Citation Nr: 21020931 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 18-00 832 DATE: April 8, 2021 ORDER Entitlement to service connection for Graves’ Disease is granted. FINDING OF FACT The Veteran’s Graves’ Disease is etiologically related to exposure to herbicide agents in service. CONCLUSION OF LAW The criteria to establish service connection for Graves’ Disease have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1968 to August 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO), which denied the Veteran service connection for Graves’ Disease. A Board hearing was held in August 2019. A transcript is of record. In October 2020, the Board remanded the Veteran’s claim to the Agency of Original Jurisdiction (AOJ) for further action consistent with the Board’s remand directives. Specifically, the Board remanded the claim for a VA examiner to opine whether the Veteran’s Graves’ Disease was related to an in-service exposure to herbicide agents. The claim is back before the Board for further appellate proceedings. The Board finds there has been substantial compliance with its remand directives, and the claims are ripe for adjudication. See Stegall v. West, 11 Vet. App. 268, 271 (1998). A Veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1110. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted on a presumptive basis for certain diseases associated with exposure to certain herbicide agents. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307, 3.309(e), 3.313. The presumption is applicable where the disease manifests to a compensable degree in a veteran who had active service for at least 90 days in the Republic of Vietnam between January 9, 1962 and May 7, 1975, even where there is no record of such disease during service. Id. However, the presumption may be rebutted by affirmative evidence to the contrary. 38 U.S.C. § 1113; 38 C.F.R. §§ 3.307, 3.309. Thus, to benefit from the presumption, the Veteran must have one of the diseases enumerated in 38 C.F.R. § 3.309(e), which does not include Graves’ Disease, and have been exposed to an herbicide agent. Importantly, where a veteran is not entitled to the presumption, service connection may be established with proof of direct causation. Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). As discussed in the October 2020 remand, the Veteran served in Vietnam and, thus, is presumed to have been exposed to herbicide agents. 38 U.S.C. § 1116(f); 38 C.F.R. § 3.307(a)(6). Therefore, the narrow issue before the Board is whether the Veteran’s Graves’ Disease has a causal relationship with his presumptive exposure to a herbicide agents. The Veteran was afforded a VA examination in January 2021. The examiner diagnosed the Veteran with Graves’ Disease. See January 2021 VA examination report. She opined that the Veteran’s Graves’ Disease was as likely as not caused by herbicide exposure. Id. In making her opinion, she explained that medical literature supports the development of Graves’ Disease after herbicide exposure. Id. The examiner is a medical professional who examined the Veteran, reviewed his medical and service history, and relied on medical literature to make her conclusion. The Board finds the examiner’s opinion highly probative. Accordingly, the Board finds that the Veteran’s Graves’ Disease is etiologically related to his in-service exposure to herbicide agents. Therefore, the criteria for service connection for Graves’ Disease have been met. See 38 C.F.R. §§ 3.102, 3.159, 3.303; Gilbert v. Derwinski, 1 Vet. App. 9, 55-57 (1990). DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Strickland 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.