Citation Nr: 21021189
Decision Date: 04/12/21	Archive Date: 04/12/21

DOCKET NO. 09-33 738
DATE: April 12, 2021

REMANDED

The issue of entitlement to service connection for cause of the Veteran’s death is remanded.

REASONS FOR REMAND

The Veteran served on active duty from October 1967 to May 1982.  The appellant is the Veteran’s surviving spouse.

This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2009 rating decision issued by a Department of Veterans Appeals (VA) Regional Office (RO).

This matter has previously been before the Board three times.  In January 2014 and July 2018, the matter was remanded with directives to comply with 38 C.F.R. § 3.311.  There has been substantial compliance with remand directives, but the RO has failed to address all theories of entitlement advanced by the appellant.  See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994).

The Veteran’s death certificate shows that the cause of death was due to cardiorespiratory arrest, acute pulmonary edema, chronic renal failure, chronic anemia, and multiple myeloma.  In a June 2009 Correspondence, the appellant asserted that service in the Vietnam War contributed to the cause of the Veteran’s death.  As the Veteran served during the Vietnam Era and multiple myeloma is a disease associated with exposure to certain herbicide agents under 38 C.F.R. § 3.309(e), the RO should determine whether the Veteran’s active duty service qualifies for service in the Republic of Vietnam or in the territorial waters of the Republic of Vietnam.  38 C.F.R. § 3.307(6).

In a December 2012 Appellate Brief, the appellant asserted that the Veteran’s service-connected toxocara uveitis was a factor in the Veteran’s death.  A medical opinion is required to answer whether the Veteran’s service-connected toxocara uveitis was a contributing factor in the Veteran’s death. 

The matters are REMANDED for the following action:

1.  Take all appropriate steps to confirm whether the Veteran served in Vietnam or was within 12 nautical miles of the Republic of Vietnam at any time during his period of active duty service or was otherwise exposed to herbicide agents during his active service.

2. Thereafter, forward the claims file to an appropriate clinician and obtain the following opinions:

(a.) Was the Veteran’s right eye toxocara uveitis at least as likely as not (50 percent or greater probability) a contributing factor in his death?  Why or why not?

(b.) Was it is at least as likely as not that multiple myeloma was proximately caused by the Veteran’s right eye toxocara uveitis.

(c.) Was it is at least as likely as not that multiple myeloma was aggravated (i.e., worsened beyond the normal progression of that disease) by the Veteran’s right eye toxocara uveitis.

A rationale for all opinions is to be provided.  All pertinent evidence, both lay and medical, should be considered.  If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training).

 

 

Timothy Berryman

Acting Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	Monica Ball Jackson, 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.