Citation Nr: 21073368 Decision Date: 12/08/21 Archive Date: 12/08/21 DOCKET NO. 16-09 099 DATE: December 8, 2021 REMANDED Entitlement to service connection for a cardiovascular disorder is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for diabetes mellitus, type II, is remanded. Entitlement to service connection for a skin disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1956 to April 1960. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). This matter comes to the Board of Veterans' Appeals (Board) on appeal from a March 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran initially requested a hearing before a Veterans Law Judge (VLJ) at the RO. See February 2016 substantive appeal (VA Form 9). Due to the COVID-19 pandemic and resulting closures, the Veteran was scheduled for a tele-hearing in June 2021 but did not appear. Another hearing was scheduled for October 2021, and the Veteran again did not appear. He has not requested that his hearing be rescheduled and has not provided an explanation for his non-attendance for his scheduled hearings. As such, his hearing request is considered withdrawn. Service connection for a cardiovascular disorder; hypertension; diabetes mellitus, type II; and a skin disorder The Veteran contends that he has a cardiovascular disorder, hypertension, and diabetes mellitus, type II, and a skin disorder related to his military service. The record documents diagnoses of, and treatment for, each of these conditions. See, e.g., May 2014 and October 2015 VA Treatment Record. The Veteran contends that he was exposed to asbestos while serving in the U.S. Navy aboard the U.S.S. Philip and U.S.S. Nicholas, and when he lived in Navy housing at Pearl Harbor. The record confirms that the Veteran was stationed at Pearl Harbor in 1957 and that he later served aboard the U.S.S. Philip and U.S.S. Nicholas. However, there is no indication that any evidentiary development was done to corroborate his purported in-service exposure to asbestos or determine whether he was exposed to asbestos while aboard these ships in service or while in Navy housing at Pearl Harbor. Also, no VA examinations are of record addressing the nature and etiology of the Veteran's cardiovascular disorder, hypertension, diabetes mellitus, type II, and skin disorder. The claims file includes a notation indicating that he failed to report for his scheduled examinations in June 2013. However, the claims file does not include any record indicating that he was actually notified of these scheduled examinations. Indeed, he reported in August 2013 that he missed the examination because he was not aware that the examinations had been scheduled and was getting married at the time. The Veteran also reports that he did not appear for a February 2014 examination because he was never informed of the examination date and did not receive any telephonic or written correspondence about the examination. See May 2014 Informal Notice of Disagreement. The claims file, again, does not include any record of an examination scheduled in February 2014. In all correspondence with the VA, the Veteran has reiterated his willingness to appear for an examination for his claims, has provided good cause for his failure to report for his June 2013 examinations, and has raised questions about whether he received proper notice of the scheduled examinations. Given the lack of medical evidence of record and the lack of documentation of notice to the Veteran regarding the scheduling of examinations, the Board cannot make a fully informed decision on this appeal. No VA examiner has opined whether the Veteran has a cardiovascular disorder, hypertension, diabetes mellitus, type II, and a skin disorder related to his military service, to include as due to his reported asbestos exposure. VA's duty to assist includes, when necessary, conducting a thorough and comprehensive medical examination. 38 U.S.C. § 5103A(d)(2); McLendon v. Nicholson, 20 Vet. App. 79 (2006). A remand is thus necessary to attempt to verify the Veteran's claimed asbestos exposure and to accord him an opportunity to undergo appropriate VA examinations, with proper notice, to determine the nature, extent, and etiology of any cardiovascular disorder, hypertension, diabetes mellitus, type II, and skin disorder that he may have. Additionally, the most recent VA treatment records in the claims file were received in January 2016 and only include records dating back to December 2015. On remand, updated VA treatment records and any outstanding private treatment records should be associated with the claims file. Accordingly, this matter is REMANDED for the following action: 1. Contact the National Personnel Records Center (NPRC), and any other appropriate repository of records, and ask them to provide any available information about the types of hazardous chemicals (including asbestos) that the Veteran would have been exposed to while serving in the U.S. Navy from October 1956 to April 1960 aboard Navy vessels, to include the U.S.S. Philip and U.S.S. Nicholas, and while living in Navy housing at Pearl Harbor. If the service department is unable to furnish such records, ask the service department to identify any other resource for such information. Document all efforts to obtain this information. If it is not possible to corroborate the alleged asbestos exposure, the RO should enter a formal finding outlining all efforts undertaken. 2. Identify and obtain any outstanding VA and private treatment recordsto include VA treatment records from December 2015 to the presentand associate them with the claims file. The Veteran should be asked to provide any information or authorization necessary for VA assistance in obtaining private treatment records. All requests and responses for the records must be documented. If any identified records cannot be obtained, notify the Veteran of the missing records, the efforts taken, and any further efforts that will be made by VA to obtain such evidence, and allow him an opportunity to provide the missing records. 