Citation Nr: 21014842 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 18-51 065 DATE: March 15, 2021 ORDER Entitlement to service connection for type 2 diabetes is granted. Entitlement to service connection for hypertension is granted. Entitlement to service connection for right and left lower extremity peripheral neuropathy is granted. Entitlement to service connection for a skin disorder is granted. FINDINGS OF FACT 1. The preponderance of the evidence supports finding that the Veteran’s type 2 diabetes is related to in-service exposure to Trichloroethylene (TCE). 2. The preponderance of the evidence supports finding that the Veteran’s hypertension is related to in-service exposure to TCE. 3. The preponderance of the evidence supports finding that the Veteran’s right and left lower extremity peripheral neuropathy is secondary to service-connected type 2 diabetes. 4. The preponderance of the evidence supports finding that the Veteran’s skin disorder began during active service and/or is related to in-service exposure to TCE. CONCLUSIONS OF LAW 1. The criteria for service connection for type 2 diabetes have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 2. The criteria for service connection for hypertension have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 3. The criteria for service connection for right and left lower extremity peripheral neuropathy have been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.310. 4. The criteria for service connection for a skin condition have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1971 to March 1974. These matters come to the Board of Veterans’ Appeals (Board) on appeal from an April 2017 rating decision issued by a U.S. Department of Veterans Affairs (VA) Regional Office. In September 2018, VA furnished a statement of the case addressing entitlement to service connection for right ear hearing loss. The Veteran did not perfect an appeal of this issue and it is not for consideration herein. A virtual hearing was held in February 2021 before the undersigned Veterans Law Judge (VLJ). This decision is being made under the “one-touch” program. A transcript of the hearing will be associated with the claims file at a later time. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). Service connection may be granted on a secondary basis for a disability that is proximately due to a service-connected condition. 38 C.F.R. § 3.310(a). Service connection is also possible when a service-connected condition has aggravated a claimed condition, but compensation is only payable for the degree of additional disability attributable to the aggravation. Allen v. Brown, 7 Vet. App. 439 (1995). In October 2006, VA amended 38 C.F.R. § 3.310 to incorporate the decision in Allen except that VA will not concede aggravation unless there is medical evidence showing the baseline level of the disability before its aggravation by the service-connected disability. 38 C.F.R. § 3.310(b). Entitlement to service connection for type 2 diabetes, hypertension, right and left lower extremity peripheral neuropathy, and a skin disorder The Veteran contends that his claimed disorders are related to in-service exposure to TCE and other contaminants while stationed at Wurtsmith Air Force Base (AFB) in Michigan. In support of his claim, he submitted multiple articles discussing groundwater contamination, to include with TCE, at Wurtsmith AFB. Associated health and environmental concerns were also addressed. The file contains no evidence strongly against the presence of these contaminants. Service personnel records confirm that the Veteran was stationed at Wurtsmith AFB. The Veteran is competent to report that he drank the water on base and was otherwise exposed to the water during showering, swimming, and the performance of his military duties. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a lay person is competent to report on that of which he or she has personal knowledge). Accordingly, the Board finds an in-service event – i.e., exposure to TCE and other contaminants. Evidence of record shows current diagnoses of diabetes, hypertension, bilateral lower extremity peripheral neuropathy, and a skin condition. The question for the Board is whether they are related to active service or events therein, or to service-connected disability. Service treatment records are negative for the claimed disorders and there is no evidence of diabetes, hypertension, or peripheral neuropathy manifested to a compensable degree within one year following discharge from active service. In February 2017, a private physician, Dr. C.B., reviewed the Veteran’s records and opined that to at least the 90 percent level of probability, his current diabetes with diabetic neuropathy, skin rashes and hypertension were all very likely secondary to in-service exposure to water contaminated with TCE. The physician discussed relevant medical evidence as well as literature regarding disorders associated with TCE. In November 2018, a private nurse (A.C., RN, BSN, CCM, LNC) provided her professional opinion that the Veteran’s in-service TCE exposure contributed to his type 2 diabetes and hypertension. She also opined that the type 2 diabetes contributed to his bilateral lower extremity peripheral neuropathy and that his chronic skin condition was at least as likely as not related to TCE exposure. The opinion was based on review of relevant medical records and was supported by adequate rationale to include reference to medical literature. Further, the opinion included a discussion of the toxic effects of TCE on various body systems as well as the Veteran’s risk factors for the claimed disorders. As set forth, the record contains positive medical opinions and the Board is unable to locate any probative evidence to the contrary. Accordingly, service connection for type 2 diabetes and hypertension is warranted on a direct basis. Right and left lower extremity peripheral neuropathy is shown to be related to diabetes and thus, secondary service connection is warranted. Regarding the skin condition, the medical opinions relate this to TCE exposure. The Veteran has also provided competent lay statements concerning the onset of this condition in approximately 1974-75 with continued outbreaks. Additionally, the Veteran’s spouse testified as to the onset of his skin condition and as a retired nurse, she is competent to provide a medical opinion to the extent of her expertise. Thus, service connection is warranted. LAURA E. COLLINS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Carsten, 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.