Citation Nr: 21067318 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 20-28 550 DATE: November 3, 2021 REMANDED Entitlement to service connection for a respiratory disability is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for cataracts is remanded. Entitlement to a rating in excess of 10 percent for diabetes mellitus is remanded. Entitlement to a rating in excess of 10 percent for diabetic neuropathy of the right lower extremity is remanded. Entitlement to a rating in excess of 10 percent for diabetic neuropathy of the left lower extremity is remanded. REASONS FOR REMAND The Veteran had active service from November 1963 to September 1967 in the United States Marine Corps (USMC). This case comes before the Board of Veterans' Appeals (Board) from April 2018 and November 2018 rating decisions issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). In August 2021, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is of record. The Board finds that additional development is necessary before the claims on appeal are decided. In November 2018, the Veteran's representative indicated that the Veteran received private treatment from Joslin Diabetes Center and St. Luke's Hospital. Those records have not been associated with the claims file. Therefore, a remand is necessary so that an attempt can be made to secure them. The Veteran has also indicated that he received treatment from the Bedford VA Medical Center (VAMC). In the June 2020 statement of the case (SOC), the Agency of Original Jurisdiction (AOJ) indicated that it requested records from the Bedford VAMC but received a negative response. A review of the claims file, however, indicates that the Bedford VAMC stated that the records were located in VA's Computerized Patient Record System (CPRS). Those records have not been associated with the claims file. Therefore, a remand is necessary so that an attempt can be made to secure them. In addition, an April 2017 VA treatment record indicated that the Veteran reported he was receiving disability benefits from the Social Security Administration (SSA). Because those records may be pertinent to the Veteran's claim, the Board finds that a remand is necessary to obtain them. Golz v. Shinseki, 590 F.3d 1317 (Fed. Cir. 2010). Regarding hypertension, the Board notes that the National Academy of Sciences (NAS) recently determined that there is "sufficient" epidemiologic evidence to conclude that there is a positive association between hypertension and herbicide exposure. In this case, however, it is unclear whether the Veteran was exposed to herbicide agents during service. Although the AOJ granted service connection for diabetes mellitus on the basis of presumption due to Agent Orange exposure, the Veteran's military personnel records do not indicate that he served in the Republic of Vietnam or its offshore waters. Rather, his records indicated that he served in Okinawa from October 1966 to June 1967. Therefore, the Board finds that a remand is necessary to obtain clarification from the Veteran regarding any claimed herbicide exposure. Regarding cataracts, during the August 2021 Board hearing, the Veteran's representative cited a study from the National Institute of Health regarding an association between the development of cataracts and diabetes mellitus. Therefore, the Board finds that a remand is necessary for a VA examination and medical opinion addressing that nature and etiology of the Veteran's claimed cataracts. Regarding diabetes mellitus and diabetic neuropathy, during the August 2021 Board hearing, the Veteran stated that his service-connected disabilities had worsened since he was last examined. Therefore, the Board finds that a remand is necessary for additional VA examinations. The matters are REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file, to include VA treatment records from the Bedford VAMC, and private treatment records from Joslin Diabetes Center and St. Luke's Hospital. 2. Obtain any pertinent, outstanding SSA disability benefits records and associate them with the claims file. 3. Contact the Veteran and his representative to clarify whether the Veteran is claiming exposure to herbicide agents in the Republic of Vietnam and, if so, the dates of the claimed exposure. If the Veteran and his attorney confirm that he is claiming exposure to herbicide agents, take all appropriate steps to verify such claimed exposure. Document in the claims file all attempts to obtain this information and all responses received. 4. Then, schedule the Veteran for an examination by an examiner with appropriate expertise to determine the nature and etiology of his claimed cataracts. Any indicated studies should be performed. Based on the examination results and a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or better) that any currently present cataract disability manifested during or is etiologically related to the Veteran's active service. The examiner should also provide an opinion as to whether it is at least as likely as not (50 percent probability or better) that any current present cataract disability is caused or aggravated by the Veteran's service-connected diabetes mellitus. In rendering this opinion, the examiner should address any studies by the National Institute of Health addressing a relationship between the development of cataracts and diabetes mellitus. A rationale for all opinions expressed must be provided. 5. Then, schedule the Veteran for an appropriate VA examination to determine the current level of severity of all impairment resulting from his service-connected diabetes mellitus. The claims file must be made available to and reviewed by the examiner. All indicated tests should be performed and all findings should be reported in detail. The examiner should provide all information required for rating purposes and describe the effects of the service-connected disability on the Veteran's ordinary activity, including his ability to work. 6. Then, schedule the Veteran for an appropriate VA examination to determine the current level of severity of all impairment resulting from his service-connected diabetic neuropathy of the bilateral lower extremities. The claims file must be made available to and reviewed by the examiner. All indicated tests should be performed and all findings should be reported in detail. The examiner should provide all information required for rating purposes and describe the effects of the service-connected disability on the Veteran's ordinary activity, including his ability to work. 7. Confirm that the VA examination reports and all opinions provided comport with this remand and undertake any other development found to be warranted. 8. Then, readjudicate the issues on appeal. If a decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Mishalanie, 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.