Citation Nr: 21072417 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 17-14 525 DATE: December 3, 2021 ORDER Entitlement to service connection for diabetes mellitus, to include as due to herbicide exposure is granted. REMANDED Entitlement to service connection for peripheral neuropathy, right upper extremity is remanded. Entitlement to service connection for peripheral neuropathy, left upper extremity is remanded. Entitlement to service connection for peripheral neuropathy, right lower extremity is remanded. Entitlement to service connection for peripheral neuropathy, left lower extremity is remanded. FINDING OF FACT The Veteran was exposed to herbicide agents while serving at Takhli Royal Thai Air Force Base (RTAFB), Thailand, and diagnosed with diabetes mellitus after service. CONCLUSION OF LAW The criteria for entitlement to service connection for diabetes mellitus have been met. 38 U.S.C. §§ 1110, 1113, 1116, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 11, 1971 to January 10, 1975 to include service at Takhli Royal Thai Air Force Base. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for diabetes mellitus, to include as due to herbicide exposure The Veteran contends that his diabetes mellitus is due to herbicide exposure while stationed in Thailand during the Vietnam War. The Veteran specifically contends that his MOS of corrosion control specialist exposed him to aircraft returning from service in Vietnam daily and had also frequently exposed him to herbicide agents while serving on the flight line at Takhli Royal Thai Air Force Base (RTAFB). Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). If a Veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases shall be service-connected if the requirements of section 3.307(a)(6) are met even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of section 3.307(d) are also satisfied. 38 C.F.R. § 3.309 (e). The Board notes that the Veteran's service personnel records show that he served in Thailand at the Takhli Royal Thai Air Force Base from May 1971 to September 1972 with a military occupational specialty (MOS) of corrosion control specialist. These diseases include diabetes mellitus. 38 C.F.R. § 3.309(e). The VA has established specific procedures for verifying exposure to herbicides in Thailand during the Vietnam Era. The VA Adjudication Procedures Manual (M21-1) is not binding on the Board. However, the Board must address relevant provisions of the M21-1 and conduct an independent analysis before determining whether the provisions may be relied upon as a factor to support its decision. Overton v. Wilkie, 30 Vet. App. 257 (2018). VA has determined that there was significant use of herbicides on the fenced-in perimeters of military bases in Thailand, intended to eliminate vegetation and ground cover for base security purposes, as evidenced in a declassified Vietnam era Department of Defense document titled "Project CHECO Southeast Asia Report: Base Defense in Thailand." Special consideration of herbicide exposure on a facts-found or direct basis should be extended to those Veterans whose duties placed them on or near the perimeters of Thailand military bases. This allows for presumptive service connection of the diseases associated with herbicide exposure. The majority of American service personnel in Thailand during the Vietnam era were stationed at the Royal Thai Air Force Bases of U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang. If a Veteran served on one of these air bases as a security policeman, security patrol dog handler, member of a security police squadron, or otherwise served near the air base perimeter, as shown by MOS, performance evaluations, or other credible evidence, then herbicide exposure should be acknowledged on a facts-found or direct basis. However, this applies only during the Vietnam era, from February 28, 1961, to May 7, 1975. See M21-1MR, Part IV, Subpart ii, Chapter 2, Section C. 10(q). The diseases listed at 38 C.F.R. § 3.309 (e) shall have become manifest to a degree of 10 percent or more any time after service, except that chloracne, porphyria cutanea tarda, and acute and subacute peripheral neuropathy shall have become manifest to a degree of 10 percent or more within a year after the last date on which the veteran was exposed to an herbicide agent during active military, naval, or air service. 38 C.F.R. § 3.307 (a)(6)(ii). VA treatment records show the Veteran is diagnosed with diabetes mellitus with peripheral angiopathy. The Veteran reported that while stationed in Thailand his duties included physically washing, prepping, painting, and applying surface materials to the outer metal surfaces of F-4 fighters and other supporting aircraft after their return from missions in Vietnam. The Veteran reported his duties required him to physically remove contaminates on the surfaces of the aircraft. The Veteran also reported that the flight-line, perimeter, and other areas of the base were sprayed with a defoliant agent. The Veteran submitted lay statements from other Veterans indicating that herbicide agents were stored at the base. The Veteran's service records indicate the Veteran insured aircraft were cleaned, painted, and coated with corrosion control chemicals. The Veteran reported he remained at Takhli RTAFB for 13 months. Although there is no record of assignment to perimeter duty, the Board finds the Veteran's consistent assertions regarding time spent near the perimeter of the Takhli Royal Thai Air Force Base to be credible. The statements of the Veteran are corroborated by the Veteran's service records, as well as by maps showing where the Veteran worked. It is also worth noting that the Veteran's performance reports repeatedly express glowing reviews of his performance and personal character. In a performance review during his time at Takhli RTAFB, the Veteran was noted to be "always prompt in accepting responsibility and never hesitates to perform tasks that are not in his career field" and noted to be "an exceptional corrosion control repairman" including "the painting and corrosion treating of all ground power equipment assigned to this squadron" and highly recommended "for promotion at the earliest possible date" and "ahead of his contemporaries." Therefore, as there is no basis on which to question the Veteran's credibility, the Board finds that the Veteran was exposed to herbicide agents while he was stationed at the Royal Thai Air Base in Takhli during the Vietnam era. See M21-1 MR, Part IV, Subpart ii, Chapter 2, Section C, Paragraph 10(q). Affording the Veteran the full benefit of the doubt, the Board finds that he was exposed to herbicides while serving in Thailand and that his diabetes mellitus can be presumed to be related to herbicide exposure in service. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Accordingly, the Veteran's claim for service connection for diabetes mellitus is granted. REASONS FOR REMAND 1. Entitlement to service connection for peripheral neuropathy, right upper extremity is remanded. 2. Entitlement to service connection for peripheral neuropathy, left upper extremity is remanded. 3. Entitlement to service connection for peripheral neuropathy, right lower extremity is remanded. 4. Entitlement to service connection for peripheral neuropathy, left lower extremity is remanded. The Board cannot make a fully-informed decision on the issue of service connection for bilateral upper and lower extremity peripheral neuropathy because no VA examiner has opined whether the Veteran's peripheral neuropathy is secondary to his service-connected diabetes melltius. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination for his bilateral upper and lower extremity peripheral neuropathy. The examiner must review the claims file. The examiner is asked to provide a response to the following: Is the Veteran's peripheral neuropathy at least as likely as not proximately due to his service-connected diabetes mellitus? L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.D. Taylor, 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.