Citation Nr: 21064116 Decision Date: 10/19/21 Archive Date: 10/19/21 DOCKET NO. 18-01 585 DATE: October 19, 2021 ORDER Entitlement to service connection for diabetes mellitus is granted, type II, is granted. Entitlement to service connection for peripheral neuropathy of the right lower extremity is granted. Entitlement to service connection for peripheral neuropathy of the left lower extremity is granted. REMANDED Entitlement to service connection for ischemic heart disease is remanded. FINDINGS OF FACT 1. The Veteran has a current diagnosis of diabetes mellitus, type II. 2. The Veteran has a current diagnosis of diabetic peripheral neuropathy of the bilateral lower extremities. 3. The Veteran served in the Republic of Vietnam, and therefore was exposed to herbicide agents. CONCLUSIONS OF LAW 1. The Veteran's diabetes mellitus, type II, was incurred in service. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309 (2021). 2. The Veteran's diabetic peripheral neuropathy of the bilateral lower extremities is caused by his diabetes mellitus. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310 (2021). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty with the United States Navy from January 1967 to October 1970. In October 2021, the Veteran testified before the undersigned at a Board hearing held via videoconference. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease. In order to prevail on the issue of service connection there must be competent evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in-service occurrence or aggravation of a disease or injury; and competent evidence of a nexus between an in-service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). A veteran who had active service in the Republic of Vietnam during the period beginning on January 9, 1962 and ending on May 7, 1975, will be presumed to have been exposed to an herbicide agent during such service unless there is affirmative evidence to establish that the Veteran was not exposed to any such agent during that service. See 38 U.S.C. § 1116(f); 38 C.F.R. § 3.307(a)(6)(iii). Type II diabetes mellitus is a disease that is presumptively associated with exposure to herbicide agents. 38 C.F.R. § 3.309(e). 1. Entitlement to service connection for diabetes mellitus, type II The Veteran's VA medical treatment records establish an active diagnosis of diabetes mellitus, type II, and diabetic peripheral neuropathy of the bilateral lower extremities. In an October 2021 hearing, the Veteran testified that during his period of active duty he had active service in the Republic of Vietnam. Additionally, the Veteran has submitted a buddy statement from a fellow service member noting that in the Veteran was sent to Da Nang Air Base in July 1968. D. C. stated that he and the Veteran were aboard the USS-Bennington, and that in July 1968, the Veteran was sent to Da Nang for approximately 8-10 hours. D.C. remembered this because he was upset that he did not get to go as well. The Board finds the Veteran's testimony and submitted buddy statement to be competent and credible evidence of his active service in the Republic of Vietnam. He is therefore presumed to have been exposed to herbicide agents. Service connection for diabetes mellitus type II is therefore granted. 2. Entitlement to service connection for diabetic peripheral neuropathy of the right lower extremity 3. Entitlement to service connection for diabetic peripheral neuropathy of the left lower extremity Service connection may be established on a secondary basis for a disability which is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a) A January 2020 VA treatment record shows that the Veteran has diabetic peripheral neuropathy of the lower extremities. As service connection for diabetes mellitus, type II, has been granted in this decision, service connection for diabetic peripheral neuropathy of the right and left lower extremities is granted on a causation basis. Id. REASONS FOR REMAND 1. Entitlement to service connection for ischemic heart disease The Veteran claims entitlement to service connection for ischemic heart disease. As noted above, the Veteran is found to have active service in the Republic of Vietnam. Further, in accordance with 38 C.F.R. §§ 3.307, 3.309, ischemic heart disease shall be presumptively service connected if the Veteran was exposed to an herbicide agent. However, at present the Veteran's medical treatment records do not establish an active diagnosis of ischemic heart disease. A medical opinion is necessary to determine whether he has ischemic heart disease. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination with an appropriate clinician to determine whether he has ischemic heart disease or a heart condition that is due to service. The entire claims file and a copy of this remand must be made available to the examiner for review. The examiner must provide an opinion as to: a. Does the Veteran have a current diagnosis of ischemic heart disease? b. If the Veteran does not have ischemic heart disease, what heart conditions, if any, does he have? c. If a heart condition other than ischemic heart disease is diagnosed, the examiner must determine whether it is at least as likely as not (50 percent or greater probability) that it is related to service, to include whether it is due to his exposure to herbicides. The examiner is advised that it is not sufficient to conclude that a heart condition that is not ischemic heart disease is unrelated to herbicide exposure solely because it is not on the list of diseases presumptively associated with herbicide exposure. The examiner must provide a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion 2. After all completed development, the AOJ should then readjudicate the claim. If the benefits sought on appeal are not granted, the Veteran and his representative should be provided a Supplemental Statement of the Case and afforded the requisite opportunity to respond before the case is returned to the Board. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Riordan, 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.