Citation Nr: 21062852 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 20-03 331 DATE: October 12, 2021 REMANDED Entitlement to service connection for diabetes, type I, to include as due to herbicide exposure, is remanded. Entitlement to service connection for a heart condition, to include as due to herbicide exposure, is remanded. Entitlement to service connection for prostate cancer, to include as due to herbicide exposure, is remanded. Entitlement to service connection for Alzheimer's disease, to include as due to herbicide exposure, is remanded. Entitlement to an initial compensable disability rating for bilateral hearing loss is remanded. Preliminary Matters The Veteran had honorable active duty service with the United States Navy from July 1959 to July 1981. This matter is before the Board of Veterans' Appeals (Board) on appeal from an October 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that in his January 2020 substantive appeal (VA Form 9), the Veteran requested a hearing before the Board. The Veteran was initially scheduled for a hearing in January 2021. The hearing was postponed to May 2021, for which the Veteran did not appear. To date, the Veteran has not requested that his hearing be rescheduled or provided good cause for his failure to show. Therefore, the Board finds the Veteran's request for a hearing to be withdrawn, and the Board will proceed with its review on the present record. REASONS FOR REMAND Although further delay is regrettable, the Board finds that a remand is necessary in this case to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claims so that he is afforded every possible consideration. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. 1. Entitlement to service connection for diabetes, type I, to include as due to herbicide exposure, is remanded. See Argument Below 2. Entitlement to service connection for a heart condition, to include as due to herbicide exposure, is remanded. See Argument Below 3. Entitlement to service connection for prostate cancer, to include as due to herbicide exposure, is remanded. See Argument Below 4. Entitlement to service connection for Alzheimer's disease, to include as due to herbicide exposure, is remanded. The Veteran seeks entitlement to service connection for type I diabetes, a heart condition, prostate cancer, and Alzheimer's disease. He asserts that all claimed disabilities are due to in-service herbicide exposure. See December 2017 claim. However, other than a May 2018 letter informing the Veteran about VA Agent Orange registry examinations, it does not appear any development was conducted on this purported exposure. Accordingly, a remand is required to clarify the nature and circumstances of this purported exposure. The Board notes that, of the claimed disabilities, prostate cancer is among the conditions presumptively associated with herbicide exposure under 38 C.F.R. § 3.309(e). The Board further notes that the Veteran has not been afforded a VA examination for any of these claimed disabilities. If it is determined that the Veteran was exposed to herbicides in service, with the exception of the prostate cancer disability, the Veteran should be afforded a VA examination for type I diabetes, a heart condition, and Alzheimer's disease to determine if the Veteran has these claimed disorders; and, if so, whether such are related to service. 5. Entitlement to an initial compensable disability rating for bilateral hearing loss is remanded. The Veteran contends that he is entitled to an increased disability rating for his service-connected bilateral hearing loss. The record reflects that the Veteran was afforded a VA audiology examination in September 2018, over three years ago. An April 2019 VA treatment record shows that the Veteran reported that he did not hear well with his hearing aids. He also reported gradual loss of hearing. Thus, it appears that the Veteran's hearing loss has worsened since his VA audiology examination. Therefore, the Board finds that a more contemporaneous examination of the service-connected bilateral hearing loss is warranted in order to ensure that the record reflects the current severity of this disability. On remand, the Agency of Original Jurisdiction (AOJ) should make appropriate efforts to ensure that all pertinent private treatment records and any updated VA records are associated with the claims file. The matters are REMANDED for the following action: This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). 1. Identify and obtain any outstanding VA and private treatment records that are not already associated with the claims file. If any record identified cannot be obtained, the Veteran and his representative should be notified of this in writing, to include all efforts taken by VA to attempt to obtain any such record. The Veteran should also be offered the option to provide any such record himself. 2. Attempt to verify the Veteran's asserted in-service exposure to Agent Orange/herbicide agents as asserted in his December 2017 claim. If more details are needed, contact the Veteran to request the information. If there is still insufficient information to verify exposure to herbicide agents, issue a Formal Finding outlining the steps taken to assist the Veteran and notify the Veteran of VA's inability to verify the in-service herbicide agent exposure. 3. If it is determined that the Veteran was exposed to herbicide agents in service, the Veteran should be scheduled for VA examination(s) before an appropriate clinician to determine the nature and etiology of his claimed disabilities of type I diabetes, a heart condition, and Alzheimer's disease. The Veteran's claim file and a copy of this remand should be provided to the examiner and the examination report should reflect that these items were reviewed. If an examination cannot be scheduled at a location to which the Veteran can safely travel, or if health considerations make the scheduling of an in-person examination not possible, the AOJ should consider whether other virtual options, to include telehealth interviews or examinations are possible. If virtual alternatives are not feasible or possible, the AOJ should indicate as much, and medical opinions based on review of the Veteran's claims file should be obtained, in lieu of an in-person or virtual examination, addressing the etiology of the Veteran's claimed disabilities. For each claimed disability, the examiner must opine whether it is at least as likely as not that any diagnosed disability manifested during, or as a result of, active military service, to include as due to in-service herbicide exposure. In addressing this question, the examiner should not state that presumptive service connection does not apply, as that will result in an inadequate opinion. A complete rationale must be provided for all opinions offered. If an opinion cannot be offered without resort to mere speculation, the examiner must fully explain why this is the case and identify what additional evidence, if any, would allow for a more definitive opinion. 4. Schedule the Veteran for a VA audiology examination to determine the current severity of his service-connected bilateral hearing loss. If an examination cannot be scheduled at a location to which the Veteran can safely travel, or if health considerations make the scheduling of an in-person examination not possible, the AOJ should consider whether other virtual options, to include telehealth interviews or examinations are possible. If virtual alternatives are not feasible or possible, the AOJ should indicate as much, and medical opinions based on review of the Veteran's claims file should be obtained, in lieu of an in-person or virtual examination, addressing the severity of the Veteran's service-connected disability. The Veteran's claims file and a copy of this remand must be provided to the examiner for review. The examiner is to perform all necessary tests and studies, and provide pure tone threshold values and speech discrimination percentages using the Maryland CNC test. The examiner should also describe the Veteran's reported effects of the Veteran's bilateral hearing loss disability on his functioning. A complete rationale must be provided for all opinions offered. If an opinion cannot be offered without resort to mere speculation, the examiner must fully explain why this is the case and identify what additional evidence, if any, would allow for a more definitive opinion. (Continued on next page) 5. After completing all indicated development, the Veteran's claims should be readjudicated based on the entirety of the evidence. If any benefit sought on appeal is not granted, the Veteran and his representative should be provided a Supplemental Statement of the Case (SSOC) and afforded the requisite opportunity to respond before the case is remanded to the Board. B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Y. MacDonald, 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.