Citation Nr: 21025307 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 15-24 449 DATE: April 27, 2021 REMANDED Entitlement to service connection for diabetes mellitus type II is remanded. Entitlement to service connection for hypertension, to include as secondary to diabetes mellitus type II, is remanded. Entitlement to service connection for peripheral neuropathy of the bilateral upper extremities, to include as secondary to diabetes mellitus type II, is remanded. Entitlement to service connection for peripheral neuropathy of the bilateral lower extremities, to include as secondary to diabetes mellitus type II, is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1971 to June 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for diabetes mellitus type II, hypertension, and bilateral upper and lower extremity peripheral neuropathy. In its January 2019 remand, the Board directed the RO to verify the Veteran’s report that he traveled to Vietnam in the later summer and early fall of 1971 by contacting the Joint Services Records Research Center (JSRRC) and/or any other appropriate repository of military records. If it was determined that there was insufficient information to verify the Veteran’s presence in Vietnam, a formal finding was to be made. In January 2021, the RO obtained the Veteran’s personnel records. Along with the personnel records the RO revieced a response to a request for information which stated that there was no evidence in the Veteran’s file to substantiate any service in the Republic of Vietnam. However, there is no formal finding following receipt of this response that the Veteran’s presence in Vietnam could not be verified, as requested by the January 2019 remand. As such, a remand is required so such formal finding can be made. See Stegall v. West, 11 Vet. App. 268, 270 (1998). The matters are REMANDED for the following action: 1. Conduct any further development deemed necessary to determine whether the Veteran traveled with his unit to the Republic of Vietnam in late summer or early fall of 1971. The Veteran’s assertions concerning his travel to Vietnam are including in his substantive appeal (labelled “Form 9” – uploaded 7/24/19) and in a lay statement submitted by a friend of the Veteran (labelled “Buddy / Lay Statement” – uploaded 6/1/17). If, after conducting any further development deemed necessary, there is insufficient evidence to verify the Veteran’s presence in Vietnam, a formal finding should be made and associated with the file. 2. If, and only if, the Veteran’s exposure to herbicide agents is verified, the Veteran should be scheduled for VA examinations to determine the etiology of his hypertension. The examiner should address: a) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s hypertension is due to service, to include any verified in-service herbicide exposure? In answering question (a), attention is invited to the 2018 NAS Update which upgraded the likelihood of an association between hypertension and exposure to herbicide agents from “limited or suggestive” evidence of an association to “sufficient” evidence of an association. b) If not, is it at least as likely as not (50 percent probability or greater) that the Veteran’s hypertension was caused by his diabetes mellitus type II? c) If not, is it at least as likely as not (50 percent probability or greater) that the Veteran’s hypertension was aggravated by his diabetes mellitus type II? A detailed rationale for the opinion must be provided. The examiner is reminded that the term “as likely as not” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that, in the examiner’s expert opinion, it is as medically sound to find in favor of the proposition as against it. 3. If, and only if, the Veteran’s exposure to herbicide agents is verified, the Veteran should be scheduled for VA examinations to determine the etiology of his bilateral upper and lower extremity peripheral neuropathy. The examiner should address: (a) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s bilateral upper and lower extremity peripheral neuropathy is due to service, to include any verified in-service herbicide exposure? (b) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s bilateral upper and lower extremity peripheral neuropathy was caused by his diabetes mellitus type II? (c) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s bilateral upper and lower extremity peripheral neuropathy was aggravated by his diabetes mellitus type II? A detailed rationale for the opinion must be provided. The examiner is reminded that the term “as likely as not” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that, in the examiner’s expert opinion, it is as medically sound to find in favor of the proposition as against it. CHRISTOPHER A. WENDELL 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.