Citation Nr: 21061564 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 17-60 614 DATE: October 4, 2021 REMANDED The claim for service connection for sarcoidosis is remanded. REASONS FOR REMAND The Veteran honorably served on active duty from September 1967 to May 1971. In a January 2015 rating decision, the Regional Office (RO) denied his claim for service connection for sarcoidosis. The Veteran appealed. In June 2021, the Veteran testified at a Board's hearing, a transcript of which is of record. In seeking service connection for pulmonary sarcoidosis, the Veteran believes that this disability was caused by his exposure to herbicide agents in service. The hearing transcript reflects the Veteran's statement that he was very athletic in high school, to include playing football, baseball, and hockey. In basic training, he reportedly achieved maximum scores on physical fitness test. Then, during his deployment to the Republic of Vietnam, he contends that he was exposed to vast amounts of herbicide agents, such as Agent Orange, stating that "they rained on us with that stuff." Upon inhaling the vapors, he recalled experiencing bouts of coughing. Subsequently, despite being in excellent physical shape, he noticed that his exertion level would "kick into" him sooner than in the guys around him. The Veteran also reported that he was diagnosed with sarcoidosis during a post-service preemployment physical examination in the 1970s. The Veteran further indicated that for many years he continued to have respiratory issues but used to get his medical care at a small facility without a pulmonologist on staff. Then, he was finally seen at the VA by Dr. T. who has seen these cases and confirmed that he does have sarcoidosis. An August 2014 VA pulmonary consultation note reflects Dr. E.C.T.'s opinion formed on a basis of an August 2014 CT chest scan that the Veteran has pulmonary sarcoidosis, radiographically stage I-II, clinically in remission. Dr. E.C.T. noted in relevant history that the Veteran had been exposed to Agent Orange during his service in the Republic of Vietnam for 1 year and 4 months and was treated with a year of steroids in 1973. Although Dr. E.C.T.'s report does not explicitly state that the Veteran's sarcoidosis is etiologically related to herbicide agent exposures, noting those exposures under his relevant history sufficiently implies that the Veteran's sarcoidosis may be etiologically related to his service. This suggestion coupled with the conclusive clinical diagnosis of sarcoidosis and the Veteran's presumptive in-service exposure to herbicide agents triggers the VA's duty to provide a medical examination which has not been provided. See 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4); see also McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Of note, the Veteran has identified the Mercy Hospital located in Chicago, Illinois, where he was initially diagnosed with sarcoidosis approximately in 1973-75. Any associated medical records may be relevant to his claim and should be obtained. Accordingly, the matters are REMANDED for the following action: 1. Assist the Veteran in obtaining his medical records from Mercy Hospital, Chicago, Illinois, from 1973-75. 2. Schedule the Veteran for a VA examination to evaluate the nature and etiology of his pulmonary disability. The examiner is asked to answer the following questions: Is it at least as likely as not (meaning probability of 50 percent or greater) that the Veteran's pulmonary sarcoidosis had onset in, was caused by, or otherwise is etiologically related to service, to include his presumptive exposure to herbicide agents? Why or why not? In forming the opinion, the examiner must consider and expressly discuss the Veteran's statements as to the onset and continuity of symptomatology, to include coughing and physical exertion levels higher than of his peers during service and any other relevant symptomatology thereafter. The examiner then should opine whether the Veteran's statements are medically consistent with the clinical signs and symptoms of sarcoidosis and explain why. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Alex Bardin, 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.