Citation Nr: 21040554 Decision Date: 07/06/21 Archive Date: 07/06/21 DOCKET NO. 16-35 758A DATE: July 6, 2021 ORDER Service connection for diabetes mellitus, type II, as due to herbicide exposure is granted. Service connection for ischemic heart disease as due to herbicide exposure is granted. FINDINGS OF FACT 1. The Veteran served in Thailand at the Korat Royal Thai Air Force Base during the Vietnam Era while on active duty and was exposed to herbicides. 2. The Veteran's current diabetes mellitus, type II, manifested to a compensable degree of at least 10 percent after separation from service. 3. The Veteran's current ischemic heart disease, diagnosed as coronary artery disease (CAD), manifested to a compensable degree of at least 10 percent after separation from service. CONCLUSIONS OF LAW 1. With resolution in reasonable doubt in the Veteran's favor, the criteria for entitlement to service connection for diabetes mellitus, type II, as due to herbicide exposure have been satisfied. 38 U.S.C. §§ 1110, 1116, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309(e). 2. With resolution in reasonable doubt in the Veteran's favor, the criteria for entitlement to service connection for ischemic heart disease as due to herbicide exposure have been satisfied. 38 U.S.C. §§ 1110, 1116, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309(e). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Air Force from December 1965 to February 1969, including service at the Korat Royal Thai Air Force Base (RTAFB). This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In a March 2020 decision, the Board denied the Veteran's claims for service connection. The Veteran appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court). In a Joint Motion for Remand (JMR), the parties agreed to vacate the Board's decision and remand the case to the Board for additional development. The JMR was incorporated by reference in a Court order dated October 2020. Service Connection Service connection may be established for a disability resulting from a disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.30. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). A veteran who served in the Republic of Vietnam during the Vietnam War is presumed to have been exposed during such service to an herbicide agent. 38 U.S.C. § 1116; 38 C.F.R. § 3.307 (a)(6)(iii). The Veteran does not claim that he was in Vietnam. Rather, the Veteran claims that he was exposed to herbicide agents based on service at the Korat RTAFB. There is not a presumption of exposure to herbicide agents for service in Thailand. VA has established a procedure for verifying a veteran's exposure to herbicide agents in Thailand during the Vietnam Era. See VA Adjudication Procedures Manual, M21-1 IV.ii.1.H.5.b (M21-1). The M21-1 states that "Compensation Service has determined that a special consideration of herbicide exposure on a factual basis should be extended to veterans whose duties placed them on or near the perimeters of Thailand military bases." Under the procedures outlined in the M21-1, if a veteran served at certain RTAFBs to include U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang, during the Vietnam Era as an Air Force security policeman, security patrol dog handler, member of the security police squadron, or "otherwise near the air base perimeter as shown by evidence of daily work duties, performance evaluation reports, or other credible evidence," then VA will "concede herbicide exposure on a direct/facts-found basis." M21-1 IV.ii.1.H.5.a. The M21-1 is not binding on the Board. 38 C.F.R. § 20.105. When relying on any M21-1 provision, the Board must independently review the matter the M21-1 addresses. Overton v. Wilkie, 30 Vet. App. 257, 264 (2018). If after such review, the Board chooses to rely on the M21-1 as a factor in its analysis or as the rule of decision, it must provide adequate reasons or bases for doing so. 1. Diabetes Mellitus Type II 2. Ischemic Heart Disease The Veteran contends that service connection for his diabetes mellitus, type II and ischemic heart disease is warranted because he was exposed to herbicide agents during his service at the Korat RTAFB. The diseases associated with herbicide exposure for purposes of the presumption of service connection include diabetes mellitus, type II, and ischemic heart disease. 38 U.S.C. § 1116(a)(2); 38 C.F.R. § 3.309. Service personnel records show that the Veteran served at the Korat RTAFB from December 1967 to January 1969 during his period of active service and his MOS was jet engine mechanic. Such service is during the Vietnam era. See 38 U.S.C. § 101(29)(B) (Vietnam Era began on August 5, 1964 and ended May 7, 1975 in the case of veterans who did not serve in the Republic of Vietnam). The Veteran was stationed at the Korat RTAFB in Thailand. The Veteran stated that his MOS entailed working 12-hour shifts in the trim pad five or six days per week. The Veteran also stated that he was the only one chosen from his group that arrived at Korat to work on the trim pad due to his experience with fixing engines. The Veteran's primary role was to test aircraft engines after a mission. The Veteran stated that the trim pad was located only about 500 feet from the fence line of the north end of the base at the end of the runway. Exposure to herbicide agents in Thailand must be determined on a facts found basis. In support of his statements, the Veteran submitted a map of the Korat RTAFB perimeter in relation to physical training, recreation and living areas. The Veteran also submitted photos of the Korat RTAFB living areas. In addition to working close to the perimeter, the Veteran also stated that for his first month on base, he lived in an open-air hootch and then moved to the barracks, which were closer to the fence around the base. The Veteran observed that near both living areas there was minimal plant life. The Veteran also stated that to travel to work each day, he would get on a shuttle that would travel down the taxiway to bring him to the trim pad. The Veteran observed that there was no vegetation along this taxi-way, and it seemed as though effort had been made to ensure none was there. Review of the evidentiary record shows that the Veteran was stationed at the Korat RTAFB during the Vietnam Era. Moreover, the Board finds that the Veteran is competent to report that his job duties entailed living and working near the air base perimeter, and his reports appear consistent throughout the appeal period and with the circumstances of his military duties as a jet engine mechanic. 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). As a result, the Board finds that the Veteran's lay assertions regarding the locations of his job duties during service in Thailand are credible. Based on such findings, the Veteran had herbicide exposure from his service in Thailand at the Korat RTAFB on a facts found basis. Next, review of the evidentiary record demonstrates the Veteran has post-service diagnoses of diabetes mellitus, type II, and ischemic heart disease, to include CAD, that manifested to a compensable degree of at least 10 percent after separation from service. While the Veteran's service treatment records (STRs) are silent for complaints of these issues, such findings are documented in medical records from September 2010, October 2010, October 2011, November 2011, April 2013, and June 2014, as well as in the Veteran's lay statements. After resolving all reasonable doubt in favor of the Veteran, the Board finds that the Veteran has presumed in-service herbicide exposure and current disabilities of diabetes mellitus, type II and ischemic heart disease that manifested to compensable degrees of at least 10 percent. As a result, service connection is warranted for diabetes mellitus, type II and ischemic heart disease on a presumptive basis, and there is no probative contrary medical opinion of record. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 3.307(a)(6), 3.309(e). D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. DeVerter, 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.