Citation Nr: 21073779 Decision Date: 12/10/21 Archive Date: 12/10/21 DOCKET NO. 17-31 164 DATE: December 10, 2021 ORDER Service connection for ischemic heart disease, to include coronary artery disease (CAD), is granted. FINDINGS OF FACT 1. The Veteran has been diagnosed with CAD. 2. It is at least as likely as not that the Veteran was exposed to herbicide agents while serving in Thailand. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran's favor, the criteria for an award of service connection for ischemic heart disease, to include 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 FINDINGS AND CONCLUSION The Veteran served on active duty in the U.S. Air Force from October 1964 to August 1968, to include service in Thailand. His decorations include the Vietnam Service Medal (VSM) and the Republic of Vietnam Campaign Medal (RVCM). This matter comes to the Board of Veterans' Appeals (Board) on appeal from a January 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In November 2021, the Veteran and his spouse testified at a Board hearing before the undersigned Veterans Law Judge, sitting in St. Louis, Missouri. A transcript of that hearing has been associated with the record. Entitlement to service connection for ischemic heart disease, to include CAD, to include as due to exposure herbicide agents. The Veteran contends that his CAD was incurred in or caused by service, to include as due to exposure to herbicide agents. Specifically, at the November 2021 Board hearing, he stated that his military occupational specialty (MOS) was military pay clerk, and that during his service in Thailand his duties involved him going all over the country and also into Vietnam to deliver payroll. He also testified at the November 2021 hearing that the barracks in which he lived in Thailand were only 75-100 feet away from the base perimeter and that the perimeter was sprayed continuously. In his June 2017 substantive appeal, he stated that the barracks also had no windows, and contended that the spraying of herbicide agents would cause an overspray that would have entered the barracks. He also testified at his November 2021 hearing that he played golf at the air base in Thailand, that he taught English to Thai students both inside the base perimeter and outside of the base, and that as far as he knew the girls who washed his laundry at the air base in Thailand used groundwater which he contended was contaminated. His primary contention is that these activities in Vietnam and/or Thailand exposed him to herbicide agents during his service. Finally, he contended in his February 2017 notice of disagreement that the VSM and RVCM decorations could not have been awarded unless he had boots on the ground in Vietnam. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). Under applicable law, a Veteran who served on active duty in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, is presumed to have been exposed to an herbicide agent, absent affirmative evidence to the contrary. See 38 C.F.R. § 3.307(a)(6)(iii). VA regulations further provide that service connection is warranted for certain diseases as presumptively due to herbicide exposure, to include CAD. 38 C.F.R. § 3.309(e). All Veterans who served in the Republic of Vietnam during the applicable time frame are presumed to have been exposed to an herbicide agent. As noted, the Veteran contends not only that his duties took him into Vietnam, but also that his service at Korat Royal Thai Air Force Base (RTAFB) exposed him to herbicide agents. In a May 2010 bulletin, VA 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. A primary source of this information was the declassified Vietnam-era Department of Defense (DOD) document entitled, "Project CHECO Southeast Asia Report: Base Defense in Thailand." Although DOD indicated that the herbicide use was commercial in nature rather than tactical (such as Agent Orange), VA determined that there was some evidence that herbicides of a tactical nature, or that of a greater strength commercial variant, were used. In light of this information, VA has determined that special consideration 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 diseases associated with herbicide exposure. The May 2010 bulletin identifies several bases in Thailand, including Korat RTAFB. VA has indicated that herbicide exposure should be acknowledged on a facts found or direct basis if (1) a United States Air Force veteran served at one of the air bases as a security policeman, a security patrol dog handler, a member of a security police squadron, or otherwise served near the air base perimeter, as shown by his or her military occupational specialty, performance evaluations, or other credible evidence; (2) an Army veteran was a member of a military police unit that served at or near a base perimeter in Thailand; or (3) an Army veteran served on an air base in Thailand and provided perimeter security. The Board must assess the credibility and weight of all the evidence to determine its probative value, accounting for the evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. See Masors v. Derwinski, 2 Vet. App. 181 (1992). Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value. In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the Veteran. As an initial matter, the Board notes that there is no material dispute that the Veteran has been diagnosed with CAD. The key issue before the Board is whether the Veteran's heart disease is directly or presumptively related to his military service. The Veteran's DD Form 214 confirms that his MOS was Disburse Accounting Specialist. Military personnel records also confirm his service at Korat RTAFB during the requisite period. In June 2017, the Veteran also submitted a report dated in May 2011 by L.W. entitled, "Vegetation Control and other uses of Herbicides and Toxic Chemicals at Korat Royal Thai Air Force Base, 1967 to 1972." The report addresses the Veteran's unit specifically and notes that the living quarters were very close to the perimeter, some of which were as near as 35 feet, and that the barracks did not have glass windows or air conditioning. It further notes that the area used for physical training was very close to the perimeter (about 35 meters), and that the softball field was about 125 feet from the perimeter. The report also includes maps of Korat RTAFB which show that the barracks and the physical training and recreation areas were adjacent to the base perimeter. It further includes photographs showing that the barracks were adjacent to the perimeter and that they did not have glass windows. The Board finds the Veteran's contentions concerning his service on and near the perimeter of Korat RTAFB credible. His contentions regarding living in barracks and participating in sports in the recreation area, both of which were near the base perimeter, are reasonably consistent with a finding that his service frequently placed him at or near the perimeter of Korat RTAFB, where herbicide agents are known to have been used. The evidence, at a minimum, gives rise to a reasonable doubt on the matter. 38 C.F.R. § 3.102. As such, and resolving reasonable doubt in his favor, the Board finds that it is at least as likely as not that he was exposed to herbicide agents while serving in Thailand. As such, and because he has also been diagnosed with CAD, the appeal is granted. Inasmuch as the Board is granting the Veteran's claim on the theory that it is at least as likely as not that his service in Thailand exposed him to herbicide agents, it need not address the argument that his duties took him into Vietnam or that his awards of the VSM and RVCM show that he served in Vietnam. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Oldroyd, 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.