Citation Nr: 21072747 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 14-12 534 DATE: December 6, 2021 REMANDED Entitlement to service connection for sleep apnea is remanded. Entitlement to service connection for a cardiovascular disability is remanded. Entitlement to service connection for a gastrointestinal disability, claimed as irritable bowel disease and Crohn's disease is remanded. Entitlement to service connection for diabetes mellitus, type II, is remanded. Entitlement to service connection for narcolepsy is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1970 to July 1976. These matters come before the Board on appeal from a May 2010 rating decision issued by a Regional Office (RO) of the United States Department of Veterans Affairs (VA). In September 2017, the Veteran presented sworn testimony before the undersigned Veterans Law Judge. A copy of the hearing transcript has been associated with the electronic claims file. In a November 2020 decision, the Board of Veterans' Appeals (Board) denied, in relevant part, the Veteran's claims currently on appeal. The Veteran subsequently appealed that decision to the Court of Appeals for Veterans Claims (CAVC). In September 2021, the CAVC granted the parties' Joint Motion for Partial Remand (JMPR), vacating that part of the November 2020 Board decision and remanded the claims for further action consistent with the JMPR. Although the Board regrets the continued delay in the adjudication of these claims, a remand is necessary to ensure that there is a complete record upon which to decide the claim. 1. Entitlement to service connection for sleep apnea is remanded. 2. Entitlement to service connection for a cardiovascular disability is remanded. 3. Entitlement to service connection for a gastrointestinal disability, claimed as irritable bowel disease and Crohn's disease is remanded. 4. Entitlement to service connection for diabetes mellitus, type II, is remanded. 5. Entitlement to service connection for narcolepsy is remanded. Pursuant to the September 2021 CAVC JMPR, in the November 2020 decision, the Board failed to explain whether the Advanced Nurse Practitioner was an "appropriate specialist" and whether the materials were considered by the clinician as the Board had ordered in the prior 2019 remand. The Board notes that while the clinician indicated that there was no current presumptive condition associated with the Veteran's service at Treasure Island as reported in the March 2014 DPRIS response, it remains unclear whether the clinician considered the materials submitted by the Veteran of contaminants found at Treasure Island. Thus, remand is warranted for clarification and/or addendum opinion as requested. Additionally, in the July 2021 appellate brief, the Veteran's representative indicated that newly obtained evidence suggested that the Veteran's service aboard the USS R.L. Wilson, USS Biddle, and USS Milwaukee may have exposed the Veteran to herbicide agents under the parameters of the newly enacted 38 U.S.C. § 1116A. The representative further alleged that this presumption could assist the Veteran in securing service connection for a cardiovascular disability and type II diabetes mellitus. Per the October 2021 Board remand for additional claims, development is necessary to clarify the veracity and nature of the Veteran's claimed in-service exposure to herbicide agents; specifically, whether Veteran's service aboard the USS R.L. Wilson, USS Biddle, and/or USS Milwaukee constitutes qualifying Blue Water service for the purposes of applying the provisions of 38 U.S.C. § 1116A and determining presumptive exposure to herbicide agents. As this development has not yet been completed and would impact the claims currently on appeal, remand is warranted pending the requested development. If the AOJ's evidentiary development confirms that the Veteran was exposed to herbicide agents due to qualifying service under 38 U.S.C. § 1116A, the examiner is also asked to determine whether the Veteran's claimed sleep apnea, narcolepsy, and gastrointestinal disability are related to any conceded exposure herbicide agents. The matters are REMANDED for the following action: Refer the entire record to the VA examiner who completed the July 2020 VA opinion. The examiner is asked to clarify whether he considered the documentation submitted by the Veteran of contaminants found at Treasure Island as well as any other information regarding contaminants at Treasure Island obtained via the development requested in 2019. If not, the examiner is asked to provide an addendum opinion regarding whether it is at least as likely as not (i.e., to at least a 50/50 degree of probability)that the Veteran's current obstructive sleep apnea, cardiac/coronary artery disease, diabetes mellitus, gastrointestinal/irritable bowel syndrome and/or Crohn's disease, and narcolepsy were incurred during or caused by active service, to include as a result of exposure to asbestos, dioxins, radiation, PCBs, and multiple other chemicals, taking into consideration the documentation submitted by the Veteran of contaminants found at Treasure Island and any other information regarding contaminants at Treasure Island obtained via the development requested in the May 2019 Board remand. If the July 2020 VA examiner is not available, obtain an addendum opinion from another appropriate substitute. If the AOJ's evidentiary development confirms that the Veteran was exposed to herbicide agents due to qualifying service under 38 U.S.C. § 1116A, the examiner is also asked to determine whether the Veteran's claimed sleep apnea, narcolepsy, and gastrointestinal disability are related to any conceded exposure to herbicide agents. Cynthia M. Bruce Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Williams, 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.