Citation Nr: 21070024 Decision Date: 11/22/21 Archive Date: 11/22/21 DOCKET NO. 18-22 637 DATE: November 22, 2021 REMANDED Entitlement to service connection for diabetes mellitus, claimed as due to herbicide agent exposure, is remanded. Entitlement to service connection for hypertension, claimed as secondary to claimed diabetes mellitus or due to herbicide agent exposure, is remanded. Entitlement to service connection for ischemic heart disease, claimed as due to herbicide agent exposure or secondary to diabetes mellitus or hypertension, is remanded. Entitlement to service connection for erectile dysfunction, claimed as secondary to claimed diabetes mellitus or hypertension, is remanded. Entitlement to service connection for peripheral vascular disease, claimed as secondary to claimed diabetes mellitus or hypertension, is remanded. Entitlement to service connection for obstructive sleep apnea (OSA), claimed as secondary to claimed diabetes mellitus, is remanded. REASONS FOR REMAND The Veteran had active duty from January 1970 to November 1978. This matter is on appeal from a January 2016 rating decision. The Veteran filed a February 2016 notice of disagreement only as to the issues noted above. The Regional Office (RO) subsequently issued an April 2018 statement of the case (SOC) as to these issues. The Veteran filed an April 2018 substantive appeal as to that SOC. The Board notes that although the Veteran also complained of separate claims regarding hearing loss and psoriasis, those issues are not part of the current appeal and were not part of the SOC . The Veteran had a hearing before the undersigned Veterans Law Judge in November 2021. The claims for entitlement to service connection for: 1. diabetes mellitus, claimed as due to herbicide agent exposure, 2. hypertension, claimed as secondary to claimed diabetes mellitus or due to herbicide agent exposure, 3. ischemic heart disease, claimed as due to herbicide agent exposure or secondary to claimed diabetes mellitus and/or hypertension, 4. erectile dysfunction, claimed as secondary to claimed diabetes mellitus or hypertension, 5. peripheral vascular disease, claimed as secondary to claimed diabetes mellitus or hypertension, and 6. OSA, claimed as secondary to diabetes mellitus are remanded. In a November 2015 letter, the Veteran claimed that his ship, the USS America CVA 66, was stationed in the waters of the Republic of Vietnam in 1970 to 1971. The Agency of Original Jurisdiction (AOJ) should perform additional development deemed warranted to determine whether the Veteran served in the territorial waters of the Republic of Vietnam for herbicide exposure. After that development has been accomplished, VA examinations should be obtained to address the service connection claims. The Board further notes that VA medical records indicate that there are outstanding private medical records, including a May 2018 record indicating private treatment from a Dr. L., a February 2009 one indicating treatment from a Dr. L.D., and an April 2009 report of hospital treatment. A remand is required to allow VA to obtain authorization and request these records. The matters are REMANDED for the following actions: 1. Perform appropriate development to determine whether the Veteran served within the territorial waters of the Republic of Vietnam during the presumptive timeframe. 2. Ask the Veteran to complete a VA Form 21-4142 for Dr. L., Dr. L.D., any pertinent hospital treatment, and any other pertinent provider(s). Make two requests for the authorized records from identified provider(s), unless it is clear after the first request that a second request would be futile. 3. After the above development has been accomplished, obtain a VA medical opinion by an appropriate clinician to determine the nature and etiology of any (a) diabetes mellitus, (b) hypertension, (c) ischemic heart disease, (d) erectile dysfunction, (e) peripheral vascular disease, and (f) OSA. VA examination(s) should not be obtained, unless one is deemed necessary to make a determination(s) for any specific disorder(s). The examiner is asked to opine whether it is at least as likely as not related that (a) diabetes mellitus, (b) hypertension, (c) ischemic heart disease, (d) erectile dysfunction, (e) peripheral vascular disease, and/or (f) OSA to an in-service injury, event, or disease. The opinions vis-à-vis herbicide exposure are only necessary if the Veteran had confirmed exposure to herbicides based on the development in #1, above. If, and only if, diabetes mellitus is found to be due to service, the examiner should also opine as to whether it is at least as likely as not that (b) hypertension, (c) ischemic heart disease, (d) erectile dysfunction, (e) peripheral vascular disease, and/or (f) OSA is (1) proximately due to diabetes mellitus or (2) aggravated beyond its natural progression by diabetes mellitus. If, and only if, hypertension is found to be due to service or due to a service-connected disability, the examiner should further opine as to whether it is at least as likely as not that (c) ischemic heart disease, (d) erectile dysfunction, and/or (e) peripheral vascular disease is (1) proximately due to hypertension or (2) aggravated beyond its natural progression by hypertension. The examiner is asked to provide a detailed rationale for EACH opinion rendered. A full review of the claims file should be provided, to include the multiple November 2015 private DBQ by Dr. M.L. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Lindio 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.