a nearly four year period between November 1979 and November 1983. 38 C.F.R. § 3.311(a)(2)(iii). In consideration of the dose estimate, the AOJ should advise that the service department records are incomplete. The Veteran’s competent and credible reports about working as a Pershing Missile Crewmember must be considered. Then, after the above development actions have been completed, furnish a VA medical examination or alternatively medical opinion for the claim. The matter is REMANDED for the following action: 1. Obtain VA treatment records from September 2018 to the present for the Veteran. Request that the Veteran identify any relevant private medical records and furnish appropriate authorization for the release of medical records. Alternatively, advise him that he may submit any medical records in his possession directly to VA. 2. Then, forward the Veteran's personnel records, service and post-service medical records, and other pertinent documents to the VA Under Secretary for Health for a dose estimate based on his service as a Pershing Missile Crewmember in accordance with 38 C.F.R. § 3.311(a)(2)(iii). 3. Then, schedule a VA hematology examination and obtain a medical opinion from an appropriately qualified physician to the determine the nature and etiology of the claimed blood disorder. If tele-health examination will provide the physician with sufficient information to render an opinion, such an examination is acceptable. The claims file and a copy of this remand must be made available to the physician for review, and the physician must specifically acknowledge receipt and review of these materials in any reports generated. The physician must provide opinions as to the following: (a) Whether it is at least as likely as not (50 percent or greater probability) that any blood disorder was caused by in-service radiation exposure. (b) If the examiner concludes that the blood disorder is not the result of radiation exposure, provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that it began during active service or is related to any incident of service. A complete rationale should accompany any opinion provided. Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. D. Simpson, 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.