Citation Nr: 21021610 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 12-32 720 DATE: April 13, 2021 ORDER Service connection for hairy cell leukemia is granted. Service connection for pancytopenia is granted. Service connection for an acquired psychiatric disorder is denied. FINDINGS OF FACT 1. Resolving all reasonable doubt in favor of the Veteran, he was exposed to herbicide agents while serving as a wheeled vehicle mechanic with a military police company at Korat Royal Thai Air Force Base in Thailand during the Vietnam era. 2. The Veteran’s currently diagnosed hairy cell leukemia is presumed to be due to his in-service exposure to herbicide agents. 3. Resolving all reasonable doubt in favor of the Veteran, his currently diagnosed pancytopenia is due to his now service-connected hairy cell leukemia. 4. The preponderance of the evidence shows that the Veteran does not have a current acquired psychiatric disorder. CONCLUSIONS OF LAW 1. The criteria for service connection for hairy cell leukemia are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for pancytopenia as secondary to hairy cell leukemia are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 3. The criteria for service connection for an acquired psychiatric disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Army from February 1969 to January 1972 and in the Navy from June 1974 to July 1992. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2012 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this case in November 2016 for further development. The Board is satisfied that there was substantial compliance with the prior remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998); D’Aries v. Peake, 22 Vet. App. 97, 105 (2008) Legal Criteria Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303 (a). Generally, service connection requires: (1) the existence of a present disability; (2) 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. See Shedden v. Principi, 381 F.3d 1163, 1166 67 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). The first requirement for any service connection claim is evidence of a disability. Boyer v. West, 210 F.3d 1351 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223 (1992). Service connection can be established based on herbicide agent exposure. 38 C.F.R. § 3.307 (a)(6). For the purposes of determining herbicide agent exposure, a veteran who served in qualifying locations during certain time periods will be presumed to have been exposed to herbicide agents. 38 C.F.R. § 3.307(a)(6)(iii)(v). If exposure is not presumed, exposure may also be established on a facts-found basis. If a veteran is presumed or found to have been exposed to herbicide agents, certain disabilities will be presumed to be causally related to such exposure. 38 C.F.R. § 3.309 (e). Special consideration of herbicide exposure on a facts-found or direct basis should be extended to those veterans whose duties placed them on or near the perimeters of Thailand military bases. If a veteran served in the U.S. Air Force at U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat or Don Muang Royal Thai Air Force Base (RTAFB) as an Air Force security policeman, security patrol dog handler, member of a security police squadron, or otherwise served near the air base perimeter, as shown by MOS (military occupational specialty), performance evaluations, or other credible evidence, then herbicide exposure may be acknowledged on a facts-found or direct basis. Service connection may be granted on a secondary basis for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310. The evidence must show: (1) that a current disability exists; and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated (worsened) by a service-connected disability. Id. 1. Service connection for hairy cell leukemia is granted. The Veteran seeks service connection for hairy cell leukemia, which he asserts is due to exposure to herbicide agents during service at Korat Air Force Base (AFB) in Thailand. Post-service medical records confirm that the Veteran has been diagnosed with hairy cell leukemia, which is among the diseases known to be associated with exposure to herbicide agents. See 38 C.F.R. § 3.309 (e). As such, the dispositive issue in this case is whether the Veteran was exposed to herbicide agents during active duty service. Military personnel records confirm that the Veteran served at Korat AFB during the Vietnam era, from September 1969 to September 1970. While the Veteran’s MOS was wheeled vehicle mechanic or wheeled vehicle repairman, military personnel records show that, in June 1970, he was assigned to the 219th MP Co., as a military police company. Additionally, the Veteran reported that he was exposed to herbicide agents while repairing vehicles on and off base. Considering the Veteran’s assignment to a military police company, the weight of the evidence is at least in equipoise regarding whether his duties frequently took him near the perimeters of Korat AFB, where herbicide agents were known to be used. Consequently, the Board finds that it is at least as likely as not that the Veteran was exposed to herbicide agents during service in Thailand during the Vietnam era. Moreover, the Veteran has a current diagnosis of hairy cell leukemia, which is a disease known to be associated with exposure to herbicide agents. See 38 C.F.R. § 3.309 (e). Accordingly, after resolving all reasonable doubt in favor of the Veteran, the Board finds that presumptive service connection for hairy cell leukemia based on in-service exposure to herbicide agents is warranted. As the criteria for service connection have been met, the appeal is granted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 2. Service connection for pancytopenia is granted. The Veteran contends that his pancytopenia is secondary to a service-connected disability. Post-service medical records confirm that the Veteran has been diagnosed with pancytopenia. Further, as of this decision, the Veteran has been granted service connection for hairy cell leukemia. With the threshold requirements for secondary service connection met, the dispositive question is whether the Veteran’s pancytopenia is due to a service-connected disability. December 2007 private treatment records show that the Veteran was diagnosed with hairy cell leukemia and pancytopenia secondary to hairy cell leukemia. Significantly, these records show that the Veteran had been admitted for pancytopenia and a workup was “felt to be consistent with hairy cell leukemia.” Based on the foregoing, the evidence supports a finding that the Veteran’s pancytopenia is at least as likely as not caused by his service-connected hairy cell leukemia, as evidenced by the December 2007 private treatment records. As such, service connection for pancytopenia as secondary to hairy cell leukemia is warranted. 38 C.F.R. §§ 3.102, 3.310. 3. Service connection for an acquired psychiatric disorder is denied. The Veteran contends that he has an acquired psychiatric disorder which is due to his military service. Based on a careful review of the subjective and clinical evidence, the preponderance of the evidence weighs against the claim for service connection for an acquired psychiatric disorder. The December 2019 VA examiner found that the Veteran did not have or had ever been diagnosed with a mental disorder. She found that he did not present with any symptoms consistent with a disorder that met the DSM V criteria. The examiner noted that the Veteran had been prescribed anti-depressants while hospitalized and recuperating from his disease. The Veteran stated that he had not been depressed. He denied all mental health symptoms, to include depression, and reported that he had a “great life.” Post-service treatment records from August 2011 do not show that the Veteran was receiving treatment for or diagnosed with a psychiatric disorder. The Board notes that the Veteran had been diagnosed with depression in a February 2010 treatment record by Dr. D. Kapur. However, Dr. Kapur did not discuss the basis for this diagnosis and noted that the Veteran denied depressive or anxiety symptoms and depressive symptomatology. Additionally, all records subsequent to this February 2010 record consistently show that the Veteran denied depressive symptoms and had not been diagnosed with an acquired psychiatric disorder. As such, the medical evidence does not demonstrate that the Veteran has a current acquired psychiatric disorder. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). The Veteran is certainly competent to report his history and subjective symptoms of an acquired psychiatric disorder, but he is not competent to provide a diagnosis of an underlying disability for such symptoms. Layno v. Brown, 6 Vet. App. 465, 470 (1994); see also Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). The Veteran has not presented any competent and credible evidence of a current diagnosis for an acquired psychiatric disorder and the available evidence does not support that the Veteran has any current persistent symptomatology that would suggest that he has an acquired psychiatric disorder. Thus, the claim for service connection for an acquired psychiatric disorder is denied. In summary, the Board finds that the preponderance of the evidence weighs against finding in favor of the Veteran’s service connection claim for an acquired psychiatric disorder. Consequently, the benefit-of-the-doubt rule does not apply, and service connection must be denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). APRIL MADDOX Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Ko, 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.