Citation Nr: 21062947 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 17-36 947 DATE: October 12, 2021 REMANDED Service connection for a mental health disorder, including posttraumatic stress disorder (PTSD) and/or a depressive disorder, is remanded. Service connection for amyotrophic lateral sclerosis (ALS) is remanded. Service connection for a blood problem due to herbicide exposure is remanded. Service connection for diabetes mellitus, type II, (DM) is remanded. Service connection for arthritis of multiple joints (neck, back, hips & shoulders) is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1968 to December 1969. At the outset, the Board notes that the Veteran originally filed his claim for service connection for PTSD. However, pursuant to the Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009), the Board has re-characterized the issue on appeal as entitlement to service connection for a mental health condition, as his medical records show that he has been diagnosed with both PTSD and a depressive disorder. This will provide the most potentially favorable review of the Veteran's claim in keeping with the Court's holding in Clemons. Mental Health As stated above, the Veteran's VA medical records show he was diagnosed by a VA psychiatrist with PTSD. See July 2016 VA record. An August 2017 VA examination did not indicate that this record had been considered and found the Veteran had no diagnosis of PTSD. A January 2016 VA examination pre-dated the Veteran's diagnosis. VA records also confirm that the Veteran has received medication to treat his PTSD and diagnosed depressive disorder. As the VA medical records to not provide a link of the Veteran's mental health disorders and his service, a nexus to his service has not been established. The VA examinations which did not consider his PTSD diagnosis or treatment are inadequate for adjudication purposes. As such, an opinion on the etiology of the Veteran's mental health disorders is warranted. ALS The Veteran has repeatedly stated that he has been diagnosed with ALS. The record shows that the Veteran has private medical treatment, but a diagnosis of ALS is not contained in the record. On remand, confirmation that complete copies of any records which show the Veteran's ALS diagnosis should be obtained. Blood Problem DM The Veteran has asserted that he was exposed to herbicides while stationed at Camp Page in Korea during his active duty service. The Veteran's military personnel records (MPRs) confirm his assignment to Camp Page during his active duty service. His military occupational specialty (MOS) was as a military policeman (MP). Effective February 24, 2011, VA amended its regulations (38 C.F.R. § 3.307) to extend a presumption of herbicide exposure to certain Veterans who served in Korea. Specifically, a Veteran who, during active military, naval, or air service, served between April 1, 1968, and August 31, 1971, in a unit that, as determined by the Department of Defense (DoD), operated in or near the Korean DMZ in an area in which herbicides are known to have been applied during that period, 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 that service. 38 C.F.R. § 3.307 (a)(6)(iv). Once exposure has been established by the evidence, the presumptions found at 38 C.F.R. § 3.309(e) are applicable. The Veteran's file, however, does not contain any evidence which establishes that he had duty along the DMZ. A history of the activities of the units to which the Veteran was assigned is not contained in the Veteran's file. Remand is necessary to obtain these records. Additionally, private medical records, or any other such records, which establish the Veteran's diagnosis of a blood disorder or DM should be sought and obtained. Arthritis of Multiple Joints An October 2017 VA examination regarding the Veteran's claim for arthritis did not indicate that private medical records diagnosing the Veteran with arthritis had been reviewed. As such, that examination is inadequate, and a new examination is warranted. The matters are REMANDED for the following action: 1. Contact the Joint Services Records Research Center (JSRRC) or any other appropriate facility and obtain a unit history of the units to which the Veteran was assigned while stationed at Camp Page, Korea. Document all requests for information as well as all responses in the claims file. 2. Contact the Veteran and afford him the opportunity to identify by name, address, and dates of treatment or examination or submit any medical treatment records which show diagnosis of amyotrophic lateral sclerosis, a blood disorder, and/or diabetes mellitus, type II. After securing the proper authorizations where necessary, arrange to obtain all the records of treatment or examination from all the sources listed by the Veteran that are not already on file. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file, and if, after making two efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and his representative. 3. Obtain an addendum opinion from Dr. E.C.R. at the Charlotte Hall VA Clinic and ask her to provide an opinion as to the etiology of PTSD diagnosed on July 27, 2016. Should Dr. E.C.R. no longer be available, schedule the Veteran for a VA examination by an appropriate clinician to determine the etiology of his diagnosed PTSD and depressive disorders. The claims file should be made available to the examiner for review. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's diagnosed PTSD and depressive disorder were incurred in, or due to, the Veteran's service. The examiner is asked to note the Veteran's diagnosis of and treatment for PSTD as documented in the July 27, 2016, VA medical record. The Veteran's lay statements regarding onset and continuity of symptomology should be recorded and considered. A rationale for all opinions must be provided. 4. After information regarding the Veteran's potential exposure to herbicides has been received as pursuant to remand directive No. 1, and if a diagnosed blood disorder has been established by evidence submitted or received pursuant to remand directive No. 2, if necessary, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any diagnosed blood disorder. The claims file should be made available to the examiner for review. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that any diagnosed blood disorder was incurred in, or due to, the Veteran's service. The Veteran's lay statements regarding onset and continuity of symptomology should be recorded and considered. A rationale for all opinions must be provided. 5. After information regarding the Veteran's potential exposure to herbicides has been received, as specified in remand directive No. 1, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his diagnosed arthritis. The claims file should be made available to the examiner for review. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's diagnosed arthritis was incurred in, or due to, the Veteran's service. The Veteran's lay statements regarding onset and continuity of symptomology should be recorded and considered. A rationale for all opinions must be provided. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish, 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.