Citation Nr: 21065579 Decision Date: 10/26/21 Archive Date: 10/26/21 DOCKET NO. 19-32 659A DATE: October 26, 2021 REMANDED Entitlement to service connection for diabetes mellitus due to herbicide exposure is remanded. Entitlement to diabetic nephropathy, claimed as kidney failure secondary to diabetes mellitus is remanded. Entitlement to service connection for hypertension due to herbicide exposure or secondary to diabetes mellitus is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1967 to July 1970. 1. Entitlement to service connection for diabetes mellitus and hypertension due to herbicide exposure The Board regrets the additional delay; however, a remand is necessary to ensure compliance with the Board's prior remand instructions and to ensure that due process is met. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Veteran contends he was exposed to Agent Orange, obtained from Edwards Air Force Base (AFB) while stationed at Rocky Mountain Arsenal and on temporary duty in Lancaster, California. He explained that his duties included growing a wheat crop and then inoculating it with wheat rust organisms. This required eliminating and controlling weeds, which he contends was done with Agent Orange obtained from Edwards AFB that he then sprayed without protective gear resulting in exposure directly to the skin and through inhaling fumes. In June 2017, the Joint Services Records Research Center (JSRRC) made a formal finding that Agent Orange was not stored or used at Lancaster or Rocky Mountain Arsenal, Colorado; therefore, exposure to tactical herbicides was not conceded. See VA Memo June 2017. It was noted that the Department of Defense (DoD) maintained a list of locations outside Vietnam and the Korean demilitarized zone where tactical herbicides such as Agent Orange were used. The DoD list did not show any use, testing, or storage of tactical herbicides at Lancaster or Rocky Mountain Arsenal; however, it was noted that routine weed killing was accomplished worldwide on military bases with commercial herbicides. For the other claimed exposure of experimental spores, the memorandum reported no evidence of such exposures or evidence of long-term health effects associated with any such exposures. In February 2021 the Board remanded the appeal to obtain a medical opinion on the nature and etiology of diabetes mellitus to include as a result of toxic exposures due to his military occupational specialty, such as commercial herbicides. The June 2021 VA examiner provided a positive nexus opinion finding diabetes mellitus due to Agent Orange exposure while working in the chemical core; however, Agent Orange exposure has not been verified. As the examiner failed to consider and address exposure to commercial herbicides as directed, a remand is necessary for an addendum opinion. In addition, the Veteran provided articles and correspondence indicating that Rocky Mountain Arsenal and Edwards AFB are EPA Superfunds and provided a history of Rocky Mountain Arsenal revealing that agricultural pesticides were produced at the Arsenal from approximately 1952 to 1982, among other substances, resulting in chemical waste. See Correspondence July 2003 and June 2016. The Board finds that a remand is necessary for further development as the evidence of record indicates possible chemical and toxic exposures in service while performing duties at Rocky Mountain Arsenal and Edwards AFB. 2. Entitlement to diabetic nephropathy, claimed as kidney failure, and hypertension secondary to diabetes mellitus is remanded. The Veteran's claims for entitlement to service connection for diabetic nephropathy and hypertension secondary to diabetes mellitus is inextricably intertwined with the entitlement to service connection for diabetes mellitus claim on appeal. Therefore, the Board finds that the claims for diabetic nephropathy and hypertension must be remanded as well. See Harris v. Derwinski, 1 Vet. App. 180 (1991) (issues are inextricably intertwined when a decision on one issue would have a significant impact on another issue). The matters are REMANDED for the following action: 1. In remanding this case, the Board makes no credibility determination, expressed or implied, at this juncture. 2. Obtain updated VA and/or private treatment records. If such records are unavailable, the Veteran's claim file must be clearly documented to that effect and the Veteran notified in accordance with 38 C.F.R. § 3.159(e). 3. Attempt to verify the Veteran's report of herbicide agents at Edwards Air Force Base. If there is insufficient information to verify exposure to herbicide agents, issue a Formal Finding outlining the steps taken to assist the Veteran and notify the Veteran. All attempts to undertake the investigation should be set out as should any and all findings. 4. Undertake appropriate development to determine the extent of the Veteran's exposure to chemicals and toxins while stationed at Rocky Mountain Arsenal, a designated EPA superfund site. 5. After the above development is completed, obtain an addendum medical opinion from a medical professional with appropriate expertise. The examiner should review the Veteran's claims file. If the examiner determines that an opinion cannot be provided without an examination, the Veteran should be scheduled for one. Based on a review of the record, and a new examination if necessary, the examiner must address the following: (a.) Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's diabetes mellitus and/or hypertension is related to the Veteran's military service, to include due to exposure to chemicals and toxins at Rocky Mountain Arsenal, a designated EPA superfund site and/or commercial herbicides and agricultural pesticides. The examiner should consider and address the Veteran's lay statements of record, to include the following: 1) the Veteran's statements concerning his exposures in-service, specifically his duties of spraying herbicides without protective gear, and the onset and continuity of symptoms; 2) the buddy statement verifying that the Veteran was tasked with growing crops, which included managing weeds, See Correspondence March 2021; and 3) the various articles submitted by the Veteran reflecting the use of chemicals and herbicide agents in the United States during his active duty service See Correspondence June 2016 and June 2003. A complete rationale containing clear conclusions with supporting data and a reasoned medical explanation connecting the two is required for all medical opinions. The examiner should also identify and explain the relevance or significance, as appropriate, of any history, clinical findings, medical knowledge, or literature, etc., relied upon in reaching the conclusion(s). If the examiner feels that a requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e., additional facts are required, or the examiner does not have the needed knowledge or training). 6. Upon completion of the above directives, complete any other necessary development after review of any additionally received records, to include additional VA examinations if warranted. 7. Finally, readjudicate the appeal. If the benefits sought on appeal remains denied, issue a supplemental statement of the case, and return the case to the Board. G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. A. Prinsen 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.