3. Then, schedule the Veteran for an appropriate VA examination to determine the nature, extent, and etiology of any cardiovascular disorder he may have, including arrhythmia and left ventricular hypertrophy. The Veteran should be provided notice of his scheduled examination, and a copy of this notice should be associated with the claims file. The claims file should be made available to, and be reviewed by, the examiner. Any indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The examiner should: a. Identify/diagnose any cardiovascular disorder, including arrhythmia and left ventricular hypertrophy, that presently exists or that has existed during the appeal period. b. For any diagnosed cardiovascular disorder, opine as to whether it is as likely as not (i.e., at least a 50 percent probability or greater) that any such diagnosed disability had its onset in, or is otherwise related to, the Veteran's service or any incident therein, to include whether such is related to his contended asbestos exposure. The examiner is advised that the Veteran is competent to report his symptoms and history and that such reports must be acknowledged and considered in formulating any opinion. A clear explanation for all opinions would be helpful, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner is unable to provide an opinion, he or she should explain why. 4. Also after completion of the actions requested in paragraphs 1 and 2 above, schedule the Veteran for an appropriate VA examination to determine the nature, extent, and etiology of his hypertension. The Veteran should be provided notice of his scheduled examination, and a copy of this notice should be associated with the claims file. The claims file should be made available to, and be reviewed by, the examiner. Any indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The examiner is asked to: Opine as to whether it is as likely as not (i.e., at least a 50 percent probability or greater) the Veteran's hypertension had its onset in, or is otherwise related to, his service or any incident therein, to include whether such is related to his contended asbestos exposure. The examiner is advised that the Veteran is competent to report his symptoms and history and that such reports must be acknowledged and considered in formulating any opinion. A clear explanation for all opinions would be helpful, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner is unable to provide an opinion, he or she should explain why. 5. Also after completion of the actions requested in paragraphs 1 and 2 above, schedule the Veteran for an appropriate VA examination to determine the nature, extent, and etiology of his diabetes mellitus, type II. The claims file should be made available to, and be reviewed by, the examiner. The Veteran should be provided notice of his scheduled examination, and a copy of this notice should be associated with the claims file. Any indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The examiner is asked to: Opine as to whether it is as likely as not (i.e., at least a 50 percent probability or greater) the Veteran's diabetes mellitus, type II had its onset in, or is otherwise related to, his service or any incident therein, to include whether such is related to his contended asbestos exposure. The examiner is advised that the Veteran is competent to report his symptoms and history and that such reports must be acknowledged and considered in formulating any opinion. A clear explanation for all opinions would be helpful, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner is unable to provide an opinion, he or she should explain why. 6. Also after completion of the actions requested in paragraphs 1 and 2 above, schedule the Veteran for an appropriate examination to determine the nature, extent, and etiology of any current skin disorder. The Veteran should be provided notice of his scheduled examination, and a copy of this notice should be associated with the claims file. The entire claims file must be made available to the examiner for review in conjunction with the examination. Any indicated tests and studies must be accomplished, and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner is asked to: a. Identify/diagnose any skin disorder, including lesions and boils, that presently exists or that has existed during the appeal period. b. For each such diagnosed skin disorder, the examiner should opine as to whether it is at least as likely as not (50 percent or greater probability) that such disorder had its onset in, or is otherwise related to, the Veteran's service or any incident therein, to include whether such is related to his contended asbestos exposure. The examiner is advised that the Veteran is competent to report his symptoms and history and that such reports must be acknowledged and considered in formulating any opinion. A clear explanation for all opinions would be helpful, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner is unable to provide an opinion, he or she should explain why. No action is required of the Veteran until he is notified by VA. However, he is advised of his obligation to cooperate in ensuring the duty to assist is satisfied. Kowalski v. Nicholson, 19 Vet. App. 171 (2005). His failure to report for the scheduled VA medical examination may impact the determination made. 38 C.F.R. § 3.655. The Veteran also is advised that he has the right to submit additional evidence and argument with respect to these matters. Kutscherousky v. West, 12 Vet. App. 369 (1999). This appeal must be afforded prompt treatment. THERESA M. CATINO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Goreham 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.