Citation Nr: 21069164 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 16-00 325A DATE: November 17, 2021 REMANDED Entitlement to service connection for diabetes mellitus type II, to include as due to herbicide exposure is remanded. Entitlement to service connection for Parkinson's disease, to include as due to herbicide exposure is remanded. Entitlement to service connection for ischemic heart disease, to include as due to herbicide exposure is remanded. Entitlement to special monthly compensation (SMC) based on Aid and Attendance/Housebound is remanded. REASONS FOR REMAND The Veteran had active duty service in the U.S. Air Force from March 1956 to August 1981. He passed away in September 2016. While there was initially some confusion as to the validity of the claim, the appellant, who is the Veteran's surviving spouse, has been properly substituted for purposes of processing the claim to completion. 1. Entitlement to service connection for diabetes mellitus type II, to include as due to herbicide exposure is remanded. The Veteran was seen for a VA examination shortly after separation in October 1981; at the time it was noted he had an increase in his fasting blood sugar. A September 1997 record shows the Veteran was diagnosed with type 2 diabetes mellitus one year earlier in 1996. On remand, please have a VA examiner address whether the fasting blood sugar note was an early indicator of diabetes that could have started in service. 2. Entitlement to service connection for Parkinson's disease, to include as due to herbicide exposure is remanded. 3. Entitlement to service connection for ischemic heart disease, to include as due to herbicide exposure is remanded. The appellant contends that the Veteran was exposed to herbicides while stationed at Ubon Royal Thailand Air Force Base (RTAFB) in Thailand. Specifically, it is alleged that the Veteran often spent time along the perimeter of the base while performing his duties. The Veteran's service personnel and treatment records confirm that he served at Ubon RTAFB in Thailand from approximately November 1966 to November 1967, where he worked as an Inventory Management Supervisor. Diabetes mellitus type II, Parkinson's disease, and ischemic heart disease are among the diseases associated with exposure to certain herbicide agents used in support of military operations in the Republic of Vietnam (Vietnam) during the Vietnam War will be considered to have been incurred in service. 38 U.S.C. § 1116(a)(1). The presumption requires exposure to an herbicide agent and manifestation of the disease to a degree of 10 percent or more within the time period specified for each disease. 38 C.F.R. § 3.307(a)(6)(ii). The Veteran does not have verified "boots on the ground" service in Vietnam, although the appellant has alleged that he did once visit Vietnam. VA recognizes that tactical or tactical-like herbicides were used on the fenced-in perimeters of military bases in Thailand. Interestingly, the Board observes a March 2017 VA Memorandum that includes a formal finding that there is a lack of information required to verify exposure to herbicides during service. As a result, the appropriate military record repository was not contacted during the appellate period. As noted above, the appellant contends that the nature of the Veteran's job placed him at the perimeter of the base. Based on the above, it does not appear that all attempts to obtain information from the appropriate military repository to verify possible herbicide exposure have been completed. On remand, this action should be completed. 4. Entitlement to special monthly compensation (SMC) based on Aid and Attendance/Housebound is remanded. Because a decision on the remanded issues addressed above could significantly impact a decision on the issue of entitlement to SMC based on Aid and Attendance/Housebound, the issues are inextricably intertwined. A remand of the claim for entitlement to SMC is thereby required. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two issues are "inextricably intertwined" when they are so closely tied together that a final decision on one issue cannot be rendered until a decision on the other issue has been rendered). The matters are REMANDED for the following action: 1. Attempt to verify the claimed exposure to herbicides (to include Agent Orange) through the appropriate military repository. Specifically, send a request to for verification as to whether the Veteran was potentially exposed to an herbicide agent during his period of service while stationed at Ubon Air Force Base in Thailand from November 1966 to November 1967 based on the nature of his job. Specifically, a determination should be made as to the nature of the Veteran's duties and whether or not he would have often been in close proximity to the perimeter of the base. Any response should be associated with the record. 2. Send the file to an appropriate clinician. A copy of the remand and file should be made available to the opinion writer. The writer should review: the October 1981 VA examination report (completed soon after service) and the September 1997 record stating diabetes was diagnosed in 1996. The writer should state whether the notation regarding fasting blood sugar was an early sign or symptom of onset of diabetes mellitus type II. If no opinion can be made, the writer should explain why. The opinion should be supported by citation to accurate facts and medical science. 3. After the development requested has been completed, the Agency of Original Jurisdiction (AOJ) should review to ensure that it is in complete compliance with the directives of this remand. Emily Tamlyn Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Miller, 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.