Citation Nr: 21061424 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 18-31 433 DATE: October 4, 2021 REMANDED Entitlement to service connection for chronic lymphocytic leukemia (CLL) is remanded. Entitlement to service connection for multiple myeloma is remanded. Entitlement to service connection for chronic renal disease, to include as secondary to multiple myeloma and CLL claims, is remanded. Entitlement to service connection for hypertension to include as secondary to multiple myeloma and CLL claims, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from July 1967 to February 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2016 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board denied the Veteran's claim in a January 2021 decision. The Veteran then appealed to the United States Court of Appeals for Veteran's Claims (CAVC), and in June 2021 CAVC vacated the January 2021 Board decision, granted a joint motion for remand, and returned the case to the Board for action consistent with the joint motion for remand. CLL and Multiple Myeloma The Veteran seeks service connection for CLL and multiple myeloma which he contends were caused by in-service exposure to the herbicides. Specifically, the Veteran argued that his exposure to herbicides while he was stationed at Fort Wainwright caused his claimed disabilities. The Veteran's personnel files and lay statements confirm his service at Fort Wainwright. Additionally, the Veteran's lay statements indicate that he would camp out near the Haines-Fairbanks pipeline after it had been sprayed with insecticide and commercial herbicides. The Veteran additionally testified that he would regularly eat meals by the pipeline, and that soldiers would dig into the topsoil to bury drinks in order to keep them cold. It is through these instances that the Veteran claims his herbicide exposure took place. At the outset, the Board notes that all of the Veteran's claims hinge on whether he was exposed to qualifying herbicide agents and/or other chemicals in service. At present, the Board finds that there is insufficient evidence in the claims file to make a determination as to that issue. A remand for additional development is therefore required. The Veteran is currently diagnosed with CLL and multiple myeloma. See May 2005, May 2006, and January 2019 Private Treatment Notes. The central issue that must be resolved is whether the Veteran was exposed to qualifying herbicides during his service at Fort Wainwright. In support of his contentions, the Veteran cited to a 1973 herbicide training conference for the Army that included multiple participants from various Alaska facilities. He believed this demonstrated that there had been prior misuse of herbicides at the Alaska facilities, including Forts Greely and Wainwright, that the training conference was meant to correct. Further, the Veteran has submitted an August 2016 letter from a private environmental scientist who noted that the Haines-Fairbanks pipeline was in an area that had to be the most dioxin contaminated land in Alaska. The Veteran also cited to many articles linking dioxin exposure to cancer However, the Board notes that a May 2016 internal VA correspondence indicated that the Department of Defense (DoD) had not identified any location in Alaska, including the Haines-Fairbanks pipeline, where Agent Orange was used, tested, or stored. In addition, the study cited by the Veteran specifically stated that no dioxin was found in any soil sample. An April 2018 VA correspondence discussed how commercial herbicides used in routine base maintenance activities such as range management, brush clearing, and weed killing were not governed under the regulations for Agent Orange exposure at 38 C.F.R. § 3.307(a)(6)(i). In addition, the Department of Defense (DoD) had not identified any location on Fort Wainwright, Alaska where Agent Orange was used, tested, stored, or transported. The Board notes that "herbicide agents" is statutorily defined as "a chemical in an herbicide used in support of the United States and allied military operations in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, specifically: 2,4-D; 2,4,5-T and its contaminant TCDD; cacodylic acid; and picloram." 38 C.F.R.§3.307(a)(6)(i) (emphasis added). Given the available evidence, the Board finds that a remand is required for the RO to undertake additional development regarding the Veteran's alleged exposure. The claims file confirms that the Veteran served at Fort Wainwright and he has described that he was exposed to herbicide agents and/or other toxins by performing his duties on the base. The medical treatises and reports submitted by the Veteran make clear that his contention is that he was exposed to herbicide agents and/or other toxins in the ground or water at Fort Wainwright during his period of service there. This information is sufficient for the RO to make requests regarding the Veteran's alleged exposure. While the reports and opinion submitted by the Veteran shed light on the use of herbicide agents and other chemicals at Fort Wainwright generally, the mere presence of toxins in various locations at Fort Wainwright or along the Haines-Fairbanks pipeline is insufficient to establish that the Veteran was exposed to those toxins without any discussion of the likely duration or intensity of the Veteran's specific exposures. Neither the Board nor the Veteran is competent to speak to the likely duration or intensity of the exposures in question, and their likely medical effects. As such, an opinion must be obtained from an appropriate professional (such as an environmental toxicologist or environmental health specialist) to address the matter. Following that, a medical opinion must be obtained with respect to the further question of whether the Veteran's CLL and myeloma can be attributed to such exposures. Hypertension and Chronic Renal Disease Finally, the Board notes the issues of entitlement to service connection for hypertension ans chronic renal disease must be held in abeyance at this time, because this issue is intrinsically intertwined with the above-noted remanded issue. See Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. The Veteran and his attorney should be asked to provide as much additional detail as possible with respect to the specific exposures the Veteran is alleging, in terms of dates, locations, and duration of the exposures. They should be asked to list each of the substances to which exposure is alleged, along with the means and duration of the exposure. 2. After the foregoing development has been completed to the extent possible, furnish the available information with respect to the approximate dates, locations, and nature of the Veteran's alleged exposure to herbicide agents to the Compensation Service with a request to review the DoD's inventory of herbicide operations to determine whether herbicides and the other toxins noted were used as claimed. Consideration should be given to the Veteran's assertions with respect to his belief that herbicides and other chemicals were present in the ground and water at Fort Wainwright and along the Haines-Fairbanks pipeline during his period of service there. Consideration should also be given to the August 2016 opinion from the private environmental scientist, and the other medical treatises of record regarding the military's use of herbicide agents and/or other chemicals. 3. If the Compensation Service's review does not confirm that herbicides were used as alleged, send a request containing the same information to the Veteran's unit(s), National Personnel Records Center, DPRIS, or any other appropriate entity for verification of exposure to those agents. 4. After the foregoing development has been completed to the extent possible, ask an appropriate professional (such as an environmental toxicologist or environmental health specialist) to review the record and address the matter of the likely duration, extent, and intensity of each of the exposures in question, as they pertain to the Veteran individually. The final report should contain a list of each of the substances to which exposure is alleged, along with a description of the likely duration, extent, and intensity of each. In so doing, the professional should consider the August 2016 private environmental scientist's opinion and the other medical treatises of record regarding the military's use of herbicide agents and other chemicals. If the professional reviewing the record cannot provide an opinion as to any particular exposure without resort to speculation, he or she must provide an explanation as to why that is so. In so doing, the professional should explain whether the inability to provide a more definitive opinion is the result of the need for additional information, or whether he or she has exhausted the limits of current medical knowledge in providing the information sought. 5. Thereafter, arrange to have a VA examiner with appropriate expertise review the record and provide an opinion as to whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that the Veteran's CLL, and/or myelomas can be attributed to any of the alleged exposures, either alone or in combination. In so doing, the examiner should discuss the medical significance, if any, of the August 2016 private environmental scientist's opinion regarding herbicide exposure at Fort Wainwright and along the Haines-Fairbanks pipeline. The examiner must provide a complete rationale for all proffered opinions. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Gresham 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.