Citation Nr: 21004597 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 16-53 741A DATE: January 27, 2021 ORDER Entitlement to service connection for coronary artery disease is granted. Entitlement to service connection for diabetes mellitus, type II, is granted. REMANDED Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded. FINDINGS OF FACT 1. Resolving the benefit of the doubt in the Veteran’s favor, he was exposed to herbicide agents while stationed in Thailand. 2. The Veteran has a current diagnosis of coronary artery disease, that is presumed due to exposure to herbicide agents. 3. The Veteran has a current diagnosis of diabetes mellitus, type II, that is presumed due to exposure to herbicide agents. CONCLUSIONS OF LAW 1. The criteria for service connection for coronary artery disease, have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for diabetes mellitus, type II, have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1956 to September 1968. The Veteran testified at a Board hearing in December 2020 before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the record. Entitlement to service connection for coronary artery disease and diabetes mellitus, type II The Veteran contends that he developed coronary artery disease and diabetes mellitus, type II, due to his exposure to herbicides while stationed in Thailand. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Certain chronic diseases will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). VA clinical records show diagnoses of coronary artery disease and diabetes mellitus, type II. Veterans exposed to Agent Orange or other listed herbicide agents are presumed service-connected for certain conditions, including ischemic heart disease and diabetes mellitus, type II, even if there is no record of such disease during service. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307 (a)(6), 3.309(e). Coronary artery disease is considered an ischemic heart disease. For purposes of establishing service connection for a disability resulting from exposure to a herbicide agent, a veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the period beginning on January 9, 1962 and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during service. 38 U.S.C. § 1116 (f). The Veteran served during the presumptive period, as noted above; however, the current evidence of record does not reflect any service in the Republic of Vietnam. Rather, the Veteran asserts that he was exposed to herbicides in Thailand, and it has been established that the Veteran served in Thailand for at least a year from September 1967 to September 1968 at Takhli Royal Thai Air Force Base. Importantly, M21-1, Part IV, Subpart ii, 1.H.4.b. sets forth steps for verifying herbicide exposure in Thailand. The first requirement is service at Royal Thai Air Force Bases (RTAFB) in U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, or Don Muang. If a Veteran served on one of these air bases as a security policeman, security patrol dog handler, member of a security police squadron, or otherwise served near the air base perimeter, as shown by MOS (military occupational specialty), performance evaluations, or other credible evidence, then herbicide exposure should be acknowledged on a facts-found or direct basis. Here, the Veteran did not serve in one of these specialties. In October 2014, the Agency of Original Jurisdiction (AOJ) issued a Formal Finding of lack of information to verify Agent Orange exposure to send to Joint Services Records Research Center. The AOJ indicated that given the Veteran’s military occupation specialty of Auto Flight Control Systems Specialist, which did not concede perimeter duties, the evidence did not support exposure to herbicides. However, significantly, the Veteran reports that during the course of his duties, he worked near the perimeter of the base. The Veteran also testified that sometimes he would leisurely walk the perimeter of the base when he was off duty. He said he observed that the foliage had been cleared. He also submitted a picture of him near the base perimeter. Moreover, the Veteran’s performance report during this period also indicated that the Veteran had shown excellent qualities in the performance of his duties, which also supports the Veteran’s credibility as such records portray him as an individual with good moral character. The Veteran’s performance report is consistent with his own description of his duties. The Board finds the Veteran’s assertions credible and supported by contemporaneous military records. Therefore, resolving any reasonable doubt in favor of the Veteran, the Board finds that, due to the Veteran’s duties and location, he was exposed to Agent Orange during his service at Takhli Royal Thai Air Force Base. Accordingly, because he currently suffers from diseases that has been identified as associated with herbicide exposure (i.e., coronary artery disease and diabetes mellitus, type II) and was exposed to herbicide agents during his service in Thailand, the Board finds that the Veteran is entitled to service connection for coronary artery disease and diabetes mellitus, type II, on a presumptive basis. 38 C.F.R. § 3.309(e). REASONS FOR REMAND Entitlement to service connection for COPD is remanded. The Veteran has also asserted that his COPD is related to exposure to herbicides. However, COPD is not one of the enumerated diseases presumed due to exposure to herbicide agents. Nevertheless, service connection for COPD may still be granted on a direct basis. See Stefl v. Nicholson, 21 Vet. App. 120 (2007); see also Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). The Veteran was afforded a VA examination in October 2014. The examiner opined that the Veteran’s lung condition (COPD) was less likely incurred in or caused by the complaints and treatment during service and offered a rationale for such finding. However, the examiner did not offer an opinion as to whether the Veteran’s COPD was at least as likely as not related to exposure to herbicide agents. Significantly, the examiner did note that environmental exposures may also be a risk factor. Thus, an addendum opinion is needed to address whether the Veteran’s COPD is related to exposure to herbicide agents. In light of the need to remand, additional VA clinical records should be obtained. The matters are REMANDED for the following action: 1. Obtain VA clinical records dated from June 2018 to the present. 2. Obtain an addendum opinion from an appropriate clinician regarding the Veteran’s COPD. The examiner must opine whether it at least as likely as not related to an in-service injury, event, or disease, including exposure to herbicide agents.   The examiner must provide a rationale to support the opinion. The examiner is advised that a negative opinion cannot be based solely on the fact that COPD is not one of the listed diseases that are presumptively associated with exposure to herbicide agents. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J.N. Moats 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.