Citation Nr: 21070866 Decision Date: 11/26/21 Archive Date: 11/26/21 DOCKET NO. 15-22 986A DATE: November 26, 2021 ORDER Entitlement to service connection for coronary artery disease (CAD) is granted. FINDING OF FACT The evidence of record shows that the Veteran's CAD is presumptively related to his in-service herbicide agent exposure. CONCLUSION OF LAW The criteria for entitlement to service connection for CAD have been met. 38 U.S.C. §§ 1110, 1116, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1968 to December 1971 during the Vietnam Era. The matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the claim in November 2018, March 2021 and July 2021 for further development by the RO. The case has been returned to the Board for further appellate action. Entitlement to service connection for CAD If a Veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases, including ischemic heart disease, to include coronary artery disease (CAD), may be service connected if the requirements of 38 U.S.C. § 1116 and 38 C.F.R. § 3.307(a)(6)(iii) are met, even though there is no record of such disease during service. 38 C.F.R. §§ 3.307(d), 3.309(e). Veterans who, during active military, naval, or air service, served in the Republic of Vietnam from February 28, 1961 to May 7, 1975, shall be presumed to have been exposed to an herbicide agent, including Agent Orange, unless there is affirmative evidence to establish that the Veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307(a)(6)(iii). "Service in the Republic of Vietnam" includes service in the waters offshore and service in other locations if the conditions of service involved duty or visitation in the Republic of Vietnam. Id. Additionally, this includes the territorial sea of the Republic of Vietnam, with the territorial seas of Vietnam "not exceeding 12 nautical miles," and is not limited to the landmass or inland waterways of that nation. Procopio v. Wilkie, 913 F. 3d 1371 (Fed. Cir. 2019). The Veteran's medical records reflect that he was diagnosed with CAD in approximately 2002. See VA examinations dated May 2020, June 2020, and August 2021 (including a medical opinion that the Veteran's CAD was more likely due to in-service herbicide agent exposure); see also private medical treatment records received by VA in August 2013. Thus, the first element for establishing service connection, a current disability, has been met. The question becomes whether the condition is related to service. CAD is listed among the conditions presumed to be service connected in veterans that have been exposed to certain herbicidal agents. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6)(iii), 3.309(e). The record shows that the Veteran served in Vietnam beginning in April 1969. See military personnel records received by VA in January 1972. Exposure to herbicide agents is therefore presumed. See also April 2015 rating decision (granting service connection for diabetes mellitus, type II, on the basis of presumptive herbicide agent exposure). As the Board has conceded exposure to herbicide agents, the Veteran's CAD is presumed to be associated with his in-service herbicide agent exposure. See 38 C.F.R. § 3.309(e). There is no clear and convincing evidence to rebut this presumption. As a result, the Board finds that the evidence supports a grant of service connection for CAD. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Minaya, Associate 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.