Citation Nr: A21017147 Decision Date: 10/22/21 Archive Date: 10/22/21 DOCKET NO. 200406-80386 DATE: October 22, 2021 ORDER Service connection for Parkinson's disease is granted. Service connection for dementia, also claimed as memory loss, is granted. Service connection for coronary artery disease, claimed as myocardial infarction, is granted. Service connection for hypotension is granted. Service connection for hypertension is granted. Service connection for incontinence is granted. Service connection for back pain is granted. Service connection for loss of coordination and balance (cerebellar dysfunction) is granted. Service connection for the residuals of cerebrovascular accident (stroke) is granted. Service connection for loss of vision is granted. Service connection for partial loss of speech is granted. THE APPELLANT'S CONTENTIONS The appellant contends that the Veteran served as a missile launch trainee specialist and a ballistic missiles analyst specialist with periodic maintenance. See June 2021 Board hearing transcript, p. 2. She asserts that, according to the Veteran's 1964 personnel records, he handled samples of radioactive materials. See June 2021 Board hearing transcript, pp. 2, 4. She also maintains that the Veteran was exposed to trichloroethylene (TCE) and methyl ethyl ketone (MEK) chemicals, and that the Veteran's conditions, to include Parkinson's disease, were caused by his exposures to TCE and MEK chemicals in service. Id., pp. 3-5. The appellant also contends that the Veteran's Parkinson's disease is secondary to radiation exposure. See April 2020 VA Form 10182; October 2019 notice of disagreement. The appellant states that the Veteran's loss of vision; dementia and memory loss; hypertension; hypotension; incontinence; loss of coordination, motor function and balance; low back pain; myocardial infarction; partial loss of speech; and stroke were caused by his Parkinson's disease. See April 2020 VA Form 10182s; October 2019 notice of disagreement. FINDINGS OF FACT 1. The Veteran's Parkinson's disease was etiologically related to chemical exposures in service. 2. The Veteran's dementia, also claimed as memory loss; myocardial infarction; hypotension; hypertension; incontinence; back pain; loss of coordination and balance; stroke; loss of vision; and partial loss of speech were caused by his service-connected Parkinson's disease. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for Parkinson's disease are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for entitlement to service connection for dementia, also claimed as memory loss, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 3. The criteria for entitlement to service connection for myocardial infarction are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 4. The criteria for entitlement to service connection for hypotension are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 5. The criteria for entitlement to service connection for hypertension are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 6. The criteria for entitlement to service connection for incontinence are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 7. The criteria for entitlement to service connection for back pain are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 8. The criteria for entitlement to service connection for loss of coordination and balance are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 9. The criteria for entitlement to service connection for stroke are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 10. The criteria for entitlement to service connection for loss of vision are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 11. The criteria for entitlement to service connection for partial loss of speech are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Air Force from September 1960 to July 1969. He died in August 2020. The appellant is his surviving spouse, and she has been substituted for the Veteran for purposes of processing his claims pending at the time of his death. This case is before the Board of Veterans' Appeals (Board) on appeal from a February 2020 Statement of the Case (SOC) by the Department of Veterans Affairs (VA) Regional Office (RO). On August 23, 2017, the President signed into law the Veterans Appeals Improvement and Modernization Act, Pub. L. No. 115-55 (to be codified as amended in scattered sections of 38 U.S.C.), 131 Stat. 1105 (2017), also known as the Appeals Modernization Act (AMA). This law creates a new framework for Veterans dissatisfied with the Department of Veterans Affairs (VA)'s decision on their claim to seek review. This decision has been written consistent with the new AMA framework. Following the February 2020 SOC, the Veteran timely appealed to the Board by filing three VA Form 10182s in April 2020. He requested a hearing with a Veterans Law Judge (VLJ). The appellant testified at a Board hearing before the undersigned VLJ on November 17, 2020. A transcript of the hearing is of record. Under the AMA framework, in adjudicating this claim, the Board may consider: (1) evidence in the record at the time of the February 2020 SOC; (2) evidence submitted by the appellant or her representative at the June 7, 2021 Board hearing, including testimony; and (3) evidence submitted by the appellant or her representative within the 90-day period following the June 7, 2021 Board hearing. 1. Parkinson's disease Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F. 3d 604 (Fed. Cir. 1996) (table). The evidence shows that the Veteran served as a missile launch trainee specialist and as a ballistic missiles analyst specialist with periodic maintenance, which involved performing maintenance on electronic equipment and missile system checkout. See Military Personnel Records. The Veteran and the appellant submitted evidence showing that TCE was used in the military as a powerful degreaser for machinery parts and equipment. See article associated with the claims file in October 2019 titled "Trichloroethylene and the Military"; see also article associated with the claims file in June 2021 titled "TCE Exposure Linked to PD". Prior to the Veteran's death, he also submitted an October 2019 unsigned buddy statement, which noted that the Veteran was exposed to TCE and MEK as they were used as a degreaser to clean the missile launch pad area. See October 2019 buddy statement. The Veteran and the appellant submitted articles showing a correlation between Parkinson's disease and the solvent TCE. See article associated with the claims file in June 2021 titled "TCE Exposure Linked to PD"; see also article associated with the claims file in June 2021 titled "health effects linked with trichloroethylene (TCE), tetrachloroethylene (PCE), benzene, and vinyl chloride exposure"; October 2019 correspondence. Further, a private physician, Dr. F.B., opined that it was more likely than not that the Veteran's Parkinson's disease was a direct result of his toxic exposures during his military service. See November 2019 letter from Dr. F.B. In light of the evidence noted above, the Board resolves doubt in the appellant's favor and finds that service connection for Parkinson's disease is warranted. 2. Dementia, also claimed as memory loss; myocardial infarction; hypotension; hypertension; incontinence; back pain; loss of coordination and balance; stroke; loss of vision; and partial loss of speech Service connection may be granted for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). In a June 2021 letter, Dr. R.G., opined that the Veteran's dementia, memory loss, coronary artery disease (myocardial infarction), hypertension, hypotension, urinary/ bowel incontinence, low back pain with sensory neuropathy, cerebellar dysfunction (loss of coordination and balance), cerebral vascular disease (which included stroke, severe auditory impairment, partial loss of speech, and progressive visual impairment) were consequences of his Parkinson's disease. Dr. R.G. noted that the Veteran was under his care for over seven years, in his private practice and at the Veteran's Administration Hospital in Murfreesboro, Tennessee. In light of the appellant's contentions and the private positive medical opinion of record, the Board resolves doubt in the appellant's favor and finds that service connection for dementia, also claimed as memory loss; myocardial infarction; hypotension; hypertension; incontinence; back pain; loss of coordination and balance; stroke; loss of vision; and partial loss of speech are granted secondary to service-connected Parkinson's disease. S.C. Krembs Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Samuelson, 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.