Citation Nr: 21013307 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 11-32 169 DATE: March 9, 2021 REMANDED Entitlement to service connection for low white blood cell count, to include as result of herbicide exposure, is remanded. Entitlement to service connection for a skin disability, to include as result of herbicide exposure, is remanded. Entitlement to service connection for colon polyps, to include as result of herbicide exposure, is remanded. Entitlement to service connection for a pericardial cyst, to include as result of herbicide exposure is remanded. Entitlement to service connection for a prostate disability, to include as result of herbicide exposure, is remanded. Entitlement to service connection for a respiratory/lung disability, to include as result of herbicide exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1966 to April 1969. The Veteran served in Vietnam from June 1967 to June 1968. This matter is before the Board of Veterans’ Appeals (Board) on appeal of an April 2010 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In September 2019, the Board issued a decision denying the Veteran’s claims. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In a September 2020 order, the Court vacated and remanded the Board’s decision for compliance with the instructions in the Joint Motion. The Joint Motion for a remand noted the Board relied on an October 2018 VA examination report. The VA examiner concluded that the none of the Veteran’s claims was related to service including exposure to tactical herbicides (commonly referred to Agent Orange). The Joint Motion found the VA examination was confusing and conclusionary. The report seemed to indicate both an immediate effect after contact with Agent Orange but also stated an 11 to 15 year half-life for Agent Orange and cited literature suggesting long term effects to Agent Orange exposure. Further, to the extent the VA examiner relied on a 11 to 15 year half-life for Agent Orange, the opinion failed to explain the significance of the amount of Agent Orange in one’s system or the applicability of this information to Veteran’s specific claims. Accordingly, the Board has determined the Veteran should receive new VA examinations to address whether any of the Veteran’s disabilities are related to service including exposure to tactical herbicides including Agent Orange. Ongoing medical records should also be obtained. The matters are REMANDED for the following action: 1. Ask the Veteran to identify all outstanding treatment records relevant to his claims. All identified VA records should be added to the claims file. All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records. 2. After records development is completed, schedule the Veteran for a VA examination to determine whether it is at least as likely as not (50 percent probability or greater) that any current disability involving a low white blood cell count had its onset during service or is otherwise related to an in-service injury, event, or disease, to include tactical herbicides such as Agent Orange. In offering the opinion, the examiner is asked to consider all types of tactical herbicides and not limit any opinions exclusively to Agent Orange. The examiner is instructed to provide an opinion as to whether the disability is related to the Veteran’s active military service or otherwise attributable to his presumed herbicide exposure regardless of whether the condition is a listed disease under 38 C.F.R. § 3.309 (e). The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran the examiner should provide a fully reasoned explanation. A rationale for all opinions expressed is requested as adjudicators are precluded from making any medical findings. 3. After records development is completed, schedule the Veteran for a VA examination to determine whether it is at least as likely as not (50 percent probability or greater) that any current disability of the skin, to include basal cell carcinoma, had its onset during service or is otherwise related to an in-service injury, event, or disease, to include in-service contact dermatitis and exposure to tactical herbicides such as Agent Orange. In offering the opinion, the examiner is asked to consider all types of tactical herbicides and not limit any opinions exclusively to Agent Orange. The examiner is instructed to provide an opinion as to whether the disability is related to the Veteran’s active military service or otherwise attributable to his presumed herbicide exposure regardless of whether the condition is a listed disease under 38 C.F.R. § 3.309 (e). The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran the examiner should provide a fully reasoned explanation. A rationale for all opinions expressed is requested as adjudicators are precluded from making any medical findings. 4. After records development is completed, schedule the Veteran for a VA examination to determine whether it is at least as likely as not (50 percent probability or greater) that any current disability of the colon, including colon polyps, had its onset during service or is otherwise related to an in-service injury, event, or disease, to include tactical herbicides such as Agent Orange. In offering the opinion, the examiner is asked to consider all types of tactical herbicides and not limit any opinions exclusively to Agent Orange. The examiner is instructed to provide an opinion as to whether the disability is related to the Veteran’s active military service or otherwise attributable to his presumed herbicide exposure regardless of whether the condition is a listed disease under 38 C.F.R. § 3.309 (e). The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran the examiner should provide a fully reasoned explanation. A rationale for all opinions expressed is requested as adjudicators are precluded from making any medical findings. 5. After records development is completed, schedule the Veteran for a VA examination to determine whether it is at least as likely as not (50 percent probability or greater) that any current disability of the heart, including a pericardial cyst, had its onset during service or is otherwise related to an in-service injury, event, or disease, to include tactical herbicides such as Agent Orange. In offering the opinion, the examiner is asked to consider all types of tactical herbicides and not limit any opinions exclusively to Agent Orange. The examiner is instructed to provide an opinion as to whether the disability is related to the Veteran’s active military service or otherwise attributable to his presumed herbicide exposure regardless of whether the condition is a listed disease under 38 C.F.R. § 3.309 (e). The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran the examiner should provide a fully reasoned explanation. A rationale for all opinions expressed is requested as adjudicators are precluded from making any medical findings. 6. After records development is completed, schedule the Veteran for a VA examination to determine whether it is at least as likely as not (50 percent probability or greater) that any current disability of the prostate, to include benign prostate hypertrophy, had its onset during service or is otherwise related to an in-service injury, event, or disease, to include tactical herbicides such as Agent Orange. In offering the opinion, the examiner is asked to consider all types of tactical herbicides and not limit any opinions exclusively to Agent Orange. The examiner is instructed to provide an opinion as to whether the disability is related to the Veteran’s active military service or otherwise attributable to his presumed herbicide exposure regardless of whether the condition is a listed disease under 38 C.F.R. § 3.309 (e). The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran the examiner should provide a fully reasoned explanation. A rationale for all opinions expressed is requested as adjudicators are precluded from making any medical findings. 7. After records development is completed, schedule the Veteran for a VA examination to determine whether it is at least as likely as not (50 percent probability or greater) that any current respiratory/lung disability, to include asthma, had its onset during service or is otherwise related to an in-service injury, event, or disease, to include tactical herbicides such as Agent Orange. In offering the opinion, the examiner is asked to consider all types of tactical herbicides and not limit any opinions exclusively to Agent Orange. The examiner is instructed to provide an opinion as to whether the disability is related to the Veteran’s active military service or otherwise attributable to his presumed herbicide exposure regardless of whether the condition is a listed disease under 38 C.F.R. § 3.309 (e). The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran the examiner should provide a fully reasoned explanation.   A rationale for all opinions expressed is requested as adjudicators are precluded from making any medical findings. J.N. MOATS Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Russell P. Veldenz, 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.