Citation Nr: 21070068 Decision Date: 11/22/21 Archive Date: 11/22/21 DOCKET NO. 17-66 219 DATE: November 22, 2021 ORDER Entitlement to service connection for Parkinson's disease, to include as secondary to herbicide exposure, is granted. REMANDED Entitlement to service connection for dementia, to include as secondary to Parkinson's disease, is remanded. FINDINGS OF FACT 1. The Veteran served within the 12 nautical miles of Vietnam. 2. Resolving doubt in the Veteran's favor, there is evidence that he has been diagnosed with Parkinson's disease. CONCLUSION OF LAW The Veteran's Parkinson's disease is presumptively related to in-service herbicide exposure. 38 U.S.C. §§ 1110, 1116B, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran had active service from July 1968 to July 1972. These matters come before the Board of Veteran's Appeals (Board) on appeal from a July 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In August 2021, the Veteran testified at a virtual Board hearing before the undersigned Veterans Law Judge (VLJ). A copy of the transcript has been associated with the Veteran's electronic claims folder. The Board notes that in the Veteran indicated he wished to withdraw his claim for entitlement to Parkinson's disease. However, at the August 2021 Board hearing, he testified that he did not recall withdrawing that issue. Therefore, the Board finds that the issue has not been properly withdrawn and is still on appeal. Entitlement to service connection for Parkinson's disease, to include as secondary to herbicide exposure, The Veteran contends that he is entitled to service connection for Parkinson's disease because he served in Vietnam and was exposed to herbicide agents. See October 2017 Notice of Disagreement (NOD). For the reasons explained below, the Board finds that entitlement to service connection is warranted. The law provides that diseases associated with exposure to certain herbicide agents used in support of military operations in the Republic of Vietnam (Vietnam) during the Vietnam era will be considered to have been incurred in service. 38 U.S.C. § 1116 (a)(1); 38 C.F.R. § 3.307 (a)(6). A Veteran is presumed to have been exposed to herbicides if he or she served in Vietnam between January 9, 1962, and May 7, 1975, unless there is affirmative evidence to establish that the Veteran was not exposed to any such agent during that service. 38 U.S.C. § 1116 (f); 38 C.F.R. § 3.307 (a)(6)(iii). The presumption of service connection 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). Parkinson's disease is on the list of diseases for which presumptive service connection can be awarded if the evidence indicates exposure to an applicable herbicide agent. 38 C.F.R. §§ 3.307 (a)(6), 3.309(e). The Board finds that the evidence is in equipoise as to whether the Veteran has a diagnosis of Parkinson's disease. In that regard, a May 2017 VA examination report found that although the Veteran had some signs and symptoms of Parkinson's disease, he did not have a definitive diagnosis at the time of the examination. On the other hand, a June 2017 disability benefits questionnaire (DBQ) submitted by the Veteran shows that he has a diagnosis of Parkinson's disease. The Board finds both opinions to be of probative value and therefore finds that the evidence is at least in equipoise. Under the Blue Water Navy Vietnam Veterans Act of 2019, Veterans who served within the 12 nautical miles of Vietnam are presumed to have been exposed to herbicide agents. 38 U.S.C. § 1116B (2020). In an April 2020 correspondence, the RO found that the Veteran served within 12 nautical miles of Vietnam and was therefore presumptively exposed to herbicide agents. As stated above, Parkinson's disease is presumed to be related herbicide exposure. 38 C.F.R. § 3.309 (e). Therefore, service connection for Parkinson's disease is granted. REASONS FOR REMAND Entitlement to service connection for dementia, to include as secondary to Parkinson's disease, is remanded. There is evidence that the Veteran's dementia may be secondary to his now service-connected Parkinson's disease (granted in the current decision). There is no medical evidence regarding this possible connection. Therefore, the Board finds that a remand is necessary to obtain a medical opinion regarding the etiology of the Veteran's dementia. At the Board hearing, the Veteran's wife testified that the Veteran had recently undergone dementia testing in Bakersfield. See Board Hearing Transcript, p.7. It is unclear if such testing was conducted at a VA or private facility. On remand, the RO should clarify if there are any outstanding VA or private treatment records and obtain them after requesting the requisite authorizations. The matters are REMANDED for the following action: 1. Contact the Veteran and request that he provide or authorize the release of any private treatment records related to his claim for entitlement to service connection for dementia, see Board testimony where the Veteran's wife testified that the Veteran underwent dementia testing in Bakersfield, as well as any other records, not already of record, that are relevant to his claim. If, after making reasonable efforts to obtain non-VA records the Agency of Original Jurisdiction (AOJ) is unable to secure same, the AOJ must notify the Veteran and (a) identify the specific records the AOJ is unable to obtain; (b) briefly explain the efforts that the AOJ made to obtain those records; (c) describe any further action to be taken by the AOJ with respect to the claim; and (d) inform the Veteran that he is ultimately responsible for providing the evidence. The Veteran must then be given an opportunity to respond. 2. Then, obtain an addendum opinion from the May 2017 VA examiner (or an appropriate medical professional) regarding the etiology of the Veteran's dementia. A copy of the Veteran's electronic claims folder, including a copy of this remand must be made available to the examiner. If the examiner finds that another examination is necessary, another examination should be scheduled. The examiner is asked to review the relevant evidence and provide an opinion on the following: (a) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran's dementia was incurred in or otherwise related to service, to include due to herbicide exposure. (b) If not, whether it is at least as likely as not (50 percent probability or greater) that the Veteran's dementia was caused or aggravated by his service-connected Parkinson's disease. (c) If aggravation is found, provide the baseline manifestations and any increased manifestations due to the service-connected Parkinson's disease. A complete rationale, with citation to appropriate medical principles, is warranted. Michael A. Pappas Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Baskerville 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.