Citation Nr: 21063451
Decision Date: 10/14/21	Archive Date: 10/14/21

DOCKET NO. 16-26 089
DATE: October 14, 2021

REMANDED

Entitlement to service connection for arthritis is remanded.

Entitlement to service connection for diabetes mellitus type II is remanded.

REASONS FOR REMAND

The Veteran has honorable active duty service from November 1981 to September 1995.  He had additional service from September 1995 to March 1996 with a discharge under conditions other than honorable.  These issues were previously remanded by the Board in June 2019.  

1. Entitlement to service connection for arthritis is remanded.

The June 2019 Board remand requested an opinion as to whether the Veteran's rheumatoid arthritis was related to Gulf War environmental exposures and the Veteran's contention his arthritis is related to the wear and tear related to 14 years of military service. 

The November 2019 VA examiner indicated rheumatoid arthritis is an autoimmune disorder and that it is not related to wear and tear.  The examiner indicated treatment with chemotherapy and methotrexate would not have been prescribed for osteoarthritis.  The examiner further determined the Veteran's rheumatoid arthritis was less likely than not related to his service in Southwest Asia as the Veteran was not exposed to Agent Orange.  This rationale is inadequate as it does not address the environmental factors to which the Veteran was exposed in Southwest Asia.  As such a remand is required for an appropriate opinion that fully addresses whether the Veteran's rheumatoid arthritis is related to exposures in Southwest Asia.

Further, since the last VA examination, the Veteran's representative has submitted evidence of a Swedish study that indicates exposure to asbestos or silica increases the risk of developing types a rheumatoid arthritis.  A general assertion was made that the Veteran was likely exposed to contaminants during his 14 years of active duty.  This evidence has not been reviewed by a VA examiner and a remand is required as the Veteran's representative has raised the contention that he was exposed to asbestos and silica in-service aboard ships.  Nor has the Veteran's exposure to asbestos or similar hazards been verified.

2. Entitlement to service connection for diabetes mellitus type II is remanded.

Since the last VA examination, the Veteran's representative has submitted evidence of a pilot study which associates asbestos exposure to the development of diabetes mellitus type II (DMII).  This evidence has not been reviewed by a VA examiner.  Thus, a remand is required to address this additional evidence.  

The matters are REMANDED for the following action:

1. Attempt to verify the Veteran's asserted in-service exposure to asbestos and silica.  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 asbestos and silica exposure.

2. Obtain an addendum opinion from an appropriate VA examiner to address the etiology of the Veteran's rheumatoid arthritis.  The examiner should specifically address the Veteran's contention his rheumatoid arthritis is related to exposure to environmental hazards in Southwest Asia.  The examiner should also address the contention, and submitted study, the rheumatoid arthritis is related to exposure to asbestos and silica in-service. 

3. Obtain an addendum opinion from an appropriate VA examiner to address the etiology of the Veteran's DMII.  The examiner should specifically address the Veteran's contention, and the submitted study, that his exposure to asbestos and silica caused or contributed to the development of the Veteran's DMII.

 

 

MICHAEL A. HERMAN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	E. Rekowski

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.